Review Of The Current Methodology Used For Assessing Hypernasality

Watching my friends’ face quiver in disgust after recounting my experience of a videofluoroscopicy and my excitement from viewing the barium travel through the oropharyngeal and pharyngeal phases of swallowing, I realized I wanted to study the extraordinary field of Communication Sciences and Disorders. During my undergraduate career at East Carolina University, my anatomy and physiology class further fostered my enthusiasm for the field when discovering how intricate and complex it is for the human body to perform a simple task such as breathing and swallowing. I was able to utilize my thirst for knowledge of the human anatomy working in Dr. Perry’s Speech Imaging and Visualization Laboratory and enhance my writing skills by reviewing peer reviewed journal articles. Ultimately working and observing lab assistants create 3D anatomical models of the laryngeal mechanism, velopharyngeal mechanism, swallowing mechanism, skull and cranium,

The opportunity to observe the work overview of a Speech Pathologist, has tremendously solidified my interest in this field. At the Diana Rogovin Speech Center at Brooklyn College, I observed clients of various ages with different speech language disorders including articulation, language, voice, fluency and accent modification. Observing clinicians at the speech center gave me the opportunity to learn how important client-clinician interaction is for the session and how essential it is to build a good relationship with the client. Although I learned the

The Harmonics-to-Noise (HNR) ratio is a measure of the proportion of harmonic sound to noise in the voice measured in decibels. (Ferrand, 2007). HNR quantifies the relative amount of additive noise (Awen & Frankel, 1994) The lower the HNR, the more noise in the voice. Laryngeal pathology may lead to poor adduction of the vocal folds and, therefore, increase the amount of random noise in the vocal note. If a person has some kind of problem in vibrating the vocal folds, due to a growth, paralysis of one or both vocal folds, or other kind of laryngeal problem, a larger amount of air escapes during vibration, creating turbulent noise. (Pabon & Plomp, 1988) The greater the proportion of noise, the greater the perceived hoarseness, breathiness or roughness and the lower the HNR figure will be, i.e. a low HNR indicates a high level of hoarseness, and a high HNR indicates a low level of hoarseness. There is a strong relationship between how we perceive voice quality and the harmonic to noise ratio (Ferrand, 2007).

Kara-lynn is a 3 year; 6 month old female presenting with a severe phonological disorder. Her results from testing indicate that her speech intelligibility is significantly reduced due to multiple phoneme collapses into /d/ of the following phonemes and consonant clusters: /p/, /g/, /k/, /s/, /z/, /θ/, /ð/, /tr/,and /gr/. In addition, the use of multiple phonological processes, including: final consonant deletion, initial consonant deletion, cluster reduction, vocalization, and deaffrication also significantly contribute to her reduced intelligibility. Her speech intelligibility in known context was calculated to be 64%, which is low for a child who is 3 years; 6 months(consider adding reference). Reduced intelligibility can impact a child’s ability to communicate wants and needs, making Kara-Lynn’s speech intelligibility an area of need.

Some of the duties of a speech pathologist are, but are not limited to, evaluate patients’ levels of speech, language, or swallowing difficulty, identify treatment options, teach patients how to make sounds and improve their voices, work with patients to develop and strengthen the muscles used to swallow, and counsel patients and families on how to cope with communication and swallowing disorders (Duties, www.bls.org, 2015). ‘If the speech-language pathologists work in medical facilities, they work with physicians and surgeons, social workers, psychologists, and other healthcare workers’ (Duties, www.bls.org, 2015).

CSD 363 is a practicum course that gives students the opportunity to provide schools with free speech and hearing screenings. This class is mutually beneficial, seeing that students have an undergraduate opportunity to start practicing skills typically developed in graduate school, and that families receive valuable services for free. The screenings given are comprised of two parts: the Fluharty Speech and Language test, and an audiology pure tone screening including a look in the ears with an otoscope. Under the supervision of a licensed supervisor, students will be giving these screenings and making recommendations about further evaluations if necessary.

Since many measures of analysis were found for pre- and post-operatory hearing outcomes (scales and tests), rendering it difficult to compare the results of each author.

On the articulation subtest of the DEAP X produced errors /ϴ/→ /f/, /ð/ → /d/ in all positions, as well as /k/→ /t/ and /g/→ /d/ in initial position. She also produced /ts/ → /tʃ/ in the final position of a word. X produced lateralizations of /ʃ/ and /s/ in all positions. The phonology subtest assess phonological processes in both single words and connected speech. On the phonology subtest she demonstrated fronting of /k/→ /t/ in initial position and blends. The single word-connected speech subtest indicated inconsistent errors when fronting /t/→ /k/. The scores based on the three subtests indicate the client produces distortions of /s/ and /sh/, as well as typical simplifications for /k/, /g/, /ϴ/, and /ð/

For my research I have chosen to discuss the key role of a Speech Language Pathologist (SLP). Speech Language Pathologists can best be recognized as qualified practitioners that identify, diagnose and treat communicative disorders (Serpanos & Senzer, 2015). There are two types of disorders that a SLP can be used for: speech disorder and language disorder. A speech disorder can best be described as a person that has trouble producing sounds correctly or fluently. A language disorder is recognized as someone who has trouble expressing thoughts, feelings and ideas through speech. SLP’s are taught how to treat each pf these disorders.

One of the most common laryngeal pathological changes is called vocal fold nodules (Phillippe H. al., et 2009). While looking at vocal fold nodules, one may notice tiny bilateral lesions. The SLP may also discover that vocal fold nodules appear as proportional mass lesions. The history of vocal fold nodules dates back to 1866, when the pathology was first discovered by Turk (Simpson B al., et 2008). “Vocal fold nodules occur more frequently in children and women (Simpson B al., et 2008).” “Another interesting fact is that 95% of the vocal fold nodule cases among adults are female and 5% male (Phillipe 2009).” Vocal fold nodules cause an hourglass closure glottal configuration secondary to the nodules developing at the junction of the

Ibrahim, Kilpatrick, Reilly, and Vogel (2009) performed a comparative study of the acoustic measures of hypernasality in the speech of school-aged children aged 2-14 years, some with cleft lip/palate and others without cleft lip/palate. Ibrahim, Kilpatrick, Reilly, and Vogel (2009) provided perceptual ratings of the hyper/hyponasality of vowel production in the children’s speech. Any child who was sick or had acquired an upper respiratory infection was excluded from the study, as was any child with cleft lip/palate who also had any other disorders or comorbidities. The study included a perceptual assessment in which two speech therapists were required to agree upon the perception of the phonemes the child produced. Each child held and sustained two vowels, followed by production of two CVC words without nasal phonemes. This process was repeated five times with each child. The

First studies used cephalometry and computed tomography (CT) to examine possible abnormalities within craniofacial structures. Both techniques are very common in medical imaging procedures. In [6] authors applied sophisticated volumetric analysis on magnetic resonance imaging (MRI) of the upper airway soft tissue structures in

The rationale for using a Maximum Phonation Time task is that it provides information on the client’s glottis efficiency, its noninvasive, and does not requires special equipment. Additionally, MPT provides information regarding the client’s respiratory function, laryngeal control, and subglottic pressure to execute a maximum sustained phonation task.

Respiratory: Lung sounds are clear on auscultation without rales, rhonchi, or wheezes. Respiration unlabored with

Woodcock Johnson Test of Psycholinguistic Abilities Revised. It has good high level tasks for specific drill down areas and strong norms including pediatrics /grade level equivalents but is not normed for ABI or other disease categories.