Intervención en trastornos pragmáticos: consideraciones metodológicas

Publication date: Available online 1 February 2018
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Marc Monfort, Adoración Juárez Sánchez
Partiendo de las necesidades propias de una perspectiva clínica, se realiza una revisión de los principales modelos interpretativos de los trastornos pragmáticos en niños y su relación con propuestas de intervención. Frente a la diversidad de los síntomas y de los cuadros patológicos y ante la pobreza de pruebas empíricas suficientes, se propone un análisis metodológico de dichas propuestas que facilite un diseño individualizado de la intervención.Based on the needs of a clinical perspective, a review of the main interpretative models of pragmatic disorders in children and their relationship with action proposals is carried out. A methodological analysis of these proposals is suggested, which provides an individualized intervention to deal with the wide range of symptoms and pathological processes and the paucity of sufficient empirical evidence.



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Intervención en trastornos pragmáticos: consideraciones metodológicas

Publication date: Available online 1 February 2018
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Marc Monfort, Adoración Juárez Sánchez
Partiendo de las necesidades propias de una perspectiva clínica, se realiza una revisión de los principales modelos interpretativos de los trastornos pragmáticos en niños y su relación con propuestas de intervención. Frente a la diversidad de los síntomas y de los cuadros patológicos y ante la pobreza de pruebas empíricas suficientes, se propone un análisis metodológico de dichas propuestas que facilite un diseño individualizado de la intervención.Based on the needs of a clinical perspective, a review of the main interpretative models of pragmatic disorders in children and their relationship with action proposals is carried out. A methodological analysis of these proposals is suggested, which provides an individualized intervention to deal with the wide range of symptoms and pathological processes and the paucity of sufficient empirical evidence.



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Intervención en trastornos pragmáticos: consideraciones metodológicas

Publication date: Available online 1 February 2018
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Marc Monfort, Adoración Juárez Sánchez
Partiendo de las necesidades propias de una perspectiva clínica, se realiza una revisión de los principales modelos interpretativos de los trastornos pragmáticos en niños y su relación con propuestas de intervención. Frente a la diversidad de los síntomas y de los cuadros patológicos y ante la pobreza de pruebas empíricas suficientes, se propone un análisis metodológico de dichas propuestas que facilite un diseño individualizado de la intervención.Based on the needs of a clinical perspective, a review of the main interpretative models of pragmatic disorders in children and their relationship with action proposals is carried out. A methodological analysis of these proposals is suggested, which provides an individualized intervention to deal with the wide range of symptoms and pathological processes and the paucity of sufficient empirical evidence.



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Specialization of the auditory system for the processing of bio-sonar information in the frequency domain: Mustached bats

Publication date: Available online 2 February 2018
Source:Hearing Research
Author(s): Nobuo Suga
For echolocation, mustached bats emit velocity-sensitive orientation sounds (pulses) containing a constant-frequency component consisting of four harmonics (CF1-4). They show unique behavior called Doppler-shift compensation for Doppler-shifted echoes and hunting behavior for frequency and amplitude modulated echoes from fluttering insects. Their peripheral auditory system is highly specialized for fine frequency analysis of CF2 (∼61.0 kHz) and detecting echo CF2 from fluttering insects. In their central auditory system, lateral inhibition occurring at multiple levels sharpens triangular frequency-tuning curves at the periphery and creates sharp spindle-shaped tuning curves and amplitude tuning. The large CF2-tuned area of the auditory cortex systematically represents the frequency and amplitude of CF2 in a frequency-versus-amplitude map. “CF/CF” neurons are tuned to a specific combination of pulse CF1 and Doppler-shifted echo CF2 or 3. They are tuned to specific velocities. CF/CF neurons cluster in the CC (“C” stands for CF) and DIF (dorsal intrafossa) areas of the auditory cortex. The CC area has the velocity map for Doppler imaging. The DIF area is particularly for Dopper imaging of other bats approaching in cruising flight. To optimize the processing of behaviorally relevant sounds, cortico-cortical interactions and corticofugal feedback modulate the frequency tuning of cortical and sub-cortical auditory neurons and cochlear hair cells through a neural net consisting of positive feedback associated with lateral inhibition.



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Suppression of the Vestibular short-latency Evoked Potential by Electrical Stimulation of the Central Vestibular System

Publication date: Available online 2 February 2018
Source:Hearing Research
Author(s): Christopher J. Pastras, Ian S. Curthoys, Ljiljana Sokolic, Daniel J. Brown
In an attempt to view the effects of the efferent vestibular system (EVS) on peripheral dynamic vestibular function, we have monitored the Vestibular short-latency Evoked Potential (VsEP) evoked by pulses of bone conducted vibration during electrical stimulation of the EVS neurons near the floor of the fourth ventricle in the brainstem of anesthetized guinea pigs. Given the reported effects of EVS on primary afferent activity, we hypothesized that EVS stimulation would cause a slight reduction in the VsEP amplitude. Our results show a substantial (>50%) suppression of the VsEP, occurring immediately after a single EVS current pulse. The effect could not be blocked by cholinergic drugs which have been shown to block efferent-mediated vestibular effects. Shocks produced a short-latency P1-N1 response immediately after the electrical artifact which correlated closely to the VsEP suppression. Ultimately, we have identified that this suppression results from antidromic blockade of the afferent response (the VsEP). It would appear that this effect is unavoidable for EVS stimulation, as we found no other effects.



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Increased Auditory Cortex Neural Response Amplitude in Adults with Chronic Unilateral Conductive Hearing Impairment

Publication date: Available online 2 February 2018
Source:Hearing Research
Author(s): Lauren V. Parry, Michael R.D. Maslin, Roland Schaette, David R. Moore, Kevin J. Munro
Animal studies have demonstrated that unilateral hearing loss can induce changes in neural response amplitude of the mature central auditory system (CAS). However, there is limited physiological evidence of these neural gain changes in the auditory cortex of human adults. The present study investigated the impact of chronic, unilateral conductive hearing impairment on cortical auditory evoked potentials (CAEPs) recorded from 15 adults (21-65 years old) in response to a 1 kHz tone (80 ms duration) presented to the impaired ear via a bone conduction transducer. The amplitude and latency of the main CAEP components were compared to those obtained from normal hearing age-matched control participants. Both P1-N1 and N1-P2 amplitudes were significantly larger in the hearing impaired relative to the control participants. Differences between groups in the mean latencies of P1, N1, and P2 were not statistically significant. These results are the first to provide direct evidence of increased neural response amplitude in the adult human auditory cortex in the presence of unilateral conductive hearing loss. Importantly, the study shows that central gain changes are a direct result of deprivation of sound rather than cochlear or neural pathology.



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Specialization of the auditory system for the processing of bio-sonar information in the frequency domain: Mustached bats

Publication date: Available online 2 February 2018
Source:Hearing Research
Author(s): Nobuo Suga
For echolocation, mustached bats emit velocity-sensitive orientation sounds (pulses) containing a constant-frequency component consisting of four harmonics (CF1-4). They show unique behavior called Doppler-shift compensation for Doppler-shifted echoes and hunting behavior for frequency and amplitude modulated echoes from fluttering insects. Their peripheral auditory system is highly specialized for fine frequency analysis of CF2 (∼61.0 kHz) and detecting echo CF2 from fluttering insects. In their central auditory system, lateral inhibition occurring at multiple levels sharpens triangular frequency-tuning curves at the periphery and creates sharp spindle-shaped tuning curves and amplitude tuning. The large CF2-tuned area of the auditory cortex systematically represents the frequency and amplitude of CF2 in a frequency-versus-amplitude map. “CF/CF” neurons are tuned to a specific combination of pulse CF1 and Doppler-shifted echo CF2 or 3. They are tuned to specific velocities. CF/CF neurons cluster in the CC (“C” stands for CF) and DIF (dorsal intrafossa) areas of the auditory cortex. The CC area has the velocity map for Doppler imaging. The DIF area is particularly for Dopper imaging of other bats approaching in cruising flight. To optimize the processing of behaviorally relevant sounds, cortico-cortical interactions and corticofugal feedback modulate the frequency tuning of cortical and sub-cortical auditory neurons and cochlear hair cells through a neural net consisting of positive feedback associated with lateral inhibition.



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Suppression of the Vestibular short-latency Evoked Potential by Electrical Stimulation of the Central Vestibular System

Publication date: Available online 2 February 2018
Source:Hearing Research
Author(s): Christopher J. Pastras, Ian S. Curthoys, Ljiljana Sokolic, Daniel J. Brown
In an attempt to view the effects of the efferent vestibular system (EVS) on peripheral dynamic vestibular function, we have monitored the Vestibular short-latency Evoked Potential (VsEP) evoked by pulses of bone conducted vibration during electrical stimulation of the EVS neurons near the floor of the fourth ventricle in the brainstem of anesthetized guinea pigs. Given the reported effects of EVS on primary afferent activity, we hypothesized that EVS stimulation would cause a slight reduction in the VsEP amplitude. Our results show a substantial (>50%) suppression of the VsEP, occurring immediately after a single EVS current pulse. The effect could not be blocked by cholinergic drugs which have been shown to block efferent-mediated vestibular effects. Shocks produced a short-latency P1-N1 response immediately after the electrical artifact which correlated closely to the VsEP suppression. Ultimately, we have identified that this suppression results from antidromic blockade of the afferent response (the VsEP). It would appear that this effect is unavoidable for EVS stimulation, as we found no other effects.



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Increased Auditory Cortex Neural Response Amplitude in Adults with Chronic Unilateral Conductive Hearing Impairment

Publication date: Available online 2 February 2018
Source:Hearing Research
Author(s): Lauren V. Parry, Michael R.D. Maslin, Roland Schaette, David R. Moore, Kevin J. Munro
Animal studies have demonstrated that unilateral hearing loss can induce changes in neural response amplitude of the mature central auditory system (CAS). However, there is limited physiological evidence of these neural gain changes in the auditory cortex of human adults. The present study investigated the impact of chronic, unilateral conductive hearing impairment on cortical auditory evoked potentials (CAEPs) recorded from 15 adults (21-65 years old) in response to a 1 kHz tone (80 ms duration) presented to the impaired ear via a bone conduction transducer. The amplitude and latency of the main CAEP components were compared to those obtained from normal hearing age-matched control participants. Both P1-N1 and N1-P2 amplitudes were significantly larger in the hearing impaired relative to the control participants. Differences between groups in the mean latencies of P1, N1, and P2 were not statistically significant. These results are the first to provide direct evidence of increased neural response amplitude in the adult human auditory cortex in the presence of unilateral conductive hearing loss. Importantly, the study shows that central gain changes are a direct result of deprivation of sound rather than cochlear or neural pathology.



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Specialization of the auditory system for the processing of bio-sonar information in the frequency domain: Mustached bats

Publication date: Available online 2 February 2018
Source:Hearing Research
Author(s): Nobuo Suga
For echolocation, mustached bats emit velocity-sensitive orientation sounds (pulses) containing a constant-frequency component consisting of four harmonics (CF1-4). They show unique behavior called Doppler-shift compensation for Doppler-shifted echoes and hunting behavior for frequency and amplitude modulated echoes from fluttering insects. Their peripheral auditory system is highly specialized for fine frequency analysis of CF2 (∼61.0 kHz) and detecting echo CF2 from fluttering insects. In their central auditory system, lateral inhibition occurring at multiple levels sharpens triangular frequency-tuning curves at the periphery and creates sharp spindle-shaped tuning curves and amplitude tuning. The large CF2-tuned area of the auditory cortex systematically represents the frequency and amplitude of CF2 in a frequency-versus-amplitude map. “CF/CF” neurons are tuned to a specific combination of pulse CF1 and Doppler-shifted echo CF2 or 3. They are tuned to specific velocities. CF/CF neurons cluster in the CC (“C” stands for CF) and DIF (dorsal intrafossa) areas of the auditory cortex. The CC area has the velocity map for Doppler imaging. The DIF area is particularly for Dopper imaging of other bats approaching in cruising flight. To optimize the processing of behaviorally relevant sounds, cortico-cortical interactions and corticofugal feedback modulate the frequency tuning of cortical and sub-cortical auditory neurons and cochlear hair cells through a neural net consisting of positive feedback associated with lateral inhibition.



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Suppression of the Vestibular short-latency Evoked Potential by Electrical Stimulation of the Central Vestibular System

Publication date: Available online 2 February 2018
Source:Hearing Research
Author(s): Christopher J. Pastras, Ian S. Curthoys, Ljiljana Sokolic, Daniel J. Brown
In an attempt to view the effects of the efferent vestibular system (EVS) on peripheral dynamic vestibular function, we have monitored the Vestibular short-latency Evoked Potential (VsEP) evoked by pulses of bone conducted vibration during electrical stimulation of the EVS neurons near the floor of the fourth ventricle in the brainstem of anesthetized guinea pigs. Given the reported effects of EVS on primary afferent activity, we hypothesized that EVS stimulation would cause a slight reduction in the VsEP amplitude. Our results show a substantial (>50%) suppression of the VsEP, occurring immediately after a single EVS current pulse. The effect could not be blocked by cholinergic drugs which have been shown to block efferent-mediated vestibular effects. Shocks produced a short-latency P1-N1 response immediately after the electrical artifact which correlated closely to the VsEP suppression. Ultimately, we have identified that this suppression results from antidromic blockade of the afferent response (the VsEP). It would appear that this effect is unavoidable for EVS stimulation, as we found no other effects.



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Increased Auditory Cortex Neural Response Amplitude in Adults with Chronic Unilateral Conductive Hearing Impairment

Publication date: Available online 2 February 2018
Source:Hearing Research
Author(s): Lauren V. Parry, Michael R.D. Maslin, Roland Schaette, David R. Moore, Kevin J. Munro
Animal studies have demonstrated that unilateral hearing loss can induce changes in neural response amplitude of the mature central auditory system (CAS). However, there is limited physiological evidence of these neural gain changes in the auditory cortex of human adults. The present study investigated the impact of chronic, unilateral conductive hearing impairment on cortical auditory evoked potentials (CAEPs) recorded from 15 adults (21-65 years old) in response to a 1 kHz tone (80 ms duration) presented to the impaired ear via a bone conduction transducer. The amplitude and latency of the main CAEP components were compared to those obtained from normal hearing age-matched control participants. Both P1-N1 and N1-P2 amplitudes were significantly larger in the hearing impaired relative to the control participants. Differences between groups in the mean latencies of P1, N1, and P2 were not statistically significant. These results are the first to provide direct evidence of increased neural response amplitude in the adult human auditory cortex in the presence of unilateral conductive hearing loss. Importantly, the study shows that central gain changes are a direct result of deprivation of sound rather than cochlear or neural pathology.



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Age Differences in Voice Evaluation: From Auditory-Perceptual Evaluation to Social Interactions

Purpose

The factors that influence the evaluation of voice in adulthood, as well as the consequences of such evaluation on social interactions, are not well understood. Here, we examined the effect of listeners' age and the effect of talker age, sex, and smoking status on the auditory-perceptual evaluation of voice, voice-related psychosocial attributions, and perceived speech tempo. We also examined the voice dimensions affecting the propensity to engage in social interactions.

Method

Twenty-five younger (age 19–37 years) and 25 older (age 51–74 years) healthy adults participated in this cross-sectional study. Their task was to evaluate the voice of 80 talkers.

Results

Statistical analyses revealed limited effects of the age of the listener on voice evaluation. Specifically, older listeners provided relatively more favorable voice ratings than younger listeners, mainly in terms of roughness. In contrast, the age of the talker had a broader impact on voice evaluation, affecting auditory-perceptual evaluations, psychosocial attributions, and perceived speech tempo. Some of these talker differences were dependent upon the sex of the talker and his or her smoking status. Finally, the results also show that voice-related psychosocial attribution was more strongly associated with the propensity of the listener to engage in social interactions with a person than auditory-perceptual dimensions and perceived speech tempo, especially for the younger adults.

Conclusions

These results suggest that age has a broad influence on voice evaluation, with a stronger impact for talker age compared with listener age. While voice-related psychosocial attributions may be an important determinant of social interactions, perceived voice quality and speech tempo appear to be less influential.

Supplemental Materials

https://doi.org/10.23641/asha.5844102

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Listeners Experience Linguistic Masking Release in Noise-Vocoded Speech-in-Speech Recognition

Purpose

The purpose of this study was to evaluate whether listeners with normal hearing perceiving noise-vocoded speech-in-speech demonstrate better intelligibility of target speech when the background speech was mismatched in language (linguistic release from masking [LRM]) and/or location (spatial release from masking [SRM]) relative to the target. We also assessed whether the spectral resolution of the noise-vocoded stimuli affected the presence of LRM and SRM under these conditions.

Method

In Experiment 1, a mixed factorial design was used to simultaneously manipulate the masker language (within-subject, English vs. Dutch), the simulated masker location (within-subject, right, center, left), and the spectral resolution (between-subjects, 6 vs. 12 channels) of noise-vocoded target–masker combinations presented at +25 dB signal-to-noise ratio (SNR). In Experiment 2, the study was repeated using a spectral resolution of 12 channels at +15 dB SNR.

Results

In both experiments, listeners' intelligibility of noise-vocoded targets was better when the background masker was Dutch, demonstrating reliable LRM in all conditions. The pattern of results in Experiment 1 was not reliably different across the 6- and 12-channel noise-vocoded speech. Finally, a reliable spatial benefit (SRM) was detected only in the more challenging SNR condition (Experiment 2).

Conclusion

The current study is the first to report a clear LRM benefit in noise-vocoded speech-in-speech recognition. Our results indicate that this benefit is available even under spectrally degraded conditions and that it may augment the benefit due to spatial separation of target speech and competing backgrounds.

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Lingual Pressure as a Clinical Indicator of Swallowing Function in Parkinson's Disease

Purpose

Swallowing impairment, or dysphagia, is a known contributor to reduced quality of life, pneumonia, and mortality in Parkinson's disease (PD). However, the contribution of tongue dysfunction, specifically inadequate pressure generation, to dysphagia in PD remains unclear. Our purpose was to determine whether lingual pressures in PD are (a) reduced, (b) reflect medication state, or are (c) consistent with self-reported diet and swallowing function.

Method

Twenty-eight persons with idiopathic PD (PwPD) and 28 age- and sex-matched controls completed lingual pressure tasks with the Iowa Oral Performance Instrument. PwPD were tested during practically defined ON and OFF dopaminergic medication states. Participants were also stratified into three sex- and age-matched cohorts (7 men, 5 women): (a) controls, (b) PwPD without self-reported dysphagia symptoms or diet restrictions, and (c) PwPD with self-reported dysphagia symptoms with or without diet restrictions.

Results

PwPD exhibited reduced tongue strength and used elevated proportions of tongue strength during swallowing compared with controls (p < .05) without an effect of medication state (p > .05). Reduced tongue strength distinguished PwPD with self-reported dysphagia symptoms from PwPD without reported symptoms or diet restrictions (p = .045) and controls (p = .002).

Conclusion

Tongue strength was significantly reduced in PwPD and did not differ by medication state. Tongue strength differentiated between PwPD with and without self-reported swallowing symptoms. Therefore, measures of tongue strength and swallowing pressures may serve as clinical indicators for further dysphagia evaluation and may promote early diagnosis and management of dysphagia in PD.

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The Effect of Remote Masking on the Reception of Speech by Young School-Age Children

Purpose

Psychoacoustic data indicate that infants and children are less likely than adults to focus on a spectral region containing an anticipated signal and are more susceptible to remote masking of a signal. These detection tasks suggest that infants and children, unlike adults, do not listen selectively. However, less is known about children's ability to listen selectively during speech recognition. Accordingly, the current study examines remote masking during speech recognition in children and adults.

Method

Adults and 7- and 5-year-old children performed sentence recognition in the presence of various spectrally remote maskers. Intelligibility was determined for each remote-masker condition, and performance was compared across age groups.

Results

It was found that speech recognition for 5-year-olds was reduced in the presence of spectrally remote noise, whereas the maskers had no effect on the 7-year-olds or adults. Maskers of different bandwidth and remoteness had similar effects.

Conclusions

In accord with psychoacoustic data, young children do not appear to focus on a spectral region of interest and ignore other regions during speech recognition. This tendency may help account for their typically poorer speech perception in noise. This study also appears to capture an important developmental stage, during which a substantial refinement in spectral listening occurs.

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Age Differences in Voice Evaluation: From Auditory-Perceptual Evaluation to Social Interactions

Purpose

The factors that influence the evaluation of voice in adulthood, as well as the consequences of such evaluation on social interactions, are not well understood. Here, we examined the effect of listeners' age and the effect of talker age, sex, and smoking status on the auditory-perceptual evaluation of voice, voice-related psychosocial attributions, and perceived speech tempo. We also examined the voice dimensions affecting the propensity to engage in social interactions.

Method

Twenty-five younger (age 19–37 years) and 25 older (age 51–74 years) healthy adults participated in this cross-sectional study. Their task was to evaluate the voice of 80 talkers.

Results

Statistical analyses revealed limited effects of the age of the listener on voice evaluation. Specifically, older listeners provided relatively more favorable voice ratings than younger listeners, mainly in terms of roughness. In contrast, the age of the talker had a broader impact on voice evaluation, affecting auditory-perceptual evaluations, psychosocial attributions, and perceived speech tempo. Some of these talker differences were dependent upon the sex of the talker and his or her smoking status. Finally, the results also show that voice-related psychosocial attribution was more strongly associated with the propensity of the listener to engage in social interactions with a person than auditory-perceptual dimensions and perceived speech tempo, especially for the younger adults.

Conclusions

These results suggest that age has a broad influence on voice evaluation, with a stronger impact for talker age compared with listener age. While voice-related psychosocial attributions may be an important determinant of social interactions, perceived voice quality and speech tempo appear to be less influential.

Supplemental Materials

https://doi.org/10.23641/asha.5844102

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Listeners Experience Linguistic Masking Release in Noise-Vocoded Speech-in-Speech Recognition

Purpose

The purpose of this study was to evaluate whether listeners with normal hearing perceiving noise-vocoded speech-in-speech demonstrate better intelligibility of target speech when the background speech was mismatched in language (linguistic release from masking [LRM]) and/or location (spatial release from masking [SRM]) relative to the target. We also assessed whether the spectral resolution of the noise-vocoded stimuli affected the presence of LRM and SRM under these conditions.

Method

In Experiment 1, a mixed factorial design was used to simultaneously manipulate the masker language (within-subject, English vs. Dutch), the simulated masker location (within-subject, right, center, left), and the spectral resolution (between-subjects, 6 vs. 12 channels) of noise-vocoded target–masker combinations presented at +25 dB signal-to-noise ratio (SNR). In Experiment 2, the study was repeated using a spectral resolution of 12 channels at +15 dB SNR.

Results

In both experiments, listeners' intelligibility of noise-vocoded targets was better when the background masker was Dutch, demonstrating reliable LRM in all conditions. The pattern of results in Experiment 1 was not reliably different across the 6- and 12-channel noise-vocoded speech. Finally, a reliable spatial benefit (SRM) was detected only in the more challenging SNR condition (Experiment 2).

Conclusion

The current study is the first to report a clear LRM benefit in noise-vocoded speech-in-speech recognition. Our results indicate that this benefit is available even under spectrally degraded conditions and that it may augment the benefit due to spatial separation of target speech and competing backgrounds.

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Lingual Pressure as a Clinical Indicator of Swallowing Function in Parkinson's Disease

Purpose

Swallowing impairment, or dysphagia, is a known contributor to reduced quality of life, pneumonia, and mortality in Parkinson's disease (PD). However, the contribution of tongue dysfunction, specifically inadequate pressure generation, to dysphagia in PD remains unclear. Our purpose was to determine whether lingual pressures in PD are (a) reduced, (b) reflect medication state, or are (c) consistent with self-reported diet and swallowing function.

Method

Twenty-eight persons with idiopathic PD (PwPD) and 28 age- and sex-matched controls completed lingual pressure tasks with the Iowa Oral Performance Instrument. PwPD were tested during practically defined ON and OFF dopaminergic medication states. Participants were also stratified into three sex- and age-matched cohorts (7 men, 5 women): (a) controls, (b) PwPD without self-reported dysphagia symptoms or diet restrictions, and (c) PwPD with self-reported dysphagia symptoms with or without diet restrictions.

Results

PwPD exhibited reduced tongue strength and used elevated proportions of tongue strength during swallowing compared with controls (p < .05) without an effect of medication state (p > .05). Reduced tongue strength distinguished PwPD with self-reported dysphagia symptoms from PwPD without reported symptoms or diet restrictions (p = .045) and controls (p = .002).

Conclusion

Tongue strength was significantly reduced in PwPD and did not differ by medication state. Tongue strength differentiated between PwPD with and without self-reported swallowing symptoms. Therefore, measures of tongue strength and swallowing pressures may serve as clinical indicators for further dysphagia evaluation and may promote early diagnosis and management of dysphagia in PD.

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The Effect of Remote Masking on the Reception of Speech by Young School-Age Children

Purpose

Psychoacoustic data indicate that infants and children are less likely than adults to focus on a spectral region containing an anticipated signal and are more susceptible to remote masking of a signal. These detection tasks suggest that infants and children, unlike adults, do not listen selectively. However, less is known about children's ability to listen selectively during speech recognition. Accordingly, the current study examines remote masking during speech recognition in children and adults.

Method

Adults and 7- and 5-year-old children performed sentence recognition in the presence of various spectrally remote maskers. Intelligibility was determined for each remote-masker condition, and performance was compared across age groups.

Results

It was found that speech recognition for 5-year-olds was reduced in the presence of spectrally remote noise, whereas the maskers had no effect on the 7-year-olds or adults. Maskers of different bandwidth and remoteness had similar effects.

Conclusions

In accord with psychoacoustic data, young children do not appear to focus on a spectral region of interest and ignore other regions during speech recognition. This tendency may help account for their typically poorer speech perception in noise. This study also appears to capture an important developmental stage, during which a substantial refinement in spectral listening occurs.

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via IFTTT

Age Differences in Voice Evaluation: From Auditory-Perceptual Evaluation to Social Interactions

Purpose

The factors that influence the evaluation of voice in adulthood, as well as the consequences of such evaluation on social interactions, are not well understood. Here, we examined the effect of listeners' age and the effect of talker age, sex, and smoking status on the auditory-perceptual evaluation of voice, voice-related psychosocial attributions, and perceived speech tempo. We also examined the voice dimensions affecting the propensity to engage in social interactions.

Method

Twenty-five younger (age 19–37 years) and 25 older (age 51–74 years) healthy adults participated in this cross-sectional study. Their task was to evaluate the voice of 80 talkers.

Results

Statistical analyses revealed limited effects of the age of the listener on voice evaluation. Specifically, older listeners provided relatively more favorable voice ratings than younger listeners, mainly in terms of roughness. In contrast, the age of the talker had a broader impact on voice evaluation, affecting auditory-perceptual evaluations, psychosocial attributions, and perceived speech tempo. Some of these talker differences were dependent upon the sex of the talker and his or her smoking status. Finally, the results also show that voice-related psychosocial attribution was more strongly associated with the propensity of the listener to engage in social interactions with a person than auditory-perceptual dimensions and perceived speech tempo, especially for the younger adults.

Conclusions

These results suggest that age has a broad influence on voice evaluation, with a stronger impact for talker age compared with listener age. While voice-related psychosocial attributions may be an important determinant of social interactions, perceived voice quality and speech tempo appear to be less influential.

Supplemental Materials

https://doi.org/10.23641/asha.5844102

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via IFTTT

Listeners Experience Linguistic Masking Release in Noise-Vocoded Speech-in-Speech Recognition

Purpose

The purpose of this study was to evaluate whether listeners with normal hearing perceiving noise-vocoded speech-in-speech demonstrate better intelligibility of target speech when the background speech was mismatched in language (linguistic release from masking [LRM]) and/or location (spatial release from masking [SRM]) relative to the target. We also assessed whether the spectral resolution of the noise-vocoded stimuli affected the presence of LRM and SRM under these conditions.

Method

In Experiment 1, a mixed factorial design was used to simultaneously manipulate the masker language (within-subject, English vs. Dutch), the simulated masker location (within-subject, right, center, left), and the spectral resolution (between-subjects, 6 vs. 12 channels) of noise-vocoded target–masker combinations presented at +25 dB signal-to-noise ratio (SNR). In Experiment 2, the study was repeated using a spectral resolution of 12 channels at +15 dB SNR.

Results

In both experiments, listeners' intelligibility of noise-vocoded targets was better when the background masker was Dutch, demonstrating reliable LRM in all conditions. The pattern of results in Experiment 1 was not reliably different across the 6- and 12-channel noise-vocoded speech. Finally, a reliable spatial benefit (SRM) was detected only in the more challenging SNR condition (Experiment 2).

Conclusion

The current study is the first to report a clear LRM benefit in noise-vocoded speech-in-speech recognition. Our results indicate that this benefit is available even under spectrally degraded conditions and that it may augment the benefit due to spatial separation of target speech and competing backgrounds.

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Lingual Pressure as a Clinical Indicator of Swallowing Function in Parkinson's Disease

Purpose

Swallowing impairment, or dysphagia, is a known contributor to reduced quality of life, pneumonia, and mortality in Parkinson's disease (PD). However, the contribution of tongue dysfunction, specifically inadequate pressure generation, to dysphagia in PD remains unclear. Our purpose was to determine whether lingual pressures in PD are (a) reduced, (b) reflect medication state, or are (c) consistent with self-reported diet and swallowing function.

Method

Twenty-eight persons with idiopathic PD (PwPD) and 28 age- and sex-matched controls completed lingual pressure tasks with the Iowa Oral Performance Instrument. PwPD were tested during practically defined ON and OFF dopaminergic medication states. Participants were also stratified into three sex- and age-matched cohorts (7 men, 5 women): (a) controls, (b) PwPD without self-reported dysphagia symptoms or diet restrictions, and (c) PwPD with self-reported dysphagia symptoms with or without diet restrictions.

Results

PwPD exhibited reduced tongue strength and used elevated proportions of tongue strength during swallowing compared with controls (p < .05) without an effect of medication state (p > .05). Reduced tongue strength distinguished PwPD with self-reported dysphagia symptoms from PwPD without reported symptoms or diet restrictions (p = .045) and controls (p = .002).

Conclusion

Tongue strength was significantly reduced in PwPD and did not differ by medication state. Tongue strength differentiated between PwPD with and without self-reported swallowing symptoms. Therefore, measures of tongue strength and swallowing pressures may serve as clinical indicators for further dysphagia evaluation and may promote early diagnosis and management of dysphagia in PD.

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The Effect of Remote Masking on the Reception of Speech by Young School-Age Children

Purpose

Psychoacoustic data indicate that infants and children are less likely than adults to focus on a spectral region containing an anticipated signal and are more susceptible to remote masking of a signal. These detection tasks suggest that infants and children, unlike adults, do not listen selectively. However, less is known about children's ability to listen selectively during speech recognition. Accordingly, the current study examines remote masking during speech recognition in children and adults.

Method

Adults and 7- and 5-year-old children performed sentence recognition in the presence of various spectrally remote maskers. Intelligibility was determined for each remote-masker condition, and performance was compared across age groups.

Results

It was found that speech recognition for 5-year-olds was reduced in the presence of spectrally remote noise, whereas the maskers had no effect on the 7-year-olds or adults. Maskers of different bandwidth and remoteness had similar effects.

Conclusions

In accord with psychoacoustic data, young children do not appear to focus on a spectral region of interest and ignore other regions during speech recognition. This tendency may help account for their typically poorer speech perception in noise. This study also appears to capture an important developmental stage, during which a substantial refinement in spectral listening occurs.

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The Effect of a Voice Therapy Program Using Semioccluded Vocal Tract Exercises in Women With Behavioral Dysphonia

Publication date: Available online 1 February 2018
Source:Journal of Voice
Author(s): Vanessa Veis Ribeiro, Amanda Gabriela de Oliveira, Jhonatan da Silva Vitor, Larissa Thais Donalonso Siqueira, Pamela Aparecida Medeiros Moreira, Alcione Ghedini Brasolotto, Kelly Cristina Alves Silverio
ObjectiveThis study aims to propose and analyze the effect of a voice therapy program (VTP) in women with behavioral dysphonia.Materials and MethodsThis is a controlled, blinded, and nonrandomized cohort study. Participants of this study were 22 women with behavioral dysphonia divided into two groups: G1, 11 women with behavioral dysphonia who received the VTP, and G2, 11 women with behavioral dysphonia who did not receive any intervention. Before and after 6 weeks, the outcome variables evaluated in both groups were auditory-perceptual evaluation of the global degree of vocal quality (vowel /a/ and counting), instrumental acoustic parameters, Voice-Related Quality of Life, vocal and larynx symptoms, and musculoskeletal pain. The statistical analysis used the Wilcoxon, chi-square, and Mann-Whitney tests (P < 0.05).ResultsAfter 6 weeks, we observed a significantly higher improvement in the general degree of vocal deviation in vowels, a reduced F0 and symptom of “fatigue while talking” in G1, and an increased “shoulder” pain intensity in G2. Both groups showed improvement in the socioemotional domain of Voice-Related Quality of Life. In addition, the comparison between the groups showed a significantly greater reduction in fundamental frequency and the “voice loss” symptom in G1 compared with G2.ConclusionsThe VTP using semioccluded vocal tract exercises obtained a positive effect on voice quality, symptoms, and musculoskeletal pain in women with behavioral dysphonia. The proposal, based on the taxonomy of voice therapy, seems to have promoted a phonatory balance, muscle relaxation, and improvement in the vocal resistance of this population.



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Voice Tremor Outcomes of Subthalamic Nucleus and Zona Incerta Deep Brain Stimulation in Patients With Parkinson Disease

Publication date: Available online 1 February 2018
Source:Journal of Voice
Author(s): Fredrik Karlsson, Elin Malinova, Katarina Olofsson, Patric Blomstedt, Jan Linder, Erik Nordh
ObjectivesWe aimed to study the effect of deep brain stimulation (DBS) in the subthalamic nucleus (STN) and caudal zona incerta (cZi) on level of perceived voice tremor in patients with Parkinson disease (PD).Study DesignThis is a prospective nonrandomized design with consecutive patients.MethodsPerceived voice tremor was assessed in patients with PD having received either STN-DBS (8 patients, 5 bilateral and 3 unilateral, aged 43.1–73.6 years; median = 61.2 years) or cZi-DBS (14 bilateral patients, aged 39.0–71.9 years; median = 56.6 years) 12 months before the assessment. Sustained vowels that were produced OFF and ON stimulation (with simultaneous l-DOPA medication) were assessed perceptually in terms of voice tremor by two raters on a four-point rating scale. The assessments were repeated five times per sample and rated in a blinded and randomized procedure.ResultsThree out of the 22 patients (13%) were concluded to have voice tremor OFF stimulation. Patients with PD with STN-DBS showed mild levels of perceived voice tremor OFF stimulation and a group level improvement. Patients with moderate/severe perceived voice tremor and cZi-DBS showed marked improvements, but there was no overall group effect. Six patients with cZi-DBS showed small increases in perceived voice tremor severity.ConclusionsSTN-DBS decreased perceived voice tremor on a group level. cZi-DBS decreased perceived voice tremor in patients with PD with moderate to severe preoperative levels of the symptom.



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Voice Tremor in Parkinson's Disease: An Acoustic Study

Publication date: Available online 1 February 2018
Source:Journal of Voice
Author(s): Patricia Gillivan-Murphy, Nick Miller, Paul Carding
BackgroundVoice tremor associated with Parkinson disease (PD) has not been characterized. Its relationship with voice disability and disease variables is unknown.ObjectivesThis study aimed to evaluate voice tremor in people with PD (pwPD) and a matched control group using acoustic analysis, and to examine correlations with voice disability and disease variables.MethodsAcoustic voice tremor analysis was completed on 30 pwPD and 28 age-gender matched controls. Voice disability (Voice Handicap Index), and disease variables of disease duration, Activities of Daily Living (Unified Parkinson's Disease Rating Scale [UPDRS II]), and motor symptoms related to PD (UPDRS III) were examined for relationship with voice tremor measures.ResultsVoice tremor was detected acoustically in pwPD and controls with similar frequency. PwPD had a statistically significantly higher rate of amplitude tremor (Hz) than controls (P = 0.001). Rate of amplitude tremor was negatively and significantly correlated with UPDRS III total score (rho −0.509). For pwPD, the magnitude and periodicity of acoustic tremor was higher than for controls without statistical significance. The magnitude of frequency tremor (Mftr%) was positively and significantly correlated with disease duration (rho 0.463). PwPD had higher Voice Handicap Index total, functional, emotional, and physical subscale scores than matched controls (P < 0.001). Voice disability did not correlate significantly with acoustic voice tremor measures.ConclusionAcoustic analysis enhances understanding of PD voice tremor characteristics, its pathophysiology, and its relationship with voice disability and disease symptomatology.



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Efficacy of Two-dimensional Scanning Digital Kymography in Evaluation of Atrophic Vocal Folds

Publication date: Available online 1 February 2018
Source:Journal of Voice
Author(s): In-Ho Bae, Soo-Geun Wang, Jin-Choon Lee, Eui-Suk Sung, Seong-Tae Kim, Yeon-Woo Lee, Duck-Hoon Kang, Yong-Jin Wang
ObjectiveThe purpose of this study was to evaluate the clinical feasibility and diagnostic accuracy of two-dimensional scanning digital kymography (2D DKG) in patients with vocal cord atrophy before and after treatment.Materials and MethodsWe analyzed the characteristics of vocal fold vibration in five patients with unilateral vocal fold paralysis and five patients with presbyphonia. In patients with vocal cord paralysis, the status before and after intracordal injection was compared. Furthermore, in patients with presbyphonia, we compared the status before and after voice therapy (Seong-Tae Kim's laryngeal calibration technique). Quantitative parameters such as amplitude and phase symmetry indices, jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time and qualitative parameters such as Voice Handicap Index, glottal gap, amplitude, and phase difference were used to evaluate the pre- and post-treatment status.ResultsIn cases of vocal cord paralysis, vibratory changes of the vocal folds before and after intracordal injection could be identified immediately using 2D DKG. In overcorrection cases, all of the measured parameters were poor except for improvement of the glottal gap. In addition, 2D DKG showed appropriately the changes in vocal cord vibration before and after voice therapy in patients with presbyphonia.ConclusionTwo-dimensional DKG may be a useful diagnostic tool in evaluation of the vibratory characteristics of entire vocal cords. In addition, it may also play a role in providing a decision for treatment modalities.



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Do Standard Instrumental Acoustic, Perceptual, and Subjective Voice Outcomes Indicate Therapy Success in Patients With Functional Dysphonia?

Publication date: Available online 1 February 2018
Source:Journal of Voice
Author(s): Stephanie Reetz, Joerg E. Bohlender, Meike Brockmann-Bauser
ObjectivesThe validity and sensitivity to change of instrumental acoustic measurements in patients with functional dysphonia have been controversially discussed. This work examines combined voice therapy effects on standard acoustic measurements, and if these agree with perceptual and subjective voice outcomes.Study designRetrospective study.MethodsThirty-nine patients (26 women, 13 men) aged 20–70 years (mean: 46.3, standard deviation 12.8) with functional dysphonia were investigated before and after combined voice therapy. Instrumental parameters included mean and range of speaking fundamental frequency (fo) and intensity (SPL (dBA)); maximum SPL and mean fo of calling voice; minimum, maximum, range of singing voice fo and SPL, jitter (%), and the Dysphonia Severity Index. Voice Handicap Index-9 international was used for subjective and Grading-Roughness-Breathiness-Asthenia-Strain scale for perceptual assessment. Differences were investigated by Wilcoxon signed ranks test and coherences by Spearman rank correlation coefficient.ResultsAfter treatment, the speaking voice fo range (7–8.13 semitones) and SPL range (12.9–14.85 dB(A)) were significantly larger (P < 0.05). Both parameters were highly correlated (P < 0.001). Subjective symptoms were significantly reduced from a mean Voice Handicap Index-9 international of 15.6–8.6, and all perceptual Grading-Roughness-Breathiness-Asthenia-Strain scale parameters were significantly improved (G: 1.05–0.51) after therapy (P < 0.05). These findings were not associated with any acoustic parameter (P > 0.05).ConclusionsSignificantly improved subjective and perceptual findings verify positive combined voice therapy effects in patients with functional dysphonia. The larger fo and SPL speaking voice range after treatment indicate an altered voice technique. These instrumental measures may be clinical indicators of therapy success and transfer effects.



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Postural control deficit during Sit-To-Walk in patients with Parkinson’s Disease and Freezing of Gait

Publication date: Available online 2 February 2018
Source:Gait & Posture
Author(s): S. Mezzarobba, M. Grassi, R. Valentini, P. Bernardis
IntroductionThe intricate linkage between Freezing of Gait (FoG) and postural control in Parkinson's disease (PD) is unclear. We analyzed the impact of FoG on dynamic postural control.Methods24 PD patients, 12 with (PD + FoG), 12 without FoG (PD-FoG), and 12 healthy controls, were assessed in ON state. Mobility and postural control were measured with clinical scales (UPDRS III, BBS, MPAS) and with kinematic and kinetic analysis during three tasks, characterized by levels of increasing difficulty to plan sequential movement of postural control: walk (W), gait initiation (GI) and sit-to-walk (STW).ResultsThe groups were balanced by age, disease duration, disease severity, mobility and balance. During STW, the spatial distribution of COP trajectories in PD + FoG patients are spread over medial-lateral space more than in the PD-FoG (p < .001). Moreover, the distribution of COP positions. in the transition between sit-to-stand and gait initiation, is not properly shifted toward the leading leg, as in PD-FoG and healthy controls, but it is more centrally dispersed (p < .01) with a delayed weight forward progression (p < .05). In GI task and walk task, COM and COP differences are less evident and even absent between PD patients.ConclusionPD + FoG show postural control differences in STW, compared with PD-FoG and healthy. Different spatial distribution of COP trajectories, between two PD groups are probably due to a deficit to plan postural control during a more demanding motor pattern, such as STW.



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Postural control deficit during Sit-To-Walk in patients with Parkinson’s Disease and Freezing of Gait

Publication date: Available online 2 February 2018
Source:Gait & Posture
Author(s): S. Mezzarobba, M. Grassi, R. Valentini, P. Bernardis
IntroductionThe intricate linkage between Freezing of Gait (FoG) and postural control in Parkinson's disease (PD) is unclear. We analyzed the impact of FoG on dynamic postural control.Methods24 PD patients, 12 with (PD + FoG), 12 without FoG (PD-FoG), and 12 healthy controls, were assessed in ON state. Mobility and postural control were measured with clinical scales (UPDRS III, BBS, MPAS) and with kinematic and kinetic analysis during three tasks, characterized by levels of increasing difficulty to plan sequential movement of postural control: walk (W), gait initiation (GI) and sit-to-walk (STW).ResultsThe groups were balanced by age, disease duration, disease severity, mobility and balance. During STW, the spatial distribution of COP trajectories in PD + FoG patients are spread over medial-lateral space more than in the PD-FoG (p < .001). Moreover, the distribution of COP positions. in the transition between sit-to-stand and gait initiation, is not properly shifted toward the leading leg, as in PD-FoG and healthy controls, but it is more centrally dispersed (p < .01) with a delayed weight forward progression (p < .05). In GI task and walk task, COM and COP differences are less evident and even absent between PD patients.ConclusionPD + FoG show postural control differences in STW, compared with PD-FoG and healthy. Different spatial distribution of COP trajectories, between two PD groups are probably due to a deficit to plan postural control during a more demanding motor pattern, such as STW.



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Postural control deficit during Sit-To-Walk in patients with Parkinson’s Disease and Freezing of Gait

Publication date: Available online 2 February 2018
Source:Gait & Posture
Author(s): S. Mezzarobba, M. Grassi, R. Valentini, P. Bernardis
IntroductionThe intricate linkage between Freezing of Gait (FoG) and postural control in Parkinson's disease (PD) is unclear. We analyzed the impact of FoG on dynamic postural control.Methods24 PD patients, 12 with (PD + FoG), 12 without FoG (PD-FoG), and 12 healthy controls, were assessed in ON state. Mobility and postural control were measured with clinical scales (UPDRS III, BBS, MPAS) and with kinematic and kinetic analysis during three tasks, characterized by levels of increasing difficulty to plan sequential movement of postural control: walk (W), gait initiation (GI) and sit-to-walk (STW).ResultsThe groups were balanced by age, disease duration, disease severity, mobility and balance. During STW, the spatial distribution of COP trajectories in PD + FoG patients are spread over medial-lateral space more than in the PD-FoG (p < .001). Moreover, the distribution of COP positions. in the transition between sit-to-stand and gait initiation, is not properly shifted toward the leading leg, as in PD-FoG and healthy controls, but it is more centrally dispersed (p < .01) with a delayed weight forward progression (p < .05). In GI task and walk task, COM and COP differences are less evident and even absent between PD patients.ConclusionPD + FoG show postural control differences in STW, compared with PD-FoG and healthy. Different spatial distribution of COP trajectories, between two PD groups are probably due to a deficit to plan postural control during a more demanding motor pattern, such as STW.



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