Dysphagia rehabilitation is employed for various types of swallowing disorders due to cerebrovascular accident, Parkinson's disease, or surgical treatments of head and neck cancers. A team approach is necessary to accurately diagnose the state of the swallowing disorder and administer adequate treatment, including rehabilitation. In chronic severe cases, community medicine involving various facilities is often effective and essential. This paper introduces the dysphagia rehabilitation performed in our hospital through two cases attributable to cerebrovascular accident and one case caused by Parkinson's disease.
Special Feature: Reports of the Voice Information Committee of the Japan Society of Logopedics and Phoniatrics
Aim: The aim of this study was to assess the practicality of the Japan Logopedics and Phoniatrics version of VHI and V-RQOL for evaluating patients who have voice-related problems. Methods: The study population consisted of 173 individuals with voice disorders and 105 normal adult volunteers from eight ENT clinics in Japan. The participants completed the Japan Logopedics and Phoniatrics version of VHI and V-RQOL as well as questionnaires regarding VHI and V-RQOL. Results: The study population showed favorable responses to the Japan Logopedics and Phoniatrics version of VHI and V-RQOL. Most of the participants thought that both VHI and V-RQOL had good potential to represent their voice-related problems. Some felt that VHI had too many question items. Conclusions: The results of this study revealed that the use of the Japan Logopedics and Phoniatrics version of VHI and V-RQOL is practical for evaluating patients who have voice-related problems.
Purpose: The purpose of this study was to examine the reliability and validity of the Japan Society of Logopedics and Phoniatrics' revised translated version of VHI and VHI-10. Participants: The participants were 173 adults with voice disorders seen at eight ENT clinics in Japan and 105 normal volunteers. There was no difference in male-to-female ratio between the groups with and without dysphonia. Analysis: The reliability of VHI and VHI-10 was measured using Cronbach's alpha of internal consistency. Criterion-related validity was assessed by the extent to which VHI predicted the presence or absence of dysphonia. Results: Cronbach's alpha indications for VHI and VHI-10 were respectively 0.98 and 0.93 for all participants. There were significant differences between the dysphonic and non-dysphonic groups in both VHI and VHI-10. Conclusion: VHI in the Japan Society of Logopedics and Phoniatrics' version consistently showed reliability. The scores of VHI and VHI-10 can predict the presence or absence of dysphonia.
The present study was designed to assess the reliability and validity of the recommended version of Voice-Related Quality of Life (V-RQOL) revised by the Voice Information Committee of the Japan Society of Logopedics and Phoniatrics. We enrolled 105 healthy adults and 173 patients with voice disorders seen at 8 institutions where members of the committee are working, and conducted an assessment of the recommended V-RQOL. Cronbach's alpha coefficient for V-RQOL was 0.942. The resulting reliability and validity of the recommended Japanese V-RQOL were considered reliable because they were internally consistent. In addition, the total V-RQOL scores of subjects with voice disorders were significantly different from the total V-RQOL scores of those without voice disorders. G-scores were significantly associated with V-RQOL scores. Furthermore, significant differences in V-RQOL score were observed between the groups of <10 and 11< seconds in MPT. The results of this study demonstrated that the Japanese version of V-RQOL recommended by the Society reflects the degree of severity of voice disorders.
This study examined differences in ability to explain the intentions of actions by others between deaf and typically developing children (TD). Both groups consisted of second- and third-year students in elementary school. Twenty-one deaf and 60 TD children were asked to describe the intentions of actions initiated by others. The task had two conditions: a model condition that there be two familiar scenes, and a non-model condition that there be two unfamiliar scenes. The results suggested that both groups had more difficulty explaining the non-model condition. Comparing the non-model task results of the deaf group and TD group, the content of the deaf group's explanations was simpler and patterns were fewer than those of the TD group. Correlation between the results of the deaf group and reading ability were high, and the usefulness of communication therapy based on this evaluation was suggested. We concluded that qualitative evaluation of explanations about two task conditions is necessary for examining the developmental character of explanations of intentions of actions by others in deaf children.
For children with hearing disabilities, the acquisition of basic Japanese pragmatic competence skills during the preschool period is one of the important predictors for inclusive elementary school adaptation. The purpose of this study was to investigate factors associated with pragmatic competence skills, including analogy, of such children during this period in Japan. The participants were 33 children who had graduated from a preschool day care center for the hearing impaired between 2006 and 2012. Their spoken Japanese pragmatic competence skills were measured using the "Test of Question-Answer Interaction Development," or "TQAID" (Toyama, H. et al., 1994). Pearson correlation analysis was performed to identify factors associated with the TQAID scores. The results indicated that the following factors had a significant correlation with the TQAID score: (1) hearing level of the unaided better-hearing ear, (2) hearing level with hearing aids or cochlear implants, (3) verbal IQ score on the WISC-R, (4) non-verbal IQ score on the WISC-R, and (5) parent involvement. Multiple regression analysis showed that hearing level with hearing aids or cochlear implants and non-verbal IQ score on the WISC-R explained 34% of variances in TQAID scores. These results confirm the importance of maintaining a suitable hearing level, by fitting hearing aids or cochlear implants, to enable spoken Japanese pragmatic competence development among hearing-disabled preschool children in Japan.
The aim of this case review was to determine the benefits or problems of cochlear implantation in elderly people with severe hearing loss, for application in their rehabilitation. Retrospective reviews of 4 cases older than 80 years at the time of cochlea implantation indicated that all cases improved in hearing threshold and speech recognition after implantation. Cochlea implantation in elderly people brought improvement in auditory performance, psychological changes such as less aggressiveness, and better daily activities. These results demonstrated that cochlear implantation is a successful treatment for improving quality of life in deaf elderly people with severe hearing loss. However, although no problems were in evidence concerning ADL (activities of daily living), all subjects had problems managing and operating their device in abnormal situations. These results indicate that skill in management and operation of their device is necessary. Carefully informed consent for patients and their families is needed before implantation, and cooperation should be requested from families or close relatives who know where to contact in times of emergency.
We investigated the effects of length and lexicality on the lexical decision task using Kana words and pseudo-homophones (i.e., nonwords that sound like real words) in children with normal reading. Participants in this study were all Japanese-speaking primary school children. They were divided into two experimental groups of different ages. The younger group consisted of second and third graders, and the older group consisted of fifth and sixth graders. As we controlled both word and pseudo-homophone stimuli for the same sound, we were able to suppose the existence of orthographic knowledge if we found lexical effect. The results revealed that RTs were significantly shorter with the word stimuli than with the pseudo-homophone stimuli. Furthermore no length effect was found in either group using Hiragana. These results appear to show that the children judged lexicality using orthographic information and processed each letter which constituted each stimulus in parallel. The recognition of lexicality effect and no length effect may suggest that children judged lexicality by orthographic lexicon in the lexical route according to the Dual Route Cascaded model.
In our speech and language outpatient clinic, we have observed patients with chief complaints of difficulties in speaking in front of people or on the telephone not only among those with stuttering syndrome but also among patients with functional dysphonia. We compared the stuttering group with the dysphonia group using a questionnaire. The stuttering group consisted of 46 adolescents and adults, and the dysphonia group consisted of 9 cases of hypertonic functional dysphonia and 3 cases of adductor spasmodic dysphonia. The results showed average awareness ages of 8 years in the stuttering group and 34 years in the dysphonia group. The stuttering group is more secretive about their stuttering problem, demonstrates greater anxiety, is more susceptible to teasing or bullying, is more frequently advised concerning speech, tends to be free from stuttering while singing, and speaks more fluently to oneself than the dysphonia group. A detailed questionnaire helps to distinguish between stuttering and dysphonia.
The recurrent laryngeal nerve sequentially branches into the posterior cricoarytenoid muscle, arytenoid muscle, lateral cricoarytenoid muscle and thyroarytenoid muscle, and each individual branch seems to be readily susceptible to localized penetrating injury. Thyroarytenoid muscle paralysis exists in theory and is referred to as partial vocal cord paralysis. Such cases are extremely rare, however. Here we report five cases of thyroarytenoid muscle paralysis. Three cases were male and two female, and three among the five patients experienced partial vocal cord paralysis after surgery under general anesthesia. The laryngeal findings of all patients showed normal abductor and adductor actions on the vocal cords and bowing of the vocal cord on the paralyzed side. We believed that diagnosis of thyroidarytenoid muscle paralysis requires not only confirmation by laryngeal endoscopy but also by laryngeal electromyogram. Breathy hoarseness caused by a glottal gap and accommodation disorder of the voice register involving antagonism between the cricoarytenoid and thyroarytenoid muscles seemed characteristic of these cases.
Thanks to dramatic advances in neonatal screening and related devices including diagnostic equipment, digital hearing aids and cochlear implants, today in theory the environment is in place for early discovery, diagnosis and educational intervention of hearing impairments in children. However, huge differences exist between areas of Japan as to the actual establishment of such systems. While in some areas systems for medical check-up, diagnosis and educational intervention are almost complete, they remain incomplete in other areas. Moreover, as most parents of hearing-impaired children are able to use spoken language only, the issue of such children's exposure to sign language is significant. Also, higher brain function is another issue of importance for evaluating language in hearing-impaired children. More speech language pathologists who can deal with these issues are needed.
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