Seminars in Speech, Language and Hearing最新文献

{"title":"Effects of Neonatal Sound Deprivation in Animal Research","authors":"D. Webster","doi":"10.1055/s-0028-1094192","DOIUrl":"https://doi.org/10.1055/s-0028-1094192","url":null,"abstract":"Elsewhere in this issue are presented complete literature reviews that are consistent with, but do not prove, the hypothesis that the mild-to-moderate hearing losses associated with recurrent or chronic otitis media in young children can cause communicative disorders. The hypothesis has not been, and perhaps cannot be, proved, since lack of rigor is inherent in long-term retrospective human studies (Hanson and Ulvestad, 1979; Ventry, 1980; Paradise, 1981.) There have been several nonhuman studies, however, that are relevant to this hypothesis; this article will review them. Although most were undertaken to explore the basic mechanisms of the development of hearing, they may also help answer the important clinical question: Is there a causal relationship between postnatal conductive hearing loss and auditory behavior, physiology, and/or morphology? At the outset we must recognize that there are both advantages and disadvantages in using nonhuman experiments to answer questions about human problems. The nonhuman studies we are interested in have usually been performed on rodents, with the conductive losses imposed either by removing the auditory ossicles or by blocking the external auditory meatus, both of which result in a conductive loss of 40 to 55 dB; this is considerably greater than the 15 to 30 dB loss suffered by children with otitis media. Furthermore, these conductive losses have been of constant duration in the rodents, whereas in otitis media children they are usually fluctuating. Moreover, hearing does not begin in most rodents until 8 to 12 days after birth and is not mature until 16 to 24 days, whereas newborn human infants already have mature hearing (although not mature processing). Finally, since we are concerned with speech and language, which are unique to the human, we must also be concerned with whether the central mechanisms of speech processing are unique to the human; if so, it may be inappropriate to apply data from experimental animals to this particular human problem. On the plus side, nonhuman experimentation can be rigorously controlled, whereas human studies cannot be. Conductive losses can be created at known times, independent of any pathology. One can design experimental and control groups. By using inbred strains, one can even approach genetic homogeneity. Diet, socioeconomic background, and medical history are not a problem, and the subjects do not move out of town before the experi-","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125987978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Surgical Management of Otitis Media","authors":"A. Meyers","doi":"10.1055/s-0028-1094191","DOIUrl":"https://doi.org/10.1055/s-0028-1094191","url":null,"abstract":"Several recent conferences have addressed the issue of defining otitis media. Acute otitis media is an inflammation of the middle ear which may or may not be of infectious origin (infection implies a microbiological etiology). Acute otitis media goes through three clinical phases: sudden onset, full expression, and resolution. When the resolution process extends beyond 3 months, the disease process is arbitrarily designated as \"chronic.\" Between 3 weeks and 3 months, the disease is noted to be in the subacute phase. In acute otitis media, the middle ear mucosa shows extensive leukocytic infiltrates and submucosal edema. Chronic otitis media with effusion includes liquid in the middle ear space. Histopathologically, the middle ear space is characterized by round cell infiltration, extensive fibrosis, proliferation of the mucous membrane, and increased gland formation. The fluid behind the tympanic membrane is either serous (a clear strawcolored effusion), mucoid (a thick, gluelike substance), or purulent (pus). Although in several instances the fluid has a mixed composition with mucoid or purulent features, the physician should, as precisely as possible, categorize the effusion as one type or the other. Recurrent acute otitis media is defined as recurrent inflammation of the middle ear cleft. The disease may show complete resolution between episodes, or manifest incomplete resolution with the presence of an effusion behind the tympanic membrane.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"509 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123421843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Audiologist and the Nonbenign Conductive Hearing Loss of Otitis Media","authors":"M. Downs","doi":"10.1055/s-0028-1094187","DOIUrl":"https://doi.org/10.1055/s-0028-1094187","url":null,"abstract":"The growing number of infants with persistent or recurrent serous otitis media has been a deep concern to several disciplines. The otolaryngologist harbors searching questions over the cause and the management of steady or fluctuating serous otitis media; the pediatrician is baffled by questions of its identification and treatment and when it should be referred to the otolaryngologist; the audiologist and language pathologist see rapidly increasing language problems resulting from its early occurrence; and the psychologist may be faced with behavior problems attendant on attacks of serous otitis media. Any adverse language learning sequelae of early recurrent serous otitis media must be related in large part to the degree of hearing loss accompanying the condition. Although some reports have ascribed behavioral problems to the presence of otitis media, and certainly the general malaise of the disease is not to be discounted, the most readily identified symptom of serous otitis media is the hearing loss. Hearing loss lends itself to exact measurement and it should therefore be possible to predict whether language learning could be compromised in any way by recurrent serous otitis. To do this we must look first at the effect on speech perception of a mild conductive hearing loss, such as is found in serous otitis media. Once this has been done, the various reports in the literature linking serous otitis media with auditory language learning problems will become more understandable.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121932383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychoeducational Sequelae of Chronic Otitis Media","authors":"P. Zinkus","doi":"10.1055/s-0028-1094188","DOIUrl":"https://doi.org/10.1055/s-0028-1094188","url":null,"abstract":"Learning disabilities are a multifaceted problem that is being intensively studied by numerous disciplines. Professionals involved in the diagnosis and treatment of the learning-disabled child can appreciate the often chaotic array of terminologies and classifications used to describe these enigmatic disorders. Numerous descriptive labels reflect etiological concepts based on neurological deficit theories, perceptual handicaps, delayed maturation, developmental dyslexia, emotional disorders, and teacher disability. This variability in definition and identification methods has led to a multitude of treatment procedures, many of which have questionable success. Little attention has been paid to the prevention of what are predominantly language-based disorders. In a very large percentage of children with disorders in learning, a disruption has occurred in the child's basic communication skills. Language function, especially receptive elements, have been disrupted. The child's ability to understand verbal instruction is oftentimes limited, and the visual language of reading is disrupted to a significant degree. It is also common for learning-disabled children to show dysfunction in auditory memory skills. Despite the confusion in terminology, one fact remains clear: the child in educational jeopardy is at an extreme disadvantage in a culture that places a high value on achievement and rewards those who are successful in that endeavor. Estimates of the incidence of learning disabilities in the United States range from 5 to 20%. Although these estimates vary in terms of the criteria used to identify the learning-disabled child, there is general agreement that literally millions of children are in educational jeopardy due to problems in learning. Of even greater significance is the fact that educational problems often begin at a very critical point in the child's emotional development. At approximately 5 years of age, the child begins to achieve a level of independent functioning and role definition that enables him to formulate the basic structure of his personality. The stresses of this age have been well documented by numerous personality theorists who caution that considerable emotional damage and turmoil can be precipitated by overtly stressful conflicts. One such conflict may result from failure in school. A particularly common, although very disruptive, type of learning disorder is the auditory processing deficit. Central auditory processing disturbances, included under the category of specific learning disabilities, include impairments of auditory attention, sequential memory, discrimination, sound blending, and closure skills. Although the child's cognitive functions remain intact, the processing of auditory input is deficient. Frequently, disturbances in central auditory processing interfere with the ability to develop reading, spell-","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122857667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General Dental Care for Patients with Cleft Palate","authors":"F. Winter, Gloria Rosenberg Gertzman","doi":"10.1055/s-0028-1095241","DOIUrl":"https://doi.org/10.1055/s-0028-1095241","url":null,"abstract":"244 Habilitation of patients with cleft palate can best be accomplished when the services of the general dentist are coordinated with other health professionals, such as orthodontists, prosthodontists, oral surgeons, plastic surgeons, psychiatrists, psychologists, geneticists, speech pathologists, audiologists, and social workers, all cooperating as a team. Each member of the team aims toward maximizing normal growth and development for the patient This is accomplished by establishing an intraand extraoral environment that will assist in development of speech and mastication while improving facial aesthetics.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121234396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninstrumental Assessment of Velopharyngeal Adequacy in Children","authors":"N. Colburn","doi":"10.1055/s-0028-1095237","DOIUrl":"https://doi.org/10.1055/s-0028-1095237","url":null,"abstract":"212 Evaluation of communication skills in speakers with cleft palate, as with other speech disordered individuals, includes assessing the content, form, and use of language, the efficiency of the auditory processing system, the structural and functional integrity of the oral peripheral mechanism for speaking tasks, and the effectiveness of the speech product to carry the message to the listener. Procedures for evaluating children with cleft palate are similar to those used in a clinic setting for all clients. The basic difference is the emphasis given to the judgment of velopharyngeal adequacy. The primary task in a communication evaluation of a person with a cleft is to make a preliminary judgment regarding the ability of the velopharyngeal area to function for speech purposes. This judgment may be based on perceptual evidence from the results of articulation testing together with a clinical diagnosis of perceived aberrant voice quality, usually hypernasality. The term \"velopharyngeal insufficiency\" (VPI) is used to describe dysfunction of the palatopharyngeal port. Riski and Millard (1979) described two different subcategories of VPI—inadequacy and incompetency. Velopharyngeal inadequacy referred to an organic deficiency or shortness of tissue in the nasopharyngeal region. Velopharyngeal incompetency was used to describe poor function in the presence of adequate tissue. The goals of the diagnostic session are: (1) to describe the child's present velopharyngeal adequacy for speech; (2) to differentiate speech problems due to velopharyngeal function from problems due to immature phonological development, hearing problems, depressed cognitive functioning, and/or additional occlusal, dental, or orofacial structural abnormalities; (3) to predict the effects on speech of further surgical or prosthodontic intervention; (4) to develop recommendations for further referrals and remediation. With the tools available to the speech pathologist, one is able to make strong inferences regarding the adequacy of the velopharyngeal mechanism. However, these tools should be used for a tentative diagnosis only. The diagnosis should then be verified through instrumental assessment techniques, such as air flow studies, cephalometrics, radiology, or endoscopy, before further rehabilitative measures are undertaken. Two recent surveys have been reported (Middleton et al., 1981; Schneider and Shprintzen, 1980) on current clinical practices in the assessment of velopharyngeal adequacy. Schneider and","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133543870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Habilitation Through Intervention: Plastic Surgery","authors":"M. Goldstein, Stamatis Arkoulakis","doi":"10.1055/s-0028-1095233","DOIUrl":"https://doi.org/10.1055/s-0028-1095233","url":null,"abstract":"Dr. Goldstein is an Assistant Clinical Professor of Plastic Surgery at the University of Medicine and Dentistry of New Jersey-Rutgers Medical School. He is the Chief of Plastic Surgery Service, St. Peter's Medical Center, where he serves as a plastic surgery consultant to the Cleft Palate Team, and Senior Attending Plastic Surgeon at Middlesex General Hospital and Medical Center at Princeton, New Jersey.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114640352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cleft Palate: A Psychologist's View","authors":"M. Kleinman","doi":"10.1055/s-0028-1095244","DOIUrl":"https://doi.org/10.1055/s-0028-1095244","url":null,"abstract":"Children born with cleft palates share many unique but similar early life experiences. Among these are problems in feeding, repeated hospitalizations, early surgery, reactions of family to facial disfigurement, defective speech development, and some degree of hearing loss (Lencione, 1980). One would anticipate that there would be certain personality characteristics that would set these individuals off in a recognizable way. However, studies on the psychological effects of clefting have not demonstrated that, as a group, cleft palate children differ significantly in personality characteristics from noncleft palate children. A primary variable may be the continuing management of the child with a cleft palate. This article will emphasize the importance of management in the formation of the child's personality. Phipps (1965) reviewed the literature on psychological and social problems of cleft palate children. He found that the studies could be divided into those that 'logically\" assessed the situation, and those based on controlled data. Though stated in many ways, the \"logical\" approach was always that people with cleft palate must suffer from severe social and psychological problems. On the other hand, controlled studies looked at the relationship between cleft palate and such variables as intelligence, adjustment, and personality. Phipps found that there was no conclusive evidence that cleft palate children differed from their noncleft peers in either personal or social adjustment. Phipps could not account for the discrepancy between the \"logical\" viewpoint and controlled research. One answer might be that the socalled \"logical\" view was derived from a theoretical orientation that minimizes the therapeutic strength of direct environmental influences. This author, as a behavior therapist who has worked with cleft palate patients for more than 20 years, takes a different position. Environmental influences affect what the child learns, and correct child management based on the laws of learning is the primary influence on the child's personality. Tisza et al., (1958) reported that the developmental history of children born with a cleft lip, cleft palate, or both was different from that of the noncleft child because of experiences peculiar to the cleft group. The majority of these infants experienced no sucking and frequently were not held while being fed. According to this study, many children underwent three or four surgical procedures, resulting in separation from home, anesthesia, pain in the oral region, and temporary restrictions of the arms and hands following surgery. The investigators reported that in their interview with mothers, the recurring theme was that the mothers felt some lack in themselves and tended to minimize or deny the existence and severity of the problem. Tisza and Gumpertz (1962) inter-","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131704878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prosthodontics in Management of the Cleft Lip and Cleft Palate Patient","authors":"D. Schwartz","doi":"10.1055/s-0028-1095243","DOIUrl":"https://doi.org/10.1055/s-0028-1095243","url":null,"abstract":"Dr. Cooper is probably more responsible than anyone else in obtaining recognition of the fact that those with untreated or inadequately treated clefts of the lip and palate are facially crippled. He was the pioneer in obtaining assistance, especially financial, for this group of individuals. The Lancaster clinic demonstrated the effectiveness of a true team approach, with an even distribution of input and a wide sharing of ideas and opinions, to achieve a better result (Cooper et al., 1979). This type of approach continues to produce the best benefits in research and treatment in the habilitation and rehabilitation of a child born with an orofacial defect.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121178853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phonological Development During the First Year: Implications for Intervention","authors":"Barbara Glazewski","doi":"10.1055/s-0028-1095235","DOIUrl":"https://doi.org/10.1055/s-0028-1095235","url":null,"abstract":"The growing trend for early identification and intervention with developmentally delayed infants has been strengthened by a supportive attitude of society in general toward children with problems, as well as legislation mandating early intervention. The re is a strong data base in the rapidly growing transdisciplinary child development literature that combines both theoretical and empirical research. Knowledge of early phonological development is important in working with infants born with clefts because aberrant compensatory articulatory postures may develop dur ing the prelinguistic period. Researchers in the field of phonological development (Oiler, 1980; Stark, 1975, 1980) have proposed and replicated a sequence that follows infant vocalizations from birth through symbolization. Shames and Rubin (1979) identified a number of processes that operated in the acquisition of language and presented them within a developmental framework (Fig. 1). T h e sound-making process of language development is of importance in dealing with infants with orofacial anomalies and is the focus of this article. Sound making will be discussed in relation to the socialization process of communication for phonological development cannot be viewed without reference to socialization. According to Ferguson and Garnica (1975):","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126334417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}