Benefits of amplification for speech recognition in background noise

The purpose of the present study was to examine the benefits of providing audible speech to listeners with sensorineural hearing loss when the speech is presented in a background noise. Previous studies have shown that when listeners have a severe hearing loss in the higher frequencies, providing audible speech (in a quiet background) to these higher frequencies usually results in no improvement in speech recognition. In the present experiments, speech was presented in a background of multitalker babble to listeners with various severities of hearing loss. The signal was low-pass filtered at numerous cutoff frequencies and speech recognition was measured as additional high-frequency speech information was provided to the hearing-impaired listeners. It was found in all cases, regardless of hearing loss or frequency range, that providing audible speech resulted in an increase in recognition score. The change in recognition as the cutoff frequency was increased, along with the amount of audible speech information in each condition (articulation index), was used to calculate the "efficiency" of providing audible speech. Efficiencies were positive for all degrees of hearing loss. However, the gains in recognition were small, and the maximum score obtained by an listener was low, due to the noise background. An analysis of error patterns showed that due to the limited speech audibility in a noise background, even severely impaired listeners used additional speech audibility in the high frequencies to improve their perception of the "easier" features of speech including voicing

Otolaryngology and Speech Therapy evaluation in the assessment of oropharyngeal dysphagia: a combined protocol proposal

Dysphagia is a symptom associated with an array of anatomical and functional changes which must be assessed by a multidisciplinary team to guarantee optimal evaluation and treatment, preventing potential complications. Aim: The aim of the present study is to present the combined protocol of clinical and swallowing videoendoscopy carried by ENT doctors and speech therapists in the Dysphagia Group of the ENT Department - University Hospital. Materials and Methods: Retrospective study concerning the use of a protocol made up of patient interview and clinical examination, followed by an objective evaluation with swallowing videoendoscopy. The exam was performed in 1,332 patients from May 2001 to December 2008. There were 726 (54.50%) males and 606 (45.50%) females, between 22 days and 99 years old. Results: We found: 427 (32.08%) cases of normal swallowing, 273 (20.48%) mild dysphagia, 224 (16.81%) moderate dysphagia, 373 (27.99%) severe dysphagia and 35 (2.64%) inconclusive exams. Conclusion: The combined protocol (Otolaryngology and Speech Therapy), is a good way to approach the dysphagic patient, helping to achieve early and safe deglutition diagnosis as far as disorder severity and treatment are concerned.

Evaluation of oral-motor movements and speech in patients with tetanus of a public service in Brazil

The characterisation of oral-motor movements and speech of patients with tetanus were investigated to determine the existence of possible signs that are characteristic of this pathology. Thirteen patients clinically diagnosed with tetanus (10 with severe tetanus and three with very severe tetanus) and admitted to an intensive care unit underwent clinical evaluation of oral-motor movements and speech. Statistical analysis indicated significant between-group differences for speech motor functions, suggesting that individuals with very severe tetanus present rigidity as a characteristic interfering in articulatory precision (P = 0 035) and movement rate (P = 0 038). For lip closure, tongue movement, palatal elevation, gag reflex and voice quality, no between-group differences were identified for the specific abnormal characteristics. The observed abnormal results indicate that muscle strength and functional status of the oral-motor system presented by most of the participants of the study did not ensure the necessary integrity for satisfactory performance. The characterisation of the oral myofunctional aspects of patients with tetanus provides medical teams, patients and families with a wider and better description of the clinical situation, giving support to the diagnosis, prognostics and treatment.

Educating speech-language pathologists for a multicultural world

This paper presents critical elements and current needs in educating speech-language pathologists for a multicultural world. A proposed paradigm shift in clinical teaching using the UK model is also introduced. In addition, a case study on the American Speech Language Hearing Association's efforts in implementing the Multicultural Action Agenda by networking with the Asian Pacific Islander caucus is described. A survey of multicultural elements in programs in Australia and New Zealand is included. finally, suggestions for collaboration with those in established professional bodies to meet the increasing needs of a multicultural world are provided. copyright (C) 2001 S. Karger AG. Basel.