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Setsuko Ogawa, Toshio Hosaka
1996 Volume 37 Issue 3 Pages
275-283
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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Effective communication methods using computerized communication aids were tested for six severe dysarthria patients who were incapable of speech and writing. All patients had been using yes-no responses and other communication methods, but these were not useful enough. Initially the various communication aids were compared in terms of individual features. The stages of treatment consisted of evaluation, aid selection, training in usage, and practice. At the same time, motivating patients to use aids voluntarily and adjusting the environment to each patient's needs using the aids were attempted through the entire treatment. At the end of treatment we found that the achievement of voluntary use of computerized communication aids was influenced by four factors: aid selection, training in usage, motivation and adjustment of environment. Findings also suggested that we need to use methods of communication properly according to each specific purpose.
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Yuichiro Hama
1996 Volume 37 Issue 3 Pages
284-288
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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The purpose of this study was to clarify the acoustical differences between normal articulation sounds [s] and Interdental articulation sounds [θ] .
Power spectrograph analysis was performed to test the sounds“asa”in 16 normal articulation speakers and 16 Interdental articulation speakers. Using the Fast Fourier Transform (FFT) for the consonant [s], the ratio of energy in the high frequency area (4kHz-8kHz) to that in the low frequency area (0 kHz-4 kHz) was calculated.
The results were as follows.
1. Evaluation of consonant [s] sounds by the ratio of the high frequency area to the low frequency area showed Interdental articulation sounds [θ] clearly distinguished from normal articulation sounds [s] .
2. In normal articulation speakers, the ratio of the high frequency area to the low frequency area was over 1.35.
3. In Interdental articulation speakers, the ratio of the high frequency area to the low frequency area was below 1.30.
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—Based on Examination of an Articulation-Disordered Child—
Kikuko Hayasaka
1996 Volume 37 Issue 3 Pages
289-297
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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We investigated primary prevention of stuttering using three preventive strategies adovocated by ASHA, applied to one case study. The purpose of such primary prevention is to prevent communication disorders before they appear.
The subject was a four-year-and-four-month-old male whose parents were anxious about his articulation. The core symptom of stuttering -syllable repetition- was observed in his speech during free play situations, but frequency was very slight. The parents were not concerned about his potential stuttering. Though we did not give guidance specifically about stuttering, we gave guidance about speech hygiene in order to decrease varuous pressures-communicative, physical and emotional. These are the main precipitating factors of stuttering.
The therapy of the articulation disorder focused on total physical and tongue movements to improve coordination skills. Because the frequency of stuttering increased and hesitation at the onset of speech was observed after an eight-month period from the intake session, we tried even harder to prevent the precipitation of stuttering through environmental adjustment. At present, we continue to follow this case, and he shows no stuttering behavior.
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Ichiko Kitano
1996 Volume 37 Issue 3 Pages
298-304
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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The author describes the favorable course after palatoplasty of a secondary adult cleft palate patient, a Brazilian of Japanese ancestry speaking Portuguese as her mother language, who learned Japanese only after coming to Japan. The patient achieved good velopharyngeal function in Japanese before Portuguese. The following characteristics were clarified by speech analysis of both languages in the course.
1) The production rates of normal word sounds with respect to the sum of stops, fricatives and affricates were 95% in Japanese and 68% in Portuguese, using a sampling of picture-drawings. This difference was significant according to the chi-square test.
2) Word endings rose and auxiliary words were omitted, with a tendency to use telegraphese noted.
3) A tendency toward appearance of approximately one-second pauses between individual words was present.
4) When mistakes such as nasalization of some words occurred, correction followed by spontaneous repetition, until correct pronunciation of the target word was finally achieved.
5) Frequently used and fluently produced words showed a transient tendency to hyperrhinolalia. However, speech evaluation 3 years after surgery revealed loss of this tendency and acquisition of good velopharyngeal function in both Japanese and Portuguese.
From the above results it was surmised that in the course of acquiring Japanese the monitor of this patient in spontaneous speech naturally promoted the application of velopharyngeal function, thereby enhancing her ability to produce correct word sounds. Moreover, since the vowel system of Portuguese resembles that of Japanese, and because most of its syllables also end in vowels, it was easy for this patient to recognize Japanese and possible to obtain a correct sound impressions of the target words. This was thought to be the reason why improvement occurred in Japanese earlier than in Portuguese despite the latter being the mother language.
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Gentaro Mizojiri, Yuko Shiba, Hiroko Yonekawa, Masaki Furukawa, Gota T ...
1996 Volume 37 Issue 3 Pages
305-311
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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The purpose of this study was to investigate matters which are required to elevate the reproducibility of perceptual evaluation using the GRBAS scales. As examiners, 5 otolaryngologists, 6 speech therapists and 6 students evaluated tape-recorded sustained vowels of 99 cases with various voice disorders. On the whole, the intra-and interexaminer's correlation coefficient was high for the G, R and B scales. However, the examiner's individual scaling standards differed from each other for the G and R scales.
Poor reproducibility was observed for the A and S scales. Listening conditions for the evaluation affected reproducibility. We proposed the following points. Quantitative standards for the G, R and B scales should be established. If evaluation is performed using tape-recorded vowels, pausing or repeating playback should be permitted until the examiner reaches his judgment. Anyone who understands the meanings of the GRBAS scales should be eligible to act as an examiner.
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Hideto Saigusa, Kenjirou Ushio, Mayumi Kunitomo, Seiji Niimi, Toshiaki ...
1996 Volume 37 Issue 3 Pages
312-316
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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Surgical treatment performed until recently for (acquired) velopharyngeal closure incompetence has consisted of plasty of the pharyngeal flap, shortening of the pharynx, and plasty of the ridge of the posterior pharyngeal wall. However, these surgical procedures have not been well documented, and have not always yielded the expected results. Therefore, we have developed a new surgical approach for treatment of velopharyngeal closure incompetence. Prior to surgery, we observed by nasopharyngeal fiberscope how the incompetence of the velopharyngeal closure could be improved by pushing the pharyngopalatine arch and the softpalate to the pharyngeal wall at phonation of non-nasal sounds, and swallowing. Then, we determined the most effective region from the pharyn-gopalatine arch to the softpalate where we should perform the surgical procedure.
The surgical procedure was as follows.
(1) Under general anesthesia, with the patient's mouth opened by a mouth gag and the base of the tongue depressed as is done for a tonsillectomy, a mucosal incision was made in the pharyngopalatine arch and a parallel incision was made in the pharyngeal wall.
(2) The mucosa between the two incisions were excised.
(3) The superior constrictor pharyngeal muscle was cut along the incision on the pharyngeal wall, and the muscle was dissected out from the deep fascia (to create a retropharyngeal space) .
(4) The stripped flap was inserted in the retropharyngeal space and sutured with 4-0 nylon thread.
We performed this procedure in three patients suffering from nasal escape and rhinolalia. Follow-up of the patients post-operatively showed improvement of velopharyngeal closure and relief of symptoms.
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Akiko Hayashi, Toshisada Deguchi, Shigeru Kiritani
1996 Volume 37 Issue 3 Pages
317-323
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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Effectiveness of the headturn preference procedure (HPP) in studying the perceptual ability of infants was examined using selected pairs of speech stimuli. In HPP, the durations of an infant's attention to each of two types of auditory stimuli are measured to examine whether infants discriminate between these stimuli. In Exp. 1, a stimulus pair of child-directed speech and band-limited noise was presented to 24 4-to 11-month-old infants. The infants demonstrated a significant preference for the speech samples. In Exp. 2, a stimulus pair of Japanese speech (native language) and English speech (non-native language) was presented. The younger group, 20 infants aged from 134 to 200 days old, did not show a significant preference for one language over the other. However, the older group, 20 infants aged from 201 to 332 days old, significantly preferred the native language. This developmental change resulted from a considerable decrease in the duration of the infant's attention with the non-native language. The present results show that HPP is sensitive enough to examine response characteristics of infants to speech stimuli and their developmental changes.
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Masahiro Kawaida, Hiroyuki Fukuda, Naoyuki Kohno
1996 Volume 37 Issue 3 Pages
324-329
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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Surgical instruments used in phonosurgery are introduced in this paper. In particular, since laryngomicrosurgery using a direct laryngoscope is especially important in the field of phonosurgery, laryngomicrosurgical instruments, including a direct laryngoscope, forceps, snare and surgical microscope, are explained in detail. In addition, our outlook for this area is described from the viewpoint of the future view of phonosurgery.
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Naosuke Sugai
1996 Volume 37 Issue 3 Pages
330-334
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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In anesthesia for phonosurgery, patients, surgeons and anesthesiologists have to share the airway. This makes anesthesia difficult although the surgery is sometimes relatively simple. Therefore, good teamwork is especially important. Elderly patients scheduled for surgery of a laryngeal tumor are often compromised with cardiovascular abnormalities and/or diabetes mellitus requiring thorough preoperative evaluation and treatment. Laryngomicrosurgery can be performed easily under inhalation anesthesia using an endotracheal tube of a smaller diameter than usual, but neuroleptanalgesia can be employed when phonation is required during the surgery. The author's method of general anesthesia for laryngomicrosurgery is described in detail. In anesthesia for infants with cleft palate, other orofacial abnormalities are common, making endotracheal intubation especially difficult. In these children, thorough preoperative evaluation is necessary for safe conduct of anesthesia.
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Yutaka Isogai
1996 Volume 37 Issue 3 Pages
335-339
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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The present status of laryngeal endoscopy using a flexible laryngofiberscope, videoendoscope, oblique-view type laryngoscope and curved laryngoscope was discussed, along with the future outlook to be expected from the rapid development of the digital image processing technique.
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Takashi Masuda, Yoshimitsu Ikeda, Sohtaro Komiyama
1996 Volume 37 Issue 3 Pages
340-341
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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We discussed the roles of phoniatric function tests in phonosurgery. It is important that phoniatric function tests should be arranged systematically and be applicable as soon as possible after phonosurgery.
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Hiroya Yamaguchi, Hitoshi Inoue
1996 Volume 37 Issue 3 Pages
342-346
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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There are two major therapeutic procedures for vocal disorders due to causes other than malignant tumors, namely, phonosurgery and conservative therapy. Conservative therapy consists of pharmaceutical treatment and voice therapy. The main purposes of pre-operative treatment are to check the general physical condition of the patient to treat local inflammation and to control bad vocal habits, if present.
The purposes of post-operative treatment consist of attainment of early wound healing, prevention of recurrence, and fine and minute adjustment of the vocal folds so as to attain a better quality of voice.
The weight of the course of treatment is as follows:
10% pre-operative treatment, 60% phonosurgery and 30% post-operative treatment.
In this report, we emphasize the importance of voice therapy before and after phonosurgery.
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Miyoko Ishige, Seiji Niimi, Koichi Mori
1996 Volume 37 Issue 3 Pages
347-354
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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The electroglottogram (EGG) has been used to measure details of vocal fold vibratory cycles for more than two decades. EGG offers advantages not only for research but also in clinical situations, as it is the most non-invasive technique for subjects and can be performed relatively easily, without requiring any expensive apparatus. It is not uncommon in Europe and the United States for EGG to be used in the clinic for routine examinations of pathological vibrations of the vocal fold.
This article covers a variety of aspects relating to EGG including the basic operating principles, the apparatus arrangement, what the EGG waveform actually represents, the validity of the wavef orm, and interpretation of the idiealized wavef orm. In addition, the usefulness of EGG as a technique to measure vibratory cycles both for physiological and pathological vocal folds, objective and visible recordings and biofeedback in voice therapy are described.
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[in Japanese]
1996 Volume 37 Issue 3 Pages
355
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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Noriko Kurauchi
1996 Volume 37 Issue 3 Pages
356-361
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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The author worked with an implanted child, deafened at the age of four years and two months, whose average hearing level was more than 135dB. The patient was introduced to a new type of language intervention program, developed by the author, consisting two stages : pre-implantation (off-rehabilitation) and post-implantation (onrehabilitation) .
By three months after introducing the cochlear implant, the child acquired the ability to discriminate words, groups of words and sentences without lip reading. The new program was thereby seen to be effective in establishimg fundamental communication and promoting language structure and language function through visual media during the offrehabilitation phase.
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[in Japanese]
1996 Volume 37 Issue 3 Pages
362-366
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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Haruo Takahashi, Yasushi Naito, Iwao Honjo
1996 Volume 37 Issue 3 Pages
367-371
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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The appropriate age for cochlear implant surgery in children is discussed from the viewpoints of plasticity of the brain for speech perception, development of temporal bone, and incidence of otitis media, by reviewing literature. In prelingually-deaf children with a cochlear implant, only extremely poor activation of the auditory association area was observed by verbal stimulation in positron emission tomography. Thickness of the temporal bone was of wide variety in children based on computed tomography. Incidence of otitis media was found to decrease with age from a peak at 1 year old, and was found to be quite low by the age of 3 or 4. These findings suggest that the appropriate age for cochlear implantation in children seems to be within 2 to 3 years from the age of 3 or 4.
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Naoki Onuma
1996 Volume 37 Issue 3 Pages
372-377
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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In order to arrive at an understanding of concern in the education of cochlear implant children, this paper presents an overview of state of auditory compensation for severe-to-profound hearing-impaired children as practiced in Japan in schools for the deaf and special classes for the hard-of-hearing which promote maximum use of residual hearing.
The following issues relating to the hearing compensation environment of pre-lingual deaf children who are expected to learn auditory skills through cochlear implants are discussed:
1. Benefits of early start of education of hearing compensation.
2. Role of educational audiologists in schools for the deaf.
3. Educational placement of hearing-impaired children.
4. Educational support for parents anticipating auditory benefits from cochlear implants in their children.
5. Pre-operative auditory training of cochlear implant candidates.
6. Enhancement of acoustic environment of classrooms.
7. Improvement of educational environment to enhance auditory learning approach.
8. Benefits of speech training emphasizing high frequency characteristics of cochlear implants.
9. Relationship between hearing compensation and use of sign language.
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Michio Kawano, Iwao Honjo, Yasushi Naito, Haruo Takahashi, Yosaku Siom ...
1996 Volume 37 Issue 3 Pages
378-382
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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The purpose of this paper is to demonstrate the importance of psychological management for schoolchildren with cochlear implants. The subjects were four deaf schoolchildren, two with prelingual and two with postlingual deafness. The prelingually deaf children needed to attend regular elementary school classes so that they could be exposed more to spoken language communication. With the postlingually deaf children, parents and teachers needed to understand that listening difficulty continues even after implantation, so that such children can be accepted and helped to overcome their incomplete listening. Parents and teachers should also understand their necessity of lipreading. Significant recovery from hearing disorders with implantations depends on appropriate psychological support to children before and after the implantation. In this sense, a multi-disciplinary team approach is needed in the rehabilitation of schoolchildren with cochlear implants.
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[in Japanese]
1996 Volume 37 Issue 3 Pages
383
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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[in Japanese], [in Japanese]
1996 Volume 37 Issue 3 Pages
384-385
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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[in Japanese], [in Japanese]
1996 Volume 37 Issue 3 Pages
386-387
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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1996 Volume 37 Issue 3 Pages
388-389
Published: July 20, 1996
Released on J-STAGE: June 22, 2010
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