Speech Areas Research Articles

Impact of pre-stroke cognitive decline on rehabilitation effectiveness and cognitive-functional status of patients in the acute period of ischemic stroke

Summary. The aim was to assess the influence of premorbid cognitive deficit on the effectiveness of rehabilitation using VR technologies and cognitive-functional status of patients in the acute period of ischemic stroke based on statistical methodology. Materials and methods: 120 patients diagnosed with ischemic stroke were examined. The IQCODE questionnaire was used to identify the patient’s cognitive decline before and the Pandas and SciPy libraries. Results: all patients had a multifunctional type of cognitive impairment with a predominant decline in the areas of executive function, memory, speech and perception. Patients of the 2nd group had a more pronounced deficit in the areas of constructive praxis, episodic memory, semantic information processing and perception. Assessment of the dynamics of cognitive impairment during therapy revealed a significant improvement in memory loss (p=0, 0034), executive dysfunction (p<0.0001) and attention impairment (p=0.0001) in patients of 1st group and regression cognitive deficit in almost all cognitive areas in patients of 2nd group. Factors impeding rehabilitation in 1st group of patients were attention (r = -0,325) and perceptual disorders (r = -0,425); in 2nd group: semantic aphasia (r = -0,425), constructive apraxia (r = -0,325), speech impairment (r = — 0,375), object agnosia (r = -0,323) and IQCODE (r = -0,395). Conclusion: pre-stroke cognitive impairments are predictors of the development and progression of post-stroke cognitive deficits and reduce the possibilities of rehabilitation and cognitive recovery. The introduction of IQCODE in the diagnosis of cognitive dysfunction in the acute period of ischemic stroke is a useful tool in predicting the course and development of cognitive deficit and studying the prospects of rehabilitation programmes using VR technologies in patients with pre-stroke cognitive impairment.

The Accuracy and Efficiency of the Speech Language Early Literacy Screening Checklist

Objectives: This study aimed to develop the “Speech Language Early Literacy Screening Checklist” in order to identify speech, language, and early literacy difficulties in children aged 5-6 years before entering elementary school. This study examined the reliability, validity, sensitivity, specificity, positive predictive value, and negative predictive value to verify the accuracy and efficiency of the checklist as a screening tool.Methods: Out of the 2,880 children who participated in the initial screening test, 155 underwent diagnostic deep tests. A total of 110 children who exhibited difficulties in language, speech, and early literacy areas were classified as the high-risk group, while those who demonstrated appropriate development in all areas were classified as the general group.Results: The Cronbach’s α value for all checklist items was .884. The content validity index rated by six language development experts was 0.70 or higher for all 36 items, with an average content validity score of 0.91. Clinical validity was confirmed through the total score differences between the general and high-risk groups classified by the diagnostic deep tests. The receiver operating characteristic (ROC) curve results for the screening checklist showed an area under the curve (AUC) of 0.858, sensitivity of 84.4%, and specificity of 76.4%. The positive predictive value (PPV) calculated from the cut-off score was 92.3%.Conclusion: The “Speech Language Early Literacy Screening Checklist” developed to identify children at high risk of language development delays before school entry has shown appropriate reliability, validity, and classification accuracy. This study suggests that the implementation of this checklist will contribute to preventing school failure by effectively identifying at-risk children aged 5-6.

Self-Assessment to Improve English Speaking Skills: an action research with Elementary School Ecuadorian students

This study aimed to determine the impact of self-assessment on speaking skills among A2 movers’ students. The data analysis revealed that its use has a favorable effect on students' speech skills and showed that they could use the content in a real context. They incorporated reflection to be aware of their learning, understood their mistakes, and tried to improve their level of preparation for better results. At that time, they took responsibility for all the steps planned in innovation because they tested their effort and progress in each activity. In addition, the improvement demonstrated in the results of the evaluation carried out by the teacher with the rubric in the posttest was significant in the final part of the unit. The self-assessment helped students take the necessary corrective measures to be more prepared to do speech exercises. According to the students' perspectives, self-evaluation helped them improve their skills because they were able to identify areas of speech that needed to be improved and gradually, could reinforce their discourse to give better descriptions of places and people.

Functional mapping of movement and speech using task-based electrophysiological changes in stereoelectroencephalography.

Stereoelectroencephalography (SEEG) has become the predominant method for intracranial seizure localization. When imaging, semiology, and scalp EEG findings are not in full agreement or definitively localizing, implanted SEEG recordings are used to test candidate seizure onset zones (SOZs). Discovered SOZs may then be targeted for resection, laser ablation, or neurostimulation. If an SOZ is eloquent, resection and ablation are both contraindicated, so identifying functional representation is crucial for therapeutic decision-making. The authors present a novel functional brain mapping technique that utilizes task-based electrophysiological changes in SEEG during behavioral tasks and test this in pediatric and adult patients. SEEG was recorded in 20 patients with epilepsy who ranged in age from 6 to 39 years (12 female, 18 of 20 patients < 21 years of age) and underwent implanted monitoring to identify seizure onset. Each performed 1) visually cued simple repetitive movements of the hand, foot, or tongue while electromyography was recorded; and 2) simple picture-naming or verb-generation speech tasks while audio was recorded. Broadband changes in the power spectrum of the SEEG recording were compared between behavior and rest. Electrophysiological functional mapping of movement and/or speech areas was completed in all 20 patients. Eloquent representation was identified in both cortex and white matter and generally corresponded to classically described functional anatomical organization as well as other clinical mapping results. Robust maps of brain activity were identified in healthy brain, regions of developmental or acquired structural abnormality, and SOZs. Task-based electrophysiological mapping using broadband changes in the SEEG signal reliably identifies movement and speech representation in pediatric and adult epilepsy patients.

Morphological and Morphometric Study of the Pterion &amp;ndash; A Cadaveric Study in Sri Lanka

Introduction: Pterion is an important landmark as its relation to the anterior branch of middle meningeal artery, Broca’s motor speech area on the left side, and surgical interventions relating to pathologies of the sphenoid ridge and optic canal as it provides access to vital structures such as sylvian fissure, circle of Willis, optic nerve, para-sellar regions, middle meningeal vessels and cavernous sinus. Approach through pterion is mostly used to treat lesions of anterior and middle cranial fossa. Pterion ossicle or Epipteric bone are sometimes mistaken as a fracture at this point.Objective: The aim is to study the types of pterions and measure the distance from various bony landmarks on skull to the midpoint of pterion.Methods: Specific measurements were taken, and type of the pterion recorded by two independent investigators in the Frankfurt plane on both sides of 37 adult dry skulls of unknown age, gender and race, without calvaria which were prepared for academic purposes, none of which showed any obvious pathology or trauma. The skulls with broken lateral walls were excluded. The linear distance from the center of the pterion to four anatomical landmarks were measured using a Vernier caliper with an accuracy of 0.1 mm.Results: The sphenoparietal type of pterion was the most common (83.8% left, 81.1% right), followed by the frontotemporal (8.1% left, 13.5% right), and epipteric (8.1% left, 2.7% right) types and the stellate type was the least commonly observed (2.7% left side only). The distances on the left and right sides respectively from the center of the pterion to the frontozygomatic suture were 3.60 ± 0.57 cm and 3.68 ± 0.50 cm, to the zygomatic arch 3.76 ± 0.39 cm and 4.03 ± 0.40 cm, to the tip of the mastoid process 7.96 ± 0.58 cm and 8.16 ± 0.61 cm, and to the topmost part of the external auditory meatus 5.42 ± 0.34 cm and 5.53 ± 0.35 cm.Conclusions: This knowledge is essential in surgical approaches and interventions via the pterion, especially for neurosurgeons while drilling a burr hole at the pterion to prevent orbital penetration due to an anterior drilling and an ineffective access for instrumentation due to a posterior drilling. It will also be helpful for surgeons, radiologists, anthropologists, forensic pathologists in their diagnosis and treatment.

Understanding Hearing Loss and Strategies for Prevention and Intervention of Hearing Impairment

The ability to perceive sound is called 'hearing'. This is possible when the ear senses the vibrations of sound in solid, liquid and gaseous substances. The ear helps us to recognize various kinds of sounds. The child starts hearing soon after birth. These sounds get imprinted on his mind and brain. These imprinted sounds become the basis of the child's knowledge of language. The child communicates through language only. Communication is an important basis for the growth of knowledge. If the child's hearing ability is normal, then his development in speech, language, communication and other areas takes place normally. But if the child has difficulty in hearing, and there is no early identification and intervention, then his development in speech, language, communication and other areas is limited in comparison to a hearing child of the same age group. Therefore, early identification and intervention of hearing impairment is absolutely necessary. Many stages have to be passed in the process of early identification and intervention. This article discusses sequentially the aspects related to understanding hearing loss, prevention of hearing impairment, and intervention.

Experience of awake craniotomy in a child (clinical case)

The objective was to demonstrate the possibility of performing awake craniotomy in a child.Materials and methods. The 9-year-old child with a dysembrioplastic neuroepithelial tumor in the left temporal lobe was planned and performed awake craniotomy. During awakening, the child performed a naming test, object designation tests, word repetition and spontaneous speech, and Luria’s test.Results. During psychological tests and intraoperative neuromonitoring, it was possible to successfully identify the speech zone and motor areas of the face, which helped to safely remove brain formation without complications. This clinical case was also interesting because the child’s native language was Kazakh, so an interpreter was presented during the intraoperative awakening.Conclusions. The case demonstrates the possibility of performing awake craniotomy in a child, which depends not only on the somatic and psychological state, but also on the professionalism of the operating team, including surgeons, anesthesiologists, neurophysiologist, neuropsychologist and a large number of nursing staff who are able to clearly interact with each other.

Neuroplasticity, music, and human brain

Introduction. Studying the influence of music on the human brain is one of the key topics in neuroscience as it allows extending our understanding of brain neuroplasticity.&#x0D; This study aimed to investigate structural brain organization in professional musicians.&#x0D; Materials and methods. We investigated 27 brains (i.e. 54 hemispheres) of male musicians, female musicians, male non-musicians, and female non-musicians by magnetic resonance imaging. All study participants were aged 20 to 30 years and did not have any mental or neurological disorders. Gray matter volume and cortex thickness in different cortical structures of the right and left hemispheres were measured.&#x0D; Results. We found major changes in the brain structure in professional musicians (both male and female) vs. non-musicians. We found differences in the macroscopic structure of the triangular region in the Broca’s motor speech area in musicians’ brain. Increases in gray matter volume in the brain of musicians and its individual cortical structures were shown in the superior temporal region, Broca’s motor speech area, hippocampus, superior parietal lobule, and other structures. We found increased thickness of cortical structures in musicians vs. non-musicians.&#x0D; Conclusions. Practicing music regularly was shown to change structural brain organization; we found significant increases in gray matter volume and cortex thickness in various cortical structures in the right and left brain hemispheres of musicians vs. non-musicians.

Personalized approach to assessing the functional result of acute ischemic stroke

BACKGROUND: The main reason for the poor prognostic outcome in stroke patients is the polymorphism of cognitive and motor impairments.&#x0D; AIM: The purpose of this study is to evaluate the impact of clinical and paraclinical factors on the functional outcome of the patient in the acute period of ischemic stroke based on statistical methodology.&#x0D; MATERIALS AND METHODS: 160 patients of the primary vascular center with a diagnosis of “Ischemic stroke” were examined. Functional outcome parameters were designated as absolute values and were calculated as the difference between Montreal Cognitive Assessment (MoCA), National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI), Modified Rankin (mRS) scale scores before and after treatment. The following criteria were considered as factors influencing the prognosis of the functional result of acute stroke: demographic characteristics, parameters of cognitive function, stroke characteristics (localization, lateralization, subtype). Mathematical statistics was performed using the Python programming language and the Pandas and SciPy libraries.&#x0D; RESULTS: The mathematical model developed in this study made it possible to identify the main neuropsychological and clinical indicators that negatively and positively affect the functional result of acute stroke. As the main factors influencing the functional result in relation to MoCA, impairments in the areas of attention, speech and executive function, age, indicators on the IQCODE and ASPECTS scales were identified. Apraxia, agnosia, executive dysfunction, sex, age, lesion side, IQCODE parameters influenced the prognosis of the degree of patient’s daily activity according to IB. Regression of neurological symptoms according to NIHSS depended on indicators in the field of perception, praxis, speech, IQCODE and ASPECTS values. Semantic aphasia, mnestic and executive dysfunction, apraxia, and IQCODE scores were important for the prognosis of disability degree according to mRS.&#x0D; CONCLUSION: The use of discriminant analysis to predict the functional result will allow to create personalized diagnostic and therapeutic strategies for managing patients in the acute period of ischemic stroke. The predictive value of clinical and paraclinical markers in relation to the recovery of motor and cognitive function of patients may be useful in the further management of ischemic stroke.

Advanced wearable strain sensors: Ionic double network hydrogels with exceptional stretchability, adhesion, anti-freezing properties, and sensitivity

In recent years, achieving satisfactory mechanical and electrical properties in hydrogels at low temperatures has proven challenging. Herein, we developed an superior ionic conductive hydrogel by a simplified one-pot method. The as-prepared Li+/AgNPs@polyacrylamide-co-polyacrylic acid (Li+/AgNPs@PAM/PAAc) double-network hydrogel exhibited remarkable stretchability of up to 1250 % at room temperature and revealed a robust adhesion on different materials, especially up to 44.2 kPa on aluminum. Furthermore, the hydrogel demonstrated high sensitivity with a gage factor (GF) of 3.20 at a strain of 200 %, and performed reliably at low temperature, with a GF of 1.42 at a strain of 100 % at - 40 °C, suggesting the maintenance of excellent mechanical and electrical properties at low temperature. These remarkable advantages highlighted the significantly enhanced performance of the ionic conductive hydrogel for applications in flexible wearable sensing devices, in the areas of intelligent speech, motion recognition, as well as electrophysiological signal monitoring.

Активація мовленнєвого розвитку в дітей переддошкільного віку

In the process of early development of all systems, language first of all suffers, because it is a reflection of complex, individual psychological processes occurring in the child's body, which depend on many factors. Corrective and speech therapy classes started in a timely manner eliminate the general lag in the child's development, since mental and emotional development are interconnected with communication. Therefore, experts strongly recommend not to wait for the child to speak independently, or to wait until the age of 4–5 years. Time can be lost, which can lead to concomitant problems, for example with the psyche. The relevance of the topic is related to the need to stimulate the development of speech activity of young children, which will ensure the correction of primary disorders of higher mental and motor functions and prevent the appearance of secondary deviations in the child's development. The purpose of the study is the formation of active speech in children aged 2.5–3 years whose language was characterized by poor vocabulary, insufficient understanding of adult language, and a decrease in communicative functions compared to peers. We investigated the level of speech development in 10 children aged 2.5–3 years whose speech development lagged behind the age norm. In our work, we used the method of speech development of children with general language underdevelopment of the third year of life, which is based on the following stages of research: determining the level of development of general motor skills, fine motor skills, active vocabulary, passive vocabulary and identifying the level of adult language understanding. The conducted research showed that all children have a delay in speech development, but it is expressed to different degrees in different children. No child showed a high level of speech development, four children are at an average level, and six are at a low level. After the application of corrective work on language development, a control study of the results of the work was conducted using the same methods that we used at the stage of diagnosing their speech development. The comparative analysis indicates that after the correctional and speech therapy work, there is not a single child with a low level of speech development, compared to six children before the work began. The speech development of the two children is almost completely in line with the age group and is rated as high. The other eight children improved significantly in all areas of speech and are rated as children with an average level of development.

Anestezija za kraniotomiju u budnom stanju - principi izvođenja

Awake craniotomy is a neurosurgical procedure that is used for the safe removal of intracranial lesions near Broca's and Wernicke's speech areas. During this procedure, speech mapping is done. Its use demands anesthesia for awake craniotomy, which includes different possibilities for the management of anesthesia with awake patients at the moment of tumor removal. There are two widely accepted concepts: "awake-awake-awake", when the patient is consciously sedated ("awake") throughout surgery, with lighter or deeper sedation (monitored anesthesia care), or "asleep-awake-asleep", when the patient is introduced into general endotracheal anesthesia while opening the skull, but is awake during lesion removal and asleep during closure. Our protocol is a form of "asleep-awake" concept, with general endotracheal anesthesia for craniotomy and awake patients during and after lesion removal (including skull closure).

Persuasion in the Business Speeches of Chief Executive Officers of Selected International Companies

This study investigated the persuasive strategies employed in the business speeches of Chief Executive Officers (CEOs) of selected international companies. Anchored in Speech Act Theory within the broader aspect of pragmatics, it analyzed 12 speeches, totalling 14,938 words, from a diverse range of international CEOs. These speeches, intended for both employees and shareholders, provided a rich corpus for examining the nuances of persuasion in a business context. The analysis focused on identifying various categories of persuasion, particularly distinguishing between direct and indirect speech acts. Utilizing a qualitative approach, 1,172 clauses were coded to elucidate the persuasive mechanisms at play. Findings revealed a predominant use of indirect persuasion by CEOs. Despite their intention to persuade, these business leaders predominantly opted for subtle, indirect speech acts, making their persuasive intent both non-obvious and inherent. Contrary to expectations, the study found a marked absence of direct rhetorical devices such as rhetorical questions, suppositions, and wonderings. This aligned with the pragmatic realities of business communication, which often eschews overtly unrealistic assertions. The analysis proposed a novel model for understanding the linguistic strategies of persuasive speech in business, highlighting both utilized and potential areas of persuasive speech acts. The implications of these findings extended beyond the specific speeches analyzed, suggesting avenues for further research. Recommendations included exploring persuasion directed at varied audiences, analyzing the perlocutionary effects post-delivery, and integrating paralinguistic and extralinguistic elements with verbal aspects of business speeches. This research not only mapped the current landscape of persuasive strategies in CEO speeches but also opened new possibilities for linguistic exploration in the realm of corporate communication.

Intervenções da Fonoaudiologia nas áreas de respiração, mastigação, deglutição e fala: uma revisão de escopo

ABSTRACT There are several types of approaches that can be used to achieve therapeutic goals in disorders related to the functions of mastication, swallowing, speech, and breathing. However, the literature lacks evidence to support their use in speech-language clinical practice. The objective of this review was to map the syntheses of evidence on speech-language pathology intervention in the areas of breathing, mastication, swallowing and speech in adults and the elderly. Only studies classified by their authors as a systematic review, studies that addressed therapy for orofacial disorders in individuals over 18 years of age were included. The procedures performed included: electronic and manual search; selection of studies; data extraction; evaluation of the quality of studies and data analysis. It was possible to observe different types of interventions mainly aimed at the swallowing function, ranging from traditional therapy to the use of devices. However, due to the limitations of the studies, the data must be interpreted with caution.

РАЗГОВОРНАЯ РЕЧЬ СКВОЗЬ ПРИЗМУ ЯЗЫКОВОЙ ВАРИАТИВНОСТИ: ЛИНГВИСТИЧЕСКИЙ И ЛИНГВОМЕТОДИЧЕСКИЙ АСПЕКТЫ

The article examines the issue of variability in language and linguodidactics, presents variable forms of language functioning, and comprehends the status of variability in the modern education. The authors substantiate everyday colloquial speech practice as a social and functional option and its inclusion in teaching German as a foreign language. The purpose of the work is to reveal the motivating linguistic and methodological potential of the German colloquial speech, to update for linguistic students the features of colloquial vocabulary and syntax in comparison with basic normative structures, and to attract students’ attention to the functional areas of colloquial speech. The article presents the authors' experience of using interactive technologies that reveal expressiveness of conversational structures developing linguistic intuition and metalinguistic skills. The authors demonstrate methods of presenting material that encourage students to creatively solve linguistic tasks to reveal the language variability.

Motor Simulation and Ostensive-inferential communication: insights and clarifications

In the article , a theoretical model of how motor simulation is a mechanism that underlies language acquisition is described. It is argued that motor areas might play a role in both the recognition of linguistic communicative and informative intentions in infants, by activating brain regions dedicated to speech processing. In this paper, I will extend the position taken there (i) by connecting my model to the features of infant-caregiver interaction in speech perception, (ii) by explaining the process that causes brains to create networks between speech areas and the motor cortex, and (iii) by showing how the most influential mindreading models can be made compatible with both the embodied simulation theory and with the cognitive abilities in children.

Effects of COVID-19 on the educational performance of children with special educational needs and disabilities: A systematic review according to children’s/youth’s and caregivers’ perspectives

This paper aims to provide a first systematic research overview of the effects of the pandemic on the educational performance of children with SEND according to children’s/youths and caregivers’ perspectives following the PRISMA statement. The studies, published between February 2020 and June 2022, were identified through the search of SCOPUS, EBSCO, PubMed, PsycInfo and two preprint-servers related to Education. In determining which studies to include in the review, the selection criteria were based on (1) articles focusing on ages 4–18 years, (2) articles focusing on children with special educational needs and (3) articles focusing on student achievement during COVID-19. The exhaustive reading and quality assessment left a final sample of nine scientific papers. According to children’s/youth’s and caregivers’ perspectives, there is clear evidence for a negative effect of COVID-19 on the educational performance of children with SEND in the areas of (1) speech and language development (2) home learning (3) academic achievement (4) learning performance and (5) remote learning. The most important findings are to be found in the difficulties faced by children in homework completion, in paying attention during online learning, in efficiently completing tasks, in managing their time and in making progress on their IEP goals during school closures.

A preliminary comparison of fluent and non-fluent speech through Turkish predictive cluttering inventory-revised

PurposeThe aim of this study is to compare the speech fluency performance of non-fluent participants namely people with stuttering (PWS), people with cluttering (PWC) and people with cluttering and stuttering (PWCS) with a fluent control group using the Turkish version of Predictive Cluttering Inventory-revised (TR-PCI-r). MethodsThe study recruited non-fluent individuals (n = 60) and fluent controls (n = 60) between the ages of 6 and 55. The non-fluent group was perceptually evaluated by two speech and language pathologists (SLP). The speaking, reading and retelling samples were collected from 18 PWC, 17 PWCS, 25 PWS and 60 controls. The scores of each factor were compared. Age and gender differences were analyzed. Validity and reliability were calculated. ResultsThe agreement between two SLPs was found to be at the barely acceptable level (κ = 0.378). PWC and PWCS produced parallel outcomes in the speech motor area. In every other domain and in total scores, PWC were different from PWCS, PWS, and the controls. There was a variation in the total scores obtained by the children and adolescents in the PWS and between males and females in the controls. Except for three items (namely items 8, 22, 27), TR-PCI-r met the content validity criterion. Furthermore, TR-PCI-r was found to be a reliable tool as shown by ɑ> 0.70 and ICC values of between 0.75 and 0.90. ConclusionThe scores from TR-PCI-r indicated that, speech motor characteristics of PWC and PWCS were similar. Other features assessed by the tool seemed to distinguish PWC from PWCS, PWS and controls.

NCOG-15. COMPARATIVE ANALYSIS OF GLIOMA INDUCED IMPAIRMENT MODELS

Abstract Speech is produced by the coordination of neural networks involved in language processing and motor control of vocal outputs, both of which can be disrupted by diffuse gliomas. Natural language is the instinctual written or spoken language profile that an individual has developed throughout his or her lifetime. Recent psycholinguistic analyses suggest that patterns of natural language may be an accurate measure for assessing clinical and behavioral conditions. One important feature of natural language is speech onset. Speech delays are common complaints among patients with glioma. Here, we assess the relationship between speech onset and histologic-molecular features of glioma. Speech onset was defined as acoustic measure of the interval of time between the release of the oral constriction in a stop consonant and the onset of subsequent voicing. Audio samples and video analysis of oral kinetics were analyzed from patients with newly diagnosed low- and high-grade glioma. Features were extracted by manual segmentation and aligned for each trial with high-density electrode arrays to record task specific responses from gliomas projecting to the cortical surface. A total of 1,120 stimuli (672 = picture naming (PN) and 448 auditory naming (AN) trials were presented. As expected, patients with glioblastoma had higher picture and auditory naming error rates (p &amp;lt; 0.001, Mann-Whitney U test) compared with diffuse low-grade gliomas. Assuming speech errors produce slower response times, we next measured only correct behavioral responses which demonstrated 7% slower speech initiation responses (p &amp;lt; 0.0001, Mann-Whitney U test) when comparing patients with glioblastoma and diffuse low-grade gliomas. Slowed speech responses did not require glioma infiltration into canonical cortical speech areas of the lateral prefrontal cortex and superior temporal gyrus. Finally, we identified electrophysiological biomarkers of speech errors. These results deepen our understanding of speech processing impairments, which are not based purely on coding errors.

71 Neuropsychological Intervention for Developmental Stuttering using Delayed Auditory Feedback Application

Objective:Brain science demonstrates that people who stutter (PWS) exhibit insufficient activation in the auditory speech area of the left hemisphere (Kikuchi, et al. 2011 ; Garnett, et al. 2018). In this study, we reported the auditory brainstem response of PWS: in PWS with moderate and severe impairment, significantly longer interpeak latencies (IPLs) between waves I and V (IPL [I-V]) of the right ear than those of the left ear were observed. However, in PWS with mild impairment, the IPLs (I-V) of the left ear were significantly longer than those of the right ear (Anzaki et al., 2020). We considered that the differences in the IPLs (I-V) between the right and left ears cause monitoring disturbance in communication, which results in developmental stuttering. It has been reported that stuttering was improved by delayed auditory feedback (DAF) (Stromsta, 1956; Sakai, 2008). Thus, we improved the DAF system and developed an application that can be used by PWS to listen to their own voices with no differences in the IPLs (I-V) between their left and right ears. We verified the effectiveness of this application.Participants and Methods:This study included five male adults with developmental stuttering (ADSs), with a mean age and handedness index of 36 years and 84, respectively. The application was adjusted so that the IPLs (I-V) of the left and right ears were the same. For example, one ADS showed that the IPL (I-V) of their right ear was 0.5 msec longer than that of their left. Subsequently, the application was adjusted so that the IPL (I-V) of his left ear would be delayed by 0.5 msec. We asked the participants to use the application for six months when free talking and reading aloud. Using the Japanese Standardized Test for Stuttering (JSTS) (Ozawa, et al. 2013), we compared their disfluencies with and without the application.Results:As per the JSTS, the stuttering severity in all participants improved. Case 1, who had severe impairment (level 5), showed a moderate improvement (level 4), Cases 2 and 3, who had moderate impairment (level 4), showed a mild improvement (level 3), and Cases 4 and 5, who had mild impairment (level 3), exhibited a normal level of improvement (level 1). We calculated the z-scores of the improvement rates of the JSTS based on the standard deviations according to the severity (Anzaki, 2019). The z-scores of Case 4 and 5 were 4.01 and 2.01, respectively, indicating a significant improvement.Conclusions:In our report last year, although ADSs with moderate and severe impairment showed improvement by stimulation intervention on the left hemisphere through the right ear, those with mild impairment exhibited only a slight or no improvement as per the JSTS (Anzaki, et al. 2021). The application developed in this study was found to significantly improve the disfluencies of all the participants as per the JSTS, especially those with mild impairment. Therefore, we considered that stuttering disorders are layered; ADSs have auditory monitoring disorder in the base.