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Volume 42 (2001)
- Issue 4 Pages 304-
- Issue 3 Pages 205-
- Issue 2 Pages 121-
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Volume 42, Issue 4
Displaying 1-11 of 11 articles from this issue
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—With the Aim of Prevention—Naomi Mizokami, Kikuko Hayasaka2001 Volume 42 Issue 4 Pages 304-310
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSIn this study, we investigated which factors influence onset of stuttering using a follow-up survey. The subjects were 5-year-old children (N=171) who had been examined in our previous study two years before. Data were obtained through their parents, using a questionnaire. The questionnaire consisted of three scales for measuring the parentchild semantic relationship, child's personality, and disfluency in the child's speech.
We classified the subjects into two groups (Improved and unimproved) according to change in the child's disfluency over two years, and compared them in terms of the parent-child semantic relationship and personality.
The results Indicated that changes in a child's disfluency can be effected by the factors of over-protection or unacceptance in the context of the parent-child semantic relationship, as well as child's dependence on the mothers in the formation of its child's personality.
We concluded that (1) over-protection by parents can bring out a child's dependence on the mother, which is one of the sustaining factors of disfluency: (2) parents' dominance or unacceptance in the parentchild semantic relationship can worsen the child's disfluency, and are therefore considered reinforcement factors of disf luency ; (3) as the degree of disf luency increases, parents' attitudes may become more over-protective or unaccepting, which can sustain and reinforce disfluency in the child's speech.
Finally, we indicated that early intervention in the parentchild semantic relationship could have an effect on prevention against onset of stuttering.View full abstractDownload PDF (849K) -
Atsushi Takeda, Emiko Oikawa, Seiko Murai2001 Volume 42 Issue 4 Pages 311-319
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSThis study was carried out in order to find out what prognostic factors affect children with specific language impairment. The subjects were 134 children who were diagnosed as having a specific language impairment at our clinic from 1988 to 1999. They were classified into two subtypes, those exhibiting expressive language delay and those showing receptive language delay. A significant difference between the two groups was seen at each time point and when the whole period of follow up was compared with a Kaplan-Meier analysis and the logrank test.
The expressive language delay group demonstrated significantly better prognosis than the receptive language delay group. Cox's proportional hazard regression model was used to investigate whether any clinical prognostic factors were confounding the underlying catch-up time. Gender and expressive/receptive language development were identified as prognostic factors affecting catch-up time.
Especially, receptive language development was seen as the most important factor.
In conclusion, it is useful for purposes of projecting prognosis to classify specific language impairment into two subtypes according to receptive language development.View full abstractDownload PDF (1184K) -
Yoshiji Kojima2001 Volume 42 Issue 4 Pages 320-324
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSPatients with spastic dysarthria and ataxic dysarthria were tested for voluntary control over speech breathing during reading and for motor speech performance. Five subjects without dysarthria provided comparison data.
Frequency of speech breathing closely correlated with speech intelligibility. Correlation between frequency of speech breathing and maximum phonating duration was relatively low.
Besides maximum phonating duration, acuity of articulatory movements affected speech breathing in patients with spastic dysarthria, whereas voluntary control over the timing of speech breathing was important in patients with ataxic dysarthria.
The findings point to the usefulness of our test for evaluating speech breathing during reading.View full abstractDownload PDF (582K) -
[in Japanese]2001 Volume 42 Issue 4 Pages 325
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSDownload PDF (128K) -
Emi Zuiki Murano2001 Volume 42 Issue 4 Pages 326-331
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSSpasmodic dysphonia (SD) is a rare neurological disorder whose etiology is still unknown. In most cases, diagnosis is achieved mainly through perceptual evaluation of the patient's voice. Nevertheless some care must be taken in order to avoid misdiagnosis. The present paper is divided into three parts. The first part discusses the SD as first reported in the literature and its definition, and gives an overview of the historical aspects of SD as to how voice professionals have changed their approach towards the disease over the years. The second part depicts the most important approaches that a voice professional should pursue in order to achieve adequate diagnosis of SD. Although acoustic-perceptual evaluation is the main means of diagnosing SD, two other aspects should be considered. One is observation of laryngeal behavior during phonation of predetermined tasks. The other is careful history-taking from patients suspected of SD in order to distinguish them from other patients with other voice disorders who have similar or identical voice characteristics. The third part describes the major differential diagnoses that should be considered with all the patients suspected of SD.View full abstractDownload PDF (2621K) -
Kiyoshi Makiyama, Masanobu Kumada, Takeo Kobayashi2001 Volume 42 Issue 4 Pages 332-342
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSThis study reviewed the usefulness of voice assessment methods for evaluation of the severity of spasmodic dysphonia (SD) . The methods reviewed were the mora method, acoustic and aerodynamic analyses, and a questionnaire for patients concerning inconvenience in daily living. There was a strong correlation between results by the mora method and the perceptual rating score. The mora method was useful also for severity assessments during follow-up. The time required to read sentences aloud and the sum of the acoustically silent periods during reading (phonatory breaks) were evaluated. The ratio of the sum of phonatory breaks to reading time (aphonetic time ratio) was also studied. The aphonic time ratio, shimmer, SNR, and standard deviation of the flow correlated significantly with the perceptual rating score, A questionnaire for evaluation of inconvenience in various situations of daily living due to SD was prepared, and its results were compared with the perceptual rating score. Inconvenience experienced by patients in their daily living, some of which cannot be detected during consultations, could be assessed by the questionnaire.From the results obtained, we propose the following parameters for evaluation of the severity of SD: severity according to perceptual evaluation, time of counting from 1 to 20, time of reading aloud, MPT, mora method, jitter, shimmer, SNR, STD-F0, sum of phonatory breaks, aphonetic time ratio, and the patient's self-evaluation of inconvenience.View full abstractDownload PDF (3100K) -
—Investigation by Questionnaire—Ryuichi Yamazaki2001 Volume 42 Issue 4 Pages 343-347
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSQuestionnaires were sent to physicians and speech and hearing therapists who examined and treated patients with spasmodic dysphonia (SD) during a 5-year period from 1994 to 1999. Questioned were the number of SD patients seen in the past 5 and 1 years, age of onset, age of initial visit, sex, classification and treatment methods. The questionnaires were sent to 81 facilities in the nationwide university hospitals, of which 45 facilities, or 56%, responded. Questioned also were the number of new outpatients in the past year and the number of patients with laryngeal cancer, sudden deafness or Bell's palsy, The morbidities of patients with the above diseases were compared retrospectively with that of spasmodic dysphonia. The findings of investigation are as follows.
1. The number of patients scen in the past 5 years was 224. Sex was confirmed in 169 patients ; 31 males (18.3%) and 138 females (81.6%) or sex ratio 1: 4.4. The ratio of the females to males was relatively higher than that found in the literatures.
2 . Classification was confirmed in 169 patients, of whom 153 (91%) had adductor type and 16 (9.5%) abductor type.
3 . Age of onset as a whole was between 14 and 77 years old (average 36.7), that of adduction type was between 14 and 77 (average 37.2) and abduction type between 15 and 71 (average 33.1) .
4 . The estimated morbidity of SD per 100, 000 population was inferred to be 0.29 originating from laryngeal cancer, 0.77 from sudden deafness and 0.94 from Bell's palsy.View full abstractDownload PDF (538K) -
Noriko Kobayashi, Hajime Hirose, Minako Koike, Yuki Hara, Hiroya Yamag ...2001 Volume 42 Issue 4 Pages 348-354
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSVoice therapy was conducted for 17 patients with spasmodic voice disorder (SD) in order to examine the effectiveness of voice therapy. Six voice therapy methods which have been known to be effective for the reduction of laryngeal tension or constriction as well as a training method for slow speech rate were used. The voice characteristics of the patients were evaluated by 3 speech therapists based on auditory impression of the degree and frequency of laryngeal constriction perceived in voice. Therapy was completed with 9 patients showing the improvement of voice quality, disappearance of difficulty in voice use, and the satisfaction of the patients. Therapy was discontinued in 2 patients as they could not attend the therapy session regularly. Therapy was still in process with 6 patients as their vocal symptoms were improving. Among 9 patients whose therapy was completed, no common factors such as age, time period between the onset of the disorder and the initiation of therapy, number of therapy sessions, severity of voice disorder were found.Four patients who revealed severe voice disorder at the initiation of therapy showed remarkable improvement and their voice was “mild” in the final evaluation. “Phonation with sigh” and “breathy phonation” were found to be effective in many patients as well as the use of slow speech rate. The results of the present study indicated that voice therapy was effective as a treatment method for SD patients and that the therapy outcome varied depending on the training methods.View full abstractDownload PDF (827K) -
Masanobu Kumada, Emi Murano, Takeo Kobayashi2001 Volume 42 Issue 4 Pages 355-361
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSAs the treatment for adductor-type spasmodic dysphonia, we mainly choose Botulinum toxin (BT) injection to thyroarytenoid muscles because it is very effective and non-invasive without any severe side effects. A neurotoxin BT type-A, produced by Clostridium botulinum, acts on neuromuscular junctions and causes temporal light palsy on the muscles. Its effectiveness continues for about three months on the average and almost one year at the most. Its main side effects are breathy hoarseness and misdeglutition. Both are not severe and continue for two weeks at most, if any. BT is injected paracutaneously from the neck to the muscle with a special 23gauge needle, which is insulatedly coated and also used as an electrode to obtain electromyography from the muscle to confirm that the needle is in the muscle. For the first injection, 2.5 mouse units (MU) of BT are injected on one side only, and then, for the following injections, the quantity is adjusted with the reference of effectiveness. The main options are 2.5 MU on one side only, 2.5 MU on each of both sides, 5.0 MU on one side only, and 5.0 MU on each of both sides.View full abstractDownload PDF (990K) -
Nobuhiko Isshiki2001 Volume 42 Issue 4 Pages 362-368
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSThyroplasty type 2, or midline lateralization thyroplasty, was performed on 11 patients with adductor spasmodic dysphonia.The voice was much improved in all except one case where the other dystonia (spasmodic torticollis), resulting in hypertrophic thyroid cartilage, made it impossible to widen the glottis. Under local anesthesia, an incision was made in the midline of the thyroid ala, leaving the underlying soft tissues intact, and the incised edges were separated to widen the glottal closure during phonation. This procedure immediately induced much relief in strain for phonation. The separation width, most frequently 3-4 mm, was maintained with use of silicone wedges.
Over-correction is advisable, taking postoperative scar contraction into account. This surgery, without inducing any disability of normal functions, has advantages of being safe, adjustable, and revisable.View full abstractDownload PDF (956K) -
Yuka Nakanishi2001 Volume 42 Issue 4 Pages 369-374
Published: October 20, 2001
Released on J-STAGE: June 22, 2010
JOURNAL FREE ACCESSPURPOSE : The purpose of this study was to investigate psychosocial consequences in patients with Spasmodic Dysphonia (SD) .
METHOD : A questionnaire was administered to 35 patients diagnosed with SD, and who were receiving Botlinum toxin treatment. Questions pertained to the length of time taken until patients were diagnosed with SD, and patients' socio psychological status and social activities.
RESULTS : 28 replies were received (80% response rate) . The study demonstrated that many patients experienced a long delay before diagnosis of SD was reached.
Patients often were required to visit two or more hospitals prior to eventual diagnosis. In addition, patients reported increased social isolation and eventual avoidance of situations in which they were required to communicate.
CONCLUSION : This study highlighted the importance of making an early diagnosis of SD. It also suggests the limited availability of streamlined services for SD detection and treatment.View full abstractDownload PDF (615K)
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