Seminars in Speech, Language and Hearing最新文献

{"title":"Hearing in Infancy: The Development of Auditory Skills and the Audiological Evaluation","authors":"J. Marlowe","doi":"10.1055/s-0028-1094173","DOIUrl":"https://doi.org/10.1055/s-0028-1094173","url":null,"abstract":"Among the most dramatic advances in the field of audiology has been the evolution of special testing techniques aimed at the infant from 0 to 24 months. Amid the urgings for early identification voiced by researchers and developmental experts (Mencher, 1977; White, 1975), there has emerged a ready supply of theoretical information and proven methods to accurately identify hearing loss close to birth. A survey of actual clinical practices, however, may reveal a discouraging gap between available knowledge and its application. Much time and effort may be expended in the evaluation of children eighteen months and older, yet the younger infant may receive only cursory and reserved attention (Simmons, 1980). Perhaps even we audiologists have fallen victim to the myth that evaluating babies is time-consuming, expensive, extraordinarily difficult, and fraught with uncertainty. Nothing could be further from the truth! While there are many areas of research as yet unexplored, we do possess sufficient developmental information and appropriate measurement techniques to identify hearing loss even in newborns. Beyond these basics, the clinician must be equipped with a sense of commitment and self-confidence which may be cultivated by study and practice. Thus, it would seem appropriate in any discussion of audiological evaluation to begin by reviewing some of the pertinent developmental data which lend validity to the assessment tools available and reveal the expected response. Strategies for successfully employing these techniques will be included, in the hope that it will become patent that prompt infant identification is not only desirable but imperative. The audiologist is in a unique position not only to perform the evaluation but to spearhead the effort to discover affected babies.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114622912","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":"Auditory Brainstem Response: Its Place in Infant Audiological Evaluations","authors":"T. Finitzo-Hieber","doi":"10.1055/s-0028-1094177","DOIUrl":"https://doi.org/10.1055/s-0028-1094177","url":null,"abstract":"A hotly debated issue among pediatric audiologists today revolves around the value of the auditory brainstem response (ABR) as an effective approach to the audiological assessment of neonates and young infants. Healthy skepticism and continued reliance on traditional behavioral procedures are due to disappointment in past \"objective\" methods, frequently heralded as the solution to all audiological problems. Initial enthusiasm for cardiovascular or respiratory responses, or the \" la te\" auditory evoked potentials utilized in the 60's, was rapidly tempered by equivocal findings and methodological problems occurring in precisely those patients most in need of assessment: infants and multihandicapped children (Gerber, 1977; Picton, 1977). Therefore, many clinicians are hesitant to abandon infant behavioral protocols they have spent years developing. On the other hand, while our skills in evaluating infants have improved, the neonate at risk and needing assessment today has unfortunately changed. Consequently, behavioral test protocols effective in a term neonate will fall short when confronted with a premature \"graduate\"","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1982-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125585693","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":"Otitis Media During Early Life: How Hazardous to Development? A Critical Review of the Evidence","authors":"J. Paradise","doi":"10.1055/s-0028-1094193","DOIUrl":"https://doi.org/10.1055/s-0028-1094193","url":null,"abstract":"In a number of recent reports1-3 developmental impairments of a lasting nature have been attributed to prolonged or repeated episodes of otitis media occurring during the first one to three years of life. The impairments described include intellectural and learning difficulties,1,2,4-8,10-13 impaired speech and language,3,5,8,9,11-13 and disturbed behavior.7,8 In some of the reports1,12 the impairments have been referred to as permanent or irreversible.\u0000 These reports, having appeared in publications directed respectively to physicians,2-4,6,8-13 speech-language-hearing professionals,1-3,5 educators,11 and psychologists,7,12 and in some instances having been cited in widely disseminated professional and lay news media (reference 14; Newsweek, June 14, 1976, p 47; New York Times, Dec 26, 1978, p C2) quite naturally have aroused broad anxiety and concern. The reports also have served to provide the impetus, or the justification, not only for aggressive casefinding programs, but also, in infants and children with recognized middle-ear effusions, for early recourse to aggressive modes of treatment, most often in the form of myringotomy and tympanostomy tube insertion.\u0000 The purpose of the present report is to review critically the body of evidence on which the supposed relationship between early otitis media and later developmental impairments is based.\u0000 DISEASE PROCESS\u0000 In the typical case of acute otitis media, pus fills the middle-ear cavity. Sooner or later the infection begins to subside—with or without the help of antimicrobial drugs—and the initially purulent middle-ear liquid changes in character, coming to resemble serum, mucus, or even glue. With continued healing the Eustachian tube gradually recovers its ventilatory function, and the middle-ear liquid eventually is resorbed, or drains, and becomes replaced by air.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1981-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126907752","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":"Role of Clinical Neuropsychology in the Management of the Aphasic Patient","authors":"D. Flaherty, Ph. K. York Haaland, Ph.D David Flaherty","doi":"10.1055/s-0028-1095023","DOIUrl":"https://doi.org/10.1055/s-0028-1095023","url":null,"abstract":"Like other professionals, the neuropsychologist may be involved in research work, clinical work, or both. In research and clinical work with brain-damaged patients, the neuropsychologist's tools are typically behavior. Because this Seminar is aimed at speech and language clinicians, this paper will attempt to explain clinical neuropsychology. It will be obvious that many of the principles, such as an information processing approach, are used by research neuropsychologists as well as speech pathologists. Clinical neuropsychology is the study of the behavioral manifestations of brain damage in humans. A great number of neurologic and behavioral variables must be considered. Neurologic variables include lesion locus, etiology, mode of onset, static or progressive damage, and time lapse between testing and onset of complaints. Patient variables (such as age, education, language background, handedness, and concurrent medical problems) and task variables (such as validity, reliability, and task difficulty) must also be considered. In research, these variables can be controlled somewhat by specifying strict selection criteria so statistical differences between groups can be attributed to a single factor, but even in research studies important variables have been overlooked (Parsons and Prigatano, 1978). In a clinical situation, the problem is even more difficult. It is dangerous in a single patient to infer a certain location of damage based on performance on a single test. Clinically, the neuropsychologist examines the functions of a particular area or system with a variety of tests and makes diagnostic inferences based on the pattern of performance on these tests. As we learn more about the relationship between certain types of errors and the locus of brain damage, qualitative analysis becomes more useful in solving this dilemma. For instance, there are numerous examples of how patients with right versus left hemisphere damage per form poorly on constructional tasks, but these patients make different types of errors and emphasize the clinical import of qualitative analysis (Goodglass and Kaplan, 1979; Lezak, 1976, Walsh, 1978).","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1981-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121060135","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":"Audiological Assessment of the Aphasic Patient","authors":"Richard H. Wilson, C. Fowler, J. Shanks","doi":"10.1055/s-0028-1095024","DOIUrl":"https://doi.org/10.1055/s-0028-1095024","url":null,"abstract":"The speech and language rehabilitation for an aphasic patient, as well as the assessment of his communicative deficits, relies substantially on auditory input. Because a hearing loss can affect patient performance during both phases of his treatment program, an audiological evaluation is a logical first step in determining the rehabilitative needs of the aphasic patient. As with any patient, the audiological evaluation serves the following two main functions: (1) it determines whether or not a lesion within the auditory system distorts a signal reaching the cortex, and (2) it determines the degree of the auditory deficit that is amenable to medical or audiologic management. Such management might include medical attention to active otological disorders or audiological attention to amplification and hearing-aid orientation. Only after these deficits are treated will speech and language intervention be optimally effective.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1981-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129918755","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 Psychiatrist's Approach to Managing the Aphasic Patient","authors":"J. Jaffe","doi":"10.1055/s-0028-1095020","DOIUrl":"https://doi.org/10.1055/s-0028-1095020","url":null,"abstract":"A discussion of psychiatry and aphasia therapy should properly begin with an obscure historic fragment that illustrates the closeness of the two disciplines. Psychoanalysis is, of course, a major theme in 20th century psychiatry. The theories of its founder, Sigmund Freud, are most popularly understood through his analysis of certain errors committed by normal people in everyday life (Freud, 1930). Among the best known of these are \"slips of the tongue,\" which he showed could originate in and express an emotional conflict of which the speaker is unaware. A popular example of such a slip is the story of the child who was warned that a guest coming for dinner had a very large nose and that it would be poor etiquette to mention the fact. The child complied, but when serving coffee to the guest at the end of the meal, asked \"Would you like some cream with your nose?\" Freud dissected this linguistic phenomenon so thoroughly that such inadvertent substitutions still bear his name. The similarity of such slips to verbal paraphasias has certainly been noticed by many speech pathologists. Less well known than the \"Freudian slip\" is the fact that prior to his invention of psychoanalysis, this accomplished neurologist wrote a monograph on aphasia (Freud, 1953). The emotional roots of many paraphasic errors are just as transparent as in the revealing speech errors of nonaphasic, neurotic patients. Thus, there is circumstantial evidence that Freud's early insights from aphasiology have profoundly informed most contemporary psychotherapies of emotional illness, a debt which is rarely acknowledged. Conversely, his concept of unconscious processes, expressed inadvertently as errors in speech, can now be used by speech pathologists to enrich their grasp of aphasic productions by adding psychodynamic understanding to their linguistic formulations. That is, a patient's \"error\" may convey a genuine unconscious message, knowledge of which may help cement the therapeutic alliance and sophisticate the rehabilitation plan. Thus may psychiatry repay an old debt to aphasiology. This historic account can be illustrated by an excerpt from the conversation of a prominent psychiatrist during his successful recovery from aphasia about 8 years ago (Dahlberg and Jaffe, 1977):","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1981-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126219903","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":"Neurolinguistic Approaches to Aphasia","authors":"H. Ulatowska","doi":"10.1055/s-0028-1095022","DOIUrl":"https://doi.org/10.1055/s-0028-1095022","url":null,"abstract":"The field of neurolinguistics was born in the 1960s in the context of the growth of multidisciplinary endeavors. It was pre­ ceded by a re-emergence of the idea of the biologic basis of language, the idea that language is an inherent capacity of hu­ mans, like vision or hearing. Neurolinguis­ tics developed from the belief that an adequate understanding of language de­ pends upon correlating information from a variety of fields concerned with the struc­ ture and function of both language and the brain. Underlying this belief is the as­ sumption that speech and language are neural processes that are amenable to analysis, using the techniques of both lin­ guistics and the neurosciences. With this set of assumptions, neurolinguistics took as its primary goal the definition of the relationship between the capacity for language and the functional organization of the human brain. It is assumed that the structure of language reflects the neural organization of the brain. This relationship is most clearly illustrated in the likenesses that exist in very differing language systems— in other words, language universals or constraints on the storage and organiza­ tion of the linguistic system. Undoubtedly, these universals reflect constraints on human perceptual processing systems and on cognitive capacities. Other generaliza­ tions can be made about specific lan­ guages, and these should be based on neurological facts as well. However, given the present state of our knowledge in both linguistics and the neurosciences, attempts to correlate linguistic and neural facts are usually ill conceived, beyond the rather general observation that a lesion in a par­ ticular part of the nervous system typically produces a certain type of language be­ havior. Nevertheless, careful descriptions of aphasic language from populations that have been adequately evaluated neurologically and that are well controlled for var­ iables such as site of lesion and handedness should bring us closer to understanding language in the brain. The last decade has witnessed a dra­ matic extension of the scope of neurolin­ guistics, which was originally restricted to investigations of the oral language of adult aphasic patients. The populations studied now include aphasic children, patients with lesions in the nondominant hemisphere, split-brain patients, hemispherectomized patients, demented patients, and the el­ derly. The communicative behaviors stud­ ied now include modalities other than oral—written language and gestural language—and connected language as well as isolated words and sentences. In addi­ tion, the methodology of testing, based primarily on standardized tests in the 1960s, has been supplemented by a battery of experimental nonstandardized tests and metalinguistic tasks that attempt to tap not only overt language structures but also mechanisms underlying particular linguis­ tic behaviors. This broadening of the scope of neurolinguistics reflects the newer view that aphasia is ","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1981-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132337354","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 Insider's Perspective","authors":"C. Moss","doi":"10.1055/s-0028-1095026","DOIUrl":"https://doi.org/10.1055/s-0028-1095026","url":null,"abstract":"I have attempted to keep very close track of books written either by aphasic persons or by people close to them, usually a spouse, ever since my stroke 13 years ago, which I eventually reported in a book (Moss, 1972). In preparation for a revised copy of that book, I communicated with 26 psychologists and psychiatrists in the United States and Eastern and Western Europe, including an exchange of letters with the then Professor A. R. Luria, dean of Soviet neuropsychologists, regarding books by or books about aphasic persons. As far as I can determine, 14 of these have been published (Buck, 1968; Dahlberg and Jaffe, 1977; Farrell, 1969; Griffith, 1970; Hodgins, 1964; Knox, 1971; Luria, 1972; McBride, 1969; Moss, 1972; Ritchie, 1966; Van Rosen, 1963; Whitehouse, 1968; Wint, 1965; and Wulf, 1973). All were published after 1960, and all, fortunately, were written or translated into English. However, many books are already out of print. Each book is written from a unique perspective, both because strokes hit widely diverse parts of the brain and because of the uncommon learning experiences of each person. The most exceptional are written by aphasic persons, people who have difficulty in using standard methods of communication because of their stroke. Of the approximately 300,000 people struck down by strokes in the United States each year, about half are afflicted with a language disturbance. This cohort presents a sizeable sample for studying the complex process of human communication and the most remarkable biologic phenomenon, human memory. All the books detail the alarming experience of what it is like to go through a stroke and the long, frustrating efforts to obtain some semblance of rehabilitation. The stroke itself is not that bad, at least for the victim. The temporal sequence is characterized by an abrupt onset and rapid evolution, and the symptoms usually reach a peak of severity in seconds or minutes. It is largely painless, brains are numb, they know only what the body experiences. The patient may react with momentary anxiety, but the initial phase almost always is characterized by varying degrees of clouding of consciousness with confusion, disorientation, and the occurrence of altered forms of symbolic expression. A severe stroke may result in loss of consciousness, complete paralysis, global aphasia, and, in one out of ten cases, death. It really is not a bad way to die. But, what follows if the patient lives, and the great majority of them do, is not at all a pleasant story.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1981-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114343737","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":"Aphasia Management: The Neurologist's Role","authors":"D. Benson","doi":"10.1055/s-0028-1095019","DOIUrl":"https://doi.org/10.1055/s-0028-1095019","url":null,"abstract":"The role of the neurologist in the understanding and outlining of the aphasias is time-honored and widely recognized. With the more recent advent of active aphasia rehabilitation that includes specialists trained to carry out this activity, the neurologist's role in total aphasia care has become less clear. In fact, a number of language therapists now propose that following stabilization of the acute medical problem, all testing and treatment of aphasia lies within their province. This article will discuss the role of the neurologist in the management of the aphasic patient, not only in the initial medical management stage but also in the care of ongoing problems dur ing the period of aphasia rehabilitation.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1981-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126597382","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":"Rehabilitation Medicine Management in Aphasia","authors":"P. Bach-y-Rita, R. Balliet, Joan Arieta, B. Long, J. Titus","doi":"10.1055/s-0028-1095021","DOIUrl":"https://doi.org/10.1055/s-0028-1095021","url":null,"abstract":"An aphasic person treated by a rehabilitation medicine service usually has a number of deficits of function, in addition to the aphasia. He is, therefore, seen as a patient who in most cases has had a cerebral vascular acident and is evaluated for a comprehensive rehabilitation program. T h e aphasia is only one problem and is approached in the context of the total patient. A rehabilitation medicine service does not necessarily treat the aphasia directly. However, in the context of treating the whole patient, a number of factors that are treated directly can influence the course of the aphasia as well as the patient's adaption to a continuing language deficit. In this article, the rehabilitation medicine team approach to the aphasic patient will be discussed. In particular, the approaches of the rehabilitation physician; the occupational therapist, and the physical therapist will be presented. Furthermore, an approach will be discussed that is not yet in the domain of common treatment, sensory feedback therapy. T h e mechanisms of recovery from central nervous system (CNS) damage will be discussed briefly.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1981-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125058043","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}