Speech Kingdom

Encino, CA, United States

Speech Kingdom

Encino, CA, United States
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Hirni D.I.,University of Basel | Kivisaari S.L.,University of Basel | Monsch A.U.,University of Basel | Taylor K.I.,University of Basel | Taylor K.I.,Speech Kingdom
Neuropsychologia | Year: 2013

Alzheimer's disease (AD) neurofibrillary pathology begins in the medial perirhinal cortex (mPRC) before spreading to the entorhinal cortex (ERC) and hippocampus (HP) in anterior medial temporal lobe (aMTL). While the role of the ERC/HP complex in episodic memory formation is well-established, recent research suggests that the PRC is required to form semantic memories of individual objects. We aimed to test whether commonly used clinical measures of episodic and semantic memory are distinctly associated with ERC/HP and mPRC integrity, respectively, in healthy mature individuals and very early AD patients. One hundred thirty normal controls, 32 amnestic mild cognitive impairment patients, some of whom are in the earliest (i.e., preclinical) stages of AD, and ten early-stage AD patients received neuropsychological testing and high-resolution anatomic and diffusion MRI. Voxel-based regression analyses tested for regions where episodic memory (delayed recall scores on the California Verbal Learning and Rey Osterrieth Complex Figure Tests) and semantic memory (Boston Naming Test, category fluency) performance correlated with gray matter (GM) regions of interest and whole-brain fractional anisotropy (FA) voxel values. When controlling for the opposing memory performance, poorer episodic memory performance was associated with reduced bilateral ERC/HP GM volume and related white matter integrity, but not with mPRC GM volume. Poor semantic memory performance was associated with both reduced left mPRC and ERC/HP GM volume, as well as reduced FA values in white matter tracts leading to the PRC. These results indicate a partial division of labor within the aMTL and suggest that mPRC damage in very early AD may be detectable with common clinical tests of semantic memory if episodic memory performance is controlled. © 2013 Elsevier Ltd.

Patterson J.,Speech Kingdom | Wilson J.A.,Newcastle University
Current Opinion in Otolaryngology and Head and Neck Surgery | Year: 2011

Purpose of review: To review the aims and clinical value of a pretreatment dysphagia assessment in head and neck cancer patients. Recent findings: Studies show that the majority of head and neck cancer patients have a functional swallow, before they commence treatment. However, those with advanced and/or pharyngeal cancer are more likely to show signs of aspiration. Changes to swallowing performance can be observed on clinical tests and a number of biomechanical differences are seen on instrumental assessment. New evidence has demonstrated that swallowing assessment prior to the commencement of treatment is predictive of swallowing difficulties up to 1 year posttreatment. The type of surgical or oncological treatment seems to be an important factor for long-term swallowing dysfunction. CONCLUSION: A swallowing evaluation is multidimensional and tests include both the clinical and the patient perspective. A pretreatment dysphagia assessment is important for identifying swallowing difficulties and highlighting patients who are likely to develop chronic dysfunction. Predictive indicators can be used to tailor patient information for the likely functional impact of treatment. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Skoruppa K.,Speech Kingdom | Peperkamp S.,French National Center for Scientific Research
Cognitive Science | Year: 2011

This paper examines whether adults can adapt to novel accents of their native language that contain unfamiliar context-dependent phonological alternations. In two experiments, French participants listen to short stories read in accented speech. Their knowledge of the accents is then tested in a forced-choice identification task. In Experiment 1, two groups of listeners are exposed to newly created French accents in which certain vowels harmonize or disharmonize, respectively, to the rounding of the preceding vowel. Despite the cross-linguistic predominance of vowel harmony over disharmony, the two groups adapt equally well to both accents, suggesting that this typological difference is not reflected in perceptual learning. Experiment 2 further explores the mechanism underlying this type of phonological learning. Participants are exposed to an accent in which some vowels harmonize and others disharmonize, yielding an increased featural complexity. They adapt less well to this regularity, showing that adaptation to novel accents involves feature-based inferences. © 2010 Cognitive Science Society, Inc.

Deary V.,Northumbria University | Miller T.,Speech Kingdom
Current Opinion in Otolaryngology and Head and Neck Surgery | Year: 2011

Purpose of review: Functional dysphonia, defined as alteration or loss of voice in the absence of physical pathology, is known to be associated with a variety of psychosocial factors including anxiety, depression and reduced quality of life. Models of functional dysphonia have tended to conceptualize the voice disorder as being the result of a failure to acknowledge and/or express this associated distress. The current literature was reviewed to identify psychosocial factors that predispose to, precipitate and perpetuate functional dysphonia and to assess the evidence for these models. Recent findings: Recent studies have identified evidence of genetic susceptibility, occupational susceptibility, a history of sexual and/or physical abuse and perfectionism as being predisposing factors. Precipitants include life events, frequency of vocal use and infections. General fatigue is identified as being a potential perpetuating factor. A recent novel theoretical model of functional dysphonia is reported, which proposes deficits in emotional processing as the core process in voice loss. Summary: Current research confirms that functional dysphonia is associated with multiple psychosocial factors. However, these findings are shown to be true of other medically unexplained symptoms in which vocal problems are absent. It is argued that, whilst intuitively appealing, there is insufficient evidence to support the popular notion that the loss of voice is the consequence of unexpressed emotion. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Broomfield J.,Speech Kingdom | Dodd B.,City University London
International Journal of Language and Communication Disorders | Year: 2011

Background: A randomized controlled trial was conducted of a whole-service cohort of children referred to the Paediatric Speech and Language Therapy Service of Middlesbrough Primary Care Trust between January 1999 and April 2000. The 730 children involved, aged up to 16 years, were diagnosed with primary speech and/or language impairment in the absence of any learning, physical or sensory difficulty. Aims: The study considered outcomes of treatment versus no treatment. Methods & Procedures: Treatment involved clinic-based interventions, provided according to local departmental criteria and care pathways, averaging 5.5 h (range 0-24 h) of contact during the 6-month period immediately following initial assessment. Assessments occurred within 8 weeks of referral and intervention began immediately thereafter. Outcomes & Results: Treatment was significantly more effective than no treatment, over 6 months, both overall (p < 0.001) and for each of the three diagnostic categories (comprehension, expression and speech, each p < 0.001). Conclusions: An average of 6 h of speech and language therapy in a 6-month period can produce significant improvement in performance, and it has been shown to be more effective than no treatment over the same 6-month period for children with primary speech and/or language impairment. © 2011 Royal College of Speech and Language Therapists.

Roulstone S.,Speech Kingdom
International Journal of Speech-Language Pathology | Year: 2015

Purpose: This paper examines the relationship between components of evidence-based practice (clinical expertise, patient perspective and research evidence). Method: Findings are examined from two research programs: the Better Communication Research Program and Child Talk, including exploratory studies of the views of parents and children regarding speech-language pathology and studies of current practice by SLPs in England. Systematic reviews of the research literature were also undertaken. The paper analyses relationships between outcomes valued by children and parents and those reported in the literature and in practice, parents' perspectives regarding intervention in comparison with clinicians' reports of practice and the extent to which research evidence underpins current practice is examined. Result: Parents and children value functional outcomes and positive experiences; these are not routinely measured in research or practice. Therapy is perceived positively by most parents; however, some are ambivalent and less clear about the rationale. Commonly used interventions are supported by evidence, but there are gaps regarding some critical therapy components. Conclusion: The paper discusses four challenges to evidence-based practice: the consistency and clarity of descriptions of interventions; consensus based models of practice; understanding of the mechanisms of change; and, finally, the operationalization of client preferences within an evidence-based practice framework. © 2015 The Speech Pathology Association of Australia Limited.

De Lamo White C.,Speech Kingdom | Jin L.,De Montfort University
International Journal of Language and Communication Disorders | Year: 2011

Background: British society is multicultural and multilingual, thus for many children English is not their main or only language. Speech and language therapists are required to assess accurately the speech and language skills of bilingual children if they are suspected of having a disorder. Cultural and linguistic diversity means that a more complex assessment procedure is needed and research suggests that bilingual children are at risk of misdiagnosis. Clinicians have identified a lack of suitable assessment instruments for use with this client group. Aims: This paper highlights the challenges of assessing bilingual children and reviews available speech and language assessment procedures and approaches for use with this client group. It evaluates different approaches for assessing bilingual children to identify approaches that may be more appropriate for carrying out assessments effectively. Methods & Procedures: This review discusses and evaluates the efficacy of norm-referenced standardized measures, criterion-referenced measures, language-processing measures, dynamic assessment and a sociocultural approach. Outcomes & Results: When all named procedures and approaches are compared, the sociocultural approach appears to hold the most promise for accurate assessment of bilingual children. Research suggests that language-processing measures are not effective indicators for identifying speech and language disorders in bilingual children, but further research is warranted. The sociocultural approach encompasses some of the other approaches discussed, including norm-referenced measures, criterion-referenced measures and dynamic assessment. Conclusions & Implications: The sociocultural approach enables the clinician to interpret results in the light of the child's linguistic and cultural background. In addition, combining approaches mitigates the weaknesses inherent in each approach. © 2011 Royal College of Speech and Language Therapists.

Code C.,University of Exeter | Petheram B.,Speech Kingdom
International Journal of Speech-Language Pathology | Year: 2011

Providing a quality service for people with aphasia is a primary goal of speech-language pathologists working with neurogenic communication disorders. This paper reviews what is known about the incidence and prevalence of aphasia and what services are provided for people with aphasia. On the basis of the stroke data, the incidence of aphasia in the developed world ranges between 0.02-0.06% with prevalence ranging between 0.1-0.4%. Average hours of treatment for aphasic people in the developed world ranges between 1-5 hours per week, with a great deal of variability, although recent research suggests that intense treatment of ∼ 9 hours per week over a relatively short period is needed in order to be effective. It is concluded that there is a significant gap between what the research suggests is the appropriate amount of treatment and actual provision throughout the English-speaking world. © 2011 The Speech Pathology Association of Australia Limited.

Hayhow R.,Speech Kingdom
International Journal of Language and Communication Disorders | Year: 2011

Background: Within medicine there is an agreed hierarchy of levels of research evidence with randomized controlled trials at the top and expert opinion at the bottom. When randomized controlled trials are the final stage in testing a treatment for which there is a sound theoretical basis both the 'Does it work?' and 'How does it work?' questions may be answered. However, when the theoretical basis is underdeveloped or contentious, then randomized controlled trials will provide only partial answers and other methods or methodologies may be needed to understand more about the mechanisms involved in the treatments. Aims: This paper aims to contribute to the debate about the nature of the evidence that is required in order to feel confident that people with communication difficulties will benefit from the treatments offered. The aim is not to discuss the relative merits of one methodology over another, but rather, by referring to one particular treatment, to show how knowledge gained from a range of research studies, using different methodologies, can be synthesized to increase one's understanding. Methods & Procedures: The initial discussion focuses on two frameworks that have been developed specifically for the evaluation of healthcare interventions. This is followed by discussion of the research evidence for the Lidcombe Program of early stuttering intervention to illustrate some issues relevant to treatment development and evaluation in the field of communication difficulty. The evidence from randomized controlled trails is related to clinicians' needs. Finally, the potential value of an iterative approach is illustrated with reference to verbal contingencies, which are an essential component of the Lidcombe Program. Main Contribution: This paper considers different sorts of evidence and their contribution to one's knowledge and practice. The content provides a practical example of how knowledge and understanding of a treatment approach can develop through a synthesis of knowledge from a programme of systematic research, from research outside the field of communication difficulty, and from the process of making sense of the experiences of both clinicians and clients who use the approach. Conclusions & Implications: The questions 'Does it work?' and 'How does it work?' are important and require different methods of investigation. Particular treatments may be viewed as better suited to one research methodology over another, but limiting research to one fails to provide the information that practitioners need in order to justify what they do and effectively to solve problems encountered in the application of particular approaches. © 2010 Royal College of Speech & Language Therapists.

Kean K.H.,Speech Kingdom
Tizard Learning Disability Review | Year: 2016

Purpose - The purpose of this paper is to provide a commentary on Clare Mander's paper entitled "An investigation of the delivery of health-related accessible information for adults with learning disabilities". The commentary discusses issues identified by the author in the field of accessible information and, more generally, inclusive communication practice. Design/methodology/approach - This commentary reviews factors which influence the communication accessibility of services and the policy, legislative and economic case for mainstreaming inclusive communication approaches. It highlights diversity in the definition of inclusive communication and the scope of its necessary implementation before proposing an approach to establishing consensus on the way forward. The commentary suggests how the task of mainstreaming inclusive communication throughout public services could be addressed, reflects on progress to date and proposes next steps for the growing numbers of those with an interest. Findings - Many factors influence communication accessibility. The communication attitude, knowledge, skills and resources individual providers and recipients bring to each interaction are as important as the whole organisation's approach towards and investment in inclusive communication approaches. Legislation, policy, demographics and reducing budgets increase the requirement to mainstream inclusive communication approaches. Achieving this objective is an enormous task. Originality/value - Reflecting on all the drivers and influences on the objective of achieving mainstreamed quality inclusive communication practice throughout public services, the author offers potential suggestions for starting to address this enormous but worthwhile task with a view to generating discussion and collaboration among those with an interest. © Emerald Group Publishing Limited.

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