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Safi M, Alzyod DM, Opoku MP, Agamy YE. Tongue strength and endurance among typically developing children and children with idiopathic speech sound disorders in the United Arab Emirates. PLoS One 2023; 18:e0289400. [PMID: 37523398 PMCID: PMC10389734 DOI: 10.1371/journal.pone.0289400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/18/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Tongue strength and endurance in adults have been extensively studied, but data on these parameters in young children remain largely unavailable. AIMS This study aimed to collect normative objective tongue strength and endurance data from a pediatric population in the United Arab Emirates (UAE) and to examine the effects of age and sex on these parameters. METHODS This normative study included a total of 65 typically developing (TD; n = 36) children and children with idiopathic speech sound disorders (ISSDs; n = 29). The participants were assigned to four age groups (range: 3-8 years) and stratified by sex. Data on their tongue strength and endurance were collected using the Iowa Oral Performance Instrument. RESULTS Tongue strength scores and endurance time increased with age in both the TD and ISSD groups. Sex had no statistically significant effects on tongue strength or endurance in either group. Furthermore, tongue strength and endurance time scores were higher in the TD group than in the ISSD group. CONCLUSIONS The data obtained in this study would add important normative data to the database of standardized measurements for maximal strength and endurance scores in the pediatric population of the UAE. Future research is encouraged to collect additional data that can help healthcare professionals objectively evaluate children with feeding, swallowing, and speech sound production difficulties.
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Affiliation(s)
- Mohammed Safi
- Department of Speech Language Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | | | - Maxwell Peprah Opoku
- Special Education Department, College of Education, United Arab Emirates University, Al Ain, UAE
| | - Yasser E Agamy
- General Physician and Clinical Tutor, Thumbay University Hospital Complex, Ajman, United Arab Emirates
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2
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Weismer G. Oromotor Nonverbal Performance and Speech Motor Control: Theory and Review of Empirical Evidence. Brain Sci 2023; 13:brainsci13050768. [PMID: 37239240 DOI: 10.3390/brainsci13050768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
This position paper offers a perspective on the long-standing debate concerning the role of oromotor, nonverbal gestures in understanding typical and disordered speech motor control secondary to neurological disease. Oromotor nonverbal tasks are employed routinely in clinical and research settings, but a coherent rationale for their use is needed. The use of oromotor nonverbal performance to diagnose disease or dysarthria type, versus specific aspects of speech production deficits that contribute to loss of speech intelligibility, is argued to be an important part of the debate. Framing these issues are two models of speech motor control, the Integrative Model (IM) and Task-Dependent Model (TDM), which yield contrasting predictions of the relationship between oromotor nonverbal performance and speech motor control. Theoretical and empirical literature on task specificity in limb, hand, and eye motor control is reviewed to demonstrate its relevance to speech motor control. The IM rejects task specificity in speech motor control, whereas the TDM is defined by it. The theoretical claim of the IM proponents that the TDM requires a special, dedicated neural mechanism for speech production is rejected. Based on theoretical and empirical information, the utility of oromotor nonverbal tasks as a window into speech motor control is questionable.
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Affiliation(s)
- Gary Weismer
- Department of Communication Sciences & Disorders, University of Wisconsin-Madison, Madison, WI 53706, USA
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Ferrara R, Iovino L, Di Renzo M, Ricci P. Babies under 1 year with atypical development: Perspectives for preventive individuation and treatment. Front Psychol 2022; 13:1016886. [PMID: 36467138 PMCID: PMC9713249 DOI: 10.3389/fpsyg.2022.1016886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2023] Open
Abstract
A baby's first year of life is a time of immense development and cerebral plasticity. Following today's research and clinical observation, the period of the first year of life provides a new challenge inasmuch it is presently clear that it is possible to identify developmental anomalies in this window of time. Effecting early screening procedures could prove very useful, especially where we find genetic vulnerabilities in brothers and sisters of autistic subjects. Interventions of this kind, already practiced by some Public Health systems, can mean taking early action and primary protective measures with significant impacts not only on the subjects (babies and family members) concerned, but also on the public purse. It is, therefore, essential to provide for specific professionalized procedures for psychologists, pediatricians and neuropsychologists to be introduced through personnel highly specialized in interventions during the first year of life.
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Affiliation(s)
- Rosaria Ferrara
- Department of Anatomy Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy
| | - Leonardo Iovino
- Department of Economic and Legal Studies, “Parthenope” University of Naples, Naples, Italy
| | | | - Pasquale Ricci
- Department of Anatomy Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy
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A novel soft robotic pediatric in vitro swallowing device to gain insights into the swallowability of mini-tablets. Int J Pharm 2022; 629:122369. [DOI: 10.1016/j.ijpharm.2022.122369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/07/2022]
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Quantitative Measurement of Swallowing Performance Using Iowa Oral Performance Instrument: A Systematic Review and Meta-Analysis. Biomedicines 2022; 10:biomedicines10092319. [PMID: 36140420 PMCID: PMC9496474 DOI: 10.3390/biomedicines10092319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 12/12/2022] Open
Abstract
Swallowing is a complex but stereotyped motor activity aimed at serving two vital purposes: alimentary function and the protection of upper airways. Therefore, any impairment of the swallowing act can represent a significant clinical and personal problem that needs an accurate diagnosis by means of reliable and non-invasive techniques. Thus, a systematic review and meta-analysis was performed to investigate the reliability of the Iowa Oral Pressure Instrument (IOPI) in distinguishing healthy controls (HC) from patients affected by swallowing disorders or pathologies and conditions that imply dysphagia. A comprehensive search was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and using PubMed, Scopus, Web of Science, Cochrane, and Lilacs databases. Overall, 271 articles were identified and, after a three-step screening, 33 case-control and interventional studies reporting IOPI measurements were included. The methodological quality of the retrieved studies resulted in being at a low risk of bias. The meta-analysis on case-control studies showed that maximum tongue pressure (MIP) values were always higher in HC than in patients, with an overall effect of the MIP difference of 18.2 KPa (17.7–18.7 KPa CI). This result was also confirmed when the sample was split into adults and children, although the MIP difference between HC and patients was greater in children than in adults (21.0 vs. 15.4 KPa in the MIP mean difference overall effect, respectively). Tongue endurance (TE) showed conflicting results among studies, with an overall effect among studies near zero (0.7 s, 0.2–1.1 s CI) and a slight tendency toward higher TE values in HC than in patients. Among the intervention studies, MIP values were higher after treatment than before, with a better outcome after the experimental tongue training exercise than traditional treatments (the MIP mean difference overall effect was 10.8 and 2.3 KPa, respectively). In conclusion, MIP values can be considered as a reliable measure of swallowing function in adults and in children, with a more marked MIP difference between HC and patients for the children population. MIP measures in patients are also able to detect the best outcome on the tongue function after the training exercise compared to traditional training.
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6
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Yoneyama T, Utsumi A, Ishizaki A, Takahashi M, Yamaguchi S, Asami T, Hironaka S. Can dentists contribute to early screening for developmental disorders in five-year-old children during health checkups? PEDIATRIC DENTAL JOURNAL 2022. [DOI: 10.1016/j.pdj.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Mogren Å, Sand A, Havner C, Sjögreen L, Westerlund A, Agholme MB, Mcallister A. Children and adolescents with speech sound disorders are more likely to have orofacial dysfunction and malocclusion. Clin Exp Dent Res 2022; 8:1130-1141. [PMID: 35723352 PMCID: PMC9562821 DOI: 10.1002/cre2.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/08/2022] Open
Abstract
Background Children with speech sound disorders (SSD) form a heterogeneous group that differs in terms of underlying cause and severity of speech difficulties. Orofacial dysfunction and malocclusions have been reported in children with SSD. However, the association is not fully explored. Objectives Our aims were to describe differences in orofacial function and malocclusion between a group of children and adolescents with compared to without SSD and to explore associations between those parameters among the group with SSD. Methods A total of 105 participants were included, 61 children with SSD (6.0–16.7 years, mean age 8.5 ± 2.8, 14 girls and 47 boys) and 44 children with typical speech development (TSD) (6.0–12.2 years, mean age 8.8 ± 1.6, 19 girls and 25 boys). Assessments of orofacial function included an orofacial screening test and assessment of bite force, jaw stability, chewing efficiency, and intraoral sensory‐motor function. Possible malocclusions were also assessed. Result Children with SSD had both poorer orofacial function and a greater prevalence of malocclusion than children with TSD. Furthermore, children with SSD and poorer orofacial function had a greater risk of malocclusion. Conclusion Our result suggests that children with SSD are more prone to having poorer orofacial function and malocclusion than children with TSD. This illustrates the importance of assessing coexisting orofacial characteristics in children with SSD, especially since orofacial dysfunction may be linked to an increased risk of malocclusion. This result highlights the need for a multiprofessional approach.
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Affiliation(s)
- Åsa Mogren
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology Karolinska Institutet Stockholm Sweden
- Public Dental Service Mun‐H‐Center, Orofacial Resource Centre for Rare Diseases Gothenburg Sweden
| | - Anders Sand
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology Karolinska Institutet Stockholm Sweden
| | - Christina Havner
- Public Dental Service Mun‐H‐Center, Orofacial Resource Centre for Rare Diseases Gothenburg Sweden
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Lotta Sjögreen
- Public Dental Service Mun‐H‐Center, Orofacial Resource Centre for Rare Diseases Gothenburg Sweden
| | - Anna Westerlund
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Monica Barr Agholme
- Department of Dental Medicine, Division of Orthodontics and Pediatric Dentistry Karolinska Institutet Stockholm Sweden
| | - Anita Mcallister
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology Karolinska Institutet Stockholm Sweden
- Medical Unit Speech and Language Pathology, Women's Health and Allied Health Professionals Theme Karolinska University Hospital Stockholm Sweden
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Pascual-Soriano A, Cervera Mérida JF. Tratamiento de la nasalidad transpalatal en un caso complejo con trastorno fonológico. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2022. [DOI: 10.5209/rlog.72880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Se presenta el proceso de evaluación e intervención logopédica en una niña de 9 años con hipernasalidad y dificultades fonológicas perceptivas y expresivas. Se evalúo el nivel fonético y fonológico del lenguaje, el timbre nasal mediante nasometría, la integridad funcional de las estructuras velopalatofaríngeas y la audición. La paciente pronunciaba los sonidos [d], [l] y [t] muy distorsionados y con características de [n], al tiempo que no era capaz de distinguirlos de la consonante nasal. La configuración de su cavidad oral y su base articulatoria idiosincrática favorecía el fenómeno de nasalidad transpalatal: presencia excesiva de resonancia nasal durante la emisión de sonidos no nasales en ausencia de disfunción velofaríngea. Para el abordaje de la hipernasalidad se aplicó un tratamiento intensivo con la herramienta de biofeedback visual Nasometer II, como recomienda la literatura existente para los casos de nasalidad de origen funcional. El tratamiento fue eficaz para el control voluntario de la reducción de la hiperrinolalia, pero no fue efectivo debido a que la paciente no fue capaz de reducir el timbre nasal en el uso espontáneo del habla.
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Ota C, Ishizaki A, Yamaguchi S, Utsumi A, Ikeda R, Kimoto S, Hironaka S, Funatsu T. Predictors of Developmental Insufficiency of Oral Function in children. PEDIATRIC DENTAL JOURNAL 2021. [DOI: 10.1016/j.pdj.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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10
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Abstract
The application of exercise science training knowledge has been of growing interest to voice professionals. This tutorial, derived from the authors' invited presentations from the "Exercise and the Voice" Special Session at the 2018 Voice Foundation Symposium, proposes a foundational theoretical structure based in exercise science, clarifies the wide range of variables that may influence voice training, and summarizes our present understanding of voice physiology from the perspective of muscle training. The body of literature on voice exercise was then analyzed from the perspective of this framework, identifying what we currently know and what we still have yet to learn.
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Affiliation(s)
- Aaron M Johnson
- Department of Otolaryngology - Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York.
| | - Mary J Sandage
- Department of Communication Disorders, Auburn University, Auburn, Alabama
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Oxilia G, Menghi Sartorio JC, Bortolini E, Zampirolo G, Papini A, Boggioni M, Martini S, Marciani F, Arrighi S, Figus C, Marciani G, Romandini M, Silvestrini S, Pedrosi ME, Mori T, Riga A, Kullmer O, Sarig R, Fiorenza L, Giganti M, Sorrentino R, Belcastro MG, Cecchi JM, Benazzi S. Exploring directional and fluctuating asymmetry in the human palate during growth. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 175:847-864. [PMID: 33973654 PMCID: PMC8360102 DOI: 10.1002/ajpa.24293] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/23/2021] [Accepted: 04/09/2021] [Indexed: 01/20/2023]
Abstract
Objectives Palate morphology is constantly changing throughout an individual's lifespan, yet its asymmetry during growth is still little understood. In this research, we focus on the study of palate morphology by using 3D geometric morphometric approaches to observe changes at different stages of life, and to quantify the impact of directional and fluctuating asymmetry on different areas at different growth stages. Materials and Methods The sample consists of 183 individuals (1–72 years) from two identified human skeletal collections of 19th and early 20th Century Italian contexts. A 3D‐template of 41 (semi)landmarks was applied on digital palate models to observe morphological variation during growth. Results Asymmetrical components of the morphological structure appears multidirectional on the entire palate surface in individuals <2 years old and become oriented (opposite bilateral direction) between 2 and 6 years of age. Specifically, directional asymmetry differentially impacts palate morphology at different stages of growth. Both the anterior and posterior palate are affected by mild alterations in the first year of life, while between 2 and 6 years asymmetry is segregated in the anterior area, and moderate asymmetry affects the entire palatal surface up to 12 years of age. Our results show that stability of the masticatory system seems to be reached around 13–35 years first by females and then males. From 36 years on both sexes show similar asymmetry on the anterior area. Regarding fluctuating asymmetry, inter‐individual variability is mostly visible up to 12 years of age, after which only directional trends can be clearly observed at a group level. Discussion Morphological structure appears instable during the first year of life and acquires an opposite asymmetric bilateral direction between 2 and 6 years of age. This condition has been also documented in adults; when paired with vertical alteration, anterior/posterior asymmetry seems to characterize palate morphology, which is probably due to mechanical factors during the lifespan. Fluctuating asymmetry is predominant in the first period of life due to a plausible relationship with the strength of morphological instability of the masticatory system. Directional asymmetry, on the other hand, shows that the patterning of group‐level morphological change might be explained as a functional response to differential inputs (physiological forces, nutritive and non‐nutritive habits, para‐masticatory activity as well as the development of speech) in different growth stages. This research has implications with respect to medical and evolutionary fields. In medicine, palate morphology should be considered when planning orthodontic and surgical procedures as it could affect the outcome. As far as an evolutionary perspective is concerned the dominance of directional asymmetries in the masticatory system could provide information on dietary and cultural habits as well as pathological conditions in our ancestors.
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Affiliation(s)
- Gregorio Oxilia
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy
| | - Jessica C Menghi Sartorio
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy.,Department of Enterprise Engineering, "Mario Lucertini" - Tor Vergata University, Rome, Italy
| | - Eugenio Bortolini
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy
| | - Giulia Zampirolo
- Section for Evolutionary Genomics Øster Farimagsgade, University of Copenhagen, København, Denmark
| | - Andrea Papini
- Dentist's Surgery, via Walter Tobagi 35, Prato, 59100, Italy
| | - Marco Boggioni
- Dentist's Surgery, via D'Andrade 34/207, Genoa Sestri Ponente, 16154, Italy
| | - Sergio Martini
- Dental Lab Technician, via Milani, 1, Verona, 37124, Italy
| | - Filippo Marciani
- Dentist's Surgery, Studio Dentistico Marciani Dr. Filippo, Via Romagnoli, 14, Lanciano, 66034, Italy
| | - Simona Arrighi
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy
| | - Carla Figus
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy
| | - Giulia Marciani
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy
| | - Matteo Romandini
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy
| | - Sara Silvestrini
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy
| | - Maria Elena Pedrosi
- Department of Biological, Geological and Environmental Sciences-, BiGeA University of Bologna, Bologna, Italy
| | - Tommaso Mori
- Department of Biology, University of Florence, Florence, Italy
| | - Alessandro Riga
- Department of Biology, University of Florence, Florence, Italy
| | - Ottmar Kullmer
- Senckenberg Research Institute, Senckenberganlage 25, Frankfurt am Main, 60325, Germany.,Department of Paleobiology and Environment, Institute of Ecology, Evolution, and Diversity, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Rachel Sarig
- Department of Oral biology, The Goldschleger School of Dental Medicine and the Dan David Center for Human Evolution, the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Luca Fiorenza
- Monash Biomedicine Discovery Institute, Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia
| | - Melchiore Giganti
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.,Radiology University Unit, University Hospital, Ferrara, Italy
| | - Rita Sorrentino
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy.,Department of Biological, Geological and Environmental Sciences-, BiGeA University of Bologna, Bologna, Italy
| | - Maria Giovanna Belcastro
- Department of Biological, Geological and Environmental Sciences-, BiGeA University of Bologna, Bologna, Italy
| | | | - Stefano Benazzi
- Department of Cultural Heritage, University of Bologna, Ravenna, Italy.,Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
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Ruscello DM, Vallino LD. The Use of Nonspeech Oral Motor Exercises in the Treatment of Children With Cleft Palate: A Re-Examination of Available Evidence. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1811-1820. [PMID: 32755484 DOI: 10.1044/2020_ajslp-20-00087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The purpose of this tutorial is to re-examine the current literature on nonspeech oral motor exercise (NSOME) in general and its use in the treatment of children with cleft palate specifically and provide a best practice recommendation. Method The Population Intervention Comparison Outcome process was used to investigate the clinical question. This systematic framework identifies the clinical population, evaluates the intervention(s) applied to the population, assesses the results of interventions, and delineates the outcome. A literature search, which examined developmental research, applied clinical research, and systematic treatment reviews, was conducted for this purpose. Results The literature reviewed herein suggests that, on a number of different levels, the implementation of NSOMEs does not result in positive communication outcomes for children with cleft palate who present with velopharyngeal dysfunction or compensatory speech errors. Conclusion Based on the current review, there is no empirical support for the use of NSOME as a direct or adjunct treatment for velopharyngeal dysfunction or compensatory speech errors. Appropriate treatments for these communication disorders include surgical, dental, and speech-based interventions.
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Affiliation(s)
- Dennis M Ruscello
- Department of Communication Sciences and Disorders, West Virginia University, Morgantown
| | - Linda D Vallino
- Head, Craniofacial Outcomes Research Laboratory, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
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Developmental Changes in Tongue Strength, Swallow Pressures, and Tongue Endurance. Dysphagia 2020; 36:854-863. [PMID: 33170325 DOI: 10.1007/s00455-020-10200-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/19/2020] [Indexed: 10/23/2022]
Abstract
Maximum tongue strength, mean swallow pressures, and tongue endurance were measured in 324 children ages 6-12 years. The purpose of this study was to measure saliva swallow pressures in absolute terms (i.e., kilopascals) and as a percentage of maximum tongue strength to determine functional reserve in across ages in children and to examine factors that may influence tongue strength and swallow pressures including age, tongue endurance, and tongue-tie. The study results showed that maximum tongue strength and swallow pressures increased with age, while tongue endurance did not. Swallow pressures averaged 44% of maximum tongue strength across ages, indicating that children typically have a functional reserve of 56%. Tongue strength and swallow pressures were not decreased in the 20 children with tongue-tie. A sample clinical case is discussed.
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Cervera-Mérida JF, Villa-García I, Ygual-Fernández A. Speech treatment in nemaline myopathy: A single-subject experimental study. JOURNAL OF COMMUNICATION DISORDERS 2020; 88:106051. [PMID: 33075681 DOI: 10.1016/j.jcomdis.2020.106051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/16/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE The objective of this work was to verify the efficacy of a treatment based on myofunctional therapy techniques which aimed to improve the tongue strength, precision, and speed of a ten-year-old girl with nemaline myopathy (NM) and the repercussions of this therapy on her speech intelligibility. NM is a rare congenital muscle disorder that causes extreme muscle weakness, especially in the face and neck, as well as severe dysarthria and dysphagia, although this does not affect the nervous system or cognitive development. METHOD This was a single-subject experimental study which used an interrupted pre- and post-treatment time-series design, and which applied autoregressive integrated moving-average predictive models and Holt exponential smoothing. During the treatment phases, the participant's tongue strength and the rate of speech diadochokinesia and voluntary lingual movements were estimated and the repercussions of the intervention in terms of speech intelligibility were ascertained via an experiment with 'naïve' judges. RESULTS The treatment produced a sustained and significant increase in the maximum strength of the patient's tongue, which increased from an initial 4 kPa to 11 kPa at the end of the treatment phase. However, this was far from the average 58 kPa for age- and sex-matched normative data. There were no significant changes either in the rates of voluntary lingual mobility or speech diadochokinesia. Speech intelligibility, as assessed by naïve judges, improved from 40 % in the pre-treatment phase to 67 % in the post-treatment phase. CONCLUSIONS NM and other rare primary muscle disorders allow us to estimate the effects of severe muscle weakness in people with dysarthria without cognitive impairment or alterations in central nervous system, peripheral nervous system or in gap junction. In this case, the treatment did not increase the patient's lingual and articulatory movement speed but did increase her tongue strength from 5 % to 10 % of the levels otherwise expected for her age and significantly improved the intelligibility of her speech and communication.
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Affiliation(s)
| | - Irene Villa-García
- Máster Universitario en Intervención Logopédica Especializada por la Universidad Católica de Valencia San Vicente Mártir, Spain
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Analysis of Labial and Lingual Strength among Healthy Chinese Adults in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217904. [PMID: 33126580 PMCID: PMC7663130 DOI: 10.3390/ijerph17217904] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/30/2022]
Abstract
This study collected 11 parameters regarding the labial and lingual strength for maximum isometric and swallowing tasks among 150 healthy Chinese adults in Taiwan. Measurements were performed using the Iowa Oral Performance Instrument (IOPI). All of the labial and lingual strength parameters were measured three times. The maximal value of three trials represents the pressure of every parameter. The overall mean (±standard deviation) and maximum isometric pressures of the lips, anterior tongue, and posterior tongue were 24.81 ± 5.64, 55.95 ± 14.13, and 53.23 ± 12.24 kPa, respectively. The mean value of posterior tongue strength was less than that of the anterior tongue by approximately 5%. The percentages of maximum isometric tongue pressure during the swallowing of saliva and water were 85% and 80% for the anterior tongue and 90% and 81% for the posterior tongue, respectively. The average endurances for the anterior tongue and posterior tongue were 13.86 ± 7.08 and 10.06 ± 5.40 s, respectively. The maximum isometric pressures were greater than both the saliva and water swallowing pressures, and the saliva swallowing pressures were greater than the water swallowing pressures. A value of 33 kPa in maximum isometric pressure could serve as a demarcation of weak tongue strength for healthy Chinese adults. As for the repeated trials of labial and lingual strength, there were no statistically significant differences for any of the pressures obtained from the 11 labial and lingual strength parameters. The normative data can be used for the objective assessment of labial and lingual strength in healthy Chinese adults.
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Preston JL, Benway NR, Leece MC, Hitchcock ER, McAllister T. Tutorial: Motor-Based Treatment Strategies for /r/ Distortions. Lang Speech Hear Serv Sch 2020; 51:966-980. [PMID: 32783706 PMCID: PMC7842851 DOI: 10.1044/2020_lshss-20-00012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/09/2022] Open
Abstract
Purpose This tutorial summarizes current best practices in treating American English /r/ distortions in children with residual speech errors. Method To enhance the effectiveness of clinicians' cueing and feedback, the phonetics of /r/ production is reviewed. Principles of acquisition, which can inform how to practice /r/ in the early stages of therapy, are explained. Elements of therapy that lack scientific support are also mentioned. Results Although there is significant variability in /r/ production, the common articulatory requirements include an oral constriction, a pharyngeal constriction, tongue body lowering, lateral bracing, and slight lip rounding. Examples of phonetic cues and shaping strategies are provided to help clinicians elicit these movements to evoke correct /r/ productions. Principles of acquisition (e.g., blocked practice, frequent knowledge of performance feedback) are reviewed to help clinicians structure the earliest stages of treatment to establish /r/. Examples of approaches that currently lack scientific support include nonspeech oral motor exercises, tactile cues along the mylohyoid muscle, and heterogeneous groupings in group therapy. Conclusion Treatment strategies informed by phonetic science and motor learning theory can be implemented by all clinicians to enhance acquisition of /r/ for children with residual errors. Supplemental Material https://doi.org/10.23641/asha.12771329.
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Affiliation(s)
| | - Nina R. Benway
- Department of Communication Sciences & Disorders, Syracuse University, NY
| | - Megan C. Leece
- Department of Communication Sciences & Disorders, Syracuse University, NY
| | - Elaine R. Hitchcock
- Department of Communication Sciences and Disorders, Montclair State University, NJ
| | - Tara McAllister
- Department of Communicative Sciences and Disorders, New York University, NY
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Exercise Science and the Vocalist. J Voice 2019; 35:376-385. [PMID: 31628045 DOI: 10.1016/j.jvoice.2019.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/11/2019] [Accepted: 09/13/2019] [Indexed: 01/18/2023]
Abstract
The application of exercise science training knowledge has been of growing interest to voice professionals. This tutorial, derived from the authors' invited presentations from the "Exercise and the Voice" Special Session at the 2018 Voice Foundation Symposium, proposes a foundational theoretical structure based in exercise science, clarifies the wide range of variables that may influence voice training, and summarizes our present understanding of voice physiology from the perspective of muscle training. The body of literature on voice exercise was then analyzed from the perspective of this framework, identifying what we currently know and what we still have yet to learn.
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