Botulinum toxin therapy is the first-line treatment for spasmodic dysphonia (SD). It is necessary to evaluate the voice of each patient to assess the severity of the disease and the therapeutic efficacy. In this paper, we describe the current state of voice evaluation after botulinum toxin therapy and our new approach. Objective evaluation includes GRBAS, CAPE-V, the mora method, and acoustic analysis, whereas subjective evaluation includes VHI and V-RQOL. However, there are problems with objective evaluation, such as the fact that it does not directly reflect the pathology of SD and is complicated. In addition, depending on the timing of the post-treatment evaluation, the subjective and objective parameters may not be correlated. Therefore, it is important to evaluate both subjective and objective assessments over time. We have developed a system that uses a smartphone to analyze the voice without the need for the patient to visit a medical facility. The system can also confirm the improvement in voices after therapy and any changes over time.

Cochlear implant (CI) surgery is an effective treatment for children with severe to profound hearing loss, and in recent years, the age at which it is indicated has been getting younger worldwide. In this review, we discuss the changes in the criteria for surgery in the United States and Japan, the current situation regarding the earlier indications for surgery as revealed by CI registry data in each country, the safety and effectiveness of CI surgery in children under 12 months of age, and the issues associated with the earlier indications. Providing auditory stimulation during a period of high brain plasticity is expected to lead to substantial improvements in speech and language development and neurodevelopment, but accurate auditory diagnosis and the establishment of a family support system are essential for the implementation of early surgery. In addition, there is a risk that multiple disabilities will manifest later, and the difficulty of evaluating the effectiveness of hearing aids in infancy has also been pointed out. In the future, it will be necessary to strengthen inter-professional collaboration, as well as to clarify the criteria for application and promote clinical practice based on the accumulation of further data.

Objective: This study aimed to investigate the characteristics of articulation disorders and related factors in children who accessed maternal and child health services for speech sound or language development disorders over a period of 9 years.
Methods: A total of 81 infants who underwent evaluation and guidance for articulation disorders by speech-language pathologists in the maternal and child health service from April 2011 to March 2020 were included in the study. We conducted a retrospective examination of the children's infant health checkup materials, as well as of their articulation test results and training records.
Results: Fifty-three children had developmental articulation difficulties, 16 had word sound sequencing errors, 4 had language developmental disorders, and 8 had specific articulation manipulations. The mean number of instructional sessions for the 10 children who completed the program as part of their school attendance was higher than that for the other children.
Discussion: More than 60% of the target children in this project had speech disorders due to errors in articulation during development. This project was used not only after infant health checkups but also outside the health checkups. Some children continued to require support for articulation disorders after starting school. It was considered necessary for speech therapists to collaborate with other professionals or with multiple agencies, including before and after schooling, as part of assessment and training for a variety of speech difficulties.

The purpose of this study was to characterize the interpersonal communication behaviors of children with attention deficit hyperactivity disorder (ADHD) with language retardation in early childhood. Thirty-six children with ADHD or autistic spectrum disorder (ASD) who had been diagnosed with language retardation in infancy were categorized into an ADHD group of 9 and an ASD group of 27. The results of the Format of Observation for Social Communication Behaviors (FOSCOM) administered at the beginning of speech and language therapy were compared retrospectively between the two groups. The results showed that the interpersonal communication behaviors of children with ADHD and ASD were similar, but the degree of deviance and part of the FOSCOM were different. Significant negative correlations were found between FOSCOM domain A scores and verbal expression in children with ADHD, but not in children with ASD. This suggests that the interpersonal communication behavior of ADHD children with language retardation in early childhood is susceptible to the language retardation and shows an underscoring and latent trend in FOSCOM reports and others.

We report the clinical course of a 46-year-old female patient who was ultimately diagnosed with psychogenic stuttering concomitant with muscle tension dysphonia (MTD), despite improvements in laryngeal findings and vocal function following voice therapy aimed at differentiating between MTD, adductor spasmodic dysphonia (AdSD), and stuttering. The patient visited our department complaining of difficulty initiating speech owing to throat tightness. Laryngeal examination revealed approximation of the arytenoids and epiglottis base during phonation, as well as adduction of the left false vocal fold. In the voice assessment, the patient reported that her voice was fine in the hospital setting, but that she experienced voice blockages depending on the situation. She did not have difficulty producing voice during self-talk or singing. Voice therapy for MTD was conducted over five sessions (6 weeks), resulting in improvements in laryngeal findings and vocal function. However, no changes were observed in the Voice Handicap Index.
In cases of MTD, coexisting conditions such as AdSD or stuttering may be present. Careful evaluation considering the laryngeal findings, voice/speech symptoms, and response to voice therapy is necessary.

The indication criteria for BONEBRIDGE^® (BB) were established by the Japanese Otolaryngological Society in 2020. Since insurance coverage began in September 2021 our department has experienced three cases, ranging from young to old hearing impaired. All three patients came to our department with a request for a means other than hearing aids (HAs), and we implanted BB after imaging using temporal bone computed tomography (CT). Surgery was performed by using an external ophthalmoscope (ORBEYE^®) under general anesthesia. Case 1) was approached from the posterior ear, Case 2) through a sigmoid incision because of microtia and external auditory canal obstruction, and Case 3) was implanted retro-sigmoidally because of chronic otitis media after canal wall down mastoidectomy. Listening ability in Cases 1) and 2) was good postoperatively, but listening ability in Case 3) did not improve because of decreased intelligibility with age; afterwards, the use of HAs was continued without the use of BB. The indications for BB surgery in such patients with decreased aided word recognition scores should be considered carefully.