Speech-language pathologists’ support for multilingual speakers’ English intelligibility and participation informed by the ICF

Publication date: Available online 21 December 2018

Source: Journal of Communication Disorders

Author(s): Helen L. Blake, Sharynne McLeod

Abstract

Purpose

To use the ICF to classify characteristics and aspirations of multilingual university students and faculty who seek speech-language pathologists' support for intelligibility in English and to identify activities, facilitators, and barriers that impact participation in society.

Method

A retrospective record review was conducted on files of 175 clients attending a university clinic for intelligibility enhancement (accent modification). Participants came from 35 countries and spoke 28 different home languages.

Results

Assessment and intervention for intelligibility enhancement involved consideration of ICF components of Body Functions and Structures (e.g., articulating phonemes, rate, prosody), Environmental Factors (e.g., support), and Personal Factors (e.g., motivation). Consonant substitutions and deletions were common, although participants were often unaware of these. For example, only 25.6% of participants reported English dental fricatives (/θ/ and /ð/) were difficult to pronounce; however, 94.9% substituted them with other phonemes such as [t] and [d]. The combination of substitutions/deletions, fast speech rate, low speaking volume, and differences in word stress exacerbated poor intelligibility. More time conversing in English was associated with greater confidence and less difficulty communicating in English, although more time knowing English was not. Difficult communication situations were reported to be conversing over the phone, talking to strangers, and communicating in English on professional fieldwork placements. Participants were motivated to seek intelligibility enhancement for academic, employment, and social reasons.

Conclusions

To ensure multilingual speakers are able to participate fully in society, intelligibility enhancement requires a multi-pronged approach where speech and environmental characteristics interweave.

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The Relationship between Speech Recognition in Noise and Non-Speech Recognition in Noise Test Performances: Implications for Central Auditory Processing Disorders Testing

Publication date: Available online 21 December 2018

Source: Journal of Communication Disorders

Author(s): Andrew J. Vermiglio, Keerthana Velappan, Paige Heeke, Emery Bulla, Xiangming Fang, Elizabeth Bonilla, Elizabeth Garner, Julia Skinner

Abstract

Background

According to the American Academy of Audiology, a recommendation for frequency-modulation systems may be based upon performances on speech perception tests that do not include background noise.

Purpose

The primary purpose of this study was to evaluate the presumption that non-speech recognition in noise test results are related to speech recognition in noise ability for a group of young adults.

Research Design

Performances on the non-speech recognition in noise tests included in the SCAN 3 A test battery were compared to speech recognition in noise performances as measured with the auditory figure ground subtest of the SCAN 3 A and the Hearing in Noise Test.

Study Sample

Fifty-four young, native speakers of American English with normal pure-tone thresholds participated in the study.

Data Collection and Analysis

For the purposes of this study, the SCAN 3 A raw scores were used. The Hearing in Noise Test was administered in a simulated sound-field environment under headphones. The Spearman rho statistic was used to determine the relationships between non-speech recognition in noise vs. speech recognition in noise test results.

Results

No significant relationships were found between the auditory figure-ground results and any of the non-speech recognition in noise subtest performances. Modest but statistically significant relationships were found between the Hearing in Noise Test Composite scores vs. the competing words-directed ear and the time compressed sentences subtests of the SCAN 3 A.

Conclusion

Of the four non-speech recognition in noise subtests that were evaluated, only the competing words-directed ear and the time-compressed sentences performances were significantly correlated to the Composite scores of the Hearing in Noise Test. The results demonstrated a limited external validity for two of the four non-SRN tests for the determination of SRN ability.

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Lower airway microbiota associates with inflammatory phenotype in severe preschool wheeze

Publication date: Available online 21 December 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Polly F.M. Robinson, Céline Pattaroni, James Cook, Lisa Gregory, Aldara Martin Alonso, Louise J. Fleming, Clare M. Lloyd, Andrew Bush, Benjamin J. Marsland, Sejal Saglani

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Epigenome-wide Meta-analysis of DNA Methylation and Childhood Asthma

Publication date: Available online 21 December 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Sarah E. Reese, Cheng-Jian Xu, Herman T. den Dekker, Mi Kyeong Lee, Sinjini Sikdar, Carlos Ruiz-Arenas, Simon K. Merid, Faisal I. Rezwan, Christian M. Page, Vilhelmina Ullemar, Phillip E. Melton, Sam S. Oh, Ivana V. Yang, Kimberley Burrows, Cilla Söderhäll, Dereje D. Jima, Lu Gao, Ryan Arathimos, Leanne K. Küpers, Matthias Wielscher

Abstract

Background

Epigenetic mechanisms, including methylation, may contribute to childhood asthma. Identifying DNA methylation profiles in asthma may inform disease pathogenesis.

Objective

To identify differential DNA methylation in newborns and children related to childhood asthma.

Methods

Within the Pregnancy And Childhood Epigenetics (PACE) consortium, we performed epigenome-wide meta-analyses of school-age asthma in relation to CpG methylation (Illumina450K) in blood measured either in newborns, in prospective analyses, or cross-sectionally, in school-age children. We also identified differentially methylated regions (DMRs).

Results

In newborns (8 cohorts, 668 cases), 9 CpGs (and 35 regions) were differentially methylated (epigenome-wide significance, FDR<0.05) in relation to asthma development. In cross-sectional meta-analysis of asthma and methylation in children (9 cohorts, 631 cases), we identified 179 CpGs (FDR<0.05) and 36 differentially methylated regions. In replication studies of methylation in other tissues, most of the 179 CpGs discovered in blood replicated, despite smaller sample sizes, in studies of nasal respiratory epithelium or eosinophils. Pathway analyses highlighted enrichment for asthma-relevant immune processes and overlap in pathways enriched both in newborns and children. Gene expression correlated with methylation at most loci. Functional annotation supports regulatory impact on gene expression at many asthma-associated CpGs. Several implicated genes are targets for approved or experimental drugs, including IL5RA and KCNH2.

Conclusion

Novel loci differentially methylated in newborns represent potential biomarkers of risk of developing asthma by school age. Cross-sectional associations in children may reflect both risk for and effects of disease. Asthma-related differential methylation in blood in children substantially replicated in eosinophils and respiratory epithelium.

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Optimal Position for Transnasal Flexible Laryngoscopy

Publication date: Available online 20 December 2018

Source: Journal of Voice

Author(s): Hamdi Tasli, Hakan Birkent, Omer Karakoc, Mert Cemal Gokgoz

Objective

Transnasal flexible laryngoscopy (TFL) is a simple, safe, and cost-effective procedure. TFL is routinely performed to awake patients in a sitting position but there is no a definite data about ideal head and neck position to be applied. The aim of this study is to determine which position is most appropriate to obtain the best laryngeal view during the TFL.

Methods

The TFL videos of 132 randomized patients were evaluated by three blind observers experienced with laryngology. Three basic head positions; simple head extension (SHE), sniffing position (SP), and neutral position (NP) were performed during the TFL-Interobserver agreements for the grading system scores were assessed by using the kappa (k) statistic.

Results

For the SHE and SP, the numbers of patients constituting grade 1 were 127 (96.2%) and 126 (95.5%), respectively, while grade 2a were 5 (3.8%) and 6 (4.5%), respectively. In NP, the number of patients constituting grade 1 was 5 (3.8%), while grade 2a was 83 (62.9%), grade 2b was 37 (28%), and grade 3 was 7 (5.3%). The k score of the SHE was 0.826 (P < 0.001) between the ratings of observer 1 and observer 2, 0.905 (P < 0.001) between observer 1 and observer 3, and 0.919 (P < 0.001) between observer 2 and observer 3. These values denote nearly perfect agreement. A complete agreement was seen in 130 of the 132 (98.48%) videos.

Conclusion

SHE and SP both provide a better glottic view than the NP and demonstrate the same success.

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Long‐term revision rates for endoscopic sinus surgery

Background

Reported revision rates for endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) vary significantly. Several investigations examining revision rates for ESS have been limited by duration of follow‐up, academic centers, or small surgeon cohorts. The objective of this study was to define the long‐term revision rates for ESS and to determine those unique patient factors that increase the risk of revision ESS.

Methods

The Utah Population Database was queried for Current Procedural Terminology codes for ESS from 1996 to 2016. Patient demographics and comorbid diagnoses were collected. Revision rates and risk factors for surgery were determined by Cox proportional hazard modeling.

Results

A total of 29,934 patients were identified, with a mean length of follow‐up of 9.7 years. The long‐term revision rate was found to be 15.9%. The mean time between surgeries decreased with higher number of revision surgeries. The time between the first and second surgery was 4.39 years and the time between the fourth and fifth surgery decreased to 2.18 years. Female gender, older age at first surgery, nasal polyps, comorbid asthma, allergy, and a family history of CRS all increased the risk of requiring revision surgery (p < 0.001).

Conclusion

The long‐term revision rate for ESS exceeds 15% and the time between revision surgeries decreased with each additional surgery being performed. Unique patient factors increased the risk of requiring revision ESS. Understanding patients' risk for revision surgery may help physicians select and counsel patients with CRS undergoing ESS.

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