Biomedical subjects

D R Beukelman

Publications and source records attributed to D R Beukelman.

36 records · Page 2Linked to original sources

PubMed1984

Microcomputer-based communication augmentation systems for two nonspeaking, physically handicapped persons with severe visual impairment.

Two different microcomputer-based communication systems were developed for nonspeaking physically handicapped individuals with severe visual impairment. One subject was 24 years old and had an inoperative optic glioma which impaired motor function as well as vision. The second subject was cortically blind with severe motor limitation secondary to an automobile accident which occurred at 17 years of age. Both communication systems employed speech synthesis as a control feature to compensate for visual impairment. Both subjects have learned to use their communication systems. The second subject has not achieved extended, independent system use due to reduced vigilance and attention span.

Adolescent↗

PubMed1981

Pinpointing: one method of improving staff compliance with rehabilitation regimens.

This project investigated the effects of a systematic pinpointing and feedback system upon staff follow-through with assignments on a rehabilitation inpatient service. The number and percentage of tasks were recorded over 8 weeks. An ABAB time series reversal design was used where the baseline phases occurred during weeks 1--2 and 5--6, and the intervention occurred during weeks 3--4 and 7--8. Intervention consisted of directing chart round interactions so that assignments were given to specific team members and a list of these tasks was distributed to the team. Results indicated that team performance was significantly affected during intervention weeks. Specifically, the percentage of pinpointing increased from 40% during baseline to an intervention average of 96%. Also, team compliance increased from baseline levels averaging 44% to a mean of 87% during the intervention. The effects of such inexpensive techniques on team effectiveness and the resultant cost benefits to patients in a rehabilitation setting are reviewed.

Cooperative Behavior↗

PubMed1981

Communication efficiency of dysarthric speakers as measured by sentence intelligibility and speaking rate.

In an effort to quantify communication efficiency, speaking rates and intelligibility scores were obtained from a normal speaking adult and 13 dysarthric speakers representing a wide range of severity. Speakers were audio recorded as they read words and sentences. A panel of judges transcribed all recordings and subjectively ranked a randomly selected sample from each speaker according to "communication efficiency." The following measures were obtained for each speaker: word and sentence intelligibility, speaking rate, rates of intelligible and unintelligible speech and a numerical ranking of communication efficiency. Results indicated that speaking rate and speech intelligibility are not closely correlated. By plotting measures that incorporate intelligibility and rate, one can rank speakers similarly to subjective rankings of communication efficiency, and distinguish mildly dysarthric from normal speakers. The addition of intelligibility and rate measures to supplement other assessment procedures in the evaluation of dysarthric speakers is discussed.

Adult↗

PubMed1981

Canon communicator use by adults: a retrospective study.

The purpose of this study was to document aspects of successful Canon Communicator use by 13 subjects. Questionnaires were completed by the speech-language pathologists serving these individuals. Subjects ranged in age from 17 to 64 years. They had used the Canon as a communication augmentation device from 2 to 24 months. All were either anarthric or severely dysarthric as a result of a neurological disorder (cerebral palsy, bilateral CVA, closed head injury, ALS) but none were diagnosed as aphasic. The decision to recommend the Canon was made mre rapidly for older adults. Although a majority of the subjects used more than one communication system, all subjects for whom the Canon remained appropriate (11 of 13) continued to use this device more frequently than other systems. No malfunction other than power supply system was reported.

Adolescent↗

PubMed1981

Ataxic dysarthria: treatment sequences based on intelligibility and prosodic considerations.

Treatment programs of four improving ataxic dysarthric speakers are reviewed. Treatment sequences were based on two overall measures of speech performance-intelligibility and prosody. Increases in intelligibility were initially achieved by control of speaking rate. A hierarchy of rate control strategies, ranging from a rigid imposition of rate through thythmic cueing to self-monitored rate control is discussed. As speakers improved their monitoring skills, a compromise was made between intelligibility and rate. Normal prosodic patterns were not achieved by the ataxic speakers due to difficulty in precisely coordinating the subtle fundamental frequency, loudness and timing adjustments needed to signal stress. Three of the four subjects were taught to use only durational adjustments to signal stress. In this way, they were able to achieve stress on targeted words consistently and minimize bizarreness which resulted from sweeping changes in fundamental frequency and bursts of loudness. The need for further clinically oriented research is discussed.

Adult↗

PubMed1980

Objective assessment of laryngectomized patients with surgical reconstruction.

The assessment of worth of the neoglottic procedure has been, for the most part, subjective in nature. Evaluation by means of sequential objective measures has been developed. The following procedures are employed in our assessment: transcription intelligibility by judges unfamiliar with the passage; rate of speech; relative intensity range; intratracheal air pressure; continuous speech per breath; functional communication profile; weight status; contrast swallow study; swallow-aspiration diary; and tumor status. Data from a patient with a Staffieri neoglottis procedure illustrate the method.

Deglutition↗

PubMed1980

A clinician-judged technique for quantifying dysarthric speech based on single-word intelligibility.

A clinician-judged technique for quantifying dysarthric speech based on single-word intelligibility was developed and evaluated in three experiments. Dysarthric speakers were audio-recorded as they read 50-word lists that had been randomly generated from sets of similar sounding words. These tapes were judged by speech pathologists using listening formats that were systematically altered by varying the number of choices available to the judges. Results indicated that some formats were more sensitive to differences that exist among severely dysarthric speakers and others were more sensitive to differences that exist among mild to moderately dysarthric speakers. Judge familiarity with the master word pool increased scores slightly but in a consistent and predictable fashion. Scores from different randomly generated word lists were similar when the influence of a speaker's day-to-day variability was controlled. Clinical implications and uses of this technique for the monitoring of change in speaker performance were discussed.

Adolescent↗

PubMed1980

Influence of passage familiarity on intelligibility estimates of dysarthric speech.

Speech pathologists often estimate intelligibility as dysarthric speakers read standard passages. The first phase of this study compared estimates of intelligibility made by speech pathologists with transcription scores made by judges unfamiliar with the speech passages. Results indicated that speech pathologists consistently overestimated intelligibility. It was hypothesized that judge familiarity with the speech sample contributed to these inflated scores. Therefore, during the second phase of the study the influence of speech sample familiarity on estimates of intelligiblity was investigated. Group of listeners judged mild, moderate, and severely dysarthric speakers under three conditions of familiarity--Unfamiliar (passage unknown), Partially Familiar (passage read twice by a normal speaker), and Most Familiar (script of the passage available). For mild and severely dysarthric speakers, passage familiarity did not significantly influence judges' estimates. For the moderately dysarthric speaker, estimates of intelligibility increased markedly with increasing passage familiarity. Clinical implications of these results are discussed.

Dysarthria↗

PubMed1980

An analysis of connected speech samples of aphasic and normal speakers.

The purpose of this study was to develop a technique for quantifying connected speech samples of aphasic individuals as they recover from the moderate to the mild range of severity. Verbal picture descriptions elicited from mild and moderate aphasic speakers were audio-recorded and compared to those elicited from normal adult and geriatric speakers. These samples were compared on the basis of a measure of amount of information conveyed (content units) and two measures of efficiency including speaking rate (syllables per minute) and rate at which information was conveyed (content units per minute). Results indicated an inverse relationship between severity of aphasia and amount of information conveyed. However, mild and high-moderate aphasic speakers tended to communicate as much information as normal speakers. Both measures of efficiency differentiated groups of mild and high-moderate aphasics from normal speakers as well as differentiating low-moderate from mild aphasic speakers. Use of this quantification system which takes into account both amount of information and efficency of communication is illustrated with data obtained from a recovering aphasic speaker.

Adult↗

PubMed1980

Nonvocal communication: performance evaluation.

With the increasing number of communication options available to severely dysarthric individuals, there is a growing need to develop techniques for the evaluation of nonvocal communication performance. A data collection and analysis system was developed in order to assess the performance of 2 nonvocal communicators. Records of entire messages were obtained along with durational measures of communication partner receiving time for each message, identity of the communication partner and location.

Adult↗

PubMed1980

Cerebral disconnection associated with anterior communicating artery aneurysm: implications for evaluation of symptoms.

The anterior communicating artery of a 34-year-old man was clipped to prevent a 2nd aneurysm bleed. Forty-five days later he was admitted to a rehabilitation program. On routine clinical examination, the patient demonstrated memory loss, disorientation, perceptual problems, decreased initiative, and inconsistent muscle control of the left limbs. Only during subsequent intensive testing did he demonstrate left-right conflict and asymmetric left-right performance consistent with a pattern of partial cerebral disconnection. Review of additional results, obtained during testing 8 months after onset, revealed reduction but not elimination of symptoms. The need to require bilateral response during evaluation of patients with potential asymmetric left-right performance is postulated.

Adult↗

PubMed1980

Communication in severe aphasia: effectiveness of three instruction modalities.

In this study to determine which modality of instruction (verbal, pantomine, or combined verbal and pantomine) was the most effective in eliciting accurate and prompt responses from severely aphasic persons, subjects completed tasks involving body movements and object manipulation in response to each of the 3 modalities of instruction. Results showed that severely aphasic persons completed single-stage commands at least as accurately and, depending on the task type, more accurately when given combined instructions than they did when given verbal or pantomined instructions only. The combined instructions also resulted in a greater mean response promptness score (correct responses only) than either verbal or pantomined instruction.

Aphasia↗

PubMed1979

The relationship between information transfer and speech intelligibility of dysarthric speakers.

The purpose of this study was to determine the relationship between information transfer and speech intelligibility, as measured by single-word and paragraph transcription across a wide range od dysarthric speakers. Nine dysarthric speakers, including ataxic, spastic, and hypokinetic types, participated in the study. Their performance was judged by 108 listeners. The correlations between information transfer and paragraph and transcription scores and between information transfer and word transcription scores were high, i.e., 0.95 and 0.90, respectively. Word transcription scores tended to be slightly lower than information transfer scores for mildly dysarthric speakers. Clinical implications of these findings were discussed.

Adult↗

PubMed1978

A comparison of techniques for measuring intelligibility of dysarthric speech.

Eight techniques for quantifying intelligibility of dysarthric speech were compared. Eight dysarthric speakers who represented a wide range of severity were recorded producing single words and sentences. Thirty-two college students performed the following intelligibility quantification tasks: percentage estimates, rating scale estimates, work and sentence transcriptions, word and sentence completions, and word and sentence multiple-choice tasks. Intelligibility scores for transcriptions were compared to estimates and to other objective tasks with the following results: (1) all measurement techniques, except word completion, rank ordered speakers similarly to transcriptions, (2) mean estimates of intelligibility closely parallel transcription scores, but dispersion of listener estimates was large, and (3) objective tasks form a hierarchy with speakers receiving lowest scores on transcriptions, intermediate scores on completions, and highest scores on multiple-choice tasks. Mean scores for words and sentences were similar. Implications of results for clinical management of dysarthria are discussed.

Adult↗

PubMed1978

Intraoral air pressure during the production of /p/ and /b/ by children, youths, and adults.

Peak intraoral air pressures produced by 12 children (age four to six years), 12 youths (age 10 to 12 years), and 12 adults (age 19 to 46 years) were measured during the production of /p/ and /b/ in 12 stimulus words placed in a carrier phrase. Mean pressures produced by children and youths were similar but significantly higher than those for adults. Pressures associated with /p/ were significantly higher than those associated with /b/ across all age groups. Mean pressures associated with the intervocalic context were significantly higher than for the postvocalic context. An inverse relationship was found between age and variability of intraoral pressure, and the variability of pressure associated with /b/ was greater across all age groups than that associated with /p/.

Adult↗

PubMed1978

Communications options for patients with brain stem lesions.

The communication treatment programs of five individuals with brain stem lesions were reviewed. The sequence of treatment included the following stages: early establishment of communication, establishment of a flexible nonvocal communication system, development of functional verbal communication, and maximizing intelligibility of speech.

Brain Stem↗

PubMed1977

A communication system for the severely dysarthric speaker with an intact language system.

Two severely dysarthric speakers who had previously spelled entire messages on an alphabet board were taught a system in which they pointed to the first letter of each word as they spoke. Rate and intelligibility of speech produced with (aided) and without (unaided) the communication system were judged by observers who viewed videotaped samples. The rate of aided and unaided speech was markedly faster than spelling the entire message. Aided speech was slower but more intelligible than unaided speech. Further analysis revealed that intelligibility was influenced by at least two factors: (1) rate and (2) information provided by the identification of the first letter of each word. For one speaker both factors contributed to increased intelligibility, while for the other speaker only initial letter information appeared to influence intelligibility.

Audiovisual Aids↗

PubMed1977

The effect of changes in velopharyngeal orifice area on vowel intensity.

This investigation studied the influence of changes in velopharyngeal orifice size on vowel intensity in normal speakers when subglottal air pressure was controlled. Controlled variations in velopharyngeal orifice area were achieved by two different methods. The effective velopharyngeal orifice areas introduced into the subjects were verified aerodynamically. A reduction in vowel intensity (SPL) was recorded during the large experimental velopharyngela orifice condition (50 mm2) when compared to a control condition. The clinical implications of these findings are discussed.

Adult↗