Speech Language

1.
Brain Lang. 2019 Aug 13;197:104676. doi: 10.1016/j.bandl.2019.104676. [Epub ahead of print]
Clinical and neuroimaging characteristics of clinically unclassifiable primary progressive aphasia.
Utianski RL1, Botha H2, Martin PR3, Schwarz CG4, Duffy JR2, Clark HM2, Machulda MM5, Butts AM6, Lowe VJ4, Jack CR Jr4, Senjem ML4, Spychalla AJ4, Whitwell JL4, Josephs KA2.
Author information
1
Department of Neurology, Mayo Clinic, Rochester, MN, USA. Electronic address: Utianski.Rene@mayo.edu.
2
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
3
Department of Health Science Research, Mayo Clinic, Rochester, MN, USA.
4
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
5
Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
6
Medical College of Wisconsin, Milwaukee, WI, USA.
Abstract
Many patients who meet core/root criteria for Primary Progressive Aphasia (PPA) are not classifiable as a recognized variant and are often excluded from neuroimaging studies. Here, we detail neurological, neuropsychological, speech and language assessments, and anatomic and molecular neuroimaging (MRI, PiB-PET, and FDG-PET) for fifteen (8 female) clinically unclassifiable PPA patients. Median age of onset was 64 years old with median 3 years disease duration at exam. Three patients were amyloid positive on PiB-PET. 14/15 patients had abnormal FDG-PETs with left predominant hypometabolism, affecting frontal, temporal, parietal, and even occipital lobes. Patients had mild to severe clinical presentations. Visualization of the FDG-PETs principal component analysis revealed patterns of hypometabolism similar to those seen in the PPA variants and suggests the brain regions affected in unclassifiable PPA patients are no different from those who are more easily classifiable. These findings may inform future modifications to the diagnostic criteria to improve diagnostic classification.

Copyright © 2019 Elsevier Inc. All rights reserved.

KEYWORDS:
Amyloid imaging; Frontotemporal dementia; Hypometabolism; PET imaging; Primary progressive aphasia

PMID: 31419589 DOI: 10.1016/j.bandl.2019.104676
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2.
Int J Audiol. 2019 Aug 16:1-8. doi: 10.1080/14992027.2019.1649478. [Epub ahead of print]
Supporting hearing health in vulnerable populations through community care workers using mHealth technologies.
van Wyk T1, Mahomed-Asmail F1, Swanepoel W1,2,3.
Author information
1
a Department of Speech-Language Pathology and Audiology, University of Pretoria , Pretoria , South Africa.
2
b Ear Sciences Centre, School of Surgery, University of Western Australia , Nedlands , Australia.
3
c Ear Science Institute Australia , Subiaco , Australia.
Abstract
Objective: Access to hearing care is challenging in low- and middle-income countries, where the burden of hearing loss is greatest. This study investigated a community-based hearing screening programme using smartphone testing by community care workers (CCWs) in vulnerable populations infected or affected by HIV. Experiences of CCWs were also surveyed. Design: The study comprised two phases. Phase one employed a cross-sectional research design to describe the community-based programme. Phase two was a survey design to describe CCW's knowledge and experiences. Study Sample: Fifteen trained CCWs administered hearing screenings on 511 participants during home-based visits using a validated smartphone application (hearScreen™) during phase one. Diagnostic follow-up assessments included evaluation using the smartphone test (hearTest™), otoscopy and tympanometry. Phase two surveyed the 15 CCW screening experiences. Results: Referral rates for adults and children were 5.0% and 4.2%, respectively. 75.0% of referred participants returned for follow-up diagnostic assessments, 33.3% were diagnosed with hearing loss and referred for further intervention. All 15 CCWs agreed that communities needed hearing services and only 6.6% did not want to continue providing hearing screening. Conclusion: Trained CCWs can decentralise hearing services to vulnerable communities using smartphone screening incorporating automated testing and measures of quality control.

KEYWORDS:
HIV and AIDS; community based; mHealth; smartphone; tele-assisted; vulnerable

PMID: 31419388 DOI: 10.1080/14992027.2019.1649478
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3.
Lang Speech Hear Serv Sch. 2019 Aug 16:1-17. doi: 10.1044/2019_LSHSS-18-0101. [Epub ahead of print]
Implementation and Perceptions of Classroom-Based Service Delivery: A Survey of Public School Clinicians.
Green L1, Chance P1, Stockholm M1.
Author information
1
Department of Communication Sciences and Oral Health, Texas Woman's University, Denton.
Abstract
Purpose The choice of service delivery model is important for public school clinicians. Despite a theoretical emphasis on inclusive classroom-based services, data from a recent American Speech-Language-Hearing Association Schools Survey indicated that the pullout model is still the more frequently used approach (American Speech-Language-Hearing Association, 2016). In the current study, public school clinicians' use and perceptions of inclusion were examined to better understand potential influences on its implementation. Method Three hundred forty-four school-based clinicians completed an online survey about their training in and implementation of inclusion services, along with their perceptions of positive and potentially challenging aspects of this model. Descriptive data were examined, and the relationships of use and perceptions to issues such as caseload size, training, school setting, teacher factors, and administrative support were analyzed. Additionally, qualitative analysis was used to examine responses to 3 open-ended questions. Results Over half of the respondents served 1%-25% of their caseload through an inclusion model, and it was most frequently utilized to address language and social skills. Teacher collaboration and planning time were the 2 most frequently reported keys to inclusion success and were also 2 of the most frequently reported challenges to implementation. Conclusions The majority of the respondents reported many positive aspects of inclusion, yet they also reported many of the same challenging perceptions and roadblocks that existed when speech-language pathologists were surveyed over 20 years ago. Based on the results of this study, training in the inclusion model, teacher "buy-in," planning time, and administrative support are relevant to successful use of classroom-based intervention.

PMID: 31419180 DOI: 10.1044/2019_LSHSS-18-0101
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4.
Lang Speech Hear Serv Sch. 2019 Aug 16:1-10. doi: 10.1044/2019_LSHSS-18-0099. [Epub ahead of print]
Concurrent Validity of the Fluharty Preschool Speech and Language Screening Test-Second Edition at Age 3: Comparison With Four Diagnostic Measures.
Eisenberg S1, Victorino K2, Murray S3.
Author information
1
Department of Communication Sciences and Disorders, Montclair State University, NJ.
2
Department of Communication Disorders and Sciences, William Paterson University of New Jersey, Wayne.
3
Passaic County Technical Institute, Wayne, NJ.
Abstract
Purpose The aim of this study was to examine the concurrent validity of the Fluharty Preschool Speech and Language Screening Test-Second Edition (Fluharty-2; Fluharty, 2001) for mass screenings of language at age 3 years. Method Participants were sixty-two 3-year-old children, 31 who had failed and 31 who had passed the Fluharty-2. Performance on the screening was compared to 4 diagnostic measures: Structured Photographic Expressive Language Test-Preschool, Second Edition; mean length of utterance in morphemes (MLUm), finite verb morphology composite, and Index of Productive Syntax (IPSyn). Results Children who failed the Fluharty-2 scored significantly lower on each of the diagnostic measures than children who passed the Fluharty-2, but the effect size for MLUm was small. Scores on the Fluharty-2 were significantly correlated with scores on the diagnostic measures. There was significant agreement for pass/fail decisions between the Fluharty-2 and diagnostic measures only for IPSyn. However, even for the IPSyn, the agreement rate for passing was only moderate (80%) and the agreement rate for failing was only fair (68%). Conclusion The Fluharty-2 showed limited agreement for pass/fail decisions with all 4 of the diagnostic measures. There was reason to question the validity of 2 of the diagnostic measures-Structured Photographic Expressive Language Test-Preschool, Second Edition and MLUm-for diagnosing language impairment in 3-year-old children. However, there were no such concerns about finite verb morphology composite or IPSyn to account for the limited agreement. Thus, it seems reasonable to conclude that the Fluharty-2 would refer both too few at-risk children and too many nonrisk children for a follow-up assessment, making it an inefficient tool for mass screenings of language.

PMID: 31419169 DOI: 10.1044/2019_LSHSS-18-0099
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5.
Am J Speech Lang Pathol. 2019 Aug 16:1-14. doi: 10.1044/2019_AJSLP-CAC48-18-0210. [Epub ahead of print]
Temporal and Episodic Analyses of the Story of Cinderella in Latent Aphasia.
DeDe G1, Salis C2.
Author information
1
Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA.
2
Department of Speech & Language Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
Abstract
Purpose The purpose of this study was to improve our understanding of the language characteristics of people with latent aphasia using measures that examined temporal (i.e., real-time) and episodic organization of discourse production. Method Thirty AphasiaBank participants were included (10 people with latent aphasia, 10 people with anomic aphasia, and 10 neurotypical control participants). Speech material of Cinderella narratives was analyzed with Praat software. We devised a protocol that coded the presence and duration of all speech segments, dysfluencies such as silent and filled pauses, and other speech behaviors. Using these durations, we generated a range of temporal measures such as speech, articulation, and pure word rates. Narratives were also coded into episodes, which provided information about the discourse macrostructure abilities of the participants. Results The latent aphasia group differed from controls in number of words produced, silent pause duration, and speech rate, but not articulation rate or pure word rate. Episodic organization of the narratives was similar in these 2 groups. The latent and anomic aphasia groups were similar in most measures, apart from articulation rate, which was lower in the anomic group. The anomic aphasia group also omitted more episodes than the latent aphasia group. Conclusions The differences between latent aphasia and neurotypical controls can be attributed to a processing speed deficit. We propose that this deficit results in an impaired ability to process information from multiple cognitive domains simultaneously.

PMID: 31419160 DOI: 10.1044/2019_AJSLP-CAC48-18-0210
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6.
Am J Speech Lang Pathol. 2019 Aug 16:1-16. doi: 10.1044/2019_AJSLP-18-0132. [Epub ahead of print]
Reading Outcomes for Individuals With Histories of Suspected Childhood Apraxia of Speech.
Miller GJ1, Lewis B1, Benchek P2, Freebairn L1, Tag J1, Budge K1, Iyengar SK2, Voss-Hoynes H2, Taylor HG3, Stein C2.
Author information
1
Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH.
2
Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH.
3
Research Institute at Nationwide Children's Hospital, Ohio State University, Columbus.
Abstract
Purpose The primary aims of this study were to examine the speech-language correlates of decoding difficulties in children with histories of suspected childhood apraxia of speech (sCAS) and to identify predictors of low-proficiency reading levels. Method Participants were school-age children and adolescents, 7-18 years of age, diagnosed with sCAS (n = 40) or speech sound disorder but no sCAS (SSD-no sCAS; n = 119). The sCAS and SSD-no sCAS reading groups were compared on measures of performance IQ, oral language, phonological awareness, rapid automatic naming, diadochokinetic rates, single word articulation, and multisyllable and nonsense word repetition. Logistic regression analyses were employed to identify predictors of low-proficiency reading in the sCAS and SSD-no sCAS groups. Results Sixty-five percent of the participants with sCAS compared to 24% of those with SSD-no sCAS were classified as low-proficiency readers based on nonsense and single word decoding. Analysis failed to reveal significant differences in reading, oral language, or phonological awareness between low-proficiency readers with sCAS and low-proficiency readers with SSD-no sCAS. Oral language and phonological awareness skills were the best predictors of reading level for all participants, followed by performance on multisyllabic word repetition and diadochokinetic rate. Conclusions The language and phonological awareness deficits of children with sCAS are related to their risks for reading failure. To a lesser degree, motor speech deficits and speech sound production also increase risks for reading difficulties. The findings justify early intervention for this subset of children.

PMID: 31419159 DOI: 10.1044/2019_AJSLP-18-0132
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7.
Am J Speech Lang Pathol. 2019 Aug 16:1-6. doi: 10.1044/2019_AJSLP-18-0259. [Epub ahead of print]
Intimate Partner Violence and Women With Disabilities: The Role of Speech-Language Pathologists.
Ballan MS1, Freyer M1.
Author information
1
School of Social Welfare, Stony Brook University, New York, NY.
Abstract
This article is a call to action for speech-language pathologists to address the overlooked problem of intimate partner violence (IPV) among women with communication disorders (CDs). The article aims to heighten awareness of the higher rates of IPV in women with disabilities compared to those without, and to identify types of CDs that can result from IPV. The article provides background on CDs and IPV and delineates the role speech-language pathologists can play in identifying abuse and assisting patients to disclose IPV. Practice recommendations are provided, including enhanced IPV assessment for women with CDs, best practices for intervention emphasizing a trauma-informed approach, and the importance of collaboration and appropriate referrals.

PMID: 31419158 DOI: 10.1044/2019_AJSLP-18-0259
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8.
Am J Speech Lang Pathol. 2019 Aug 16:1-23. doi: 10.1044/2019_AJSLP-18-0238. [Epub ahead of print]
The Effect of Working Memory Training on a Clinical Marker of French-Speaking Children With Developmental Language Disorder.
Stanford E1, Durrleman S1, Delage H1.
Author information
1
Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.
Abstract
Purpose Our work investigates the production of 3rd-person accusative clitic pronouns in French-speaking typically developing (TD) children and children with developmental language disorder (DLD) following a novel working memory (WM) training program (12 hr of effective training) that specifically targets the components of WM that have been shown to be impaired in children with DLD and to be directly related to the mastery of clitics (Delage & Frauenfelder, submitted for publication; Durrleman & Delage, 2016). Method Sixteen TD children aged 5-12 years and 26 age-matched children with DLD completed our 8-week WM training program. Furthermore, an age-matched control group of 16 TD children and 17 children with DLD followed a scholastic training regime matched for intensity and frequency. Syntax and WM were assessed prior to and following the WM/scholastic training. Results Significant posttraining WM gains were found in TD children and children with DLD who took part in the WM training, and the production rate of 3rd-person accusative clitics significantly increased in children with DLD following the WM training. No significant WM or syntax gains were observed in the control group. Conclusion These findings are noteworthy as Melby-Lervåg and Hulme's (2013) meta-analysis concluded that existing WM training programs show short-lived generalized effects to other comparable measures of WM, but that there is no evidence that such training generalizes to less directly related tasks. That our study led to gains in skills that were not trained (i.e., syntax) suggests that a WM training regime that is firmly grounded in theory and that targets the specific mechanisms shown to underpin the acquisition of syntax may indeed provide effective remediation for children with DLD.

PMID: 31419156 DOI: 10.1044/2019_AJSLP-18-0238
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9.
Am J Speech Lang Pathol. 2019 Aug 16:1-13. doi: 10.1044/2019_AJSLP-CAC48-18-0227. [Epub ahead of print]
Treatment Fidelity Procedures for an Aphasia Intervention Within a Randomized Controlled Trial: Design, Feasibility, and Results.
Conlon EL1, Braun EJ1, Babbitt EM1,2, Cherney LR1,2,3.
Author information
1
Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL.
2
Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL.
3
Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL.
Abstract
Purpose This study reports on the treatment fidelity procedures implemented during a 5-year randomized controlled trial comparing intensive and distributed comprehensive aphasia therapy. Specifically, the results of 1 treatment, verb network strengthening treatment (VNeST), are examined. Method Eight participants were recruited for each of 7 consecutive cohorts for a total of 56 participants. Participants completed 60 hr of aphasia therapy, including 15 hr of VNeST. Two experienced speech-language pathologists delivered the treatment. To promote treatment fidelity, the study team developed a detailed manual of procedures and fidelity checklists, completed role plays to standardize treatment administration, and video-recorded all treatment sessions for review. To assess protocol adherence during treatment delivery, trained research assistants not involved in the treatment reviewed video recordings of a subset of randomly selected VNeST treatment sessions and completed the fidelity checklists. This process was completed for 32 participants representing 2 early cohorts and 2 later cohorts, which allowed for measurement of protocol adherence over time. Percent accuracy of protocol adherence was calculated across clinicians, cohorts, and study condition (intensive vs. distributed therapy). Results The fidelity procedures were sufficient to promote and verify a high level of adherence to the treatment protocol across clinicians, cohorts, and study condition. Conclusion Treatment fidelity strategies and monitoring are feasible when incorporated into the study design. Treatment fidelity monitoring should be completed at regular intervals during the course of a study to ensure that high levels of protocol adherence are maintained over time and across conditions.

PMID: 31419155 DOI: 10.1044/2019_AJSLP-CAC48-18-0227
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10.
Am J Speech Lang Pathol. 2019 Aug 16:1-13. doi: 10.1044/2019_AJSLP-CAC48-18-0225. [Epub ahead of print]
Clinical Assessment of Characteristics of Apraxia of Speech in Primary Progressive Aphasia.
Duncan ES1, Donovan NJ1, Sajjadi SA2.
Author information
1
Department of Communication Sciences & Disorders, Louisiana State University, Baton Rouge.
2
Department of Neurology, University of California, Irvine.
Abstract
Purpose We sought to examine interrater reliability in clinical assessment of apraxia of speech (AOS) in individuals with primary progressive aphasia and to identify speech characteristics predictive of AOS diagnosis. Method Fifty-two individuals with primary progressive aphasia were recorded performing a variety of speech tasks. These recordings were viewed by 2 experienced speech-language pathologists, who independently rated them on the presence and severity of AOS as well as 14 associated speech characteristics. We calculated interrater reliability (percent agreement and Cohen's kappa) for these ratings. For each rater, we used stepwise regression to identify speech characteristics significantly predictive of AOS diagnosis. We used the overlap between raters to create a more parsimonious model, which we evaluated with multiple linear regression. Results Results yielded high agreement on the presence (90%) and severity of AOS (weighted Cohen's κ = .834) but lower agreement for specific speech characteristics (weighted Cohen's κ ranging from .036 to .582). Stepwise regression identified 2 speech characteristics predictive of AOS diagnosis for both raters (articulatory groping and increased errors with increased length/complexity). These alone accounted for ≥ 50% of the variance of AOS severity in the constrained model. Conclusions Our study adds to a growing body of research that highlights the difficulty in objective clinical characterization of AOS and perceptual characterization of speech features. It further supports the need for consensus diagnostic criteria with standardized testing tools and for the identification and validation of objective markers of AOS. Additionally, these findings underscore the need for a training protocol if diagnostic tools are to be effective when shared beyond the research teams that develop and test them and disseminated to practicing speech-language pathologists, in order to ensure consistent application.

PMID: 31419154 DOI: 10.1044/2019_AJSLP-CAC48-18-0225
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11.
Am J Speech Lang Pathol. 2019 Aug 16:1-12. doi: 10.1044/2019_AJSLP-CAC48-18-0224. [Epub ahead of print]
A Retrospective Study of Long-Term Improvement on the Boston Naming Test.
Sachs A1, Rising K1, Beeson PM1.
Author information
1
Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson.
Abstract
Purpose Lexical retrieval impairment is a universal characteristic of aphasia and a common treatment focus. Although naming improvement is well documented, there is limited information to shape expectations regarding long-term recovery. This was the motivation for a retrospective study of longitudinal data on the Boston Naming Test (BNT; Kaplan, Goodglass, & Weintraub, 1983, 2000). Method BNT scores were analyzed from a heterogeneous cohort of 42 individuals with anomia associated with a range of aphasia types. The data were collected over the course of 20 years from individuals who had participated in treatment and received at least 2 BNT administrations. A linear mixed model was implemented to evaluate effects of initial BNT score, time postonset, and demographic variables. For those over 55 years of age, BNT change was evaluated relative to data from the Mayo Clinic's Older Americans Normative Studies. Results There was a significant average improvement of +7.67 points on the BNT in individuals followed for an average of 2 years. Overall, the average rate of improvement was +5.84 points per year, in contrast to a decline of 0.23 points per year in a healthy adult cohort from the Mayo Clinic's Older Americans Normative Studies. Naming recovery was approximately linear, with significant main effects of initial BNT score (i.e., initial severity) and time postonset; the greatest changes were noted in those whose initial severity was moderate. Conclusions These findings indicate a positive prognosis for naming improvement over time regardless of demographic factors and provide estimates for clinical predictions for those who seek rehabilitation during the chronic phase.

PMID: 31419151 DOI: 10.1044/2019_AJSLP-CAC48-18-0224
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12.
J Stroke Cerebrovasc Dis. 2019 Aug 12:104318. doi: 10.1016/j.jstrokecerebrovasdis.2019.104318. [Epub ahead of print]
Medical Mobile Applications for Stroke Survivors and Caregivers.
Piran P1, Thomas J2, Kunnakkat S2, Pandey A2, Gilles N2, Weingast S2, Burton D3, Balucani C2, Levine SR4; Mobile Applications for Stroke (MAPPS) Investigators.
Author information
1
The State University of New York (SUNY) Downstate Medical Center, New York, New York. Electronic address: pirouzpiran@gmail.com.
2
The State University of New York (SUNY) Downstate Medical Center, New York, New York.
3
College of Medicine, New York, New York; CUNY Hunter School of Public Health Brooklyn, New York, New York.
4
The State University of New York (SUNY) Downstate Medical Center, New York, New York; Department of Neurology, Kings County Hospital Center, New York, New York.
Abstract
BACKGROUND:
Recent studies estimate nearly half of the US population can access mobile medical applications (apps) on their smartphones. The are no systematic data available on apps focused on stroke survivors/caregivers.

OBJECTIVE:
To identify apps (a) designed for stroke survivors/caregivers, (b) dealing with a modifiable stroke risk factor (SRF), or (c) were developed for other purposes but could potentially be used by stroke survivors/caregivers.

METHODS:
A systematic review of the medical apps in the US Apple iTunes store was conducted between August 2013 and January 2016 using 18 predefined inclusion/exclusion criteria. SRFs considered were: diabetes, hypertension, smoking, obesity, atrial fibrillation, and dyslipidemia.

RESULTS:
Out of 30,132 medical apps available, 843 (2.7%) eligible apps were identified. Of these apps, (n = 74, 8.7%) apps were specifically designed for stroke survivors/caregivers use and provided the following services: language/speech therapy (n = 28, 37%), communication with aphasic patients (n = 19, 25%), stroke risk calculation (n = 11, 14%), assistance in spotting an acute stroke (n = 8, 10%), detection of atrial fibrillation (n = 3, 4%), direction to nearby emergency room (n = 3, 4%), physical rehabilitation (n = 3, 4%), direction to the nearest certified stroke center (n = 1, < 2%), and visual attention therapy (n = 1, <2%). 769 apps identified that were developed for purposes other than stroke. Of these, the majority (n = 526, 68%) addressed SRFs.

CONCLUSIONS:
Over 70 medical apps exist to specifically support stroke survivors/caregivers and primarily targeted language and communication difficulties. Apps encompassing most stroke survivor/caregiver needs could be developed and tested to ensure the issues faced by these populations are being adequately addressed.

Copyright © 2019 Elsevier Inc. All rights reserved.

KEYWORDS:
Stroke; caregiver; cerebrovascular disease; mobile applications; recovery

PMID: 31416761 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104318
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13.
Neurorehabil Neural Repair. 2019 Aug 16:1545968319868709. doi: 10.1177/1545968319868709. [Epub ahead of print]
Auditory, Phonological, and Semantic Factors in the Recovery From Wernicke's Aphasia Poststroke: Predictive Value and Implications for Rehabilitation.
Robson H1, Griffiths TD2, Grube M2,3,4, Woollams AM5.
Author information
1
1 University of Reading, Reading, UK.
2
2 Newcastle University, Newcastle-upon-Tyne, UK.
3
3 Aarhus University, Denmark.
4
4 Technische Universität, Berlin, Germany.
5
5 University of Manchester, Manchester, UK.
Abstract
Background. Understanding the factors that influence language recovery in aphasia is important for improving prognosis and treatment. Chronic comprehension impairments in Wernicke's aphasia (WA) are associated with impairments in auditory and phonological processing, compounded by semantic and executive difficulties. This study investigated whether the recovery of auditory, phonological, semantic, or executive factors underpins the recovery from WA comprehension impairments by charting changes in the neuropsychological profile from the subacute to the chronic phase. Method. This study used a prospective, longitudinal observational design. Twelve WA participants with superior temporal lobe lesions were recruited 2 months post-stroke onset (2 MPO). Language comprehension was measured alongside a neuropsychological profile of auditory, phonological, and semantic processing and phonological short-term memory and nonverbal reasoning at 3 poststroke time points: 2.5, 5, and 9 MPO. Results. Language comprehension displayed a strong and consistent recovery between 2.5 and 9 MPO. Improvements were also seen for slow auditory temporal processing, phonological short-term memory, and semantic processing but not for rapid auditory temporal, spectrotemporal, and phonological processing. Despite their lack of improvement, rapid auditory temporal processing at 2.5 MPO and phonological processing at 5 MPO predicated comprehension outcomes at 9 MPO. Conclusions. These results indicate that recovery of language comprehension in WA can be predicted from fixed auditory processing in the subacute stage. This suggests that speech comprehension recovery in WA results from reorganization of the remaining language comprehension network to enable the residual speech signal to be processed more efficiently, rather than partial recovery of underlying auditory, phonological, or semantic processing abilities.

KEYWORDS:
aphasia; auditory comprehension; neuroplasticity; reorganization; stroke recovery

PMID: 31416400 DOI: 10.1177/1545968319868709
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14.
Int J Speech Lang Pathol. 2019 Aug 15:1-12. doi: 10.1080/17549507.2019.1650110. [Epub ahead of print]
Speech-language pathologists' perceptions of the use of telepractice in the delivery of services to people with Parkinson's disease: A national pilot survey.
Swales M1, Theodoros D1, Hill AJ1, Russell T1.
Author information
1
a Centre for Research in Telerehabilitation, School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , Australia.
Abstract
Purpose: To explore the perceptions, use and interest to use telepractice by speech-language pathologists (SLPs) to deliver services to people with Parkinson's disease (PwPD). Method: A cross-sectional, mixed-methods online survey was conducted. Recruitment of SLPs with an active caseload of PwPD was conducted through non-probability, purposive sampling. Data were analysed using frequency distribution and thematic analysis. Result: A total of 63 SLPs responded. The majority (82.5%) were interested in telepractice, but only 23.1% provided services to PwPD online. Monitoring of motor speech function, and therapy were the primary services delivered online. Of those who did not currently offer online services to PwPD, 77.5% expressed interest to use telepractice. The development of telepractice guidelines and a comprehensive list of available software were the resources most requested to assist clinicians in offering such services. Most perceived telepractice as an appropriate delivery method for speech-language pathology services. However, views regarding the preference for face-to-face delivery were divided. Conclusion: SLPs view telepractice as a viable service delivery model for PwPD, but uptake of the model is variable. Several key barriers and resource limitations must be addressed to facilitate the implementation and sustainability of telepractice in clinical services.

KEYWORDS:
Parkinson’s disease; speech-language pathology; telepractice

PMID: 31416341 DOI: 10.1080/17549507.2019.1650110
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Select item 31415960
15.
Stem Cell Res. 2019 Jul 31;40:101524. doi: 10.1016/j.scr.2019.101524. [Epub ahead of print]
Generation of a human iPS cell line (CGMH.SLC26A4919-2) from a Pendred syndrome patient carrying SLC26A4 c.919-2A>G splice-site mutation.
Cheng YF1, Chan YH2, Hu CJ3, Lu YC3, Saeki T4, Hosoya M5, Saegusa C5, Fujioka M5, Okano H4, Weng SM6, Hsu CJ7, Chang KH8, Wu CC9.
Author information
1
Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Speech Language Pathology and Audiology, National Taipei University of Nursing Health Sciences, Taipei, Taiwan.
2
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan; Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
3
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
4
Department of Physiology, Keio University School of Medicine, Tokyo, Japan.
5
Department of Otorhinolaryngology, Keio University School of Medicine, Tokyo, Japan.
6
Department of Speech Language Pathology and Audiology, National Taipei University of Nursing Health Sciences, Taipei, Taiwan; Department of Pediatrics, Wan Fang Hospital, Taipei Medical University, Taoyuan, Taiwan.
7
Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
8
Department of Neurology, Chang Gung Memorial Hospital and University School of Medicine, Taipei, Taiwan. Electronic address: gophy5128@cgmh.org.tw.
9
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: chenchiwu@ntuh.gov.tw.
Abstract
SLC26A4 is the second most frequent gene implicated in congenital hearing loss after GJB2 mutations. Here, we report the generation of induced pluripotent stem cells (iPSCs), from a patient who was carrying a homozygous c.919-2A>G variant in the SLC26A4 gene. This is the most common variant of SLC26A4 gene in the Chinese population and the second most prevalent one in other Asian countries. The established patient-derived iPSC displayed all the features of pluripotent stem cell markers and had the ability to differentiate into all of the three germ layers and possessed a normal karyotype.

Copyright © 2019. Published by Elsevier B.V.

PMID: 31415960 DOI: 10.1016/j.scr.2019.101524
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16.
Neuroimage. 2019 Aug 12:116096. doi: 10.1016/j.neuroimage.2019.116096. [Epub ahead of print]
Common cortical architectures for phonological working memory identified in individual brains.
Scott TL1, Perrachione TK2.
Author information
1
Graduate Program for Neuroscience, Boston University, USA.
2
Department of Speech, Language, and Hearing Sciences, Boston University, USA. Electronic address: tkp@bu.edu.
Abstract
Phonological working memory is the capacity to briefly maintain and recall representations of sounds important for speech and language and is believed to be critical for language and reading acquisition. Whether phonological working memory is supported by fronto-parietal brain regions associated with short-term memory storage or perisylvian brain structures implicated in speech perception and production is unclear, perhaps due to variability in stimuli, task demands, and individuals. We used fMRI to assess neurophysiological responses while individuals performed two tasks with closely matched stimuli but divergent task demands-nonword repetition and nonword discrimination-at two levels of phonological working memory load. Using analyses designed to address intersubject variability, we found significant neural responses to the critical contrast of high vs. low phonological working memory load in both tasks in a set of regions closely resembling those involved in speech perception and production. Moreover, within those regions, the voxel-wise patterns of load-related activation were highly correlated between the two tasks. These results suggest that brain regions in the temporal and frontal lobes encapsulate the core neurocomputational components of phonological working memory; an architecture that becomes increasingly evident as neural responses are examined in successively finer-grained detail in individual participants.

Copyright © 2019. Published by Elsevier Inc.

KEYWORDS:
Individual-subject analyses; Nonword discrimination; Nonword repetition; Phonological working memory; Pseudowords; fMRI

PMID: 31415882 DOI: 10.1016/j.neuroimage.2019.116096
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17.
PLoS One. 2019 Aug 15;14(8):e0220386. doi: 10.1371/journal.pone.0220386. eCollection 2019.
A comprehensive study on bilingual and multilingual speech emotion recognition using a two-pass classification scheme.
Heracleous P1, Yoneyama A1.
Author information
1
Education and Medical ICT Laboratory, KDDI Research, Inc., 2-1-15 Ohara, Fujimino-shi, Saitama 356-8502 Japan.
Abstract
Emotion recognition plays an important role in human-computer interaction. Previously and currently, many studies focused on speech emotion recognition using several classifiers and feature extraction methods. The majority of such studies, however, address the problem of speech emotion recognition considering emotions solely from the perspective of a single language. In contrast, the current study extends monolingual speech emotion recognition to also cover the case of emotions expressed in several languages that are simultaneously recognized by a complete system. To address this issue, a method, which provides an effective and powerful solution to bilingual speech emotion recognition, is proposed and evaluated. The proposed method is based on a two-pass classification scheme consisting of spoken language identification and speech emotion recognition. In the first pass, the language spoken is identified; in the second pass, emotion recognition is conducted using the emotion models of the language identified. Based on deep learning and the i-vector paradigm, bilingual emotion recognition experiments have been conducted using the state-of-the-art English IEMOCAP (four emotions) and German FAU Aibo (five emotions) corpora. Two classifiers along with i-vector features were used and compared, namely, fully connected deep neural networks (DNN) and convolutional neural networks (CNN). In the case of DNN, 64.0% and 61.14% unweighted average recalls (UARs) were obtained using the IEMOCAP and FAU Aibo corpora, respectively. When using CNN, 62.0% and 59.8% UARs were achieved in the case of the IEMOCAP and FAU Aibo corpora, respectively. These results are very promising, and superior to those obtained in similar studies on multilingual or even monolingual speech emotion recognition. Furthermore, an additional baseline approach for bilingual speech emotion recognition was implemented and evaluated. In the baseline approach, six common emotions were considered, and bilingual emotion models were created, trained on data from the two languages. In this case, 51.2% and 51.5% UARs for six emotions were obtained using DNN and CNN, respectively. The results using the baseline method were reasonable and promising, showing the effectiveness of using i-vectors and deep learning in bilingual speech emotion recognition. On the other hand, the proposed two-pass method based on language identification showed significantly superior performance. Furthermore, the current study was extended to also deal with multilingual speech emotion recognition using corpora collected under similar conditions. Specifically, the English IEMOCAP, the German Emo-DB, and a Japanese corpus were used to recognize four emotions based on the proposed two-pass method. The results obtained were very promising, and the differences in UAR were not statistically significant compared to the monolingual classifiers.

PMID: 31415592 PMCID: PMC6695118 DOI: 10.1371/journal.pone.0220386
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Conflict of interest statement
Select item 31412741
18.
Percept Mot Skills. 2019 Aug 14:31512519870032. doi: 10.1177/0031512519870032. [Epub ahead of print]
Speech Perception: Phonological Neighborhood Effects on Word Recognition Persist Despite Semantic Sentence Context.
Cervera-Crespo T1, González-Álvarez J1,2.
Author information
1
1 Department of Basic Psychology, University of Valencia, Spain.
2
2 Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.
Abstract
This study tested the hypothesis that two lexical properties, both phonological neighborhood density (ND) and neighborhood frequency (NF), influence the recognition of target words when preceded by either a semantically congruent or semantically neutral context. Our study is the first to test this hypothesis using a language other than English (i.e., Spanish). We used highly familiar bisyllabic nouns with medium-frequency occurrence as target words, and we expected recognition accuracy to increase as ND and NF decreased in both semanticallly congruent and semantically neutral sentences. We presented 48 undergraduate listeners with a set of 80 words, differing in ND and NF, within these two sentence contexts (i.e., 160 sentences). We then tested the relationships between ND, NF, and variations in semantic sentence context within a linear logistic model and found that words with a low frequency of neighbors were more likely to be correctly recognized in both sentence contexts. Thus, during word recognition, the influence of phonological competition outweighed semantic sentence context even when words were presented in Spanish.

KEYWORDS:
auditory word recognition; phonological proximity; sentence context

PMID: 31412741 DOI: 10.1177/0031512519870032
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19.
J Speech Lang Hear Res. 2019 Aug 13:1-14. doi: 10.1044/2019_JSLHR-S-18-0392. [Epub ahead of print]
Second Language Learners' Listener Impressions of Foreigner-Directed Speech.
Bobb SC1, Mello K1, Turco E1, Lemes L1, Fernandez E1, Rothermich K2.
Author information
1
Department of Psychology, Gordon College, Wenham, MA.
2
Department of Communication Sciences & Disorders, East Carolina University, Greenville, NC.
Abstract
Background According to sociolinguistic frameworks such as Communication Accommodation Theory, English native speakers modify their speech to meet the communicative needs of non-native speakers (Beebe & Giles, 1984). However, when foreigner-directed speech is used inappropriately, it may lead to overaccommodation, which in turn can act counterproductively toward communicative goals. Purpose To date, much of the research on foreigner-directed speech toward non-native speakers has focused on its acoustic parameters, but few studies have examined how second language learners interpret it emotionally and pragmatically. Method This study asked 36 English second language learners to listen to four types of speech accommodation styles (casual, clear, infant-directed, and foreigner-directed) spoken by four different speakers. Their task was to evaluate the extent to which the speaker was easy to understand, competent, condescending, friendly, and respectful. Results Acoustic analyses of the speech stimuli showed that speakers used distinct acoustic cues for each speech accommodation style, for example, slower speech rate for foreigner-directed speech. The rating results show that second language learners of English judged casual speech as least intelligible, least competent, and least friendly compared to all other speech types. Respectfulness ratings show that participants perceived casual speech as less respectful compared to clear speech and infant-directed speech, but not foreigner-directed speech. However, no effects were found for condescension. Conclusion The results suggest second language learners in the current experiment generally perceived speech accommodation positively.

PMID: 31412215 DOI: 10.1044/2019_JSLHR-S-18-0392
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Select item 31411947
20.
Lang Speech Hear Serv Sch. 2019 Aug 13:1-17. doi: 10.1044/2019_LSHSS-18-0100. [Epub ahead of print]
A National Survey of Speech-Language Pathologists' Engagement in Interprofessional Collaborative Practice in Schools: Identifying Predictive Factors and Barriers to Implementation.
Pfeiffer DL1,2, Pavelko SL3, Hahs-Vaughn DL4, Dudding CC5.
Author information
1
Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD.
2
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD.
3
Department of Speech-Language Pathology, University of St. Augustine for Health Sciences, Dallas, TX.
4
Department of Learning Sciences, University of Central Florida, Orlando.
5
Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA.
Abstract
Purpose This study examined the models of collaboration used by school-based speech-language pathologists (SLPs) during the provision of special education services including factors predicting use of the interprofessional collaborative practice (IPP) model and barriers to collaboration. Method School-based SLPs responded to a survey on models of collaboration within their work setting. Anchored vignettes were created to determine their engagement in 3 different models (i.e., multidisciplinary, interdisciplinary, and interprofessional) used in the provision of special education services during evaluation and intervention. Predictive factors supporting and/or hindering the use of IPP were identified. Results Results demonstrated low percentages of school-based SLPs engaging in IPP during initial evaluations (8%), eligibility meetings (43%), and intervention sessions (14%). Three factors predicted use of IPP in schools: prior training in collaboration, years of experience, and educational setting. The most frequently cited barriers to SLPs' engagement in collaboration included time constraints/scheduling (48%), resistance from other professionals (23%), and lack of support from employers/administration (11%). Conclusions The results of the current study indicated that systemic change is needed at both the university and public school levels. At the university level, preprofessional students need collaborative learning opportunities that are integrated across programs and colleges. School-based SLPs and other education professionals could benefit from job-embedded learning focused on IPP to increase their knowledge and engagement in IPP and improve student outcomes. Supplemental Material https://doi.org/10.23641/asha.9340760.

PMID: 31411947 DOI: 10.1044/2019_LSHSS-18-0100
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Select item 31411819
21.
PM R. 2019 Aug 14. doi: 10.1002/pmrj.12236. [Epub ahead of print]
Identification of Paradoxical Vocal Fold Movement with Diagnostic Ultrasound: Confirmation with Video Laryngoscopy.
Finnoff JT1, Orbelo DM2, Ekbom DC2.
Author information
1
Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
2
Department of Otolaryngology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Abstract
A well-recognized cause of dyspnea in athletes is vocal cord dysfunction (VCD). VCD is characterized by paradoxical vocal fold movement (PVFM) in which the vocal folds adduct (close) during inspiration.1 Symptoms of VCD include wheezing, stridor, dyspnea, and exercise intolerance. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

KEYWORDS:
Speech and Language Disorders; Sports Medicine; Ultrasonography

PMID: 31411819 DOI: 10.1002/pmrj.12236
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Select item 31410865
22.
Ann N Y Acad Sci. 2019 Aug 14. doi: 10.1111/nyas.14215. [Epub ahead of print]
Sequence and hierarchy in vocal rhythms and phonology.
Fitch WT1.
Author information
1
Department of Cognitive Biology, University of Vienna, Vienna, Austria.
Abstract
I explore the neural and evolutionary origins of phonological hierarchy, building on Peter MacNeilage's frame/content model, which suggests that human speech evolved from primate nonvocal jaw oscillations, for example, lip smack displays, combined with phonation. Considerable recent data, reviewed here, support this proposition. I argue that the evolution of speech motor control required two independent components. The first, identified by MacNeilage, is the diversification of phonetic "content" within a simple sequential "frame," and would be within reach of nonhuman primates, by simply intermittently activating phonation during lip smack displays. Such voicing control requires laryngeal control, hypothesized to necessitate direct corticomotor connections to the nucleus ambiguus. The second component, proposed here, involves imposing additional hierarchical rhythmic structure upon the "flat" control sequences typifying mammalian vocal tract oscillations and is required for the flexible combinatorial capacity observed in modern phonology. I hypothesize that phonological hierarchy resulted from a marriage of a preexisting capacity for sequential structure seen in other primates, with novel hierarchical motor control circuitry (potentially evolved in tool use and/or musical contexts). In turn, this phonological hierarchy paved the way for phrasal syntactic hierarchy. I support these arguments using comparative and neural data from nonhuman primates and birdsong.

© 2019 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.

KEYWORDS:
evolution of language; frame/content theory; phonology; rhythm; speech

PMID: 31410865 DOI: 10.1111/nyas.14215
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23.
Cortex. 2019 Jul 16;119:386-400. doi: 10.1016/j.cortex.2019.07.003. [Epub ahead of print]
Retrieval practice and spacing effects in multi-session treatment of naming impairment in aphasia.
Middleton EL1, Rawson KA2, Verkuilen J3.
Author information
1
Research Department, Moss Rehabilitation Research Institute, Elkins Park, PA, USA. Electronic address: middleer@einstein.edu.
2
Department of Psychology, 332 Kent Hall, Kent State University, Kent, OH, USA.
3
Educational Psychology, City University of New York Graduate Center, New York, NY, USA.
Abstract
Retrieval practice and spacing are two factors shown to enhance learning in basic psychological research. The present study investigated the clinical applicability of these factors to naming treatment in aphasia. Prior studies have shown that naming treatment that provides retrieval practice (i.e., practice retrieving names for objects from semantic memory) improves later naming performance in people with aphasia (PWA) more so than repetition training. Repetition training is a common form of naming treatment that can support errorless production of names for objects, but it does not provide retrieval practice. Prior work has also demonstrated enhanced naming treatment benefit in PWA when an item's training trials are separated by multiple intervening trials (i.e., spacing) compared to only one intervening trial (i.e., massing). However, in those studies, items were only trained in one session. Also, the effects of the learning factors were probed after one day and one week. The goal of the present study was to examine the effects of retrieval practice and spacing in a more clinically-inspired schedule of delivery and to assess the effects of the learning factors at retention intervals of greater functional significance. Matched sets of errorful items for each of four PWA were presented for multiple trials of retrieval practice or repetition in a spaced or massed schedule in each of multiple training sessions. Mixed regression analyses revealed that retrieval practice outperformed repetition, and spacing outperformed massing, at an initial post-treatment test administered after one week. Furthermore, the advantage for retrieval practice over repetition persisted at a follow-up test administered after one month. The potential clinical relevance of retrieval practice and spacing for multi-session interventions in speech-language treatment is discussed.

Copyright © 2019 Elsevier Ltd. All rights reserved.

KEYWORDS:
Aphasia; Lexical access; Naming treatment; Retrieval practice; Spacing effect

PMID: 31408823 DOI: 10.1016/j.cortex.2019.07.003
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Select item 31408356
24.
Breastfeed Med. 2019 Aug 13. doi: 10.1089/bfm.2019.29132.job. [Epub ahead of print]
ABM Clinical Protocol #17: Guidelines for Breastfeeding Infants with Cleft Lip, Cleft Palate, or Cleft Lip and Palate-Revised 2019.
Boyce JO1,2, Reilly S2,3, Skeat J1, Cahir P4; Academy of Breastfeeding Medicine.
Collaborators (27)
Author information
1
1Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia.
2
2Speech and Language Group, Murdoch Children's Research Institute, Melbourne, Australia.
3
3Menzies Health Institute Queensland, Griffith University, Southport, Australia.
4
4Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
PMID: 31408356 DOI: 10.1089/bfm.2019.29132.job
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Select item 31408045
25.
Ear Hear. 2019 Aug 9. doi: 10.1097/AUD.0000000000000767. [Epub ahead of print]
Quantifying the Range of Signal Modification in Clinically Fit Hearing Aids.
Rallapalli V1, Anderson M2, Kates J3, Balmert L4, Sirow L5, Arehart K3, Souza P1,6.
Author information
1
Department of Communication Sciences & Disorders, Northwestern University, Evanston, Illinois, USA.
2
Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, USA.
3
Department of Speech Language Hearing Sciences, University of Colorado at Boulder, Boulder, Colorado, USA.
4
Biostatistics Collaboration Center, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
5
I Love Hearing Inc., Port Washington, New York, USA.
6
Department of Communication Sciences & Disorders, Knowles Hearing Center, Northwestern University, Evanston, Illinois, USA.
Abstract
OBJECTIVES:
Hearing aids provide various signal processing techniques with a range of parameters to improve the listening experience for a hearing-impaired individual. In previous studies, we reported significant differences in signal modification for mild versus strong signal processing in commercially available hearing aids. In this study, the authors extend this work to clinically prescribed hearing aid fittings based on best-practice guidelines. The goals of this project are to determine the range of cumulative signal modification in clinically fit hearing aids across manufacturers and technology levels and the effects of listening conditions including signal to noise ratio (SNR) and presentation level on these signal modifications.

DESIGN:
We identified a subset of hearing aids that were representative of a typical clinical setting. Deidentified hearing aid fitting data were obtained from three audiology clinics for adult hearing aid users with sensorineural hearing loss for a range of hearing sensitivities. Matching laboratory hearing aids were programmed with the deidentified fitting data. Output from these hearing aids was recorded at four SNRs and three presentation levels. The resulting signal modification was quantified using the cepstral correlation component of the Hearing Aid Speech Quality Index which measures the speech envelope changes in the context of a model of the listener's hearing loss. These metric values represent the hearing aid processed signal as it is heard by the hearing aid user. Audiometric information was used to determine the nature of any possible association with the distribution of signal modification in these clinically fit hearing aids.

RESULTS:
In general, signal modification increased as SNR decreased and presentation level increased. Differences across manufacturers were significant such that the effect of presentation level varied differently at each SNR, for each manufacturer. This result suggests that there may be variations across manufacturers in processing various listening conditions. There was no significant effect of technology level. There was a small effect of pure-tone average on signal modification for one manufacturer, but no effect of audiogram slope. Finally, there was a broad range of measured signal modification for a given hearing loss, for the same manufacturer and listening condition.

CONCLUSIONS:
The signal modification values in this study are representative of commonly fit hearing aids in clinics today. The results of this study provide insights into how the range of signal modifications obtained in real clinical fittings compares with a previous study. Future studies will focus on the behavioral implications of signal modifications in clinically fit hearing aids.

PMID: 31408045 DOI: 10.1097/AUD.0000000000000767
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Select item 31407873
26.
Autism Res. 2019 Aug 13. doi: 10.1002/aur.2176. [Epub ahead of print]
Acoustic properties of early vocalizations in infants with fragile X syndrome.
Hamrick LR1, Seidl A2, Tonnsen BL1.
Author information
1
Department of Psychological Sciences, Purdue University, West Lafayette, Indiana.
2
Speech, Language, & Hearing Sciences, Purdue University, West Lafayette, Indiana.
Abstract
Fragile X syndrome (FXS) is a neurogenetic syndrome characterized by cognitive impairments and high rates of autism spectrum disorder (ASD). FXS is often highlighted as a model for exploring pathways of symptom expression in ASD due to the high prevalence of ASD symptoms in this population and the known single-gene cause of FXS. Early vocalization features-including volubility, complexity, duration, and pitch-have shown promise in detecting ASD in idiopathic ASD populations but have yet to be extensively studied in a population with a known genetic cause for ASD such as FXS. Investigating early trajectories of these features in FXS may inform our limited knowledge of potential mechanisms that predict later social communication outcomes. The present study addresses this need by presenting preliminary findings which (a) characterize early vocalization features in FXS relative to low-risk controls (LRC) and (b) test the specificity of associations between these features and language and ASD outcomes. We coded vocalization features during a standardized child-examiner interaction for 39 nine-month-olds (22 FXS, 17 LRC) whose clinical outcomes were assessed at 24 months. Our results provide preliminary evidence that within FXS, associations between vocalization features and 24-month language outcomes may diverge from those observed in LRC, and that vocalization features may be associated with later ASD symptoms. These findings provide a starting point for more research exploring these features as potential early markers of ASD in FXS, which in turn may lead to improved early identification methods, treatment approaches, and overall well-being of individuals with ASD. Autism Res2019. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Although vocal features of 9-month-olds with FXS did not differ from those of low-risk controls, several features were associated with later language and ASD outcomes at 24 months in FXS. These preliminary results suggest acoustic data may be related to clinical outcomes in FXS and potentially other high-risk populations. Further characterizing these associations may facilitate understanding of biological mechanisms and risk factors associated with social communication development and ASD.

© 2019 International Society for Autism Research, Wiley Periodicals, Inc.

KEYWORDS:
acoustics; autism spectrum disorder; canonical babbling; fragile X syndrome; pitch; vocalization duration; volubility

PMID: 31407873 DOI: 10.1002/aur.2176
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Select item 31407612
27.
Logoped Phoniatr Vocol. 2019 Aug 13:1-10. doi: 10.1080/14015439.2019.1650392. [Epub ahead of print]
Development of a method for assessment of dysarthria in a foreign language: a pilot study.
Näsström AK1, Schalling E2,3.
Author information
1
a Klara Speech and Language Pathology Clinic , Stockholm , Sweden.
2
b Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet , Stockholm , Sweden.
3
c Functional Area Speech and Language Pathology, Karolinska University Hospital , Stockholm , Sweden.
Abstract
Purpose: It is increasingly more common for Speech and Language Pathologists in Sweden to encounter individuals with dysarthria who speak a different language. The aim of the present pilot study was to develop and test a systematic method to be used in collaboration with an interpreter, for assessment of acquired dysarthria in people speaking a language not familiar to the Speech and Language Pathologist. Methods: Seven participants, speaking standard Arabic, were assessed by a Swedish speaking Speech and Language Pathologist using this method and with help of a certified interpreter. The participants were also assessed with equivalent test items from the Swedish "Dysarthria assessment," with instructions translated to Arabic, by a Speech and Language Pathologist speaking standard Arabic and the results were compared. Results: There were no significant differences between the assessments by the Swedish speaking Speech and Language Pathologist and the Arabic speaking Speech and Language Pathologist in the domains "Respiration and phonation," "Articulation," "Listener Comprehension" and "Severity of dysarthria." There was a significant difference between assessments in the domain "Oromotor and velopharyngeal function." Intra- and inter-rater reliability was also calculated using Intraclass Correlation Coefficient and their 95% Confidence Interval. Intra-rater reliability was excellent and inter-rater reliability was very good. Conclusion: The study indicates that a Speech and Language Pathologist, with help of an interpreter, can carry out an assessment of dysarthria in a language unknown to the Speech and Language Pathologist with results comparable to results from an assessment carried out by a Speech and Language Pathologist who speaks the foreign language.

KEYWORDS:
Dysarthria; dysarthria assessment; foreign language; systematic assessment

PMID: 31407612 DOI: 10.1080/14015439.2019.1650392
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Select item 31406616
28.
J Pediatr Genet. 2019 Sep;8(3):109-122. doi: 10.1055/s-0039-1693663. Epub 2019 Jul 25.
A Review of Psychosocial Factors of Marfan Syndrome: Adolescents, Adults, Families, and Providers.
Nielsen C1, Ratiu I2, Esfandiarei M1, Chen A3, Selamet Tierney ES3.
Author information
1
Biomedical Sciences Program, College of Graduate Studies, Midwestern University, Glendale, Arizona, United States.
2
Speech-Language Pathology Program, College of Health Sciences, Midwestern University, Glendale, Arizona, United States.
3
Department of Pediatric Cardiology, Stanford University, Palo Alto, California, United States.
Abstract
The purpose of this article was to review the current literature on psychosocial implications of Marfan syndrome (MFS) and its impact on adolescents, adults, their families and to provide important considerations for providers. Since the previous reviews in 2015, numerous studies have been published that are included in the current review. This literature review was conducted using PubMed, Medline, PsychINFO, ERIC, Web of Science, and Academic Search Premier databases and only articles that studied psychosocial factors that influence MFS patients as adolescents, adults, family members, or their interactions with providers were included in this review. Of the 522 articles reviewed, 41 were selected based on the inclusion and exclusion criteria. All articles were peer-reviewed. MFS has various implications that can impact one's life; studies have shown that MFS causes a negative impact on an individual's formative years, quality of life, reproductive decision-making, work participation, and satisfaction with life. Clinicians and multidisciplinary teams should be aware of these factors to provide support focusing on coping strategies for the patient and their family.

KEYWORDS:
Marfan syndrome; caregivers; chronic pain; coping; psychosocial factors; quality of life

PMID: 31406616 PMCID: PMC6688882 [Available on 2020-09-01] DOI: 10.1055/s-0039-1693663
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Select item 31405758
29.
J Prosthodont Res. 2019 Aug 9. pii: S1883-1958(19)30122-7. doi: 10.1016/j.jpor.2019.07.011. [Epub ahead of print]
Screening for masticatory disorders in older adults (SMDOA): An epidemiological tool.
Cavalcanti RVA1, Magalhães Junior HV2, Pernambuco LA3, Lima KC4.
Author information
1
Federal University of Rio Grande do Norte (UFRN), Department of Speech, Language and Hearing Sciences, Natal, Rio Grande do Norte, Brazil. Electronic address: renatacavalcanti@ccs.ufrn.br.
2
Federal University of Rio Grande do Norte (UFRN), Department of Speech, Language and Hearing Sciences, Natal, Rio Grande do Norte, Brazil.
3
Federal University of Paraíba (UFPB), Department of Speech, Language and Hearing Sciences, João Pessoa, Paraíba, Brazil.
4
Federal University of Rio Grande do Norte (UFRN), Department of Dentistry, Natal, Rio Grande do Norte, Brazil.
Abstract
PURPOSE:
Masticatory changes in the older adult population may cause nutritional impairment, so epidemiological studies are important to allow specific public health interventions. Thus, this study aims at constructing and validating an instrument for screening for masticatory disorders in older adults (SMDOA).

METHODS:
Validation study. First step: validity evidence based on test content. Defining the construct and elaborating the questions by a panel of experts and evaluating the representativeness and relevance of the items in relation to the construct by a committee of 28 experts. Analysis was performed through the Content Validity Index for Items (CVI-I) and the Content Validity Index (CVI). Second stage: validity evidence based on response processes. The questionnaire was applied to 40 older adults (≥60 years) using the cognitive interview strategy. Quantitative and qualitative analysis of the responses was carried out. Third stage: validity evidence based on the internal structure. The instrument was applied to 295 older adult patients and a confirmatory factorial analysis was performed to fit the model.

RESULTS:
The first version of SMDOA consisted of 16 issues related to chewing. The CVI and CVI-I were satisfactory, and only one question was excluded. The instrument with 15 questions was well evaluated by the older adults, only requiring minor adjustments to the morphosyntax. After the confirmatory factorial analysis, adjustments were made in its internal structure resulting in the 9-question model in two factors regarding function and masticatory perception.

CONCLUSIONS:
The SMDOA presented good evidence of validity in its content, response processes and internal structure.

Copyright © 2019 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:
Aged; Epidemiology; Mass screening; Mastication; Validation studies

PMID: 31405758 DOI: 10.1016/j.jpor.2019.07.011
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Select item 31405300
30.
Int J Speech Lang Pathol. 2019 Aug 12:1-10. doi: 10.1080/17549507.2019.1648550. [Epub ahead of print]
Story-telling abilities of young Indigenous and non-Indigenous Australian children across three protocols.
Pearce WM1, Flanagan K2.
Author information
1
a School of Allied Health, Australian Catholic University, MacKillop Campus , North Sydney , NSW , Australia.
2
b School of Allied Health, Australian Catholic University, McAuley Campus , Brisbane , QLD , Australia.
Abstract
Purpose: Little is documented about the story-telling skills of Indigenous Australian children. Therefore, this study explores the complexity of stories produced by Indigenous and non-Indigenous Australian children in their first year of school. Method: An observational design allowed comparison across cultural groups and story protocols. Three stories were elicited from 49 Indigenous and non-Indigenous children aged 4;10 to 6;5. Stories were analysed using the Index of Narrative Complexity (INC) to generate scores for each story element. Story elements were further categorised and evaluated for level of use across participants. Story protocol and cultural group effects were explored using ANOVA. Result: Participant stories featured high use of characters, initiating events, attempts, and consequences; and little use of internal plans, formulaic markers, causal adverbial markers and evaluations. Story complexity scores did not differ between the Indigenous and non-Indigenous children, but significant differences were evident among the three, story protocols. Conclusion: Findings suggest that story elicitation protocols and analysis methods used in this study may be appropriate for use with both Indigenous and non-Indigenous children from urban contexts. However, caution is needed when making diagnostic decisions based on story complexity without well-developed, culturally appropriate protocols and normative data.

KEYWORDS:
Indigenous; children; language assessment; macrostructure

PMID: 31405300 DOI: 10.1080/17549507.2019.1648550
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Select item 31403955
31.
NeuroRehabilitation. 2019 Aug 7. doi: 10.3233/NRE-192725. [Epub ahead of print]
Touchscreen tablet-based cognitive assessment versus paper-based assessments for traumatic brain injury.
Wallace SE1, Donoso Brown EV2, Schreiber JB3, Diehl S4, Kinney J5, Zangara L6.
Author information
1
Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA, USA.
2
Department of Occupational Therapy, Duquesne University Pittsburgh, PA, USA.
3
School of Nursing, Duquesne University, Pittsburgh, PA, USA.
4
Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, USA.
5
Good Shepherd Rehabilitation, Allentown, PA, USA.
6
Pediatric Therapy Specialists, Inc., Avonworth School District, Pittsburgh, PA, USA.
Abstract
BACKGROUND:
Electronic cognitive assessment tools present potential benefits for clinical practice; however, they warrant examination before use with clinical populations such as people with traumatic brain injury (TBI).

OBJECTIVE:
The primary study purpose was to compare results from a tablet-based, electronic cognitive assessment to two paper cognitive assessments when administered to adults with TBI. We also explored the effect of iPad comfort on performance.

METHODS:
We employed a quasi-experimental, correlational study design. Forty adults with between 18 to 615 months post TBI completed the Standardized Touchscreen Assessment of Cognition (STAC), the Montreal Cognitive Assessment (MoCA), and the Cognitive Linguistic Quick Test (CLQT) in a systematically, counterbalanced order. We compared participants' performance on these tools and examined the effect of iPad comfort.

RESULTS:
Three STAC subtests had a good relationship with CLQT subtests: orientation, generative naming category, and generative naming first letter. A good relationship was also identified between two STAC and two MoCA subtests: orientation and generative naming first letter. People who were very comfortable using the iPad performed statistically better on the STAC first letter fluency item than participants who were not comfortable.

CONCLUSIONS:
Moderate correlations suggest validity for some STAC items; however, modifications and further testing are needed.

KEYWORDS:
Cognitive assessment; electronic assessment; mobile technology; traumatic brain injury

PMID: 31403955 DOI: 10.3233/NRE-192725
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32.
J Voice. 2019 Aug 8. pii: S0892-1997(19)30201-2. doi: 10.1016/j.jvoice.2019.06.020. [Epub ahead of print]
Immediate Effect of Semioccluded Vocal Tract Exercises Using Resonance Tube Phonation in Water on Women Without Vocal Complaints.
Bonette MC1, Ribeiro VV2, Xavier-Fadel CB3, Costa CDC1, Dassie-Leite AP4.
Author information
1
The Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO, Irati, PR, Brazil.
2
The Centro de Estudos da Voz - CEV, São Paulo, SP, Brazil; The Speech-Language Pathology Department, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
3
The Universidade Federal do Paraná - UFPR, Curitiba, PR, Brazil.
4
The Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO, Irati, PR, Brazil. Electronic address: pauladassie@hotmail.com.
Abstract
OBJECTIVE:
To analyze the immediate effects of semioccluded vocal tract exercises on vocal quality and vocal self-assessment using resonance tube phonation in water in women without voice complaints, and to compare these results with those obtained using tongue trills and unvoiced fricative exercises.

METHODS:
This was a quasi-experimental study. The participants were 30 women aged 18-39 years and without vocal complaints. All participants performed three exercises for 3 minutes: experimental exercise (EE: phonation into a resonance flexible tube in water exercise), control exercise (tongue trill exercise), and placebo exercise (PE: unvoiced fricative exercise). Three outcomes were analyzed-vocal self-assessment, auditory-perceptual evaluation, and acoustic analysis.

RESULTS:
The vocal self-assessment showed significantly greater improvement after EE than after the other exercises. There were no significant differences in auditory-perceptual evaluation or acoustic analyses in any of the voice exercises.

CONCLUSION:
The EE promoted an immediate positive effect in the subjective self-assessment, with better results compared with PE. However, the clinical vocal evaluation did not indicate immediate positive effects after 3 minutes of EE, control exercise, or PE.

Copyright © 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

KEYWORDS:
Exercises; Phonation; Voice; Voice quality; Voice training

PMID: 31402081 DOI: 10.1016/j.jvoice.2019.06.020
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33.
Biomed Res Int. 2019 Mar 28;2019:8930904. doi: 10.1155/2019/8930904. eCollection 2019.
Otitis Media: Long-Term Effect on Central Auditory Nervous System.
Colella-Santos MF1, Donadon C2, Sanfins MD2, Borges LR2.
Author information
1
Department of Human Development and Rehabilitation (DDHR), School of Medical Sciences, State University of Campinas (FCM/UNICAMP), Rua Tessália Vieira de Camargo 126, Cidade Universitária "Zeferino Vaz", 13083-887 Campinas, SP, Brazil.
2
Child and Adolescent Health Program, Center for Investigation in Pediatrics, School of Medical Sciences, State University of Campinas (FCM/UNICAMP), Tessália Vieira de Camargo 126, 13083-887 Campinas, SP, Brazil.
Abstract
OBJECTIVES:
To analyze the central auditory nervous system function through behavioral and electrophysiological tests in children with a history of otitis media and subsequent bilateral tubes placement surgery.

METHODS:
The participants were divided into two groups between eight and 14 years old: control group (CG) consisted of 40 children with no history of otitis media; experimental group (EG) consisted of 50 children with documented history of otitis media and undertook a surgery for bilateral tubes placement. All children completed audiological evaluation (audiometry, speech audiometry, and immittance audiometry), behavioral evaluation (tests: dichotic digits, synthetic sentence identification with ipsilateral competing message, gaps-in-noise, frequency pattern), and electrophysiological evaluation (Auditory Brainstem Response, ABR, Frequency Following Response, FFR (verbal), and Long Latency Auditory Evoked Potential, LLAEP).

RESULTS:
The EG group showed significantly poorer performance (p<0.001) than the CG for all auditory abilities studied. The results revealed significant latency delays and reduced amplitude (p<0.05) of waves III and V for ABR; significant latency delay was seen of potentials P2, N2, and P300 for LLAEP; significant latency delays and reduced amplitude (p<0.05) were observed for FFR in children with a history of otitis media.

CONCLUSION:
The results demonstrate negative effect of otitis media in the auditory abilities and electrophysiological measures in children with a history of otitis media.

PMID: 31032365 PMCID: PMC6458954 DOI: 10.1155/2019/8930904
[Indexed for MEDLINE] Free PMC Article
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Select item 30783748
34.
J Neurol. 2019 May;266(5):1136-1140. doi: 10.1007/s00415-019-09243-x. Epub 2019 Feb 19.
Writing, reading, and speaking in blepharospasm.
Ferrazzano G1, Conte A1,2, Belvisi D1, Fabbrini A2, Baione V2, Berardelli A1,2, Fabbrini G3,4.
Author information
1
IRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, IS, Italy.
2
Department of Human Neurosciences, Sapienza University of Rome, Viale dell' Università 30, 00185, Rome, Italy.
3
IRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, IS, Italy. giovanni.fabbrini@uniroma1.it.
4
Department of Human Neurosciences, Sapienza University of Rome, Viale dell' Università 30, 00185, Rome, Italy. giovanni.fabbrini@uniroma1.it.
Abstract
The aim of the study was to evaluate the effects of writing, reading, and speaking on orbiculari oculi (OO) muscle spasms and on the blink rate in patients with blepharospasm (BSP). Patients with hemifacial spasm (HFS) and healthy subjects (HS) acted as control subjects. Thirty patients with BSP, 20 patients with primary HFS and 20 age-matched healthy subjects were videotaped according to a standardized procedure: at rest with eyes open; while writing a standard sentence on paper; while writing a standard sentence on a blackboard keeping the head straight; during a conversation based on a simple topic (speaking task); and while reading a standard text aloud. Two independent movement disorders specialists reviewed the videotapes and measured the number of OO spasms and blinks in each segment. Writing and reading reduced the number of OO spasms in BSP patients, whereas speaking did not. On the other hand, writing, reading, and speaking did not modify spasms in HFS patients. These tasks modulated the blink rate in all the three groups of subjects (BSP, HFS, and HS). Our hypothesis is that the modulation of OO spasm in BSP during writing and reading depends on influences coming from occipital areas onto the brainstem circuits. Whether cognitive training with reading and writing may be used to improve OO muscle spasms is an issue that warrants further investigation.

KEYWORDS:
Blepharospasm; Blink rate; Reading; Speaking; Verbal language task; Writing

PMID: 30783748 DOI: 10.1007/s00415-019-09243-x
[Indexed for MEDLINE]
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Select item 30302560
35.
Pathologe. 2018 Dec;39(Suppl 2):175-176. doi: 10.1007/s00292-018-0513-z.
[Opening speech of the Congress President of the German Society for Pathology].
[Article in German]
Röcken C1.
Author information
1
Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität Kiel, Arnold-Heller-Str. 3/14, 24105, Kiel, Deutschland. christoph.roecken@uksh.de.
PMID: 30302560 DOI: 10.1007/s00292-018-0513-z
[Indexed for MEDLINE]
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Select item 30068632
36.
Neurology. 2018 Aug 28;91(9):377-378. doi: 10.1212/WNL.0000000000006093. Epub 2018 Aug 1.
The evaluation of pain in the aphasic patient: Wordless suffering.
Brodtmann A1, Egorova N2.
Author information
1
From the Florey Institute of Neuroscience and Mental Health (A.B., N.E.) and Department of Psychology (A.B., N.E.), University of Melbourne; and Eastern Cognitive Disorders Clinic (A.B.), Box Hill Hospital, Monash University, Melbourne, Australia. agbrod@unimelb.edu.au.
2
From the Florey Institute of Neuroscience and Mental Health (A.B., N.E.) and Department of Psychology (A.B., N.E.), University of Melbourne; and Eastern Cognitive Disorders Clinic (A.B.), Box Hill Hospital, Monash University, Melbourne, Australia.
Comment on
Experimental pain assessment in patients with poststroke aphasia. [Neurology. 2018]
PMID: 30068632 DOI: 10.1212/WNL.0000000000006093
[Indexed for MEDLINE]
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Select item 29976119
37.
Cochlear Implants Int. 2018 Nov;19(6):312-323. doi: 10.1080/14670100.2018.1493970. Epub 2018 Jul 5.
Language processing fluency and verbal working memory in prelingually deaf long-term cochlear implant users: A pilot study.
Kronenberger WG1,2, Henning SC2, Ditmars AM2, Pisoni DB2,3.
Author information
1
a Department of Psychiatry , Indiana University School of Medicine , Indianapolis , IN , USA.
2
b DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery , Indiana University School of Medicine , Indianapolis , IN , USA.
3
c Speech Research Laboratory, Department of Psychological and Brain Sciences , Indiana University , Bloomington , IN , USA.
Abstract
OBJECTIVE:
Verbal working memory (WM) is more strongly correlated with spoken language skills in prelingually deaf, early-implanted cochlear implant (CI) users than in normal-hearing (NH) peers, suggesting that CI users access WM in order to support and compensate for their slower, more effortful spoken language processing. This pilot study tested the feasibility and validity of a dual-task method for establishing the causal role of WM in basic language processing (lexical access speed) in samples of 9 CI users (ages 8-26 years) and 9 NH peers.

METHODS:
Participants completed tests of lexical access speed (rapid automatized picture naming test and lexical decision test) under two administration conditions: a standard condition and a dual-task WM condition requiring participants to hold numerals in WM during completion of the lexical access speed tests.

RESULTS:
CI users showed more dual-task interference (decline in speed during the WM condition compared to the standard condition) than NH peers, indicating that their lexical access speed was more dependent on engagement of WM resources. Furthermore, dual-task interference scores were significantly correlated with several measures of speed-based executive functioning (EF), consistent with the hypothesis that the dual-task method reflects the involvement of EF in language processing.

CONCLUSION:
These pilot study results support the feasibility and validity of the dual-task WM method for investigating the influence of WM in the basic language processing of CI users. Preliminary findings indicate that CI users are more dependent on the use of WM as a compensatory strategy during slow-effortful basic language processing than NH peers.

KEYWORDS:
Cochlear implant; Deafness; Executive functioning; Language; Working memory

PMID: 29976119 PMCID: PMC6247421 [Available on 2019-11-01] DOI: 10.1080/14670100.2018.1493970
[Indexed for MEDLINE]
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Select item 29969313
38.
Clin Linguist Phon. 2018;32(8):739-757. doi: 10.1080/02699206.2018.1435723. Epub 2018 Feb 8.
The role of language proficiency and linguistic distance in cross-linguistic treatment effects in aphasia.
Conner PS1, Goral M1,2,3, Anema I4, Borodkin K5, Haendler Y6, Knoph M3,7, Mustelier C1, Paluska E1, Melnikova Y8, Moeyaert M9.
Author information
1
a Speech-Language-Hearing Sciences , Lehman College of the City University of New York , Bronx , New York , USA.
2
b Speech-Language-Hearing Sciences , Graduate Center of the City University of New York , New York , USA.
3
c MultiLing, Department of Linguistics and Scandinavian Studies , University of Oslo , Oslo , Norway.
4
d Communication Disorders Department , SUNY New Paltz , New Paltz , New York , USA.
5
e Department of Communication Disorders , Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
6
f Laboratoire de linguistique formelle , Université Paris Diderot , Paris , France.
7
g Department of Speech and Language Disorders , Statped , Oslo , Norway.
8
h Parcours d'Enfant , Montreal , Quebec , Canada.
9
i Educational Psychology and Methodology , University at Albany , SUNY , Albany, NY , USA.
Abstract
Current findings from intervention in bilingual aphasia are inconclusive regarding the extent to which levels of language proficiency and degree of linguistic distance between treated and non-treated languages influence cross-language generalisation and changes in levels of language activation and inhibition following treatment. In this study, we enrolled a 65-year-old multilingual speaker with aphasia and administered treatment in his L1, Dutch. We assessed pre- and post-treatment performance for seven of his languages, five of high proficiency and two of lower proficiency. We asked whether treatment in L1 would generalise to his other languages or increase interference among them. Forty hours of treatment were completed over the course of five weeks. Each language was tested three times at pretreatment and at post-treatment. Testing included measures of narrative production, answering questions, picture description and question generation. Dependent measures examined language efficiency, defined as Correct Information Units (CIUs)/min, as well as language mixing, defined as proportion of code-mixed whole words. We found that our participant's improved efficiency in Dutch was mirrored by parallel improvement in the four languages of high proficiency: English, German, Italian and French. In contrast, in his languages of lower proficiency, Norwegian and Spanish, improved efficiency was limited. An increase in code-mixing was noted in Spanish, but not in Norwegian. We interpret the increased code-mixing in Spanish as indication of heightened inhibition following improvement in a language of close linguistic proximity, Italian. We conclude that an interaction of language proficiency and linguistic similarity affects cross-language generalisation following intervention in multilingual aphasia.

KEYWORDS:
Multilingual; aphasia; cross-linguistic; efficiency; language mixing; treatment generalisation

PMID: 29969313 PMCID: PMC6169517 DOI: 10.1080/02699206.2018.1435723
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Select item 29927780
39.
Ear Hear. 2019 Mar/Apr;40(2):295-311. doi: 10.1097/AUD.0000000000000615.
Reducing Simulated Channel Interaction Reveals Differences in Phoneme Identification Between Children and Adults With Normal Hearing.
Jahn KN1, DiNino M, Arenberg JG.
Author information
1
Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA.
Abstract
OBJECTIVES:
Channel interaction, the stimulation of overlapping populations of auditory neurons by distinct cochlear implant (CI) channels, likely limits the speech perception performance of CI users. This study examined the role of vocoder-simulated channel interaction in the ability of children with normal hearing (cNH) and adults with normal hearing (aNH) to recognize spectrally degraded speech. The primary aim was to determine the interaction between number of processing channels and degree of simulated channel interaction on phoneme identification performance as a function of age for cNH and to relate those findings to aNH and to CI users.

DESIGN:
Medial vowel and consonant identification of cNH (age 8-17 years) and young aNH were assessed under six (for children) or nine (for adults) different conditions of spectral degradation. Stimuli were processed using a noise-band vocoder with 8, 12, and 15 channels and synthesis filter slopes of 15 (aNH only), 30, and 60 dB/octave (all NH subjects). Steeper filter slopes (larger numbers) simulated less electrical current spread and, therefore, less channel interaction. Spectrally degraded performance of the NH listeners was also compared with the unprocessed phoneme identification of school-aged children and adults with CIs.

RESULTS:
Spectrally degraded phoneme identification improved as a function of age for cNH. For vowel recognition, cNH exhibited an interaction between the number of processing channels and vocoder filter slope, whereas aNH did not. Specifically, for cNH, increasing the number of processing channels only improved vowel identification in the steepest filter slope condition. Additionally, cNH were more sensitive to changes in filter slope. As the filter slopes increased, cNH continued to receive vowel identification benefit beyond where aNH performance plateaued or reached ceiling. For all NH participants, consonant identification improved with increasing filter slopes but was unaffected by the number of processing channels. Although cNH made more phoneme identification errors overall, their phoneme error patterns were similar to aNH. Furthermore, consonant identification of adults with CI was comparable to aNH listening to simulations with shallow filter slopes (15 dB/octave). Vowel identification of earlier-implanted pediatric ears was better than that of later-implanted ears and more comparable to cNH listening in conditions with steep filter slopes (60 dB/octave).

CONCLUSIONS:
Recognition of spectrally degraded phonemes improved when simulated channel interaction was reduced, particularly for children. cNH showed an interaction between number of processing channels and filter slope for vowel identification. The differences observed between cNH and aNH suggest that identification of spectrally degraded phonemes continues to improve through adolescence and that children may benefit from reduced channel interaction beyond where adult performance has plateaued. Comparison to CI users suggests that early implantation may facilitate development of better phoneme discrimination.

PMID: 29927780 PMCID: PMC6309331 [Available on 2020-03-01] DOI: 10.1097/AUD.0000000000000615
[Indexed for MEDLINE]
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Select item 29923867
40.
Ear Hear. 2019 Mar/Apr;40(2):272-286. doi: 10.1097/AUD.0000000000000612.
In a Concurrent Memory and Auditory Perception Task, the Pupil Dilation Response Is More Sensitive to Memory Load Than to Auditory Stimulus Characteristics.
Zekveld AA1,2,3, Kramer SE3, Rönnberg J1,2, Rudner M1,2.
Author information
1
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
2
Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping and Örebro Universities, Linköping, Sweden.
3
Section Ear & Hearing, Department of Otolaryngology-Head and Neck Surgery and Amsterdam Public Health research institute VU University Medical Center, Amsterdam, The Netherlands.
Abstract
OBJECTIVES:
Speech understanding may be cognitively demanding, but it can be enhanced when semantically related text cues precede auditory sentences. The present study aimed to determine whether (a) providing text cues reduces pupil dilation, a measure of cognitive load, during listening to sentences, (b) repeating the sentences aloud affects recall accuracy and pupil dilation during recall of cue words, and (c) semantic relatedness between cues and sentences affects recall accuracy and pupil dilation during recall of cue words.

DESIGN:
Sentence repetition following text cues and recall of the text cues were tested. Twenty-six participants (mean age, 22 years) with normal hearing listened to masked sentences. On each trial, a set of four-word cues was presented visually as text preceding the auditory presentation of a sentence whose meaning was either related or unrelated to the cues. On each trial, participants first read the cue words, then listened to a sentence. Following this they spoke aloud either the cue words or the sentence, according to instruction, and finally on all trials orally recalled the cues. Peak pupil dilation was measured throughout listening and recall on each trial. Additionally, participants completed a test measuring the ability to perceive degraded verbal text information and three working memory tests (a reading span test, a size-comparison span test, and a test of memory updating).

RESULTS:
Cue words that were semantically related to the sentence facilitated sentence repetition but did not reduce pupil dilation. Recall was poorer and there were more intrusion errors when the cue words were related to the sentences. Recall was also poorer when sentences were repeated aloud. Both behavioral effects were associated with greater pupil dilation. Larger reading span capacity and smaller size-comparison span were associated with larger peak pupil dilation during listening. Furthermore, larger reading span and greater memory updating ability were both associated with better cue recall overall.

CONCLUSIONS:
Although sentence-related word cues facilitate sentence repetition, our results indicate that they do not reduce cognitive load during listening in noise with a concurrent memory load. As expected, higher working memory capacity was associated with better recall of the cues. Unexpectedly, however, semantic relatedness with the sentence reduced word cue recall accuracy and increased intrusion errors, suggesting an effect of semantic confusion. Further, speaking the sentence aloud also reduced word cue recall accuracy, probably due to articulatory suppression. Importantly, imposing a memory load during listening to sentences resulted in the absence of formerly established strong effects of speech intelligibility on the pupil dilation response. This nullified intelligibility effect demonstrates that the pupil dilation response to a cognitive (memory) task can completely overshadow the effect of perceptual factors on the pupil dilation response. This highlights the importance of taking cognitive task load into account during auditory testing.

PMID: 29923867 PMCID: PMC6400496 DOI: 10.1097/AUD.0000000000000612
[Indexed for MEDLINE] Free PMC Article
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Select item 29894380
41.
Ear Hear. 2019 Mar/Apr;40(2):260-271. doi: 10.1097/AUD.0000000000000611.
The Emotional Communication in Hearing Questionnaire (EMO-CHeQ): Development and Evaluation.
Singh G1,2,3,4, Liskovoi L2, Launer S1,5, Russo F2,4.
Author information
1
Phonak AG, Stäfa, Switzerland.
2
Department of Psychology, Ryerson University, Toronto, Canada.
3
Department of Speech-Language Pathology, University of Toronto, Toronto, Canada.
4
Toronto Rehabilitation Institute, Toronto, Canada.
5
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
Abstract
OBJECTIVES:
The objectives of this research were to develop and evaluate a self-report questionnaire (the Emotional Communication in Hearing Questionnaire or EMO-CHeQ) designed to assess experiences of hearing and handicap when listening to signals that contain vocal emotion information.

DESIGN:
Study 1 involved internet-based administration of a 42-item version of the EMO-CHeQ to 586 adult participants (243 with self-reported normal hearing [NH], 193 with self-reported hearing impairment but no reported use of hearing aids [HI], and 150 with self-reported hearing impairment and use of hearing aids [HA]). To better understand the factor structure of the EMO-CHeQ and eliminate redundant items, an exploratory factor analysis was conducted. Study 2 involved laboratory-based administration of a 16-item version of the EMO-CHeQ to 32 adult participants (12 normal hearing/near normal hearing (NH/nNH), 10 HI, and 10 HA). In addition, participants completed an emotion-identification task under audio and audiovisual conditions.

RESULTS:
In study 1, the exploratory factor analysis yielded an interpretable solution with four factors emerging that explained a total of 66.3% of the variance in performance the EMO-CHeQ. Item deletion resulted in construction of the 16-item EMO-CHeQ. In study 1, both the HI and HA group reported greater vocal emotion communication handicap on the EMO-CHeQ than on the NH group, but differences in handicap were not observed between the HI and HA group. In study 2, the same pattern of reported handicap was observed in individuals with audiometrically verified hearing as was found in study 1. On the emotion-identification task, no group differences in performance were observed in the audiovisual condition, but group differences were observed in the audio alone condition. Although the HI and HA group exhibited similar emotion-identification performance, both groups performed worse than the NH/nNH group, thus suggesting the presence of behavioral deficits that parallel self-reported vocal emotion communication handicap. The EMO-CHeQ was significantly and strongly (r = -0.64) correlated with performance on the emotion-identification task for listeners with hearing impairment.

CONCLUSIONS:
The results from both studies suggest that the EMO-CHeQ appears to be a reliable and ecologically valid measure to rapidly assess experiences of hearing and handicap when listening to signals that contain vocal emotion information.

PMID: 29894380 PMCID: PMC6400448 DOI: 10.1097/AUD.0000000000000611
[Indexed for MEDLINE] Free PMC Article
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Select item 29863599
42.
Ear Hear. 2019 Mar/Apr;40(2):243-252. doi: 10.1097/AUD.0000000000000608.
Predictors of Reading Skills in Children With Listening Concerns.
Sharma M1,2, Cupples L1,2,3, Purdy SC4.
Author information
1
Department of Linguistics, Australian Hearing Hub, Macquarie University, Sydney, New South Wales, Australia.
2
The HEARing CRC, Audiology, Hearing and Speech Sciences, University of Melbourne, Melbourne, Victoria, Australia.
3
CCD, Australian Hearing Hub, Macquarie University, Sydney, New South Wales, Australia.
4
Speech Science, School of Psychology, University of Auckland, Auckland, New Zealand.
Abstract
OBJECTIVES:
Previous research shows that children with reading disorders perform poorly on auditory processing (AP) tasks. Correlational studies have also shown significant associations between some AP tasks and word and nonword reading. There is less clear evidence for AP contributions to spelling and passage reading. The aim of this research was to extend current knowledge by investigating the association between a range of AP measures used clinically and children's reading of words, nonwords, and passages, as well as word spelling.

DESIGN:
Regression analyses were conducted on data from 90 children 7 to 13 years of age (58 males) with reported listening and/or reading concerns. All children had normal hearing sensitivity and were tested on AP tasks including the frequency pattern test (FPT), dichotic digits test, random gap detection test, and the masking level difference. Reading tasks included word, nonword, and passage reading. Phonologic processing, core language skills, nonverbal intelligence, memory, and attention were also measured.

RESULTS:
All multiregression analyses were fixed order with age and gender, nonverbal intelligence, core language, phoneme manipulation, and digits backward scores included in the model before AP measures. FPT was the only AP task that accounted for significant unique variance in word/nonword reading and nonword spelling, but not passage reading.

CONCLUSIONS:
The findings from this study failed to show an association between many clinically used AP measures and children's reading and spelling outcomes. Nevertheless, they reiterate the importance of evaluating FPT in children with word reading disorders. The findings justify further investigation into the role of this test when diagnosing children with reading or spelling disorders.

PMID: 29863599 DOI: 10.1097/AUD.0000000000000608
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Select item 29768633
43.
Appl Clin Inform. 2018 Apr;9(2):326-335. doi: 10.1055/s-0038-1649509. Epub 2018 May 16.
Evaluating the Efficiency and Safety of Speech Recognition within a Commercial Electronic Health Record System: A Replication Study.
Hodgson T1, Magrabi F1, Coiera E1.
Author information
1
Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, New South Wales, Australia.
Abstract
OBJECTIVE:
To conduct a replication study to validate previously identified significant risks and inefficiencies associated with the use of speech recognition (SR) for documentation within an electronic health record (EHR) system.

METHODS:
Thirty-five emergency department clinicians undertook randomly allocated clinical documentation tasks using keyboard and mouse (KBM) or SR using a commercial EHR system. The experiment design, setting, and tasks (E2) replicated an earlier study (E1), while technical integration issues that may have led to poorer SR performance were addressed.

RESULTS:
Complex tasks were significantly slower to complete using SR (16.94%) than KBM (KBM: 191.9 s, SR: 224.4 s; p = 0.009; CI, 11.9-48.3), replicating task completion times observed in the earlier experiment. Errors (non-typographical) were significantly higher with SR compared with KBM for both simple (KBM: 3, SR: 84; p < 0.001; CI, 1.5-2.5) and complex tasks (KBM: 23, SR: 53; p = 0.001; CI, 0.5-1.0), again replicating earlier results (E1: 170, E2: 163; p = 0.660; CI, 0.0-0.0). Typographical errors were reduced significantly in the new study (E1: 465, E2: 150; p < 0.001; CI, 2.0-3.0).

DISCUSSION:
The results of this study replicate those reported earlier. The use of SR for clinical documentation within an EHR system appears to be consistently associated with decreased time efficiencies and increased errors. Modifications implemented to optimize SR integration in the EHR seem to have resulted in minor improvements that did not fundamentally change overall results.

CONCLUSION:
This replication study adds further evidence for the poor performance of SR-assisted clinical documentation within an EHR. Replication studies remain rare in informatics literature, especially where study results are unexpected or have significant implication; such studies are clearly needed to avoid overdependence on the results of a single study.

Schattauer GmbH Stuttgart.

PMID: 29768633 PMCID: PMC5955718 DOI: 10.1055/s-0038-1649509
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Conflict of interest statement
Publication types, MeSH terms
Select item 29691794
44.
J Autism Dev Disord. 2018 Sep;48(9):3144-3162. doi: 10.1007/s10803-018-3584-z.
Efficacy of the ASAP Intervention for Preschoolers with ASD: A Cluster Randomized Controlled Trial.
Boyd BA1,2, Watson LR3, Reszka SS4, Sideris J5,6, Alessandri M7, Baranek GT4,5, Crais ER3, Donaldson A8, Gutierrez A7, Johnson L9, Belardi K3,10.
Author information
1
Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7190, USA. brian.boyd@ku.edu.
2
Juniper Gardens Children's Project, University of Kansas, 444 Minnesota Ave., Kansas City, KS, 66101-2914, USA. brian.boyd@ku.edu.
3
Division of Speech and Hearing Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7190, USA.
4
Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7190, USA.
5
USC Chan Division of Occupational Science and Therapy, 1540 Alcazar Street, CHP 133, Los Angeles, CA, 90089-9003, USA.
6
FPG Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
7
Department of Psychology, College of Arts and Sciences, University of Miami, P.O. Box 248185, Coral Gables, FL, 33124-0751, USA.
8
Department of Speech and Hearing Sciences, Portland State University, 724 SW Harrison, Rm 93, Portland, OR, 97201, USA.
9
Special Education Programs, University of Minnesota, Minneapolis, USA.
10
Speech-Language Pathology, Rangos School of Health Sciences, Duquesne University, Pittsburgh, USA.
Abstract
The advancing social-communication and play (ASAP) intervention was designed as a classroom-based intervention, in which the educational teams serving preschool-aged children with autism spectrum disorder are trained to implement the intervention in order to improve these children's social-communication and play skills. In this 4-year, multi-site efficacy trial, classrooms were randomly assigned to ASAP or a business-as-usual control condition. A total of 78 classrooms, including 161 children, enrolled in this study. No significant group differences were found for the primary outcomes of children's social-communication and play. However, children in the ASAP group showed increased classroom engagement. Additionally, participation in ASAP seemed to have a protective effect for one indicator of teacher burnout. Implications for future research are discussed.

KEYWORDS:
ASAP; Autism spectrum disorder; Engagement; Randomized controlled trial; School interventions; Social-communication

PMID: 29691794 DOI: 10.1007/s10803-018-3584-z
[Indexed for MEDLINE]
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45.
Biol Cybern. 2018 Jun;112(3):253-276. doi: 10.1007/s00422-018-0749-y. Epub 2018 Feb 9.
Coupling relations underlying the production of speech articulator movements and their invariance to speech rate.
Lancia L1, Rosenbaum B2,3.
Author information
1
Laboratoire de Phonétique et Phonologie (CNRS, Sorbonne Nouvelle), 19 rue des Bernardins, 75005, Paris, France. leonardo.lancia@univ-paris3.fr.
2
German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, 04103, Leipzig, Germany.
3
Institute of Ecology, Friedrich Schiller University Jena, Dornburger Str. 159, 07743, Jena, Germany.
Abstract
Since the seminal works of Bernstein (The coordination and regulation of movements. Pergamon Press, Oxford, 1967) several authors have supported the idea that, to produce a goal-oriented movement in general, and a movement of the organs responsible for the production of speech sounds in particular, individuals activate a set of coupling relations that coordinate the behavior of the elements of the motor system involved in the production of the target movement or sound. In order to characterize the configurations of the coupling relations underlying speech production articulator movements, we introduce an original method based on recurrence analysis. The method is validated through the analysis of simulated dynamical systems adapted to reproduce the features of speech gesture kinematics and it is applied to the analysis of speech articulator movements recorded in five German speakers during the production of labial and coronal plosive and fricative consonants at variable speech rates. We were able to show that the underlying coupling relations change systematically between labial and coronal consonants, but are not affected by speech rate, despite the presence of qualitative changes observed in the trajectory of the jaw at fast speech rate.

KEYWORDS:
Coupling relations; Motor control; Recurrence analysis; Speech articulation; Speech rate

PMID: 29426980 DOI: 10.1007/s00422-018-0749-y
[Indexed for MEDLINE]
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46.
J Dev Behav Pediatr. 2018 Apr;39(3):246-253. doi: 10.1097/DBP.0000000000000541.
Speed of Language Comprehension at 18 Months Old Predicts School-Relevant Outcomes at 54 Months Old in Children Born Preterm.
Marchman VA1, Loi EC2, Adams KA3, Ashland M1, Fernald A1, Feldman HM2.
Author information
1
Department of Psychology, Stanford University, Stanford, CA.
2
Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, CA.
3
Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY.
Abstract
OBJECTIVE:
Identifying which preterm (PT) children are at increased risk of language and learning differences increases opportunities for participation in interventions that improve outcomes. Speed in spoken language comprehension at early stages of language development requires information processing skills that may form the foundation for later language and school-relevant skills. In children born full-term, speed of comprehending words in an eye-tracking task at 2 years old predicted language and nonverbal cognition at 8 years old. Here, we explore the extent to which speed of language comprehension at 1.5 years old predicts both verbal and nonverbal outcomes at 4.5 years old in children born PT.

METHOD:
Participants were children born PT (n = 47; ≤32 weeks gestation). Children were tested in the "looking-while-listening" task at 18 months old, adjusted for prematurity, to generate a measure of speed of language comprehension. Parent report and direct assessments of language were also administered. Children were later retested on a test battery of school-relevant skills at 4.5 years old.

RESULTS:
Speed of language comprehension at 18 months old predicted significant unique variance (12%-31%) in receptive vocabulary, global language abilities, and nonverbal intelligence quotient (IQ) at 4.5 years, controlling for socioeconomic status, gestational age, and medical complications of PT birth. Speed of language comprehension remained uniquely predictive (5%-12%) when also controlling for children's language skills at 18 months old.

CONCLUSION:
Individual differences in speed of spoken language comprehension may serve as a marker for neuropsychological processes that are critical for the development of school-relevant linguistic skills and nonverbal IQ in children born PT.

PMID: 29309294 PMCID: PMC5866178 DOI: 10.1097/DBP.0000000000000541
[Indexed for MEDLINE] Free PMC Article
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47.
Cereb Cortex. 2018 May 1;28(5):1816-1830. doi: 10.1093/cercor/bhx100.
Functional Characterization of the Human Speech Articulation Network.
Basilakos A1, Smith KG1,2, Fillmore P3, Fridriksson J1, Fedorenko E4,5,6.
Author information
1
Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA.
2
Department of Speech Pathology and Audiology, University of South Alabama, Mobile, AL 36688, USA.
3
Department of Communication Sciences and Disorders, Baylor University, Waco, TX 76798, USA.
4
Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
5
Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
6
Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
Abstract
A number of brain regions have been implicated in articulation, but their precise computations remain debated. Using functional magnetic resonance imaging, we examine the degree of functional specificity of articulation-responsive brain regions to constrain hypotheses about their contributions to speech production. We find that articulation-responsive regions (1) are sensitive to articulatory complexity, but (2) are largely nonoverlapping with nearby domain-general regions that support diverse goal-directed behaviors. Furthermore, premotor articulation regions show selectivity for speech production over some related tasks (respiration control), but not others (nonspeech oral-motor [NSO] movements). This overlap between speech and nonspeech movements concords with electrocorticographic evidence that these regions encode articulators and their states, and with patient evidence whereby articulatory deficits are often accompanied by oral-motor deficits. In contrast, the superior temporal regions show strong selectivity for articulation relative to nonspeech movements, suggesting that these regions play a specific role in speech planning/production. Finally, articulation-responsive portions of posterior inferior frontal gyrus show some selectivity for articulation, in line with the hypothesis that this region prepares an articulatory code that is passed to the premotor cortex. Taken together, these results inform the architecture of the human articulation system.

PMID: 28453613 PMCID: PMC5907347 DOI: 10.1093/cercor/bhx100
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48.
Med J Malaysia. 2017 Feb;72(1):37-45.
Towards developing high-fidelity simulated learning environment training modules in audiology.
Dzulkarnain AA1, Rahmat S2, Mohd Puzi NA2, Badzis M3.
Author information
1
International Islamic University Malaysia, Kulliyyah of Allied Health Sciences, Department of Audiology and Speech-Language Pathology, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia. ahmadaidil@iium.edu.my.
2
International Islamic University Malaysia, Kulliyyah of Allied Health Sciences, Department of Audiology and Speech-Language Pathology, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia.
3
International Islamic University Malaysia, Kulliyyah of Education, Gombak, Department of Educational Psychology and Counselling, Selangor, Malaysia.
Abstract
INTRODUCTION:
This discussion paper reviews and synthesises the literature on simulated learning environment (SLE) from allied health sciences, medical and nursing in general and audiology specifically. The focus of the paper is on discussing the use of high-fidelity (HF) SLE and describing the challenges for developing a HF SLE for clinical audiology training.

METHODS:
Through the review of the literature, this paper discusses seven questions, (i) What is SLE? (ii) What are the types of SLEs? (iii) How is SLE classified? (iv) What is HF SLE? (v) What types of SLEs are available in audiology and their level of fidelity? (vi) What are the components needed for developing HF SLE? (vii) What are the possible types of HF SLEs that are suitable for audiology training? Publications were identified by structured searches from three major databases PubMed, Web of Knowledge and PsychInfo and from the reference lists of relevant articles. The authors discussed and mapped the levels of fidelity of SLE audiology training modules from the literature and the learning domains involved in the clinical audiology courses.

RESULTS:
The discussion paper has highlighted that most of the existing SLE audiology training modules consist of either low- or medium-fidelity types of simulators. Those components needed to achieve a HF SLE for audiology training are also highlighted.

CONCLUSION:
Overall, this review recommends that the combined approach of different levels and types of SLE could be used to obtain a HF SLE training module in audiology training.

PMID: 28255138
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