The lexical attributes of words include frequency of occurrence and familiarity. It has been reported that these attributes influence reading and spelling fluency. In this study, usage frequency of words, that is, how frequently words are used in handwriting and typing, was added to the lexical attributes. The purpose of this study was to investigate lexical attribute effects on spelling latency and duration of Hiragana words in normal Japanese adults. Spelling-to-dictation tasks of 226 Hiragana words were conducted in 30 Japanese adults, and word attribute effects on spelling latency and duration were analyzed. Results showed that familiarity significantly affected spelling latency and usage frequency significantly affected spelling duration. These results indicate that lexical processing is not completed before spelling movement is initiated. This suggests that it is better to use not only frequency of occurrence but also familiarity and usage frequency for investigating lexical attribute effects on spelling fluency.
The purpose of this study was to examine the effect of Hiragana reading training on accuracy and fluency in 126 kindergarten children who had not learned Hiragana reading/writing in the classroom. The children were divided into two matched groups: training and control. Furthermore, each group was subdivided into three levels of attainment: good, moderate and severe; or five levels of attainment: good, moderate, severe-high, severe-middle and severe-low. Reading training of 71 Hiragana characters was carried out from October during 8 weeks (total 60-80 min.) only for the training group children. The results for reading accuracy showed that all children in the training group improved significantly in character reading between before and after the training period; however, all children in the control group also improved significantly within the same period. Among the attainment subgroups, moderate and severe training subgroups improved significantly in character reading, but the moderate and severe control subgroups also improved significantly. The severe-high and severe-low training subgroups improved significantly in character reading, but there were no significant differences within the severe-high and severe-low control subgroups. The results for reading fluency showed that whereas the training good subgroup improved significantly, no significant difference occurred within the control good subgroup. The results of this study suggest that the effect of reading training in kindergarten children is limited.
The aim of this study was to evaluate the efficacy of voice therapy for patients with essential vocal tremor and try to develop a suitable voice therapy program for this disorder. Two patients were enrolled in this study. We performed a phonatory function analysis, which demonstrated that the tremor symptoms were milder when the patients spoke softly and briefly with a slightly elevated pitch. We found that an effective voice therapy technique was to weaken the activation levels of the adductor laryngeal muscles. As part of the systematic voice therapy program, we provided our patients with strategies for reducing their vocal tremor from an exaggerated vowel phonation to a normal conversational level. In both patients, compared to their pre-therapy status, their post-therapy status showed improvements in the voice handicap index (VHI) and voice-related quality of life (V-RQOL) scores, the acoustic parameters of voice, and the score of the mora method during sentence reading. This voice therapy program was not effective enough to remove the vocal tremor completely, but it could improve the patients' symptoms in regular conversation. Our suggested therapy program will prove an effective solution for voice tremor patients in the future and will provide a non-invasive treatment option for anxious patients.
The purpose of this study was to acquire basic data applicable to decreasing verbal perseveration in aphasia. We performed two picture naming tasks. In study 1, the subjects were 22 patients with aphasia (14 males, 8 females). The naming task was conducted while controlling for the following three factors: semantic category (animals/tools), color information (black-and-white/color), and presentation interval (1 second/10 seconds). The results revealed a possibility that semantic category and the combination of semantic category and presentation interval are related to the occurrence of perseveration. In study 2, the subjects were 28 patients with aphasia (18 males, 10 females). The naming task was conducted while controlling for the semantic category (animals/tools) and the presentation interval, which was strictly managed (1 second/10 seconds/20 seconds). The results confirmed that perseverations in the animals category occurred more frequently and were maintained for longer times than those in the tools category. These findings suggest that items belonging to non-living categories, rather than living categories, might be useful for inhibiting the occurrence of perseverations during the treatment of aphasic patients.
To evaluate the effects of voice therapy for 35 patients with vocal fold nodules performed in our clinic, we measured voice handicap index (VHI) and maximum phonation time (MPT) before and after the therapy and analyzed the results. GRBAS scale was also used, and for acoustic aspects, jitter, shimmer, noise-to-harmonic ratio (NHR), and fundamental frequency (F0) were evaluated. We observed significant improvements in VHI, MPT, and shimmer, and also a significant increase in F0 after voice therapy. No significant changes in jitter or NHR were observed after voice therapy when comparing all patients as one group, but patients whose jitter or NHR measurement before the therapy was over the cutoff values showed a significant improvement.
In this study, 80% of patients had an occupation which requires vocal abuse, and 39% were teachers who work in schools, kindergartens, or nursery schools. Using silence therapy to treat patients whose occupation requires vocal abuse is difficult, and here we showed that voice therapy mainly consisting of vocal hygiene instruction and vocal function exercises could provide improvements without forbidding patients to vocalize.
In 26 out of the 35 (74%) patients, improvements by conservative voice therapy were observed, and the other 9 patients were improved by microscopic laryngeal surgery. Our study showed that voice therapy was effective for vocal fold nodules, and also revealed that some patients required laryngeal microsurgery, suggesting the importance of determining whether the conservative method should be adopted in all cases.
While phonomicrosurgery is the most commonly adopted phonosurgical procedure, a definite postoperative voice rest protocol has not yet been established. In this study, we assessed the effectiveness of our postoperative voice rest protocol. Thirty-one patients who underwent phonomicrosurgery for vocal improvement purposes in our institution between August 2016 and August 2019 were incorporated in this study. Our postoperative voice rest instruction protocol consisted of complete voice rest for 3 postoperative days (pods), relative voice rest using confidential voice for a limited time during 4 to 7 pods, and daily conversation during 8 to 14 pods. Compliance of complete voice rest was 70.9% in our study. Improvement rates of multiple vocal parameters were compared between the complete compliance group (CC group) and incomplete compliance group (IC group). At 3 months after surgery, a significantly higher improvement rate was observed in G score of the CC group compared with that of the IC group. However, no significant differences were observed between the 2 groups regarding improvement rates of glottic closure, MPT, and VHI. As the compliance rate of complete voice rest was higher than previous reports and no significant differences were observed between the 2 groups in any parameter 6 months after surgery, this study suggested the clinical suitablitity of our postoperative voice rest instruction protocol for successful vocal recovery after phonomicrosurgery. Furthermore, compliance of 3 days of complete voice rest was considered to boost early vocal recovery after surgery.
The authors experienced a case of vocal fold bamboo nodes which appeared along with vocal nodules in a 29-year-old woman who was diagnosed as systemic lupus erythematosus (SLE). The patient visited our outpatient clinic complaining of hoarseness. She exhibited a strong tendency of daily vocal abuse. An initial flexible laryngeal endoscopic examination revealed bilateral vocal fold nodules in the middle portion of the vocal folds and bilateral white bamboo nodes in the posterior third portion of the vocal folds. Stroboscopic examination showed asymmetrical vibratory phases of the mucosal wave and mild anteroposterior narrowing of the supraglottic space. To treat her functional problems, voice therapy was provided. Post-therapy examination demonstrated improvements in both self-evaluation and instrumental/clinical measures, although the vocal lesions remained the same.
The causes of the bamboo nodes in this patient are suspected as follows: 1) The patient's vocal abuse caused vocal nodules in the middle portion of the vocal fold mucosa. 2) The presence of the vocal nodules increased the vibration of the membranes between the nodules and the process. 3) The increased vibration led to accumulation of immune complexes and subsequent bamboo nodes in the posterior third of the membranous vocal folds. This case report indicates that, in patients with SLE, although voice therapy does not solve the organic aspects of the problems, it is important for identifying functional components of the voice problems. We therefore view voice therapy as a valuable treatment option.
We report a patient with aphasia who showed LASC errors in writing to dictation of two-Kanji compound words. The patient had undergone a craniotomy for excision of a tumor in the left temporal lobe. LASC (legitimate alternative spelling of component) errors are generally observed in patients with surface dysgraphia and are related to semantic impairment. However, our patient showed many LASC errors despite correct performance in an auditory comprehension task, suggesting that our patient's LASC errors did not result from semantic impairment. Analysis by cognitive neuropsychological method indicated that the patient's principal impairment pertained to access to the orthographic lexicon from the semantic system within the spelling lexical route. Analysis of LASC errors revealed that an alternative spelling showed a high consistency ratio of the Kanji character, and therefore we considered that the patient utilized the intact sub-lexical route over the impaired lexical route. Surface dysgraphia is classified into two subtypes: semantic and orthographic. We deduced that our patient's surface dysgraphia was close to the orthographic subtype.