How great is the negative impact of masking and social distancing and how can we enhance communication skills in the elderly people?

Remote Check as a tele-health instrument for cochlear implant recipients: Analysis of impact and feasibility of application

PURPOSE

The number of cochlear implant (CI) surgeries is growing over time, with the risk of overloading CI centers in the post-surgical management. Telemedicine is a possible solution to address this phenomenon. Remote Check (RC) is an application that is specific for CI recipients monitoring. The aim of this study is to evaluate the feasibility of application, potential economic impact and patients' acceptance of RC.

METHODS

The study is retrospective investigation, data on clinical, audiological features (from remote and on-site evaluation), and satisfaction surveys of 66 consecutive patients were collected; costs required for RC and for on-site evaluations were recorded as well.

RESULTS

One hundred and ninety RC sessions were completed by the patients (2.88 sessions per patient). RC and on-site audiometry significantly correlated except for the 500 Hz frequency. Estimated costs for the Italian National Health System for RC review and on-site evaluations were 1.32€ and 3.49€ per minute, respectively. High satisfaction for RC was reached in 91 % of patients.

CONCLUSION

RC revealed to be a reliable, cost-effective and well accepted tool in CI monitoring. This study preliminarily supports the hypothesis that RC could be a valid instrument to reduce CI management overload in the outpatient clinic.

Cognitive-communication difficulties due to traumatic brain injury sustained in adults 55 years and older: A survey of speech-language pathology professional practice in Australia

PURPOSE

Limited research informs management of cognitive-communication difficulties following traumatic brain injury (TBI) in older adulthood. The purpose of this study was to understand the characteristics and practice of speech-language pathologists (SLPs) working with people who sustained TBI at ≥55 years and more specifically their management of cognitive-communication difficulties with this population. This included assessment and treatment practices, resource needs, barriers to practice, and impact to service delivery from COVID-19 restrictions.

METHOD

A cross-sectional survey-based design with non-probability sampling of SLPs working in Australia with adults with TBI was utilised. Descriptive statistics and content analysis were used for analysis of survey data.

RESULT

Fifty responses were eligible for inclusion. Participants predominantly worked in inpatient rehabilitation (48%), acute (40%), and community settings (36%). Service delivery to adults who sustained TBI at ≥55 years commonly included cognitive-communication management. Assessment and treatment trends are described. Most SLPs (74%) perceived barriers to cognitive-communication management, often relating to time and funding, that existed prior to the COVID-19 pandemic. Pandemic restrictions presented additional challenges.

CONCLUSION

Research relating to cognitive-communication difficulties following TBI in older adulthood is required to support evidence-based practice and inform services for older adults who sustain TBI.

Age-related changes in auditory perception. Hearing loss in the elderly: aging ear or aging brain?

Hearing loss in the elderly is a very common disease: it is estimated to affect up to a third of the population aged 65 years or more, and 50% of people over 75 years old. There is a growing amount of data concerning the association between hearing loss and cognitive decline. Various possible mechanisms at the basis of this association have been proposed, such as the "common cause hypothesis," the "cascade hypothesis," and the "cognitive load hypothesis."Critically reviewing the data is essential to highlight the features of the relationship between hearing loss and cognitive decline. Most of the hearing tests available should take into account that dementia or even just mild cognitive impairment (MCI) may lead to poor performance during examination. On the other hand, clinicians should also remember that tests used to assess cognitive function require an adequate hearing capacity.In this article we propose to analyze current diagnostic tests, treatment options, auditory processing, and rehabilitation strategies for hearing loss in the elderly in order to facilitate the management of this handicap in this fragile population.

Effects on communication due to face mask use: an integrative review

OBJECTIVES

to integrate evidence from studies on auditory perceptual and speech production effects in communication situations with face mask use.

METHODS

an integrative literature review, in MEDLINE, Cochrane Library and Embase databases. The guiding question was: what effects on communication (perceptual-auditory and speech production) occur with face mask use?

RESULTS

searches in electronic databases resulted in 1,478 studies and filtering resulted in 29 final studies.

CONCLUSIONS

mask use has effects on communication, both in perception and speech production, factors that are also related to quality of life, stress and socio-emotional factors. These data can impact on indicators and alerts in favor of adopting strategies to manage mask use, involving speech production and perception when wearing a mask in health services.

Acoustic and perceptual impact of face masks on speech: A scoping review

During the COVID-19 pandemic, personal protective equipment such as facial masks and coverings were mandated all over the globe to protect against the virus. Although the primary aim of wearing face masks is to protect against viral transmission, they pose a potential burden on communication. The purpose of this scoping review was to identify the state of the evidence of the effect of facial coverings on acoustic and perceptual speech outcomes. The scoping review followed the framework created by Arksey & O'Malley (2005) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR; Tricco et al., 2018). The search was completed in May 2021 across the following databases: PubMed, EMBASE, PsycINFO, Web of Science, and Google Scholar. A total of 3,846 records were retrieved from the database search. Following the removal of duplicates, 3,479 remained for the title/abstract screen and 149 were selected for the full-text review. Of these, 52 were included in the final review and relevant data were extracted. The 52 articles included in the final review consisted of; 11 studied perceptual outcomes only, 16 studied acoustic outcomes only, and 14 studied both perceptual and acoustic outcomes. 13 of these investigated acoustic features that could be used for mask classification. Although the findings varied from article to article, many trends stood out. Many articles revealed that face masks act as a low pass filter, dampening sounds at higher frequencies; however, the frequency range and the degree of attenuation varied based on face mask type. All but five articles that reported on perceptual outcomes showed a common trend that wearing a face mask was associated with poorer speech intelligibility. The findings of the scoping review provided evidence that facial coverings negatively impacted speech intelligibility, which is likely due to a combination of auditory and visual cue degradation. Due to the continued prevalence of mask use, how facial coverings affect a wider variety of speaker populations, such as those with communication impairments, and strategies for overcoming communication challenges should be explored.

A proposed artificial intelligence-based real-time speech-to-text to sign language translator for South African official languages for the COVID-19 era and beyond: In pursuit of solutions for the hearing impaired

Background

The emergence of the coronavirus disease 2019 (COVID-19) pandemic has resulted in communication being heightened as one of the critical aspects in the implementation of interventions. Delays in the relaying of vital information by policymakers have the potential to be detrimental, especially for the hearing impaired.

Objectives

This study aims to conduct a scoping review on the application of artificial intelligence (AI) for real-time speech-to-text to sign language translation and consequently propose an AI-based real-time translation solution for South African languages from speech-to-text to sign language.

Methods

Electronic bibliographic databases including ScienceDirect, PubMed, Scopus, MEDLINE and ProQuest were searched to identify peer-reviewed publications published in English between 2019 and 2021 that provided evidence on AI-based real-time speech-to-text to sign language translation as a solution for the hearing impaired. This review was done as a precursor to the proposed real-time South African translator.

Results

The review revealed a dearth of evidence on the adoption and/or maximisation of AI and machine learning (ML) as possible solutions for the hearing impaired. There is a clear lag in clinical utilisation and investigation of these technological advances, particularly in the African continent.

Conclusion

Assistive technology that caters specifically for the South African community is essential to ensuring a two-way communication between individuals who can hear clearly and individuals with hearing impairments, thus the proposed solution presented in this article.

Masking care: A qualitative investigation of the impact of face masks on the experience of stroke rehabilitation from the perspective of staff and service users with communication difficulties

BACKGROUND

Face mask use has become widespread as a means of reducing transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Research suggests face coverings can impact speech discrimination, therapeutic alliance and the interpretation of non-verbal cues. However, there is little research into the impact of face masks on people with communication difficulties (pwCD) post-stroke.

AIMS

To explore the perspectives of service users and staff on a stroke rehabilitation unit in order to understand the impact of staff wearing face masks on the experience of rehabilitation for pwCD. Strategies that might improve the experience of rehabilitation for pwCD were also explored.

METHODS & PROCEDURES

Semi-structured interviews and a focus group were conducted with six pwCD and five health professionals (HPs) on a stroke rehabilitation unit. The data were analysed using reflexive thematic analysis.

OUTCOMES & RESULTS

Four main interacting themes were identified from the data: (1) face masks as a barrier to effective communication; (2) face masks as a barrier to human connection and therapeutic relationships; (3) the impact of face masks on an individual is influenced by multiple internal and external factors; and (4) there is a need for service provision to evolve to meet pwCD's needs when using face masks.

CONCLUSIONS & IMPLICATIONS

Findings shed light on how face masks can act as a barrier for pwCD within the rehabilitative process, and emphasize that each individual with communication difficulties is likely to be affected to a differing extent, as a result of multiple interacting factors. HPs are encouraged to consider the individual holistically, tailor strategies and adapt to each individual's needs. Further research is required to understand how to optimize rehabilitation outcomes when face masks are used.

WHAT THIS PAPER ADDS

What is already known on the subject There is evidence face masks can affect speech discrimination, therapeutic alliance and interpretation of non-verbal cues. The existing literature predominantly considers people with hearing impairments, mental health needs or the general public. The potential for face masks to impact pwCD post-stroke is high, given pre-existing communication barriers and evidence of increased social isolation. What this paper adds to existing knowledge This study is the first of its kind to explore how face mask use by HPs impacts the experience of rehabilitation for pwCD post-stroke. The authors consider the need to tailor compensatory strategies to each individual and adapt them to meet service users' needs. What are the potential or actual clinical implications of this work? HPs should monitor closely the impact of face mask use on pwCD with whom they are working, and consider what adaptations to delivery are required. It would be helpful for clinicians to have a discussion with pwCD post-stroke to understand the impact of face mask use on them personally and what strategies they would find most helpful within rehabilitation. Additional training by speech and language therapists on supporting effective communication and successful interaction with pwCD may be indicated in the context of face mask use.

Speech Impaired by Half Masks Used for the Respiratory Tract Protection

Filtering half masks belong to the group of personal protective equipment in the work environment. They protect the respiratory tract but may hinder breath and suppress speech. The present work is focused on the attenuation of sound by the half masks known as "filtering facepieces", FFPs, of various construction and filtration efficiency. Rather than study the perception of speech by humans, we used a generator of white noise and artificial speech to obtain objective characteristics of the attenuation. The generator speaker was either covered by an FFP or remained uncovered while a class 1 meter measured sound pressure levels in 1/3 octave bands with center frequencies 100-20 kHz at distances from 1 to 5 m from the speaker. All five FFPs suppressed acoustic waves from the octave bands with center frequencies of 1 kHz and higher, i.e., in the frequency range responsible for 80% of the perceived speech intelligibility, particularly in the 2 kHz-octave band. FFPs of higher filtration efficiency stronger attenuated the sound. Moreover, the FFPs changed the voice timbre because the attenuation depended on the wave frequency. The two combined factors can impede speech intelligibility.

The Impact of Face Masks on the Emotional Reading Abilities of Children-A Lesson From a Joint School-University Project

Wearing face masks has become a usual practice in acute infection events inducing the problem of misinterpreting the emotions of others. Empirical evidence about face masks mainly relies on adult data, neglecting, for example, school kids who firmly are dependent on effective nonverbal communication. Here we offer insights from a joint school-university project. Data indicate that emotional reading of 9 to 10 years old pupils (N = 57) was similarly impaired as adults on an overall performance level, but that their selective performance on specific emotions was quite different. Kids showed extreme problems in reading the emotion disgust, strong effects on fear and sadness, and only mild effects on happiness, but also even better performances for emotional states anger and neutral when faces were masked. This project did gain not only relevant data about children's perception but also made clear how fruitful seriously conducted school projects can be to encourage the interest and commitment for Science, Technology, Engineering, and Mathematics (STEM)-relevant topics.