Evaluating the role of speech-language pathology with patients with communication disability in the acute hospital setting using the ICF

The practice of speech-language pathology in the acute care hospital setting has changed dramatically over the last 20 years. Speech-language pathologists now routinely assess and manage patients with dysphagia as well as patients with acquired communication disorders. In practice, clinicians have tended to direct their limited resources toward the assessment and management of patients with dysphagia before addressing the needs of patients with acquired communication disorders. This practice has resulted in a decline in speech-language pathology services for patients with communication disorders and has led some clinicians to question the role of the speech-language pathologist in the acute care hospital setting. This article continues this discussion by evaluating the role of the speech-language pathologist in the acute care hospital setting within the context of the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF; WHO, 2001). It argues that by adopting the ICF, speech-language pathologists have a sound rationale for broadening their role to identify the communication needs of all hospital inpatients who experience communication difficulties in the acute care hospital setting.

Characteristics of speech following cervical spinal cord injury

The present study examined 24 individuals with either complete or incomplete injuries to the cervical spinal cord through the use of standardized assessments of dysarthria and a perceptual rating scale. Perceptual assessment revealed predominantly prosodic and phonatory disturbances, while physical impairments were common in the respiratory and laryngeal subsystems of speech production. A reduction in intelligibility and speaking rate resulted in a diminished communicative effectiveness ratio for most participants. Individuals showed a high degree of variation, with no clear relationship between lesion type and impairments present. Further investigation is required to verify the physiological nature of the respiratory and laryngeal impairments found in the present investigation and to determine the relative contributions of these to the overall presentation of speech and voice post cervical spinal cord injury (CSI).

Efficacy of speech pathology management for chronic cough: a randomised placebo controlled trial of treatment efficacy

Background: Chronic cough that persists despite medical treatment may respond to speech pathology intervention, but the efficacy of such treatment has not been investigated in prospective randomised trials. The aim of this study was to determine the efficacy of a speech pathology intervention programme for chronic cough. Methods: A single blind, randomised, placebo controlled trial was conducted in 87 patients with chronic cough that persisted despite medical treatment. Patients were randomly allocated to receive either a specifically designed speech pathology intervention or a placebo intervention. Participants in both groups attended four intervention sessions with a qualified speech pathologist. Results: Participants in the treatment group had a significant reduction in cough (8.9 to 4.6, p, 0.001), breathing (7.9 to 4.7, p < 0.001), voice (7.3 to 4.6, p < 0.001) upper airway (8.9 to 5.9, p < 0.001) symptom scores and limitation (2.3 to 1.6, p < 0.001) ratings following intervention. There was also a significant reduction in breathing (6.8 to 5.6, p=0.047), cough (7.6 to 6.3, p=0.014), and limitation ( 2.3 to 2.0, p=0.038) scores in the placebo group, but the degree of improvement was significantly less than in the treatment group (p < 0.01). Clinical judgement of outcome indicated successful ratings in 88% of participants in the treatment group compared with 14% in the placebo group ( p, 0.001). Conclusion: Speech pathology is an effective management intervention for chronic cough which may be a viable alternative for patients who do not respond to medical treatment.

Secondary school support teachers' perception of speech-language pathology services to adolescents

A survey was conducted to investigate secondary school support teachers' perceptions of speech-language pathology services to students experiencing language difficulties. Information was sought regarding support teachers' understanding of language disorder, their experience with students who have language difficulties and their involvement with speech-language pathologists with regard to these students. Support teachers' views on supporting adolescents who are experiencing language difficulties were also sought as well as information regarding their satisfaction with speech-language pathology services to adolescents. Findings indicated variations in support teachers' perceptions, including mixed views regarding how speech-language pathologists should offer assistance to students. The need for support teachers and speech-language pathologists to offer each other professional training was indicated.

Microprocessor simulation of speech-encoding

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Evaluating the appropriateness of speech input in marine applications : a field evaluation

This paper discusses the first of three studies which collectively represent a convergence of two ongoing research agendas: (1) the empirically-based comparison of the effects of evaluation environment on mobile usability evaluation results; and (2) the effect of environment - in this case lobster fishing boats - on achievable speech-recognition accuracy. We describe, in detail, our study and outline our results to date based on preliminary analysis. Broadly speaking, the potential for effective use of speech for data collection and vessel control looks very promising - surprisingly so! We outline our ongoing analysis and further work.

The verbal transformation effect:an exploration of the perceptual organization of speech

Six experiments investigated the influence of several grouping cues within the framework of the Verbal Transformation Effect (VTE, Experiments 1 to 4) and Phonemic Transformation Effect (PTE, Experiments 5 and 6), where listening to a repeated word (VTE) or sequence of vowels (PTE) produces verbal transformations (VTs). In Experiment 1, the influence of F0 frequency and lateralization cues (ITDs) was investigated in terms of the pattern of VTs. As the lateralization difference increased between two repeating sequences, the number of forms was significantly reduced with the fewest forms reported in the dichotic condition. Experiment 2 explored whether or not propensity to report more VTs on high pitch was due to the task demands of monitoring two sequences at once. The number of VTs reported was higher when listeners were asked to attend to one sequence only, suggesting smaller attentional constraints on the task requirements. In Experiment 3, consonant-vowel transitions were edited out from two sets of six stimuli words with ‘strong’ and ‘weak’ formant transitions, respectively. Listeners reported more forms in the spliced-out than in the unedited case for the strong-transition words, but not for those with weak transitions. A similar trend was observed for the F0 contour manipulation used in Experiment 4 where listeners reported more VTs and forms for words following a discontinuous F0 contour. In Experiments 5 and 6, the role of F0 frequency and ITD cues was investigated further using a related phenomenon – the PTE. Although these manipulations had relatively little effect on the number of VTs and forms reported, they did influence the particular forms heard. In summary, the current experiments confirmed that it is possible to successfully investigate auditory grouping cues within the VTE framework and that, in agreement with recent studies, the results can be attributed to the perceptual re-grouping of speech sounds.

Effects of syllable structure in aphasic errors:implications for a new model of speech production

Current models of word production assume that words are stored as linear sequences of phonemes which are structured into syllables only at the moment of production. This is because syllable structure is always recoverable from the sequence of phonemes. In contrast, we present theoretical and empirical evidence that syllable structure is lexically represented. Storing syllable structure would have the advantage of making representations more stable and resistant to damage. On the other hand, re-syllabifications affect only a minimal part of phonological representations and occur only in some languages and depending on speech register. Evidence for these claims comes from analyses of aphasic errors which not only respect phonotactic constraints, but also avoid transformations which move the syllabic structure of the word further away from the original structure, even when equating for segmental complexity. This is true across tasks, types of errors, and, crucially, types of patients. The same syllabic effects are shown by apraxic patients and by phonological patients who have more central difficulties in retrieving phonological representations. If syllable structure was only computed after phoneme retrieval, it would have no way to influence the errors of phonological patients. Our results have implications for psycholinguistic and computational models of language as well as for clinical and educational practices.