Speech Symptoms Research Articles

Spasmodic Dysphonia: Botulinum Toxin Injection after Recurrent Nerve Surgery

The purpose of this study was to determine if botulinum toxin injections into the thyroarytenoid muscle would reduce symptoms in adductor spasmodic dysphonic patients who had experienced symptom recurrence after recurrent laryngeal nerve surgery. Five patients were seen between 3 to 10 years after surgery with a return of speech symptoms and persistent unilateral vocal fold paralysis. Before injection, comparisons with controls on spectrographic measures of pitch and voice breaks, aperiodicity, and sentence length demonstrated significant symptoms of spasmodic dysphonia (p less than or equal to 0.02). Electromyographic measures demonstrated equal levels of thyroarytenoid muscle activation on the operated and non-operated sides with bipolar needle electrodes, and heightened activity in both muscles relative to normal. Therefore, symptom return was associated with thyroarytenoid innervation after recurrent nerve surgery. In all patients, the thyroarytenoid muscle on the side operated on was injected with type A botulinum toxin. In two patients, toxin was also injected on the side not operated on. Significant (p less than or equal to 0.002) reductions in all speech symptoms occurred after injection. Electromyographic measures demonstrated significant reductions in the percent activation levels of both the injected muscle and noninjected muscles (p less than or equal to 0.01). Botulinum toxin injections were an effective treatment of post-surgical symptom recurrence in adductor spasmodic dysphonia.

Language Pathology

Language pathology is a broad term, used to refer to the symptoms of speech and language speech and language disorders, the aetiologies of these disorders, and the methods and results of the disciplines which study them. The major disciplines involved are medicine, psychology, and linguistics (including speech science). It is neither possible nore desirable, in an inter-disciplinary field, to ignore the contribution of other sciences. Here, however, the concentration will be, so far as is feasible, on the distincitve role of linguistics in the investigation of language disorders. The term language disorder is used as a general label for any persistent non-normal linguistic behaivor in children or adults.

The cerebellar-vestibular basis of learning disabilities in children, adolescents and adults: hypothesis and study.

This paper provides a description of the cerebellar-vestibular-determined (CV) neurological and electronystagmographic (ENG) parameters characterizing 4,000 patients with learning disabilities. Of this sample, 1465 or 36.6% were children, 1156 or 28.9% adolescents, and 1379 or 34.5% adults. Using a set of diagnostic methods and criteria, the incidence of CV-dysfunction in this diverse sample was statistically equivalent to that reported by neurologists and neurotologists in a prior "blind" analysis of 115 dyslexic children. Over 94% of both the learning disabled and the dyslexic samples showed two or more abnormal neurological or ENG parameters indicating a CV-dysfunction whereas less than 1% evidenced hard neurological signs of a cerebral disorder. These and related data suggested that: (1) learning disabilities and dyslexia may be cerebellar-vestibular-based and reflect a single disorder and that (2) the varying academic, speech, concentration, activity, and related symptoms characterizing learning disabled persons seem to be shaped by a diverse group of cerebellar-vestibular-determining mechanisms rather than distinct neurophysiological disorders; also, (3) cerebellar-vestibular dysfunctioning and learning disabilities may secondarily trigger altered and/or compensatory cerebral processing and dominance mechanisms. (4) The cerebral cortex apparently plays a vital, compensatory role in shaping the final symptoms. A cerebellar-vestibular basis of learning disabilities is proposed. This conceptualization is consistent with, encompasses, and/or readily explains most of these clinical diagnostic, therapeutic, and research data as well as the many and varied hypotheses.

A double‐blind study of verapamil in the treatment of stuttering

ABSTRACTThis paper investigates the statement by Zachariah (The Antiseptic, 1980, Vol. 77, pp. 87–88) that low dose verapamil was effective in controlling stuttering in a majority of patients when compared to placebo. Fourteen subjects were studied over 6 weeks through a double‐blind trial which looked at the speech symptoms, physiological changes and individual subjective ratings of speech. No significant differences were found between the periods of verapamil treatment and placebo.

On the Role of Psychometric Tests Played in Grasping Aphasic Symptoms

Sixty-eight variables, consisting of the results of 25 subtests of the “Standard Language Test of Aphasia” (SLTA) and 43 speech symptom variables evaluated from conversational speech, were classified by the cluster analysis method. The relatively high similarities among the subtests within SLTA, and the relatively low similarities between SLTA-subtests and the other speech symptoms and among the speech symptoms themselves are shown in the dendrogram. These results suggest thst many aspects of the speech symptoms of aphasia cannot be fully grasped by the SLTA used as a psychometric test-battery.

Iterative Patterns of Phonemic and Semantic Variations in a Case of Jargonaphasia.

Two kinds of speech symptoms observed in a jargon aphasic was reported ; “the iterative pattern of phonemic variation and semantic variation” . The former is the same as the stereotypic pattern of alliteration and assonance of neologism, which was described by Green (1969). The latter, which we described for the first time in this paper, is characterized by a series of several words which have closely semantic relations each other or belong to the same semantic category. So the iterative pattern of phonemic variation (=alliteration and assonance) is characteristic to neologistic jargon, as that of semantic variation is suggested to be characteristic to a certain type of the semantic jargon.

Speech symptoms associated with early signs of Shy Drager syndrome.

Speech disturbances reflecting impaired laryngeal control were found in ten patients whose autonomic dysfunction was associated with central neurological disease (Shy Drager Syndrome). In contrast, ten patients with progressive autonomic failure without evidence of CNS involvement had no difficulties on speech function tasks in comparison with normal controls. Presence of speech symptoms may aid in the clinical differentiation between patients with pure autonomic dysfunction and those with central neurological involvement.

Dysarthric symptomatology of Friedreich's ataxia

Subjective judgments of 16 speech dimensions were used to rate the speech of 22 Friedreich's ataxics. The study attempted to determine what groupings of speech dimensions describe the ataxic speech and if the subjects could be grouped by their speech symptoms. The results indicated that two speech factors were present, a general dysarthric factor and a phonatory stenosis factor. Subject groupings revealed three groups, the first characterized by a general dysarthria without vocal stenosis, the second characterized by phonatory stenosis and mild general dysarthric symptoms, and the third characterized by mild symptoms on both speech factors. Evidence was presented to show that more than one pattern of dysarthria could occur in one family.

Cluttering as a Complex of Learning Disabilities

The purpose of this paper is to identify support for cluttering as a syndrome of learning disability symptoms. According to Van Riper (1970), American speech-language pathologists consider cluttering to be a fluency problem. Consequently, many do not fully understand the diverse speech, language, and behavioral symptoms which typify the disorder. Cluttering was first considered a psychological incongruity with speech manifestations as the foremost symptom (Froeschels, 1946). More recent descriptions of cluttering emphasize an hereditary or constitutional central nervous system disability affecting all modalities of communication and general behavior (Freund, 1952; 1970). The syndrome may be more adequately defined when viewed as a complex of learning disabilities. A review of literature is summarized for both cluttering and learning disabilities, in which it is apparent the two groups exhibit striking resemblances. All major cluttering symptoms fit three basic categories consistent with learning deficits: language disorders in all modalities, speech disturbances, and perceptual/motor deficits. A fourth, seemingly unique yet universally noted characteristic involves the person's lack of awareness of his disabilities. A case study of a 22-year-old male is presented, which supports the strong affiliation between cluttering and learning disabilities. Clinical implications concerning the, need for thorough assessment of individuals complaining of prosody disorders are discussed.

Anterior pituitary hormone secretion in chronic schizophrenia--an approach to neurohumoral mechanisms.

Prolactin, FSH, LH and TSH were determined in repeated samples of serum from 16 unmedicated male patients with chronic schizophrenia. Changes in the mental states between the 2 occasions were related to changes in hormone levels. Significant inverse correlations were established between prolactin and incoherence of speech, between prolactin and total positive symptoms and between FSH and poverty of speech. A significant positive correlation was established between FSH and delusions. These findings are discussed in the context of evidence concerning the role of monoamines in the control of anterior pituitary function, and of the dopamine and other monoamine hypotheses of schizophrenia. Although prolactin secretion was not as low, as would be predicted on the basis of the dopamine overactivity hypothesis of schizophrenia, the relationship between symptom change and change in prolactin secretion was consistent with the hypothesis that increasing symptom severity is associated with increasing dopamine release from the tubero-infundibular system.

Deviant speech characteristics in motor neuron disease.

Speech and language characteristics of motor neuron disease (MND) change with disease progression. In this study, symptoms most prevalent in general also occurred in the early stages of the disease. These were not the most characteristic or severe in later stages, although present. As neurological symptoms became more severe, the predominant speech and language characteristics changed to severe abnormalities. It is, therefore, difficult to assign specific patterns of speech and language symptoms characteristic of all MND patients at all stages of the disease. A low but positive correlation existed between length of illness and number of shared (co-occurring) dimensions (severity). Neurological symptoms of tongue atrophy and dysphagia were most strongly related to decrease in intelligibility of speech; abnormal pulmonary function and difficulty breathing were least involved with speech disorders.

A Qualitative and Quantitative Evaluation of Parkinsonians Three to Six Years Following Thalamotomy (Part 2 of 2)

Seventy-eight patients with parkinsonism have been assessed over a postoperative interval of 3–6 years from 3 major aspects: (1) history and physical examination, (2) specific psychological tests, and (3) a battery of clinical quantitative neurological tests. The results were separated into the effects of (1) the first thalamotomy, (2) the second thalamotomy, and (3) thalamotomy plus <i>L</i>-dopa therapy. <i>1. The first thalamotomy. </i>Contralateral tremor and rigidity both responded well to surgery in the qualitative and quantitative evaluations and remained at an improved level for about three years. Although general function was also usually improved over this interval, removal of tremor and rigidity did not guarantee functional improvement. Progression in bradykinesia, speech and mental symptoms did not change with thalamotomy. <i>2. The second thalamotomy. </i>The results were similar but not as good quantitatively nor as enduring as those of the first thalamotomy. An adverse effect on mental symptoms was seen more frequently. <i>3. Thalamotomy plus </i><i>L</i><i>-dopa. </i>The drug appeared to have specific action on bradykinesia, appeared synergistic with surgery in relieving rigidity and to a lesser degree, tremor. <i>L</i>-Dopa-resistent tremor responded to thalamotomy as well as the general tremor category in the pre-<i>L</i>-dopa period. Thalamotomy usually prevents iatrogenic <i>L</i>-dopa-induced dyskinesias in the limbs contralateral to the side of surgery, but had no certain effect upon the commoner facial and axial dyskinesias.

A qualitative and quantitative evaluation of parkinsonians three to six years following thalamotomy.

Seventy-eight patients with parkinsonism have been assessed over a postoperative interval of 3–6 years from 3 major aspects: (1) history and physical examination, (2) specific psychological tests, and (3) a battery of clinical quantitative neurological tests. The results were separated into the effects of (1) the first thalamotomy, (2) the second thalamotomy, and (3) thalamotomy plus <i>L</i>-dopa therapy. <i>1. The first thalamotomy. </i>Contralateral tremor and rigidity both responded well to surgery in the qualitative and quantitative evaluations and remained at an improved level for about three years. Although general function was also usually improved over this interval, removal of tremor and rigidity did not guarantee functional improvement. Progression in bradykinesia, speech and mental symptoms did not change with thalamotomy. <i>2. The second thalamotomy. </i>The results were similar but not as good quantitatively nor as enduring as those of the first thalamotomy. An adverse effect on mental symptoms was seen more frequently. <i>3. Thalamotomy plus </i><i>L</i><i>-dopa. </i>The drug appeared to have specific action on bradykinesia, appeared synergistic with surgery in relieving rigidity and to a lesser degree, tremor. <i>L</i>-Dopa-resistent tremor responded to thalamotomy as well as the general tremor category in the pre-<i>L</i>-dopa period. Thalamotomy usually prevents iatrogenic <i>L</i>-dopa-induced dyskinesias in the limbs contralateral to the side of surgery, but had no certain effect upon the commoner facial and axial dyskinesias.

Mother-child interaction and its relationship to speech disorders

The family dynamics model proposes that role development and symptom behavior can have functional value in stabilizing family relationships. Functional articulatory disorders were postulated to be explained as “scapegoat” role behavior within this model. The study gathered data about mothers' verbal behavior toward two of her children — one with a functional articulatory disorder and one speech-symptom free. The results showed that these mothers did not treat their children differently on the basis of the speech symptom under non-achievement oriented conditions and where the speech-symptom child was the older sibling. Under achievement conditions and when the speech-symptom child was younger, mothers were more directive and supportive and also more negative toward the speech-symptom child. The results are interpreted as consistent with the “scapegoat” explanation and the model is seen as having application in treating children with functional articulatory speech defects.

Speech pathology and symptom therapy in the interdisciplinary treatment of psychogenic aphonia.

No AccessJournal of Speech and Hearing DisordersResearch Article1 Nov 1969Speech Pathology and Symptom Therapy in the Interdisciplinary Treatment of Psychogenic Aphonia Arnold E. Aronson Arnold E. Aronson Mayo Clinic, Mayo Graduate School of Medicine, Rochester, Minnesota Google Scholar More articles by this author https://doi.org/10.1044/jshd.3404.321 SectionsAboutPDF ToolsAdd to favoritesDownload CitationTrack Citations ShareFacebookTwitterLinked In Additional Resources FiguresReferencesRelatedDetailsCited by Journal of Voice1 Nov 2021A Comparison of Voice and Psychotherapeutic Treatments for Adults With Functional Voice Disorders: A Systematic ReviewHeidi Gray, Leah Coman, Chloe Walton, Sarah Thorning, Elizabeth Cardell and Kelly A. Weir Nippon Jibiinkoka Gakkai Kaiho121:12 (1474-1478)20 Dec 2018機能性発声障害の診断と治療 The Egyptian Journal of Otolaryngology33:4 (679-684)1 Oct 2017Successful management of functional aphonia using a modified voice therapy technique: a case seriesAboloyoun I. Ali, Marglani Osama, Elmorsy A. Soha, El Kholy M. Rasha and Farooq U. Mian Nippon Jibiinkoka Gakkai Kaiho117:9 (1173-1178) HNO61:8 (678-682)1 Aug 2013Psychogene AphoniePsychogenic aphoniaC.-A. Bader and B. Schick Mara Behlau and Thomas Murry (2012) International and intercultural aspects of voice and voice disorders Communication Disorders in Multicultural and International Populations10.1016/B978-0-323-06699-0.00019-4 Journal of Voice25:1 (62-66)1 Jan 2011Differences in Temporal Variables Between Voice Therapy Completers and DropoutsCarissa Portone-Maira, Justin C. Wise, Michael M. Johns and Edie R. Hapner Contemporary Issues in Communication Science and Disorders37:Fall (131-140)1 Oct 2010Using Manual Tension Reduction Treatment in Treating Pediatric Functional DysphoniaBridget A. Russell Estudos de Psicologia (Campinas)26:2 (227-236)1 Jun 2009Disfonia funcional psicogênica por puberfonia do tipo muda vocal incompleta: aspectos fisiológicos e psicológicosCarla Aparecida Cielo, Bárbara Costa Beber, Celina Rech Maggi, Daiane Körbes, Clarissa Flores Oliveira, Danúbia Emanuele Weber and Aline Ramos Tusi International Journal of Speech-Language Pathology10:4 (210-230)1 Jan 2008The role of psychogenic and psychosocial factors in the development of functional voice disordersJanet Baker History of Psychiatry19:3 (339-357)1 Sep 2008Electrotherapy and mental illness: then and nowSander L. Gilman Celia F. Stewart and Elizabeth Allen Voice Therapy for Unilateral Vocal Fold Paralysis Vocal Fold Paralysis10.1007/3-540-32504-2_7 Journal of Voice17:3 (308-318)1 Sep 2003Psychogenic voice disorders and traumatic stress experience: a discussion paper with two case reportsJanet Baker Logopedics Phoniatrics Vocology27:2 (84-91)1 Jan 2002Psychogenic voice disorders--heroes or hysterics? A brief overview with questions and discussionJanet Baker Current Opinion in Otolaryngology & Head and Neck Surgery7:3 (125)1 Jun 1999The efficacy of voice treatmentDouglas M. Hicks Journal of Speech, Language, and Hearing Research41:1 (S101-S116)1 Feb 1998Treatment EfficacyLorraine Olson Ramig and Katherine VerdoliniLanguage, Speech, and Hearing Services in Schools27:3 (257-270)1 Jul 1996Management of Functional Voice Disorders in AdolescentsRobert C. Peppard Otolaryngologic Clinics of North America24:5 (1059-1073)1 Oct 1991Functional Voice DisordersJames A. Koufman and P.David Blalock Journal of Psychosomatic Research31:4 (483-490)1 Jan 1987The psychiatric and social characteristics of patients with functional dysphoniaAllan House and Harry B. Andrews Psychiatry47:3 (211-232)1 Aug 1984Psychotherapy with the Hysterical Personality: An Interpersonal ApproachJohn D. W. Andrews The Canadian Journal of Psychiatry30:1 (71-73)1 Feb 1984Conversion Mutism: Case Report and DiscussionL.U. Thorpe, D.L. Keegan and G.A. Veeman Journal of Communication Disorders16:1 (63-66)1 Feb 1983Cough offset schwa as a means of eliciting initial phonation in functional aphonia: Two case reportsJohn K. Torgerson Archives of Oto-Rhino-Laryngology227:1-2 (171-345)1 Apr 1980Funktionelle Stimmst�rungen und ihre BehandlungFunctional disorders of the voice and their treatmentG�nther Habermann Journal of Behavior Therapy and Experimental Psychiatry6:1 (75-78)1 Apr 1975Behavioral treatment of functional aphoniaRobert C. Marshall and Mary T. Watts Volume 34Issue 4November 1969Pages: 321-341 Get Permissions Add to your Mendeley library History Published in issue: Nov 1, 1969PubMed ID: 5349139 Metrics Topicsasha-topicsasha-article-typesleader-topicsCopyright & PermissionsCopyright © 1969 American Speech-Language-Hearing AssociationPDF downloadLoading ...

SPEECH AND LANGUAGE DISORDERS IN PRESCHOOL CHILDREN: A PREVENTIVE APPROACH

From 4 to 9% of elementary school children with normal to superior intelligence exhibit symptoms of developmental speech and language disorders, such as: stuttering (or stammering);* severely defective articulation in the absence of hearing loss; and finally the syndrome of multiple perceptual, motor, and language disorder. These developmental deviations or disorders interfere markedly with early school adaptation. If no adequate help is forthcoming the symptoms may increase in severity and interfere with the achievement and social adaptation of the children concerned. The sex ratio reported has been, as a rule, 75% boys to 25% girls. The importance of the preschool years for language development has been established in many studies.1, 2 McCarthy referred to the "amazingly rapid acquisition of an extremely complex system of symbolic habits by young children,"1 while Penfield and Roberts3 mentioned the "biological time table for language learning," and assumed that the most intensive learning occurs between 2 and 4 years of age. Studies in language development carried out earlier in the century were mostly normative, focusing upon the number of different sounds and words mastered by the majority of children at a given age1, 4, 5 Thus we expect the "average" child to begin using his first words between 10 and 18 months of age, to master approximately 300 words at age 2, and approximately 1,000 words at age 3. In a more recent study, Templin compared her findings concerning children's learning of consonant sounds with those of other investigators.6 The pediatrician, trying to evaluate a child's stage of language development may want to know what specific sounds a child should be able to master at what particular age.

DISTURBANCES OF SPATIAL ORIENTATION AND VISUAL ATTENTION, WITH LOSS OF STEREOSCOPIC VISION

The following case is placed on record as it is an excellent example of a type of special disturbances of vision which claim our interest, not only on account of their relative rarity, but chiefly because they throw considerable light on the functions and modes of activity of the cerebral cortex, and particularly on those processes which are concerned in the integration and association of sensations. The case is described at length as the patient exhibited many symptoms which could be fully understood only when carefully studied and analyzed. We were particularly fortunate in that he was an intelligent, willing and objective witness, and had no disturbances of speech, or motor or sensory symptoms that could complicate our observations. On the other hand, we have made our discussion of his condition as concise as possible with due regard to clearness, more especially as one of us has recently recorded six

NERVOUS SYMPTOMS FOLLOWING SUNSTROKE

During the summer of 1911, because of the excessive heat there were more than the usual number of cases of heat exhaustion. It seemed to me, therefore, that a discussion of some of the resulting nervous symptoms would not be inappropriate. Of the number of cases seen in the course of years two are here reported because of their unusual character. The first was that of a patient in whom a severe sunstroke was followed by multiple nervous lesions producing acute cerebellar ataxia, loss of speech and spastic symptoms, an unusual combination. The second was that of a cook in whom because of overheating there occurred muscular spasms. The interesting feature was that he had an old poliomyelitis of one leg. In spite of this the muscular spasms were just as marked in the palsied limb as elsewhere, this being an interesting contribution to the theory that the spasms are

POST-DIARRHŒAL ACUTE ATAXIA.

Dr. Henry J. Berkley, in the<i>Johns Hopkins Hospital Bulletin</i>, February, gives an instructive case of pseudo-tabes following an attack of diarrhœa. This is probably the first recorded case of its kind, and affords room for possible differences of opinion as to etiology; the argument ofDr. Berkley, however, is well sustained, and worthy of being weighed by his co-laborers. The term " acute ataxia" has been employed byProfessor Leyden, of Berlin, in<i>Zeitschrift für klinische Medicin</i>, 1891, to describe certain cases of suddenly beginning ataxia of movement; first, the cerebral variety, characterized by disturbances of speech and psychical symptoms in addition to the ataxic phenomena; and second, the sensible, marked by the presence of various anæsthesias and paræsthesias, without psychical complication. With both these types there may be paralyses, or they may be absent in both. Following certain of the infectious diseases, notably typhus fever and diphtheria, there may