Catálogo de publicaciones - revistas

<jats:sec> <jats:title>Purpose</jats:title> <jats:p>This was a companion study to a previous one (Biller &amp; Johnson, 2019). The purpose was to develop a detailed descriptive profile of a minimally verbal child with a unique medical history and autism spectrum disorder (ASD). The present report describes his social-cognitive and speech sound production abilities in relation to his potentially burgeoning spoken language.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>This in-depth, descriptive, clinical single-case study focused on a 3-year-old boy who was diagnosed with a chromosomal abnormality and ASD. The size of his spoken vocabulary fell at the upper limit for classifying a child as minimally verbal. His demographic information was obtained, in addition to general information from his mother. Four social-cognitive and three speech sound production abilities were assessed, as well as his overall performance in both domains. The study included a parent interview and two child assessment sessions.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>The child exhibited low social-cognitive and speech sound production abilities for his age, with social-cognitive abilities higher than speech sound production abilities. Comparison with the previous study revealed substantial gaps in social cognition and speech sound production between this child and five other minimally verbal children with ASD. His higher abilities in these two domains co-occurred with his larger spoken vocabulary size.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Although the child's social-cognitive abilities were low for his age, with his speech sound production abilities even lower, both domains were perhaps high enough to support spoken vocabulary at the upper limit for minimally verbal children. Indeed, there appeared to be quantitative and qualitative differences between him and other minimally verbal children in the previous study. The possibility was explored that there is a point or threshold along the developmental continua for social cognition and speech sound production that allows for expansion into useful language.</jats:p> </jats:sec>

<jats:sec> <jats:title>Purpose</jats:title> <jats:p>We report on a study that replicates previous treatment studies using Abstract Semantic Associative Network Training (AbSANT), which was developed to help persons with aphasia improve their ability to retrieve abstract words, as well as thematically related concrete words. We hypothesized that previous results would be replicated; that is, when abstract words are trained using this protocol, improvement would be observed for both abstract and concrete words in the same context-category, but when concrete words are trained, no improvement for abstract words would be observed. We then frame the results of this study with the results of previous studies that used AbSANT to provide better evidence for the utility of this therapeutic technique. We also discuss proposed mechanisms of AbSANT.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>Four persons with aphasia completed one phase of concrete word training and one phase of abstract word training using the AbSANT protocol. Effect sizes were calculated for each word type for each phase. Effect sizes for this study are compared with the effect sizes from previous studies.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>As predicted, training abstract words resulted in both direct training and generalization effects, whereas training concrete words resulted in only direct training effects. The reported results are consistent across studies. Furthermore, when the data are compared across studies, there is a distinct pattern of the added benefit of training abstract words using AbSANT.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Treatment for word retrieval in aphasia is most often aimed at concrete words, despite the usefulness and pervasiveness of abstract words in everyday conversation. We show the utility of AbSANT as a means of improving not only abstract word retrieval but also concrete word retrieval and hope this evidence will help foster its application in clinical practice.</jats:p> </jats:sec>

<jats:sec> <jats:title>Purpose</jats:title> <jats:p>Social communication is the set of abilities that allows individuals to achieve relevant social goals across contexts. Speech-language pathology evaluation and treatment of traumatic brain injury (TBI)-related social communication problems should be informed by evidence-supported theories of social communication. The primary purpose of this article is to summarize the results of a scoping review of theoretical models that speech-language pathologists may apply to the evaluation and treatment of social communication problems of adults with TBI.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>A scoping review was conducted of PubMed, PsycINFO, and Embase for sources published in English between 1989 and 2020 that described human social communication and participation. Resulting sources were systematically examined for social communication models.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Nine theoretical models were identified that speech-language pathologists may apply to their assessment and treatment of social communication abilities of adults with TBI. Identified models were categorized thematically into one of three classes: cognitive models, social competence models, and pragmatic models. Using a framework developed for the purposes of this article, each identified model was evaluated, and one exemplar model in each class is described in depth.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Social communication problems in adults post-TBI are common. The existence of multiple models empowers speech-language pathologists to select individual-focused assessment and treatment approaches to maximize intervention outcomes.</jats:p> </jats:sec>

<jats:sec> <jats:title>Purpose</jats:title> <jats:p>This systematic review aimed to establish language and speech markers to support the clinical diagnosis of primary progressive aphasia (PPA) and its clinical phenotypes. Our first objective was to identify behavioral language and speech markers of early-stage PPA. Our second objective was to identify the electrophysiological correlates of the language and speech characteristics in PPA.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>The databases MEDLINE, Web of Science, and Embase were searched for relevant articles. To identify behavioral markers, the initial subjective complaints and the language and speech deficits detected during the initial diagnostic evaluation were summarized for PPA in general and each clinical variant according to the 2011 consensus diagnostic criteria (nonfluent variant [NFV], semantic variant, and logopenic variant [LV]). To identify electrophysiological markers, the studies in which event-related potentials (ERPs) were elicited by a language or speech paradigm in patients with PPA were included.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>In total, 114 relevant studies were identified, including 110 behavioral studies and only four electrophysiological studies. This review suggests that patients with the semantic variant could be accurately differentiated from the NFV and LV in the initial stages based on the consensus criteria. Nonetheless, the early differentiation between the NFV and LV is not straightforward. In the four electrophysiological studies, differences in the latency, amplitude, and topographical distribution of the semantic N400 component were found between patients with PPA and healthy controls.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>To accurately differentiate the NFV from the LV, it could be important to assess the language and speech degeneration by more specific assessments and by more objective diagnostic methods that offer insights into the language-related processes. Electrophysiological markers of PPA were not identified in this review due to the low number of studies that investigated language-related ERPs. More controlled ERP studies in larger patient cohorts are needed to investigate the diagnostic applicability of language-related ERPs in PPA.</jats:p> </jats:sec> <jats:sec> <jats:title>Supplemental Material</jats:title> <jats:p> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://doi.org/10.23641/asha.12798080">https://doi.org/10.23641/asha.12798080</jats:ext-link> </jats:p> </jats:sec>

<jats:sec> <jats:title>Purpose</jats:title> <jats:p>Proficiency with complex syntax is important for language and reading comprehension, and production of complex syntax begins to emerge shortly after a young child begins using two-word combinations. Complex syntax production in preschool children with hearing loss who use spoken language has been explored minimally. The purpose of this study was to compare complex syntax production of 4-year-old children with hearing loss to age-matched and language-matched peers with normal hearing.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>Seventy-two children completed a language assessment battery, including a structured language sample. Complex syntax density and number and accuracy of productions of particular types of complex syntax were compared across three groups: 4-year-old children with hearing loss, an age-matched group of children with normal hearing, and an mean length of utterance (MLU)–matched group of children with normal hearing.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Children with hearing loss had lower complex syntax density and fewer correct productions of coordinated clauses, subordinate clauses, and simple infinitives than their age-matched, but not language-matched, peers. Furthermore, children with hearing loss had lower accuracy than the age-matched group on simple infinitives and lower accuracy than both the age- and MLU-matched groups on full propositional complements and subject relative clauses.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Children with hearing loss exhibit delays in complex syntax acquisition as compared to their same-age peers and disruptions in development on some complex structures as compared to MLU-matched, younger children.</jats:p> </jats:sec> <jats:sec> <jats:title>Supplemental Material</jats:title> <jats:p> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://doi.org/10.23641/asha.14080193">https://doi.org/10.23641/asha.14080193</jats:ext-link> </jats:p> </jats:sec>

<jats:sec> <jats:title>Purpose</jats:title> <jats:p>Hospitalized, medically complex patients with new tracheostomy are at risk for aspiration. This study reports incidence of aspiration in these patients with new tracheostomy and investigates possible risk factors for aspiration and silent aspiration in this patient population.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>Retrospective review of instrumental swallowing evaluations from hospitalized inpatients with new tracheostomy tubes to determine frequency of aspiration and silent aspiration and patient factors associated with aspiration. Patient variables including sex, age, reason for hospital admission, reason for tracheostomy, duration of intubation, time since tracheostomy placement, and tracheostomy cuff and cap status were examined as possible risk factors for aspiration and silent aspiration.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of the 272 patients with new tracheostomies who underwent instrumental swallowing evaluation, 59% aspirated on at least one consistency. Odds of aspiration were twice as high in patients with uncapped tracheostomy compared to closed (i.e., cap or speaking valve in place). Odds of aspiration were 3.4 times greater with patients who underwent tracheostomy for an oropharyngeal etiology (oropharyngeal or laryngeal tumor, surgery, or infection). Of the patients who aspirated, 81% aspirated silently on at least one consistency. Odds of silent aspiration was 4.5 greater with an uncapped tracheostomy.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Medically complex patients with new tracheostomy are at risk for aspiration and benefit from instrumental swallowing evaluations. Future prospective research is warranted to determine contributing factors responsible for this risk. Lastly, speech pathologists play an important role in the patient’s recovery.</jats:p> </jats:sec>

<jats:sec> <jats:title>Purpose:</jats:title> <jats:p>Speech-language pathologists are increasingly being recognized as key members of concussion management teams. This study investigates whether self-report of communication problems postconcussion may be useful in identifying clients who could benefit from speech-language pathology services.</jats:p> </jats:sec> <jats:sec> <jats:title>Method:</jats:title> <jats:p>Participants included 41 adolescents and adults from an outpatient specialty concussion clinic. All completed the La Trobe Communication Questionnaire (LCQ) at admission, and 23 repeated this measure at discharge. Participants were prospectively enrolled, with chart reviews providing demographic, injury, and medical factors. The analysis considered (a) communication complaints and resolution over time, including comparison to two previously published LCQ studies of typical adults and adults with and without traumatic brain injury (TBI); (b) the relationship between communication complaints, participant factors, and common concussion assessments; and (c) factors related to speech-language pathology service referral for rehabilitation.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>At first visit, 12 of 41 participants (29%) reported communication problems, although 19 (46%) reported difficulty with greater than half of LCQ items. At a group level, compared to published reference data of both people with chronic mixed severity TBI and controls, participants in this study reported more problems at first visit with communication overall, as well as greater difficulty with the LCQ Initiation/Conversation Flow subscale. Partner Sensitivity subscale scores at first visit were also greater than published control data. LCQ subscale scores of Initiation/Conversation Flow and Partner Sensitivity decreased from first visit to last visit, demonstrating resolution over time. Only concussion symptom scales and not demographic, injury, or cognitive screenings were related to LCQ scores. The same two LCQ subscales, Initiation/Conversation Flow and Partner Sensitivity, predicted referral for speech-language pathology services, along with symptom scales and being injured due to motor vehicle crash.</jats:p> </jats:sec> <jats:sec> <jats:title>Discussion:</jats:title> <jats:p>A subset of people recovering from concussion report experiencing communication problems. Reporting of particular communication problems was related to referral for speech-language pathology rehabilitation services and may be useful in directing care after concussion.</jats:p> </jats:sec>

<jats:sec> <jats:title>Purpose:</jats:title> <jats:p>COVID-19 caused a worldwide conversion from in-person therapy to telehealth; however, limited evidence to support the efficacy of remotely delivering standardized tests puts the future of widespread telehealth use at risk. The aim of this study is to investigate the reliability of scoring a speech sound assessment administered in real-world scenarios including two examples of telehealth technology.</jats:p> </jats:sec> <jats:sec> <jats:title>Method:</jats:title> <jats:p>A total of thirty-nine 3- to 8-year-olds were administered the Goldman-Fristoe Test of Articulation–Third Edition. Licensed speech-language pathologists (SLPs) concurrently scored children's responses in person and in two telehealth conditions considered typical and enhanced. Mean standard scores and interrater reliability results were compared among the three conditions. Descriptive statistics were used to summarize the frequency of technology and behavior disruptions during administration and the results of an SLP telehealth perception survey.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>All scoring conditions were found to be highly correlated, with mean differences revealing no systematic differences of one condition over- or underestimating another. Although response agreement was high (85%–87%), final sounds in words or sounds that are difficult to observe tended to attenuate reliability. Neither child nor technology disruptions affected SLPs' ability to score responses. Despite no significant differences between conditions on scoring reliability, SLP participants reported they continued to prefer in-person over a telehealth speech sound assessment.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>This study supports the provision of a pediatric speech sound assessment using consumer-grade equipment, as in-person, typical telehealth, and enhanced telehealth scoring conditions produced similar results. However, SLP participants' skeptical attitudes toward remote delivery of standardized tests reveal an ongoing barrier to widespread telehealth use.</jats:p> </jats:sec> <jats:sec> <jats:title>Supplemental Material:</jats:title> <jats:p> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://doi.org/10.23641/asha.19593367">https://doi.org/10.23641/asha.19593367</jats:ext-link> </jats:p> </jats:sec>

<jats:sec> <jats:title>Purpose:</jats:title> <jats:p>A mixed-method approach was used to investigate the lived experiences of adults with mild traumatic brain injury (mTBI). The study aimed to understand the perceived relationship between cognitive-communication problems, thinking and communication concerns, and neurobehavioral symptoms. We hypothesized that individuals with cognitive-communication problems would attribute their problems with communication to their mTBI history and their self-perceived problems would be correlated with symptomatology.</jats:p> </jats:sec> <jats:sec> <jats:title>Method:</jats:title> <jats:p>The Neurobehavioral Symptom Inventory (NSI) and an online cognitive-communication survey was used to conduct a study of 30 adults with mTBI history. Quantitative survey and NSI scores were analyzed with content analysis and correlational statistics.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> The average NSI Total score was 17 with the following subscale scores: somatic (5), affective (8), and cognitive (3.9). Participants reported problems with expressive communication (56%), comprehension (80%), thinking (63%), and social skills (60%). Content analysis revealed problems in the following areas: expression (e.g., verbal, and written language), comprehension (reading and verbal comprehension), cognition (e.g., attention, memory and speed of processing, error regulation), and functional consequences (e.g., academic work, social problems, and anxiety and stress). A Pearson correlation indicated a statistically significant relationship ( <jats:italic>p</jats:italic> &lt; .01) between the Communication Survey Total and the Total, Somatic, Affective, and Cognitive subscales. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>This study highlights a multifactorial basis of cognitive-communication impairment in adults with mTBI. We show that those with mTBI history perceive difficulties with cognitive-communication skills: conversations, writing, and short-term memory/attention. Furthermore, those with mTBI perceive their cognitive-communication problems after injury have impacted their vocational, social, and academic success.</jats:p> </jats:sec>