Effect of Oral Muscle-Strengthening Training Using a Smartphone Application on Pronunciation in Older Adults: A Randomized Controlled Trial.

Background: The present study analyzed the relationship between oral motor and cognitive functions in community-dwelling older Korean adults. Methods: Study participants included 113 community-dwelling older adults with a mean age of 73.84 years. Subjects' cognition was assessed using the Korean version of the Montreal Cognitive Assessment, and tongue, cheek, and lip pressures were assessed using the Iowa Oral Performance Instrument. Tongue and masseter thicknesses were measured using an ultrasound device (Sonon, Healcerion, Roseville, CA, USA). The occlusal force was measured using a specialized device (Innobyte, Kube Innovation, Montreal, QC, Canada), and the number of lost teeth was directly verified by a dental hygienist. Results: Results of analysis of cognitive function according to demographic characteristics of older community-dwelling adults revealed a significant difference in cognitive function according to education level and employment status. Cognitive function demonstrated a positive correlation with oral motor function, including pressure on the cheek, lips, and tongue, thickness of the masseter and tongue, occlusal force, number of lost teeth, and age. Hierarchical regression analysis revealed that demographic characteristics and cheek, lip, tongue, and masseter functions did not affect cognition, whereas occlusal force and number of lost teeth significantly affected cognition. In this study, oral motor function, excluding occlusal force and number of lost teeth, did not affect cognition. Conclusions: Future studies, however, are required to analyze the relationship between oral motor function and cognition in older adults with a wider range of such functions.

Pronunciation difficulties in older adults frequently stem from age-related weakening of the oral muscles, necessitating accessible and engaging training approaches. This study aimed to evaluate the effectiveness of oral muscle strengthening exercises using immersive educational content to improve pronunciation in older adults. Individuals aged 65 years and older were screened using the Speech Mechanism Screening Test. Those classified as normal were assigned to receive oral muscle strengthening exercises combined with realistic educational content twice per week for 6 weeks. To assess improvements in pronunciation, the following measures were evaluated: Total Percentage of Consonants Correct (PCC), Proportion of Whole-Word Correctness (PWC), Phonological Mean Length of Utterance (PMLU), Proportion of Whole-Word Proximity (PWP) and Percentage of Vowels Correct (PVC). Additionally, phonological error patterns were analysed. According to repeated-measures ANOVA, the intervention group showed significantly greater improvements than the control group post-intervention in PCC (from 97.87 at baseline to 98.99 post-intervention, p = 0.003), PWC (from 0.91 to 0.96, p < 0.001) and PMLU (from 8.49 to 8.53, p = 0.03). Vowel change errors significantly decreased (from 0.80 to 0.40, p = 0.04). Oral muscle strengthening exercises that incorporate immersive educational content are effective in improving selected pronunciation outcomes in older adults. These findings therefore suggest that these exercises may serve as feasible interventions for enhancing speech intelligibility in this population.

Currently, there is no theoretically justified, evidence-based metric for evaluating segmental and prosodic components of multisyllabic words (MSWs). A pilot study evaluated a MSW metric embedded in non-linear phonological- and language-processing frameworks. Six MSWs were analyzed in 10 Canadian English-speaking 5-year-olds with typically developing speech, and eight French-speaking children, ages 3–4 years, with protracted phonological development (PPD). Mismatches were tallied (with and without vowels), with totals ranked by word and participant, then compared with ranks from Phonological Mean Length of Utterance (PMLU) and Percent Consonants Correct (PCC) tallies. For both groups, the number of different ranks was significant in comparisons of MSW metrics with PMLU and PCC. Rank orderings were systematically higher for English-speaking children using the MSW metric, with/without vowels, and for French-speaking children using the MSW metric with vowels. Overall, the MSW metric was particularly suitable for fine-grained differentiation of phonological accuracy in MSW production.

Bilingualism is increasingly the norm in the United States with at least 20% of Americans being bilingual. This change in linguistic demography has created a new challenge to accurately diagnose speech disorders among bilingual children. This study explores Acoustic Landmark Detection (ALD) system as an objective approach to characterizing similarities and differences in speech production in child speakers of Standard English and Jamaican Creole (JC). Eight JC-English bilingual children were recorded speaking eleven words three times in each language. Words were transcribed and entered into PROPH + to provide: (1) Phonological Mean Length of Utterance [pMLU], (2) phonotactic structure, and (3) Percent Consonants Correct (PCC). Landmarks were hand-marked to determine probable landmark sequences based on canonical word production. Canonical landmark sequences were aligned with detected landmark sequences in both languages using the Needleman-Wunsch global alignment algorithm. Analysis revealed that if PCC indicates JC and English words are different, the mismatch between landmark tends to be lower (higher production accuracy); if phonotactics indicate JC and English words are different, mismatch tends to be slightly higher (lower accuracy); and if pMLU indicates word differences, mismatch tends to be higher (lower accuracy). Our finding support traditional linguistic expectations regarding bilingual speakers’ similarities and differences.

Objectives: This study investigated the validity of four language measures, i.e., phonological mean length of utterance (PMLU), the proportion of whole-word proximity (PWP), the proportion of whole-word correctness (PWC), and percentage of correct consonants, in assessing phonological development in Jordanian Arabic (JA) speaking children with phonological disorders in comparison with typically developing (TD) children.Methods: The study involved 88 monolingual JA-speaking children within the age range of 5 to 6 years, with 44 children diagnosed with phonological disorders and 44 TD children. Each group was further categorized into two age groups, namely 5;0-5;6 and 5,7-6,0. Data were gathered by observing the interactions between the children and their caregivers or parents using age-appropriate toys. A minimum of 100 utterances were collected from each participant.Results: The study found that TD children performed better than the children with phonological disorders on all measures, indicating delayed phonological performance in the phonological disorders group. Positive correlations between the measures were also observed, indicating their ability to provide significant information about children’s phonological abilities. Specific speech sound errors and substitution patterns exhibited by children with phonological disorders were identified, highlighting the motor control and articulatory challenges experienced by this group. Age was found to be a significant factor in the development of TD children, while children with phonological disorders showed similar scores across different age groups.Conclusion: These findings support the usage of the four measures for understanding phonological development in children with phonological disorders, accurately diagnosing them and tracking their progress.

Dental checkups are integral to maintaining oral function in older adults and are a critical determinant of overall health and quality of life. However, their impact on oral function parameters remains understudied. This study investigated the association between dental checkup attendance and oral function in older adults. This cross-sectional study recruited a convenience sample of 235 older adults (75.1 ± 5.6 years, 125 males). Participants were categorized based on biannual dental checkup attendance. Seven oral parameters were assessed: oral cleanliness, oral dryness, occlusal support, oral motor function, tongue pressure, masticatory performance, and swallowing function. Statistical analyses included the Mann‒Whitney U test, chi-squared test, and linear regression analysis. Significant differences between attendees and non-attendees were found in sex, body mass index, and oral hygiene practices. Oral cleanliness (p = 0.005), masticatory performance (p < 0.001), and swallowing function (p = 0.001) were significantly better in checkup attendees. Non-attendance at dental checkups was consistently associated with the extent of declined oral function in crude (B:0.45; 95%CI:0.12,0.77) and fully adjusted models (B:0.56; 95%CI:0.16,0.97). Given the positive association between dental checkup non-adherence and declined oral function, encouraging community-based awareness campaigns with accessible dental care could promote checkup attendance. Consequently, it contributes to maintaining oral function in the older adult population.

The purpose of this study was to identify the relationship between the strength of the tongue/lip strength and speech production for dysarthric adults with cerebral palsy. The maximal tongue and lip strengths of 22 normal adults, 27 dysarthric adults (10 adults with mild dysarthria, 10 adults with moderate dysarthria, and 7 adults with severe dysarthria) were measured with Iowa Oral Performance Instrument (IOPI). The percentage of correct consonants (PCC) and speech intelligibility were calculated from the words and sentences spoken by the subjects. The results of the study are as follows: First, both the maximal tongue and the maximal lip strength differed significantly between the control group and the group with dysarthria. While the group with mild dysarthria did not show meaningful difference in maximal tongue and lip strengths from the control group, the group with moderate and severe dysarthria showed significantly weaker tongue and lip strength than the control group and the group with mild dysarthria. Second, the current study suggests the existence of a significant correlation between the maximal tongue and lip strength and the PCC and speech intelligibility within all subjects with dysarthria. These findings can serve as an effective foundation to diagnose dysarthria quickly and accurately. The results of this study also indicate that in addition to the maximal tongue strength, the maximal lip strength can prove to be an important index in predicting the speech intelligibility of dysarthric adults with cerebral palsy.

말소리 장애 유아의 평가와 중재를 위해서는 일반 유아의 말소리 발달 양상에 대한 정보가 필요하다. 본 연구는 일반 유아의 말소리 발달 양상을 분절음 단위와 단어 단위 지표를 사용하여 종단적으로 살펴보는 것을 목적으로 하였다. 2세 유아 3명, 3세 유아 2명을 대상으로 1년 6개월의 기간 동안 평균 6개월(5-8개월) 간격으로 총 4회, 자발화 맥락에서 분절음 단위 지표로 음소목록 유형 수, 총 자음 산출 수, 자음정확도(PCC)를 평가하였고, 단어 단위 지표로 단어단위복잡률(PMLU), 단어단위근접률(PWP), 단어단위정확률(PWC)로 평가하였다. 종단적으로 확인한 유아들의 말소리 발달에서 몇 가지 특성을 확인할 수 있었다. 3세 후반에서 4세 초반에는 지표의 증가율이 둔화되고 일부 지표는 천장효과가 나타나 이 시기에 유아들의 말소리 발달이 완성기에 들어서는 것으로 추정할 수 있었다. 그러나 일부 유아는 3세 전반에 이미 그러한 양상을 보여주어 개인차를 보여 주었다. 평가 지표에 따른 차이도 나타났는데, 분절음 단위의 PCC는 3세 후반에서 평균 95%(90.3∼97.1%)에 도달한 반면, 단어 단위의 PMLU는 5세까지 지속적으로 변화하였다. 또한 PCC가 집단 평균을 따라가는 것으로 나타난 일부 유아는 PMLU에서 집단 평균에 도달하지 못하였다. 이는 취학 전 유아의 말소리 발달 평가에서 분절음과 단어 단위 분석결과를 종합하여 사용할 필요성이 있음을 시사한다.This study aims to examine developmental characteristics of speech sounds in toddlers through segmental and whole word evaluation. Three toddlers of 2 years old and two toddlers of 3 years old participated in the study for the duration of one and a half years. Evaluations of spontaneous speech were performed four times with 6 month interval. Three indexes for segment level such as Number of Phonetic Inventory, Total Number of Consonants, and Percentage of Correct Consonant(PCC) and 3 indexes for whole word level such as Phonological Mean Length of Utterance(PMLU), Proportion of Whole-Word Proximity(PWP), and Proportion of Whole-word Correctness(PWC) were used for evaluation. The longitudinal study revealed several characteristics of speech sound development of participants. Around the time when toddlers reach the age of 4, each index started to increase at a slower pace with some demonstrating ceiling effect. These results suggest that the phonological development of toddlers entered stable stage at this said period. That said. however, there were individual differences for each child. There were differences regarding indexes as well. On average, PCC reached 95% at the later period of the age 3, whereas PMLU continued to change until the age of 5. Some toddlers whose PCC was in the normal developmental range showed PMLU lower than the group average. These results suggest that a comprehensive use of both segmental and whole word level analyses may be necessary in evaluating the phonological development of toddlers.

Background/Objectives: Oral frailty and hypofunction in older adults are strongly associated with declines in nutritional status, physical function, swallowing ability, and overall health. Isolated interventions usually fail to achieve sufficient improvement since these conditions result from interrelated biological, psychological, and social factors. Multidisciplinary approaches combining oral management, nutritional support, and physical rehabilitation have shown promise. This narrative review synthesized evidence from 15 studies examining multifaceted interprofessional interventions across hospitals, communities, long-term care facilities, and home-care settings. Methods: A structured search of PubMed and Web of Science (2000-2025) identified original studies assessing oral, nutritional, or physical outcomes in older adults post-interprofessional interventions. Fifteen eligible studies were extracted; the findings were integrated using narrative synthesis owing to design and outcome heterogeneity. Results: Educational multidisciplinary interventions improved oral hygiene, caregiver awareness, and oral motor function. Multidisciplinary rehabilitation and multidomain programs consistently improved tongue pressure, swallowing function, mastication ability, appetite, body composition, activities of daily living, and oral intake resumption. Nutrition support team-delivered interventions reduced aspiration risks and improved oral environment and swallowing function. Community-based programs using munchy meals and combined exercises enhanced oral and physical functions. Social participation provided psychological benefits. Home-care dysphagia rehabilitation enabled 69% of tube-fed patients to resume oral intake. Conclusions: This narrative review supports a triadic, interprofessional approach in geriatric care, highlighting consistent improvements in oral function through integrated oral, nutritional, and rehabilitative interventions.

The deterioration of oral function to a state of oral hypofunction (OHF) is reportedly associated with malnutrition and frailty. Thus, we Investigated the association of OHF with physical characteristics and function and test the effects of a programme including comprehensive oral and physical exercises and textured lunch gatherings (COPE-TeL programme) on oral and physical function in older adults with OHF. Eighty-six community-dwelling older adults were randomly assigned into control (n=43) or intervention (n=43) groups. The participants were further divided into OHF and normal oral function (NOF) sub-groups based on initial oral examinations. The intervention group participated in the 12-week COPE-TeL programme, while the control group performed the physical exercise regimen only. The differences in measured variables for physical and oral function between the OHF and NOF groups were statistically tested, and changes in the proportion of participants with OHF were examined. Physical function, such as hand grip strength and walking speed, was significantly lower in the OHF group at the initial assessment. The proportion of participants with OHF was 56% in the intervention group and 67% in the control group before the trial, which became significantly reduced after completing the COPE-TeL programme in the intervention group (26%, P=.002), but not in the controls (61%, P=.549). Older adults with OHF may have diminished physical function. The COPE-TeL programme of oral and physical exercises along with textured lunch gatherings may be effective for older adults with OHF.

Background/Objectives: Unwanted loneliness is the gap between the social relations a person has and those they want. The main objective of this research is to assess the impact of a multidimensional community-based intervention on the feeling of unwanted loneliness in the population over the age of 65 years old who live alone, are under social risk, or are socially isolated living on La Palma island. Methods: A quasi-experimental study was designed with pre- and post-intervention (at three months) measurements, with no control group or randomization. A sample comprising 90 subjects was estimated for a small–moderate (0.3) or large (0.8) effect size, with a significance level (α) of 0.05 and a power (1 − β) of 0.8. Results: The intervention was initiated with 90 participants in 8 of the 9 Basic Health Districts from the La Palma Health Area. A moderate effect size (d = −0.77; 95%CI [−1.02, −0.52]) was evidenced in self-perceived loneliness. Three months after the proposed community-based intervention, significant differences were evidenced in adequate eating habits, physical activity, support network, anxiety, depression, and perceived social support. Conclusions: Compartiendo Salud (Sharing Health) presents promising results, as it exerts positive effects on health management among older adults that live alone. The results of this intervention could serve as a model to design replicable strategies in other communities, improving the quality of life and levels of perceived social support in older adults.

Positive Effects of "Textured Lunches" Gatherings and Oral Exercises Combined with Physical Exercises on Oral and Physical Function in Older Individuals: A Cluster Randomized Controlled Trial.

BACKGROUND Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents’ role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders. OBJECTIVE This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention. METHODS A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants’ speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants). RESULTS The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received. CONCLUSIONS The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/54426

BackgroundChildren born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents’ role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders.ObjectiveThis study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention.MethodsA randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants’ speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants).ResultsThe protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received.ConclusionsThe results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve.International Registered Report Identifier (IRRID)DERR1-10.2196/54426

Closed-loop therapy in older adults with type 1 diabetes: hypoglycaemia benefits and risk stratification