The latest medical research on Speech Pathologist

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Transcription Decisions of Conjoined Independent Clauses Are Equitable Across Dialects but Impact Measurement Outcomes.

Language, Speech, and Hearing Services

Transcription of conjoined independent clauses within language samples varies across professionals. Some transcribe these clauses as two separate utterances, whereas others conjoin them within a single utterance. As an inquiry into equitable practice, we examined rates of conjoined independent clauses produced by children and the impact of separating these clauses within utterances on measures of mean length of utterance (MLU) by a child's English dialect, clinical status, and age.

The data were archival and included 246 language samples from children classified by their dialect (African American English or Southern White English) and clinical status (developmental language disorder [DLD] or typically developing [TD]), with those in the TD group further classified by their age (4 years [TD4] or 6 years [TD6]).

Rates of conjoined independent clauses and the impact of these clauses on MLU varied by clinical status (DLD < TD) and age (TD4 < TD6), but not by dialect. Correlations between the rate of conjoined clauses, MLU, and language test scores were also similar across the two dialects.

Transcription decisions regarding conjoined independent clauses within language samples lead to equitable measurement outcomes across dialects of English. Nevertheless, transcribing conjoined independent clauses as two separate utterances reduces one's ability to detect syntactic differences between children with and without DLD and document syntactic growth as children age.

https://doi.org/10.23641/asha.25822675.

The Growth of Complex Syntax in School-Age African American Children Who Speak African American English.

Journal of Speech, Language, and

Syntax provides critical support for both academic success and linguistic growth, yet it has not been a focus of language research in school-age African American children. This study examines complex syntax performance of African American children in second through fifth grades.

The current study explores the syntactic performances of African American children (N = 513) in Grades 2-5 on the Test of Language Development-Intermediate who speak African American English. Multilevel modeling was used to evaluate the growth and associated changes between dialect density and syntax. Analyzed data were compared both to the normative sample and within the recruited sample.

The results suggest that dialect density exerted its impact early but did not continue to influence syntactic growth over time. Additionally, it was not until dialect density was accounted for in growth models that African American children's syntactic growth resembled normative expectations of a standardized language instrument.

The current study suggests that failure to consider cultural language differences obscures our understanding of African American students' linguistic competence on standardized language assessments.

Validation of the Mediated Learning Observation Instrument Among Children With and Without Developmental Language Disorder in Dynamic Assessment.

Journal of Speech, Language, and

In this validation study, we examined the factor structure of the mediated learning observation (MLO) used during the teaching phase of dynamic assessment. As an indicator of validity, we evaluated whether the MLO factor structure was consistent across children with and without developmental language disorder (DLD).

Two hundred twenty-four children (188 typically developing and 36 DLD) from kindergarten to second grade completed a 30-min individual mediated learning session on narrative production. Performance during the session was rated using the 12-item MLO by clinicians on affect, behavior, arousal, and elaboration. Exploratory and confirmatory factor analyses were conducted to establish the factor structure and reliability of the MLO.

Factor analysis of the MLO suggested a stable three-factor model with adequate fit indices across kindergarten and school-age samples, across both typically developing and DLD subgroups with good to excellent reliability. The final 11-item MLO (one item was removed due to low factor loading) comprises three subscales including (a) cognitive factor, (b) learning anticipation, and (c) learning engagement.

The MLO is a valid and reliable instrument for assessing language learning skills in children with and without DLD during dynamic assessment. Practical implications and suggestions for future research addressing the utilization of MLO in dynamic assessment are provided.

Effects of Speech Characteristics on Electroglottographic and Instrumental Acoustic Voice Analysis Metrics in Women With Structural Dysphonia Before and After Treatment.

Journal of Speech, Language, and

Literature suggests a dependency of the acoustic metrics, smoothed cepstral peak prominence (CPPS) and harmonics-to-noise ratio (HNR), on human voice loudness and fundamental frequency (F0). Even though this has been explained with different oscillatory patterns of the vocal folds, so far, it has not been specifically investigated. In the present work, the influence of three elicitation levels, calibrated sound pressure level (SPL), F0 and vowel on the electroglottographic (EGG) and time-differentiated EGG (dEGG) metrics hybrid open quotient (OQ), dEGG OQ and peak dEGG, as well as on the acoustic metrics CPPS and HNR, was examined, and their suitability for voice assessment was evaluated.

In a retrospective study, 29 women with a mean age of 25 years (± 8.9, range: 18-53) diagnosed with structural vocal fold pathologies were examined before and after voice therapy or phonosurgery. Both acoustic and EGG signals were recorded simultaneously during the phonation of the sustained vowels /ɑ/, /i/, and /u/ at three elicited levels of loudness (soft/comfortable/loud) and unconstrained F0 conditions.

A linear mixed-model analysis showed a significant effect of elicitation effort levels on peak dEGG, HNR, and CPPS (all p < .01). Calibrated SPL significantly influenced HNR and CPPS (both p < .01). Furthermore, F0 had a significant effect on peak dEGG and CPPS (p < .0001). All metrics showed significant changes with regard to vowel (all p < .05). However, the treatment had no effect on the examined metrics, regardless of the treatment type (surgery vs. voice therapy).

The value of the investigated metrics for voice assessment purposes when sampled without sufficient control of SPL and F0 is limited, in that they are significantly influenced by the phonatory context, be it speech or elicited sustained vowels. Future studies should explore the diagnostic value of new data collation approaches such as voice mapping, which take SPL and F0 effects into account.

Experienced Adult Cochlear Implant Users Show Improved Speech Recognition When Target Fitting Parameters Are Applied.

Ear and Hearing

The aim of the present study was to investigate whether prediction models built by de Graaff et al. (2020) can be used to improve speech recognition in experienced adult postlingual implanted Cochlear CI users. de Graaff et al. (2020) found relationships between elevated aided thresholds and a not optimal electrical dynamic range (<50 CL or >60 CL), and poorer speech recognition in quiet and in noise. The primary hypothesis of the present study was that speech recognition improves both in quiet and in noise when the sound processor is refitted to match targets derived from the prediction models from de Graaff et al. (2020). A second hypothesis was that subjectively, most of the CI users would find the new setting too loud because of an increase in C levels, and therefore, prefer the old settings.

A within-participant repeated measures design with 18 adult Cochlear CI users was used. T- and C-levels were changed to "optimized settings," as predicted by the model of de Graaff et al. (2020). Aided thresholds, speech recognition in quiet, and speech recognition in noise were measured with the old settings and after a 4-week acclimatization period with the optimized settings. Subjective benefit was measured using the Device Oriented Subjective Outcome Scale questionnaire.

The mean electrical dynamic range changed from 41.1 (SD = 6.6) CL to 48.6 (SD = 3.0) CL. No significant change in aided thresholds was measured. Speech recognition improved for 16 out of 18 participants and remained stable for 2 participants. Average speech recognition scores in quiet significantly improved by 4.9% (SD = 3.8%). No significant change for speech recognition in noise was found. A significant improvement in subjective benefit was found for one of the Device Oriented Subjective Outcome subscales (speech cues) between the old and optimized settings. All participants chose to keep the optimized settings at the end of the study.

We were able to improve speech recognition in quiet by optimizing the electrical dynamic range of experienced adult CI users, according to the prediction models built by de Graaff et al. (2020). There was no significant change in aided thresholds nor in speech recognition in noise. The findings of the present study suggest that improved performance for speech recognition in quiet in adult Cochlear CI users can be achieved by setting the dynamic range as close as possible to values between 50 and 60 CL when the volume level is at 10.

Conversation and pragmatics in children who are hard-of-hearing: a scoping review.

Journal of Deaf Studies and

Technological and therapeutic advances have allowed many children who are born hard-of-hearing (HoH) to start school with age-appropriate spoken la...

The Perspectives of Haitian Parents on Heritage Language Maintenance.

Speech Language Path

The study sought to understand Haitian parents' perspectives on heritage language maintenance with typically developing children.

Semistructured interviews were conducted with 10 Haitian parents of typically developing children. A thematic analysis was conducted to determine recurring themes.

Participants desired to preserve the heritage language; however, factors such as linguistic and class ideologies of Haiti, xenophobia within the United States, and English monolingualism hindered parents' success in maintaining the heritage language.

The findings from this study demonstrate the need for additional research and resources to help support the Haitian community's desire for heritage language maintenance to promote healthy communication practices, decrease language loss, and foster social communication in the home and community.

A Goal-Writing Framework for Motor-Based Intervention for Childhood Apraxia of Speech.

Speech Language Path

There are multiple frameworks for goal writing that are applicable to the practice of speech-language pathology. Motor-based speech disorders are a subset of speech sound disorders that are thought to require specific elements of intervention that are typically not addressed in the traditional frameworks used in the clinical setting. The purpose of this tutorial is to review general approaches of goal writing and suggest additional elements that may be used to improve the efficiency and effectiveness of treatment for childhood motor speech disorders, specifically childhood apraxia of speech (CAS).

Existing models of goal writing were reviewed to ascertain elements common to most of these models. A basic framework was chosen and modified to include behaviors, conditions, and approaches to goal measurement tailored to the clinical needs of children with CAS. A resource for clinical decision making for children with CAS was developed to inform goal writing at the onset of treatment and adaptations that occur over the course of treatment. Case studies are presented to demonstrate how the presented framework can be applied to writing goals for motor-based treatment for two different children with CAS.

Children with CAS require a specialized approach to intervention, which requires goals to reflect the unique clinical needs of this population. This tutorial offers resources that use the best available research evidence and current understanding of effective treatment practices for CAS to guide clinical decision making for motor-based intervention and goal writing. This tutorial is intended to guide treatment planning across varied settings to facilitate progress and optimize treatment outcomes for children with CAS.

A Picture May Be Worth 1,000 Words, but Is It Worth a Letter? Examining Whether the Choice of Label Affects the Perception of Speech Sounds.

Journal of Speech, Language, and

Researchers often use identification or goodness rating tasks to assess speech perception for different populations. These tasks provide useful information about a listener's willingness to accept a range of acoustically variable stimuli as belonging to the same category and also about assessing how stimuli that are labeled the same may not be perceived as equally good versions of a particular speech sound. Many methodological aspects of these simple tasks have been tested, but one aspect that has not is the choice of label. In this study, we examine response patterns to images versus letters, as studies with different populations (children vs. adults) or different methods (typical behavioral study vs. visual world paradigm) may vary in the type of label used.

Eighty-one adult listeners completed phoneme identification and goodness ratings tasks with either images of response options (a picture of a bear and a picture of a pear) or with letter labels (a capital B and P).

The results suggest that choice of label does not alter performance within the tasks studied here. In addition, the results did show the expected finding that the slope of the response curve is steeper in an identification task than in a goodness rating task.

These results suggest that it is possible to compare across studies that use different response options, a benefit to research and practice because letter labels can be used for nonimageable words and nonwords, whereas images may be best used for participants who are younger or have poorer reading skills.

The Accompanying Effect in Responses to Auditory Perturbations: Unconscious Vocal Adjustments to Unperturbed Parameters.

Journal of Speech, Language, and

The present study examined whether participants respond to unperturbed parameters while experiencing specific perturbations in auditory feedback. For instance, we aim to determine if speakers adjust voice loudness when only pitch is artificially altered in auditory feedback. This phenomenon is referred to as the "accompanying effect" in the present study.

Thirty native Mandarin speakers were asked to sustain the vowel /ɛ/ for 3 s while their auditory feedback underwent single shifts in one of the three distinct ways: pitch shift (±100 cents; coded as PT), loudness shift (±6 dB; coded as LD), or first formant (F1) shift (±100 Hz; coded as FM). Participants were instructed to ignore the perturbations in their auditory feedback. Response types were categorized based on pitch, loudness, and F1 for each individual trial, such as Popp_Lopp_Fopp indicating opposing responses in all three domains.

The accompanying effect appeared 93% of the time. Bayesian Poisson regression models indicate that opposing responses in all three domains (Popp_Lopp_Fopp) were the most prevalent response type across the conditions (PT, LD, and FM). The more frequently used response types exhibited opposing responses and significantly larger response curves than the less frequently used response types. Following responses became more prevalent only when the perturbed stimuli were perceived as voices from someone else (external references), particularly in the FM condition. In terms of isotropy, loudness and F1 tended to change in the same direction rather than loudness and pitch.

The presence of the accompanying effect suggests that the motor systems responsible for regulating pitch, loudness, and formants are not entirely independent but rather interconnected to some degree.

Do Acoustic Characteristics of Dysarthria in People With Parkinson's Disease Differ Across Languages?

Journal of Speech, Language, and

Cross-language studies suggest more similarities than differences in how dysarthria affects the speech of people with Parkinson's disease (PwPD) who speak different languages. In this study, we aimed to identify the relative contribution of acoustic variables to distinguish PwPD from controls who spoke varieties of two Romance languages, French and Portuguese.

This bi-national, cross-sectional, and case-controlled study included 129 PwPD and 124 healthy controls who spoke French or Portuguese. All participants underwent the same clinical examinations, voice/speech recordings, and self-assessment questionnaires. PwPD were evaluated off and on optimal medication. Inferential analyses included Disease (controls vs. PwPD) and Language (French vs. Portuguese) as factors, and random decision forest algorithms identified relevant acoustic variables able to distinguish participants: (a) by language (French vs. Portuguese) and (b) by clinical status (PwPD on and off medication vs. controls).

French-speaking and Portuguese-speaking individuals were distinguished from each other with over 90% accuracy by five acoustic variables (the mean fundamental frequency and the shimmer of the sustained vowel /a/ production, the oral diadochokinesis performance index, the relative sound level pressure and the relative sound pressure level standard deviation of the text reading). A distinct set of parameters discriminated between controls and PwPD: for men, maximum phonation time and the oral diadochokinesis speech proportion were the most significant variables; for women, variables calculated from the oral diadochokinesis were the most discriminative.

Acoustic variables related to phonation and voice quality distinguished between speakers of the two languages. Variables related to pneumophonic coordination and articulation rate were the more effective in distinguishing PwPD from controls. Thus, our research findings support that respiration and diadochokinesis tasks appear to be the most appropriate to pinpoint signs of dysarthria, which are largely homogeneous and language-universal. In contrast, identifying language-specific variables with the speech tasks and acoustic variables studied was less conclusive.

Examining Adolescent Language Performance in Discourse Production Across Four Elicitation Tasks.

Language, Speech, and Hearing Services

Comprehensive spoken language assessment should include the evaluation of language use in naturalistic contexts. Discourse elicitation and analysis provides the opportunity for such an evaluation to occur. In this article, our overall aim was to describe adolescents' language performance on four elicitation tasks and determine if there are task-related differences across the elicitation tasks.

Forty-four typically developing adolescents with ages ranging from 12;2 to 17;11 (years;months; M = 15;2; 21 boys and 23 girls) participated in the study. They completed four spoken discourse tasks: (a) story generation using a wordless picture book, (b) fable retell, (c) six personal narratives in response to emotion-based prompts, and (d) monologic response to two stories that contained a moral dilemma. Responses were transcribed and analyzed for four language performance measures tapping into language productivity, syntactic complexity, lexical diversity, and verbal facility.

Despite individual variability in performance, mean scores were close to median scores for most measures, suggesting a symmetrical distribution. As expected, all four language performance measures were significantly different across the four elicitation tasks. The personal narrative task elicited the longest samples, with the highest verbal fluency. In contrast, both lexical diversity and syntactic complexity were the strongest in response to the fable retell and the moral dilemma tasks.

This investigation provides speech-language pathologists with an overview of how task-related factors may impact adolescent language performance. These findings may be used to support their clinical decision-making processes in choosing a suitable discourse task when conducting a comprehensive spoken language assessment. Three hypothetical case examples are used to illustrate the decision-making process.

https://doi.org/10.23641/asha.25761768.