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Calandruccio L.,Hearing Health Science | Buss E.,University of North Carolina at Chapel Hill | Hall J.W.,University of North Carolina at Chapel Hill
Journal of the Acoustical Society of America | Year: 2014

Masked speech perception can often be improved by modulating the masker temporally and/or spectrally. These effects tend to be larger in normal-hearing listeners than hearing-impaired listeners, and effects of temporal modulation are larger in adults than young children [Hall et al. (2012). Ear Hear. 33, 340-348]. Initial reports indicate non-native adult speakers of the target language also have a reduced ability to benefit from temporal masker modulation [Stuart et al. (2010). J. Am. Acad. Aud. 21, 239-248]. The present study further investigated the effect of masker modulation on English speech recognition in normal-hearing adults who are non-native speakers of English. Sentence recognition was assessed in a steady-state baseline masker condition and in three modulated masker conditions, characterized by spectral, temporal, or spectro-temporal modulation. Thresholds for non-natives were poorer than those of native English speakers in all conditions, particularly in the presence of a modulated masker. The group differences were consistent across maskers when assessed in percent correct, suggesting that a single factor may limit the performance of non-native listeners similarly in all conditions. © 2014 Acoustical Society of America.

Kelly H.,Hearing Health Science
Cochrane database of systematic reviews (Online) | Year: 2010

BACKGROUND: Aphasia is an acquired language impairment following brain damage which affects some or all language modalities: expression and understanding of speech, reading and writing. Approximately one-third of people who have a stroke experience aphasia. OBJECTIVES: To assess the effectiveness of speech and language therapy (SLT) for aphasia following stroke. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (last searched April 2009), MEDLINE (1966 to April 2009) and CINAHL (1982 to April 2009). In an effort to identify further published, unpublished and ongoing trials we handsearched the International Journal of Language and Communication Disorders, searched reference lists of relevant articles and contacted other researchers and authors. SELECTION CRITERIA: Randomised controlled trials comparing SLT versus no SLT, SLT versus social support or stimulation, and one SLT intervention versus another SLT intervention. SLT refers to a formal speech and language therapy intervention that aims to improve language and communication abilities and in turn levels of communicative activity and participation. Social support and stimulation refers to an intervention which provides social support or communication stimulation but does not include targeted therapeutic interventions. Direct comparisons of different SLT interventions refers to SLT interventions that differ in terms of duration, intensity, frequency or method of intervention or in the theoretical basis for the SLT approach. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted the data and assessed the quality of included trials. We sought missing data from study investigators if necessary. MAIN RESULTS: We included 30 trials (41 paired comparisons) in the review: 14 subcomparisons (1064 participants) compared SLT with no SLT; six subcomparisons (279 participants) compared SLT with social support and stimulation; and 21 subcomparisons (732 participants) compared two approaches to SLT. In general, the trials randomised small numbers of participants across a range of characteristics (age, time since stroke and severity profiles), interventions and outcomes. Suitable statistical data were unavailable for several measures. AUTHORS' CONCLUSIONS: This review shows some indication of the effectiveness of SLT for people with aphasia following stroke. We also observed a consistency in the direction of results which favoured intensive SLT over conventional SLT, though significantly more people withdrew from intensive SLT than conventional SLT. SLT facilitated by a therapist-trained and supervised volunteer appears to be as effective as the provision of SLT by a professional. There was insufficient evidence to draw any conclusions in relation to the effectiveness of one SLT approach over another.

Skowronski M.D.,Michigan State University | Crary M.A.,Hearing Health Science | Shrivastav R.,Michigan State University
Journal of the Acoustical Society of America | Year: 2013

Spontaneous swallowing in dysphagic individuals has been shown to occur at a lower rate compared to healthy controls, and passive swallowing detection may function as a valid screening test to identify dysphagia in at-risk populations. To automate swallow identification, acoustic source and vocal tract features were extracted from two types of swallows and eight upper airway movements from nine healthy subjects. Swallow vs non-swallow classification accuracy was 96.3 ± 1.1%. The results provide useful methods for further development of automated tools for identification of patients with swallowing impairment. © 2013 Acoustical Society of America.

Beers A.N.,BC Childrens Hospital | Shahnaz N.,University of British Columbia | Westerberg B.D.,Hearing Health Science | Kozak F.K.,BC Childrens Hospital | Kozak F.K.,University of British Columbia
Ear and Hearing | Year: 2010

Objectives: Wideband reflectance (WBR) is a middle ear analysis technique that quantifies frequency-specific sound conduction over a wide range of frequencies. One shortcoming of WBR is that there is limited normative data, particularly for pediatric populations and children with middle ear pathology. The goals of this study were to establish normative WBR data for early school-aged children; to determine whether WBR differs significantly between Caucasian and Chinese children, male and female children, and children and adults (experiment 1); and to compare the normative pediatric WBR data with the WBR data obtained from children with abnormal middle ear conditions (experiment 2). Design: WBR was measured from 78 children with normal middle ear status with an average age of 6.15 yrs and 64 children with abnormal middle ear status with an average age of 6.34 yrs. Control group subjects and subjects without previously diagnosed middle ear pathology were recruited from eight elementary schools in the Greater Vancouver Area. Subjects with known middle ear pathology were recruited through the British Columbia Children's Hospital Otolaryngology department. Middle ear effusion (MEE) was identified in one of the two ways. In the British Columbia Children's Hospital group, MEE was diagnosed by a pediatric otolaryngologist (OTL) using pneumatic otoscopy and video otomicroscopy. These cases (21 ears) were classified as OTL confirmed. Subjects who were assessed through screenings at their elementary schools and suspected to have MEE based on audiological test battery results including elevated air conduction thresholds, flat low- and high-frequency tympanograms, and absent transient-evoked otoacoustic emissions were classified as not OTL confirmed (21 ears). Data were statistically analyzed for effects of gender, ethnicity (Caucasian versus Chinese), age (child versus adult), and middle ear condition. WBR equipment used for this study was from Mimosa Acoustics (RMS-system, version 4.03). Data were averaged in one-third octave bands collected from 248 frequencies ranging from 211 to 6000 Hz. Results: Control group subject data (experiment 1) revealed no effects of gender or ear, and their interactions with frequency were not significant. There was a significant interaction between ethnicity (Caucasian versus Chinese) and frequency. Chinese children had lower energy reflectance (ER) values over the mid-frequency range. ER was significantly different between pediatric data and previously collected adult data. Diseased group ER was significantly different among all four middle ear conditions (normal, mild negative middle ear pressure, severe negative middle ear pressure, and MEE) (experiment 2). The overall test performance of ER was objectively evaluated using receiver operating characteristic (ROC) curve analyses; it was compared across frequencies averaged in one-third octave bands. Statistical comparison of the area under ROC (AUROC) plots revealed that ER above 800 Hz (except for ER at 6300 Hz) had better test performance in distinguishing normal middle ear status from MEE compared with ER at 630 and 800 Hz. Although not statistically different from other frequencies between 800 and 5000 Hz, ER at 1250 Hz had the largest AUROC curve (sensitivity of 96% and specificity of 95%) and was selected for further analysis. Comparison of AUROC curves between WBR at 1250 Hz and static admittance at 226-Hz probe tone frequency revealed significantly better test performance for WBR in distinguishing between healthy ears and Mee. Conclusions: A preliminary set of normative ER data have been generated for a pediatric population between the ages of 5 and 7 yrs, which were significantly different from previously gathered normative adult ER data. In this study, pediatric normative data were warranted for testing children, but ethnic-specific norms were not required to detect middle ear pathology and changes in middle ear status. WBR shows promise as a clinical diagnostic tool for measuring the mechanoacoustic properties of the middle ear and the changes that result in the presence of negative middle ear pressure or MEE. Copyright © 2010 by Lippincott Williams & Wilkins.

Lanting C.P.,University of Groningen | De Kleine E.,University of Groningen | Langers D.R.M.,University of Groningen | Langers D.R.M.,Hearing Health Science | Van Dijk P.,University of Groningen
PLoS ONE | Year: 2014

Tinnitus is a percept of sound that is not related to an acoustic source outside the body. For many forms of tinnitus, mechanisms in the central nervous system are believed to play a role in the pathology. In this work we specifically assessed possible neural correlates of unilateral tinnitus. Functional magnetic resonance imaging (fMRI) was used to investigate differences in sound-evoked neural activity between controls, subjects with left-sided tinnitus, and subjects with right-sided tinnitus. We assessed connectivity patterns between auditory nuclei and the lateralization of the sound-evoked responses. Interestingly, these response characteristics did not relate to the laterality of tinnitus. The lateralization for left- or right ear stimuli, as expressed in a lateralization index, was considerably smaller in subjects with tinnitus compared to that in controls, reaching significance in the right primary auditory cortex (PAC) and the right inferior colliculus (IC). Reduced functional connectivity between the brainstem and the cortex was observed in subjects with tinnitus. These differences are consistent with two existing models that relate tinnitus to i) changes in the corticothalamic feedback loops or ii) reduced inhibitory effectiveness between the limbic system and the thalamus. The vermis of the cerebellum also responded to monaural sound in subjects with unilateral tinnitus. In contrast, no cerebellar response was observed in control subjects. This suggests the involvement of the vermis of the cerebellum in unilateral tinnitus. © 2014 Lanting et al.

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