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At least 487 records · Page 27Linked to original sources

Cortical deafness: a longitudinal study.

We have studied a patient with MRI-confirmed bilateral absence of considerable portions of her temporal lobes resulting in cortical deafness. Although physiologic measures demonstrate normal peripheral hearing sensitivity, this patient's speech has the inflection and prosodic characteristics associated with profound peripheral hearing loss, and she is unable to understand spoken communication. Behaviorally obtained pure-tone thresholds taken over nearly 20 years range from normal to moderate hearing loss with normal middle ear muscle reflexes and normal ABRs; however, we consistently found abnormal middle latency and cortical evoked potentials. Because of her total inability to communicate auditorily, this patient was ultimately taught American Sign Language and educated at the Louisiana School for the Deaf. This rare case highlights the importance of using multiple audiologic measures sensitive to abnormalities at various levels of the auditory system.

Adult↗

Trial of intensive compared with weekly speech therapy in preschool children.

Forty two preschool children referred to a speech therapy department were randomly allocated to receive intensive individual speech therapy or the more traditional once weekly approach. Boys and minority ethnic groups were referred most frequently. Speech therapy improved expression more than comprehension, as measured on Reynell scales. The mean improvements were 0.5 SDs (95% confidence intervals (CI) 0.3 to 0.7) and 0.3 (95% CI 0.1 to 0.5) respectively. There was a greater improvement in children receiving intensive compared with weekly therapy in the expression scores (0.8 SDs (95% CI 0.5 to 1.1) v 0.2 SDs (95% CI -0.1 to 0.5]. White and non-white children had similar improvements in comprehension scores but white children had greater improvement in expression scores (1.1 SDs v 0.3 SDs). This difference was seen in both therapy groups. Randomised trials are useful in the evaluation of speech therapy in children.

Child, Preschool↗

A home-centered instructional communication strategy for severely handicapped children.

Family involvement is an essential element of language intervention with severely handicapped children for several reasons. First, the parent-child interaction is the focus of normal language development, and can be a powerful impetus in language learning for handicapped children. Second, limited generalization and maintenance of skills often occur when they are acquired in environments that do not also teach the appropriate use of skills. Third, parents can be successful intervention agents and may generalize their skills to other interactions with their child. Training conducted in the home must be compatible with that environment: it should involve only those skills that are of immediate use in the home. The Instructional Communication Strategy described herein represents such a program. It is a synthesis of training strategies used with normal and handicapped children, and is applicable regardless of child's level of functioning, age, or handicapping condition. This training model involves considerable modification in the role of speech-language pathologists dealing with the severely handicapped. The professional's skills are best utilized for assessment, program development, monitoring progress, and training specialized skills. The parents provide most of the direct training; however, professionals are also utilized for the child's maximum benefit.

Child↗

Vowel patterns in developmental apraxia of speech: three longitudinal case studies.

Vowel inventories and error patterns for three children with suspected developmental apraxia of speech (DAS) were analysed over a 3-year period using phonetic transcriptions of connected speech samples. The children demonstrated complete English vowel inventories except for rhotics. However, accuracy of vowel targets in connected speech did not normalize during this period. No consistent patterns of vowel errors were found. There was no decrease in vowel accuracy with increased utterance length or syllable complexity. Findings indicate persistence of vowel inaccuracy in the presence of a relatively complete vowel inventory. This longitudinal data can help to build consensus on use of vowels as a potential clinical marker for differential diagnosis of DAS.

Apraxias↗

Evaluation of an intervention program: relation between children's phonology and parents' communicative behavior.

Parents of 9 preschoolers with Down syndrome participated in a training program focusing on phonological skills. Three of the children were producing multiword utterances, but their speech was characterized by jargon and/or inconsistent errors. The remaining 6 children had very few spoken words or were mute; some relied on a Makaton sign vocabulary. Parents attended twelve 3-hour training sessions. Videotapes of parent-child interactions (made before, during, and after the program) were analyzed for number and type of children's phonological errors and rating of parents' therapeutic skills. Results showed that measures of the children's phonological abilities were correlated with their parents' interactional communication skills.

Child↗

[Management of stuttering in children].

This paper presents definition and characteristics of appearance, psychological consequences, risk factors, differential diagnosis, and management of stuttering in children. Stuttering requires early recognition and management in order to prevent the consequences of secondary psychological disturbances. Management associating speech and behavioral therapies must be entrusted to expert specialists.

Child↗

Introduction to qualitative research and its application to stuttering.

BACKGROUND: Those engaged in research might argue that we are involved in a process of explaining the world to others and to ourselves. The way in which we go about that process differs. The kind of questions we are concerned about answering will determine the approach we use, the information we gather and how we analyse the data. Some research questions are best answered using qualitative methods. AIMS: To explain the place of qualitative research methods within the context of different approaches to scientific enquiry. To describe qualitative research through an examination of the characteristics that differentiate it from quantitative approaches, to describe the types of strategies used, and the roles the researcher may adopt. To show how these methods have been applied to the study of stuttering. METHODS & PROCEDURES: Stuttering research was reviewed with the aim of finding studies using a range of qualitative methods. Work for discussion was selected based on historical importance, the methods used and the contribution the work has made to our understanding of stuttering and qualitative methods. MAIN CONTRIBUTION: Papers using explorative qualitative research and mixed methodologies are described and their various contributions to our understanding of stuttering are discussed. CONCLUSIONS: The qualitative research reviewed in this paper has added to our understanding of the experiences, thinking and views of people who stutter. The reports on people's experiences of therapy show that we still have much to learn and that we need to listen to our clients and involve them in therapy and in outcome planning.

Adult↗

Direct and indirect therapy for word sound deafness.

This paper evaluates two therapy programmes conducted with PK, an aphasic individual with word sound deafness. The first aimed directly to improve discrimination skills, using minimal pair tasks supported with lip reading. Disappointingly, there were no changes on discrimination tests after this therapy, even when PK could benefit from lip reading information. The second, indirect, programme of therapy aimed to change the communication behaviours of PK's wife. Strategies such as writing and simplifying information were modelled and practiced. A detailed information booklet, outlining the target strategies and explaining PK's main strengths and weaknesses supported the programme. Evaluation of this therapy involved pre- and post-therapy analysis of interactions between PK and his wife, with biographical questions forming the basis of the interactions. There were several changes after therapy on this measure. The number and length of communication breakdowns were reduced, and more questions were answered accurately. This study suggests that, in some cases of severe word sound deafness, indirect therapies may be most effective.

Aged↗

Some direct and generalized effects of replacing an autistic man's echolalia with correct responses to questions.

We extended the use of operant procedures to decrease immediate echolalia and increase the appropriate responding to questions of a 21-year-old autistic man. Three experiments were conducted in which the overall plan was to encourage the subject to remain quiet before, during, and after the presentation of questions and teach him to use environmental cues (i.e., word cards or a model's responses) to increase the likelihood of responding correctly. Multiple baseline designs demonstrated that echolalia was rapidly replaced with correct stimulus-specific responses. In addition, there were a variety of generalized improvements in the subject's verbal responses to questions. The procedures and results are contrasted to previous research in an attempt to explain the encouraging findings.

Adult↗

Mental illness and communication.

Historical and more recent descriptions of mental illness emphasise the prominent nature of communicative difficulties in persons with these diagnoses (Sims 1995) and a large part of psychiatric intervention is verbally-mediated. Within this study, a theoretically-driven therapy programme addressed the communication needs of two persons with schizophrenia. Significant improvements were demonstrated using valid and reliable outcome measures.

Adult↗

Systematic review: the treatment of anal fissure.

BACKGROUND: Anal fissure is one of the most common anorectal conditions encountered in clinical practice. Most patients experience anal pain with defecation and minor bright red rectal bleeding, allowing a focused history to direct the evaluation. METHODS: A systematic medical literature search of NIH, Pubmed, and MEDLINE using the search terms anal fissure, sphincterotomy, anal surgery and anal fissure medical therapy. English language was not a restriction. Cited references were used to find additional studies. RESULTS: No single treatment is the best choice for all patients. Because pharmacological therapy is not associated with permanent alterations in continence, a trial of either a topical sphincter relaxant or botulin toxin injection, along with adequate fluid and fibre intake, is a reasonable option. However, because pharmacological therapy has lower healing and higher relapse rates, surgery can be offered in the first instance to patients without incontinence risk factors who have severe, unrelenting pain and are willing to accept a small risk of incontinence, for the highest likelihood of prompt healing and the lowest risk of recurrence. CONCLUSIONS: Both non-operative and operative approaches currently exist for the management of anal fissure. Improved non-surgical therapies may continue to lessen the role of sphincter-dividing surgery in future.

Administration, Oral↗

The role of specific consequences in the maintenance of three types of questions.

This research replicated and extended a study by Williams, Donley, and Keller (2000). In that study, children with autism received a box with an object inside and learned to ask "What's that?," "Can I see it?," and "Can I have it?" to have the name of the object, to see the object, and to get the object, respectively. The purpose of the present research was to determine if the three questions (a) were three independent repertoires of behavior, (b) constituted three instances of a single functional response class, or (c) belonged to a chain of behavior. The 3 boys with autism who participated responded independently to each question when the consequences for each question were altered. This indicates that the three target responses were three independent repertoires of behavior, each one reinforced and maintained with its specific consequences. Thus, this procedure serves to teach children with autism to ask questions with flexibility according to a variable context.

Autistic Disorder↗

Visual-auditory integration during speech imitation in autism.

Children with autistic spectrum disorder (ASD) may have poor audio-visual integration, possibly reflecting dysfunctional 'mirror neuron' systems which have been hypothesised to be at the core of the condition. In the present study, a computer program, utilizing speech synthesizer software and a 'virtual' head (Baldi), delivered speech stimuli for identification in auditory, visual or bimodal conditions. Children with ASD were poorer than controls at recognizing stimuli in the unimodal conditions, but once performance on this measure was controlled for, no group difference was found in the bimodal condition. A group of participants with ASD were also trained to develop their speech-reading ability. Training improved visual accuracy and this also improved the children's ability to utilize visual information in their processing of speech. Overall results were compared to predictions from mathematical models based on integration and non-integration, and were most consistent with the integration model. We conclude that, whilst they are less accurate in recognizing stimuli in the unimodal condition, children with ASD show normal integration of visual and auditory speech stimuli. Given that training in recognition of visual speech was effective, children with ASD may benefit from multi-modal approaches in imitative therapy and language training.

Adolescent↗