Seminars in Speech, Language and Hearing最新文献

{"title":"Stuttering Therapy for Children","authors":"H. Gregory, D. Hill","doi":"10.1055/s-0028-1095211","DOIUrl":"https://doi.org/10.1055/s-0028-1095211","url":null,"abstract":"Our present frame of reference for studying the development of stuttering, and for the treatment and prevention of s tut ter ing, takes into consideration characteristics of the child, environmental variables, and the way in which these factors interact. Clinical experience has shown that no specific characteristic of a child, for example, a language deficit or problem of speech motor control, will by itself result in stuttering, nor will environmental stress alone cause stuttering. Case studies reveal that differing patterns of both subject variables and environmental factors contribute to increased disfluency and/or stuttering in children. In this article, we will show how we use these two categories of contributing factors as a frame of reference in differential evaluation and therapy. The evaluation process will be described and treatment strategies will be discussed, indicating how each takes into account a child's specific needs. The major emphasis will be on developmental intervention with preschool children followed by a brief consideration of elementary school age children who display varying degrees of stuttering behavior and awareness that speech is difficult. The diagram in Figure 1 represents an overview of the differential evaluation and therapy process applied in dealing with young children. The first decision to be made concerns the level of initial evaluation. Based on information gained from a telephone interview with the parents, a child is referred either for a screening evaluation or an indepth speech and language evaluation. During initial contacts, approximately 50 percent of parents we have seen expressed concern about a perceived disfluency difference that had existed for less than a year, and reported no other concern about speech and language development or behavioral characteristics (for example, auditory, attentional, motor, and social).","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126643842","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":"Tube Fitting: Myth, Magic, or Method","authors":"R. Rowland","doi":"10.1055/s-0028-1095198","DOIUrl":"https://doi.org/10.1055/s-0028-1095198","url":null,"abstract":"This article is neither a defense of tube fitting nor a condemnation of more traditional fittings. Many of the conclu sions drawn are not substantiated","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115154940","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":"Management of Amplification for Infants","authors":"M. Rubin","doi":"10.1055/s-0028-1095201","DOIUrl":"https://doi.org/10.1055/s-0028-1095201","url":null,"abstract":"","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"500 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132132356","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 Fitting of Hearing Aid Instruments","authors":"H. Goldberg","doi":"10.1055/s-0028-1095203","DOIUrl":"https://doi.org/10.1055/s-0028-1095203","url":null,"abstract":"As of now there is no generally accepted, credible method of validating the use value of a hearing-aid fitting. Since the development of the modern hearing aid, the fitting of a hearing prosthesis has been basically an art form. The acceptance of most hearing-aid fittings is judged by the subject, the built-in biases of the clinician, or the hearing-aid dispenser. The current, basic method of assessing the efficiency of hearing-aid use stresses some form of speech discrimination. Speech discrimination does not depend solely upon the acoustical contribution of the hearing prosthesis. There are many factors contributing to the recognition of a speech signal other than the hearing-aid response. The following is a short list of the more prominent causes for the deterioration of speech discrimination skills. 1. A prolonged hearing loss would cause a memory regression that contributes to errors, leading to erroneous scoring. 2. The speech material used may be unfamiliar to the listener (unfamiliar words and sounds will contribute to discrimination error because they are difficult to recognize). 3. Because of a learning process, the initial discrimination scores may be lower and not indicative of the final discrimination ability following hearing-aid use. 4. Different regional dialects within the same language code may contribute to errors of discrimination. 5. The difficulty of word lists vary, causing differences of discrimination scores relative to the per cent of correct identification. 6. Congenitally deaf individuals and persons foreign to our language system cannot be evaluated with conventional word lists. Because of the foregoing and other variables, it appears evident that speech testing is not a sufficiently reliable and repeatable method of validating the effectiveness of a hearing prosthesis. Barfod (1979) described an auditory, psychologic interface and analyzes the basic reasoning that interferes with speech validation of a hearing prosthesis, at the time of initial fitting. The classic work of Shore, Bilger, and Hirsh (1960) underscored the lack of reliability and repeatability of measurements when phonetically balanced words are used for","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115440100","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 Clinical Utility of Hearing Aid Analyzers","authors":"Robert Martin","doi":"10.1055/s-0028-1095199","DOIUrl":"https://doi.org/10.1055/s-0028-1095199","url":null,"abstract":"The use of instrumentation is rapidly improving the quality of all of our lives. Mechanics no longer need to rely on engine sputters and rumbles to locate a source of trouble; they use diagnostic equipment to assess spark plug function and timing while the engine runs at various speeds. Members of the health care team have computerized xray equipment that yields incredibly clear pictures of tissues located deep inside the human body. Those of us involved in hearing testing and hearing aid fitting, have also felt the massive impact of the new technology. The days of watch-tick hearing tests and bulky hearing aids have given way to sophisticated audiometric equipment and all-in-theear hearing aids. We now measure middle ear function accurately and painlessly. We also measure the brain's electrical response to click stimuli as the sounds pass from the ear through the brainstem en route to the auditory cortex. In many ways, the future is here and we routinely conduct tests that, 20 years ago, would have been considered impossible.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125558202","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":"Output Limitation/Compression","authors":"J. Heide","doi":"10.1055/s-0028-1095204","DOIUrl":"https://doi.org/10.1055/s-0028-1095204","url":null,"abstract":"The primary objective of an adequate hearing aid fitting is to achieve amplification of acoustic energy at all frequencies in the audible range of human hearing. Most important is the ability to present speech information at a comfortable loudness level without exceeding the user's loudness discomfort when input signals are increased at the microphone of the hearing aid. This objective is easily and naturally accomplished for normal hearing individuals in whom the dynamic range of hearing covers an area from the threshold of hearing to the threshold of discomfort and pain of more than 125 to 130 dB SPL. The input to the ear in most environments, from quite to very loud, basically covers the same range. Normal hearing individuals are able to protect against a discomfort producing sound level by removing themselves from the loud sound or by providing some sort of input limitations such as covering the ears. This objective is not as easily accomplished when dealing with most types of sensorineural hearing impairment wherein the dynamic range of residual hearing is far smaller than the range for normal environmental sounds. The dynamic range of hearing is that range of intensities with which the ear can deal effectively; from the weakest to the loudest sound or from threshold of hearing to threshold of loudness discomfort. As mentioned earlier, this range is very large for normal hearing individuals (approximately 125-130 dB). In the presence of hearing impairment, the dynamic range of hearing is often decreased dramatically. For example, an individual with a threshold of hearing at 50 dB and a threshold of discomfort at 110 dB will only be able to deal effectively with the range of 50 to 110 dB or a dynamic range of 60 dB. Over the years, output limiting in hearing aids has been used to protect the user against loudness discomfort or pain when input signals reach critical levels. From an engineering view, this has been accomplished by means of compression or peak clipping circuits. The peak clipping circuits are fairly simple to employ in that the objective is to protect the user against excessive loudness. However, compression amplification is probably the most difficult and confusing system to investigate and understand in the appropriate fitting of hearing losses with amplification. Conventional, linear amplifiers function on a 1:1 ratio relating input/output function. That is, as the input signal is increased, the output","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122905653","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":"Clinical Management of the Hearing Aid Patient","authors":"Robert E. Sandlin, P. Sample","doi":"10.1055/s-0028-1095202","DOIUrl":"https://doi.org/10.1055/s-0028-1095202","url":null,"abstract":"There is no general consensus of opinion relating to appropriate hearingaid evaluation procedures and patient management practices among those who are making decisions about hearing-aid devices for the hearing-impaired individual. The plethora of evaluation methods for determining the most appropriate instrumentation gives moot testimony to the range of opinion and practices. Although the literature devoted to hearing aid evaluation procedures is rather considerable, it pales in comparison to the diversity of approaches employed by dispenser and audiologist alike. It is not the intent of this paper to delineate the exact techniques that should be employed in the evaluation process. However, personal conviction dictates that the following concepts should be incorporated into the development of a sound procedure (no pun intended) for determining appropriate amplification. 1. All measurements of patient re-sponse to acoustical stimuli should be made in a calibrated sound field. 2. Tolerance measurement should be undertaken to determine maximum power output (MPO) requirements. 3. Unaided and aided threshold measurements at frequencies of 250, 500, 750, 1000, 1500, 2000, 3000, and 4000 hertz (Hz) should be obtained. 4. Ability to detect differences between frequencies (1/3 octaves) within the 250 to 4000 Hz range should be assessed.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127059936","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":"Clinical Implications of Nonverbal Methods of Hearing Aid Selection and Fitting","authors":"D. Pascoe","doi":"10.1055/s-0028-1095200","DOIUrl":"https://doi.org/10.1055/s-0028-1095200","url":null,"abstract":"Two recent articles present excellent classifications of hearing-aid selection procedures (Levitt, 1978; Harford, 1979). As is often the case with classifications, these articles show that the same set of facts can be seen from different perspectives and can be subdivided into different families with totally different nomenclatures. A great thinker stated that the ability to order things into likes and unlikes is the foundation of human thought (Bronowski, 1951). Thus, a proliferation of classifications should be seen as continued attempts to understand a very complex set of data. The complexity involved in such comparisons demands that all pertinent data be looked at from as many angles as possible in order to appreciate the clinical implications of each procedure.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125946572","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 Processing Disorders: Therapeutic Approaches","authors":"D. F. Barr, T. A. Mullin","doi":"10.1055/s-0028-1095195","DOIUrl":"https://doi.org/10.1055/s-0028-1095195","url":null,"abstract":"","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122546391","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":"Assessment of Central Auditory Function in the Severely Multi-Handicapped Child","authors":"Martha E. Davis","doi":"10.1055/s-0028-1095193","DOIUrl":"https://doi.org/10.1055/s-0028-1095193","url":null,"abstract":"The severely multihandicapped child poses intriguing problems to the audiologist who is attempting to assess auditory status. The current literature suggests that recent advances in both behavioral testing methods and physiologic measurement procedures have substantially reduced the problems of examining the peripheral auditory mechanism in this population (Cox, 1976; Decker and Wilson, 1977; Fisch and Back, 1961; Fulton and Lloyd, 1975; Lowell, 1976). However, researchers in the field have largely ignored the assessment of central auditory function in severely multihandicapped children. This article will examine several issues involving the assessment of central auditory function in the severely multihandicapped child with four specific goals: (1) to evaluate the definition of central auditory function as it applies to the population of severely multihandicapped children, (2) to explore the role of the audiologist who evaluates this population, (3) to discuss several possible evaluation strategies, and (4) to examine the potential prognostic and therapeutic value of assessing central auditory function in this specific population.","PeriodicalId":364385,"journal":{"name":"Seminars in Speech, Language and Hearing","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1980-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129289461","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}