Relationships between infants and their caregivers start to develop from birth, and a wholesome attachment between them is nurtured by the care provided through communication. Recently, such care is regarded to be based on intersubjective communication which shares emotions between the child and the caregiver, and the quality of its communicative musicality. In the case of children with hearing impairments, it is crucial for them to recognize the emotions of both themselves and others and to establish a solid attachment with their caregivers, in order for them to acquire functional language and desirable sociality later in their lives. From this perspective, this paper analyzed clinical scenes of a speech, language, and hearing therapist and examined and defined the necessary intersubjective communication support for children with hearing impairments and their caregivers. It is desirable to establish a methodology for speech, language, and hearing therapists to support caregivers in formulating their care for children with hearing impairments.
In clinical practice, laryngopharynx local anesthesia is a procedure used when performing biopsies, removing foreign bodies, etc. We have been conducting videoendoscopic laryngeal surgery under local anesthesia since 2003, and in such cases suppression of throat reflex and laryngeal reflex is important. To achieve this, it is necessary to properly deliver the anesthetic to the target site.
With local anesthesia, the amount to be administered is predetermined and its effective time is limited. For these reasons, in order to obtain stable effectiveness it is important to administer the anesthetic efficiently according to a set procedure. First, Xylocaine Viscous 2% should be administered to the laryngopharynx. Next, Xylocaine 4% should be sprayed progressively from the pharyngeal cavity to the laryngeal cavity, followed by a second application to the same area, this time using a cotton swab. As the anesthetic effectiveness of Xylocaine is said to weaken after about 20 minutes, the anesthesia process needs to be completed within 20 minutes.
At Fukushima Medical University, to date a total of 316 patients have undergone videoendoscopic laryngeal surgery under the local anesthesia method described above. Of these, 16 patients (5.1%) had surgery discontinued because throat reflex could not be suppressed or the reflex occurred during the surgery. These results indicate that the prescribed method is useful. Anesthesia performed by systematic procedure was deemed an important factor for successful videoendoscopic laryngeal surgery under local anesthesia.
We developed a new training program for laryngeal stroboscopic rating. To determine the utility of this program, we examined levels of knowledge of stroboscopic evaluation and actual rating scores for vocal fold vibration by stroboscopy before and after the training program. The participants were 21 speech therapy students. After the training program, their amount of knowledge of stroboscopic evaluation was significantly increased from before. Stroboscopic rating scores were not significantly increased from before except for the rating score of regularity of vocal fold vibration. This lack of noticeable improvement was attributed to the fact that the stroboscopic rating scores were already at 80% before the training program, so we assumed that the scores were affected by the ceiling effect. The participants who scored lower than the median before the training program significantly increased their rating scores on all evaluation items of vocal fold vibration. The above results suggest that this training program can be highly recommended for stroboscopic evaluation, especially for speech therapists who are not adept at rating vocal fold vibration.
The purpose of this study was to investigate the effectiveness of cochlear implantation in the elderly. We compared scores of the syllable test before surgery and 3 months after cochlear implantation in 20 elderly subjects over 75 years old. We also compared scores of the syllable, word and sentence tests at 3 months after implantation between the same elderly subjects and 12 pre-old surgery recipients aged 65 to 74.
In the elderly subjects, syllable test scores were improved at 3 months post-surgery. In comparison with the pre-old group, scores of the syllable and word tests were not significantly different. However, the sentence test scores were significantly lower in the elderly than in the pre-old group. These results indicate that cochlear implantation is an effective treatment for elderly subjects over the age of 75.
From this study, further research is warranted to investigate the effect of aging on hearing abilities after cochlear implantation. It is also necessary to research the long-term benefits of cochlear implantation for the elderly.
The working definition of cluttering focuses on speed and irregularity of speech, frequency of normal disfluency, and coarticulation. Cluttering is often comorbid with stuttering. In this study, articulation rates and frequency of disfluency in a picture explanation task were measured in nine cluttering-stuttering students, 10 LD, AD/HD, and/or ASD students, and 24 control students. No significant differences were found between the three groups in terms of articulation rates. The results made clear the necessity to examine a more appropriate measurement target such as free utterance, etc. In addition, the results showed that frequencies of normal disfluency as high as those of the cluttering-stuttering group existed in the LD, AD/HD and/or ASD group.
Patients with vocal fold atrophy suffer from atrophy of the vocal fold lamina propria and muscle layer caused by various factors including aging. Patients of vocal fold atrophy present with breathy voice due to glottic insufficiency. It has previously been reported that voice therapy is effective for vocal fold atrophy. Here, we evaluated the effectiveness of voice therapy for patients with vocal fold atrophy caused by aging seen in our clinic.
We examined 19 patients (11 males and 8 females) who received voice therapy and evaluation among patients diagnosed with glottic insufficiency due to vocal fold atrophy. We statistically analyzed the parameters of maximum phonation time (MPT), voice handicap index (VHI) and acoustic evaluation before and after the therapy. The treatment we conducted as voice therapy was comprehensive voice therapy focused on vocal function exercises and abdominal breathing, augmented by options including resonance tube or yawn-sigh therapy.
After treatment, MPT, VHI, shimmer, and noise to harmonic ratio (NHR) were significantly improved. This suggests that voice therapy is effective for patients with vocal fold atrophy. In addition, voice therapy was more effective for patients who have no occupation than for patients who have an occupation. This observation suggests that voice therapy is more effective for patients who engage in less phonation.
We examined aspects of speech disorder in 42 adults (age: 31.5±13.4 yr) who stuttered (AWSs) and who were aware of their stuttering. The Japanese Standardized Test for Stuttering was administered. From their utterances in the test, we analyzed the frequency and severity of their stuttering, and we checked for the presence of any speech sound disorder and the read aloud rate. Cluster analysis was also performed using the Ward method, with main stuttering symptoms and read aloud rate as variables. Sixteen subjects (38.1%) with a main stuttering symptom showed normal oral fluency or a very mild level of stuttering. However, they were still suffering from stuttering. Fourteen subjects (33.3%) had speech sound disorders along with stuttering. Among the 14 subjects with speech sound disorders, 13 subjects showed lateral articulation. Furthermore, our observations suggested that AWSs with a fast read aloud rate are less likely to have had onset in early childhood than AWSs in other groups. In the cluster analysis, the subjects divided into four groups, with non-fluency gradually increasing in severity from A group to D group. However, the groups segmented according to cluster analysis did not necessarily agree with levels of non-fluency frequency and stuttering severity. In the A, B, and C groups, reading aloud was the easiest task, and conversely it was most difficult in D group. The read aloud task may be a key task that can be administered to predict improvement in the severity of stuttering.