We explored the effectiveness of rehabilitation in terms of dysphagia among elderly patients. We studied 80 hospitalized patients aged ≥65 years. We explored whether age, gender, concomitant disease, pneumonia, cognitive decline, engagement in activities of daily living (ADLs), and summed Hyodo scores upon (fiberoptic) endoscopic evaluation of swallowing before treatment affected recovery from dysphagia. The ability to eat after treatment served as the dependent variable. Rehabilitation allowed 38 of the 80 patients to regain the capacity to eat. In terms of Hyodo scores, good pharyngeal clearance and pharyngeal sensation after swallowing were associated with the effectiveness of rehabilitation, but a significant number of patients with good pharyngeal performance did not regain the capacity to eat. Multiple regression analyses revealed that pneumonia and a lower level of participation in ADLs significantly reduced the effectiveness of rehabilitation for dysphagia. Such rehabilitation among the elderly must consider overall patient needs and their prognoses.
This study evaluated the macro-structure of narrative development using the High-Point Analysis method, revealed the developmental characteristics and factors structure, and analyzed the micro-structure by quantitative linguistic method. The subjects were 44 children with hearing loss, in deaf school, aged 7 to 11 years, whose average hearing level was 99.6 dBHL (1 SD 13.8). The results showed that narrative productions were poor in the lower grades but developmental changes enabling acquisition of macro-structure occurred rapidly in the upper grades. The macro-structure was composed of two factors, "scene setting" and "story line." It was difficult for the lower grades to use the latter factor and grand design was poor, and they tended to produce narratives by enumeration of major events. Concerning micro-structure, the MLU (mean length of utterance) tended to be higher at the same time as macro-structure development. In the intervention program, the results suggested the importance of paying attention to development into narrative compositions consisting of multiple factors. The importance of increasing vocabulary and improving grammatical knowledge by consistent language instruction from early childhood was also indicated.
We investigated development of visual analysis and orthographic input lexicon in children with developmental dyslexia, using a character/non-character decision task and a lexical decision task with Kanji stimuli. In the character/non-character decision task, the dyslexia group made significantly more errors for real characters than the control group, whereas there was no significant group difference for non-characters which were visually similar to real characters. In the lexical decision task, the dyslexia group made more errors than the control group for words, pseudohomophonic nonwords, and nonpseudohomophonic nonwords which were visually similar to words. In contrast, such a significant group difference was not observed for nonpseudohomophonic nonwords which were visually dissimilar to words. These results suggest that the children with developmental dyslexia in this study did not develop visual analysis and orthographic input lexicon to the extent of the control group.
Objective: To investigate diagnostic methods and surgical indications for microscopic vocal fold lesions that showed few abnormalities in preoperative voice examinations of elite vocal performers (EVPs).
Subject and Method: The subjects were EVPs with complaints related to singing who visited Tokyo Voice Center. The patients were 4 singers who underwent surgical treatment for micro lesions. Although there were no obvious abnormalities noted in various voice examinations before and after surgery, a stroboscopic examination revealed micro lesions of their vocal fold mucosa. After considering whether these could be the cause of the main complaint, microlaryngoscopic surgery was performed under general anesthesia.
Result: In all cases, the micro lesions disappeared after surgery, and subjective complaints also improved.
Conclusion: It is necessary to judge surgical indications after well considering the consistency of micro lesions confirmed from detailed observation of vocal fold vibration and appropriate inquiry into the chief complaint.
I reported a patient with acquired phonological dyslexia who showed phonological processing deficit. I analyzed the consistency effect in reading aloud of kanji non-words to examine the mechanism of his kanji non-word reading disorder. He showed poorest performance with inconsistent atypical non-words composed of low-frequency kanji. Furthermore, lexicalization errors which were orthographically similar to kanji non-word stimuli appeared more frequently in kanji non-words that in non-words composed of high-frequency kanji. These results suggested that the patient's kanji non-word reading disorder was likely due to impairment of the character-to-sound conversion system. In other words, his impairment of character-to-sound conversion rules may cause him to have difficulty in reading kanji non-words that have ambiguous correspondence between character and sound.
This outcome suggests that the consistency of reading influences accuracy of reading aloud of kanji non-words.
After a young infant is diagnosed with hearing loss in newborn hearing screening etc., support of parents in accepting their child's disability is important. In this study, we show the progress of 3 cases (involving 2 sets of parents) of parental problems caused by early detection of hearing loss at age 0, and report on support of parents from the standpoint of speech-language-hearing therapists. Case 1 and case 2 are siblings. The parents were distressed when both siblings were found to have a hearing loss, but with support from a speech-language-hearing therapist from an early stage, interaction with the patient parent association, and solid support from family and friends, active involvement between the parents and their children became possible, and language acquisition has progressed smoothly. In Case 3, the same support as in the previous 2 cases initially was insufficient to enable acceptance of their child's disability, preventing progress in training carried out in the home. However, once home training reached a stable level of involvement, the volume of vocabulary understood by the child increased. In this case, the parents were greatly upset by the diagnosis of early hearing loss, and the issues indicated in previous reports were confirmed. These cases suggest that support to enable parents of young children with hearing disabilities to accept their situation requires multifaceted and detailed guidance as well as evaluation of the quality of family relationships by a speech-language-hearing therapist from an early stage.
Aglossia is an extremely rare congenital disease. While the condition is commonly discussed in the context of school-aged children, reports of the disease in newborns are rare. Herein, for the first time, we describe the course of a child who was born with aglossia and whose language acquisition was observed over time. The patient underwent tracheotomy and received continuous support from a team of doctors and speech-language-hearing therapist (ST). The interventions used and the course of language acquisition in other children who were born with aglossia were then assessed. We next used fluoroscopy to characterize articulation dynamics, as indicated by the formant-based analysis of vowels. Ultimately, we describe the effects of tracheotomy on articulatory acquisition of language development in children with aglossia.
This study reports progressive dysphagia in an elderly patient with normal gait and cognition functions. He was hospitalized three times in the course of three and a half years, during which time his dysphagia progressed following exacerbation of chronic obstructive pulmonary disease (COPD). Dysphagia was thought to have resulted from kyphosis and upper airway inflammation that are caused by COPD. His dysphagia was characterized by a loss of muscle strength involved in swallowing and an increase in pharyngeal sensory threshold. The course of dysphagia was progressive and irreversible. His self-knowledge about dysphagia was poor, and he could not understand the risk of aspiration pneumonia. Because his level of long-term care need under the long-term care insurance system was low owing to his normal gait and cognition, treatment after discharge was difficult. Concomitant chronic diseases occur frequently in COPD patients, and dysphagia is considered one of them.