Dysphagia after acute stroke is common, and different locations of lesion result in distinct swallowing disturbance patterns. Based on accurate evaluation, we can select suitable rehabilitative approaches for individual patients, including respiratory therapy, food modification, postural changes, medication, and oral care. Subsequently, the incidence rate of aspiration and pneumonia decrease. The presence of dysphagia can be a predictor of the prognosis of acute stroke, and thus it is important to prevent aspiration and maintain adequate nutrition. In severe cases, botulinum toxin injection or surgery needs to be considered, in conjunction with continuous therapy by swallowing specialists and non-oral feeding. In addition, a regional alliance system is necessary for long-term dysphagia intervention.
Language is a higher brain function which is uniquely human ability. Since the 19th century, functional localization and differentiation of language in the cerebral cortex have been proposed. Recently, more detailed findings relating to functional localization and differentiation have been reported in studies involving functional imaging of the human brain. In the language areas, syntax, sentence comprehension, phonology and lexico-semantic centers are divided as functional modules which correspond to the left dorsal inferior frontal gyrus, ventral inferior frontal gyrus, superior temporal gyrus, and angular/supramarginal gyrus, respectively. Moreover, all of these four regions are basically left-dominant. Meanwhile, we have recently examined melody processing in comparison with language processing, and have found right-dominance in the activations of the auditory areas. It is interesting to note that the higher brain functions related to uniquely human abilities showed such differential hemispheric dominances.
The purposes of this study were to clarify the articulations of maxillarily defected patients after tumor operation and to clarify the effectiveness of a maxillary prosthesis on their speech. The subjects were 9 patients wearing maxillary prostheses for their maxillary defects. We conducted 4 tests for each patient with and without a maxillary prosthesis: a hypernasality test, articulation test, blowing test, and speech intelligibility test. Articulation disorder, nasal air emission, and speech intelligibility all improved by wearing a maxillary prosthesis. When a maxillary prosthesis was not worn, unvoiced consonants tended to be misheard as fricative consonants, and voiced consonants as nasal consonants. It is thought that without a prosthesis maxillary defect causes increased nasal escape and unstable articulation positions. The improved speech by wearing a prosthesis suggests that maxillary prostheses are effective as a treatment against maxillarily defective speech.
The aim of study #1 was to weigh the familiarity and imageability of children in the fifth to eighth grade age bracket against the corresponding values of adults. The aim of study #2 was to examine the effects of lexical properties on printed kanji word comprehension, reading aloud, and word auditory comprehension in fourth grade children. The lexical properties used in study #2 were familiarity, imageability, and grade of acquisition. Study #1 revealed that familiarity values rated by children had slightly different trends from those of adults. Some high-familiarity words in adults were considered low-familiarity words in children. Because of this result, the lexical properties of children were used in study #2. Study #2 demonstrated that imageability had the strongest influence on printed Kanji word comprehension and word auditory comprehension. Grade of acquisition had the most effect on reading aloud, followed by imageability. The results of this study using lexical properties rated not by adults but by children suggest that learning starts with words in which the ease of recalling a sensuous image is effective for improving printed kanji word comprehension, reading aloud, and word auditory comprehension in children.
This study investigated the effect of delayed auditory feedback (DAF) on non-hypokinetic type dysarthrias, including one UUMN, two ataxics, and two mixed cases. The set of tasks consisted of both spontaneous speech and a long-sentence reading. The task set was conducted under two conditions: one without DAF (condition A) and another with DAF (condition B). The task set under the two conditions was performed once per week in the order of A, B, and A. The results showed that speech intelligibility improved in four of the five cases under the DAF condition, suggesting that DAF is effective for dysarthrias other than the hypokinetic type. An additional analysis was conducted to examine the relationship between improvement of speech intelligibility and acoustic characteristics (reduction of speaking rate, extension of vowel length, expansion of vowel space in the F1-F2 space, etc.). The causes for speech intelligibility improvement due to DAF usage are discussed based on the analysis.
The purpose of this study was to investigate whether bi-mora frequency affects the frequency of stuttering in Japanese children. The participants were 15 elementary school children aged from 7 to 11 who stuttered. Thirteen nonwords with high bi-mora frequency and 13 nonwords with low bi-mora frequency were used. The findings indicated that nonwords with high bi-mora frequencies exhibited significantly lower frequency of stuttering than those with low bi-mora frequencies. This result suggests that bi-mora frequency might affect the frequency of stuttering.
We developed a new test of long-term memory, the Figure Learning Test (FLT), modeled on the corresponding process of Kanji character learning, which consists of three times of copying and recall of non-verbal figures matched to semantic meaning. The participants were 75 normal school children and six developmental dyslexic children in the first to sixth grades of primary school. There was no significant correlation between the score of delayed recall on the FLT and the result of Kanji word dictation in the normal children. When long-term memory of non-verbal figures is not significantly low, other factors may also affect the attainment of Kanji character writing. The dyslexic children, especially upper graders, showed lower scores in delayed recall on the FLT, below -1.5SD or -2SD, and/or in matching meanings to the figures. These findings suggested that long-term memory of non-verbal figures affects the attainment of Kanji character learning.
Purpose: The purpose of this study was to examine the reliability and validity of the Japanese versions of VHI and V-RQOL. Participants: The participants were 275 individuals treated at ENT clinics in four areas of Japan: 112 individuals exhibited dysphonia and 163 did not. VHI was administered to 161 individuals and V-RQOL, to 114 individuals. No differences in male/female ratio or mean age between individuals with or without dysphonia were found in the two groups. Analysis: The reliability of VHI and V-RQOL was measured according to Cronbach's alpha of internal consistency. Criterion-related validity was assessed by the extent to which VHI and V-RQOL predict the presence or absence of dysphonia. Results: Cronbach’s alpha of VHI was 0.96 for the dysphonic individuals and 0.97 for the non-dysphonic individuals. Cronbach’s alpha of V-RQOL was 0.91 for dysphonic individuals and 0.78 for non-dysphonic individuals. There were significant differences between the dysphonic and non-dysphonic groups with both VHI and V-RQOL. Conclusions: VHI and V-RQOL in their Japanese versions showed a high level of reliability, and the presence or absence of dysphonia can be predicted through VHI and V-RQOL.
We investigated the typical development of reading fluency by measuring the speed of reading aloud, and the factors responsible for reading fluency. The participants for this study were 872 primary school children from the 1st to 6th grades. We used Hiragana and Katakana words as well as Hiragana and Katakana nonwords and paragraphs as stimuli. The results showed that the articulation time of reading words aloud decreased rapidly from the 1st to 3rd grade, and then decreased slowly to the 6th grade. In contrast, the articulation time of reading nonwords and paragraphs aloud decreased from the 1st to 6th grade, suggesting that it is more important to evaluate the reading speed of paragraphs in view of the necessity of reading paragraphs in daily life. The results of multiple regression analysis demonstrated that ability of automatization and phonological awareness are crucial factors that affect reading speed. The contribution of the former increased with grade; in contrast, the latter's contribution grew smaller. In addition, the findings suggested that the contribution of vocabulary to the reading speed of words and paragraphs is also important.