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Biomedical subjects

John Van Borsel

Publications and source records attributed to John Van Borsel.

17 recordsLinked to original sources

Assessment of stuttering in a familiar versus an unfamiliar language.

UNLABELLED: The present study investigated how well individuals knowledgeable about stuttering are able to make disfluency judgments in clients who speak another language than their own. Fourteen native speakers of Brazilian Portuguese identified and judged stuttering in Dutch speakers and in Portuguese speakers. Fourteen native speakers of Dutch identified and judged stuttering in Brazilian Portuguese speakers and in Dutch speakers. It was found that judges can make similar level of judgment in a native and a foreign language, and that native and foreign judges can make similar level of judgment irrespective of native/foreign differences. It was also found, however, that the Dutch judges performed significantly better in identifying native stutterers than foreign stutterers. And for the identification of nonstutterers, both panels performed better in their native language than in the foreign language, and in their native language they both performed better than the other panel. Both the Brazilian Portuguese and the Dutch speaking panel were generally also less confident, and found identification of stuttering more difficult in the foreign language than in the native language. In addition, when asked for the characteristics that helped them identify stutterers, they provided more detail in the native language than in the foreign language. Also a number of differences were found between the two panels which may be due to differences in training or cultural background. The implications of the findings for clinical practice and for future research in this area are discussed. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) describe how language influences the identification of a speech disorder such as stuttering, and (2) list, and (3) define behaviors that help to identify stuttering in a foreign language.

Adolescent↗

Speech disruption under delayed auditory feedback in multilingual speakers.

UNLABELLED: The present study investigated the language familiarity hypothesis formulated by Mackay [(1970). How does language familiarity influence stuttering under delayed auditory feedback? Perceptual and Motor Skills, 30, 655-669] that bilinguals speak faster and stutter less under delayed auditory feedback (DAF) when speaking their more familiar language than a less familiar language. Thirty normally fluent native speakers of Dutch (17 males and 13 females, aged between 18;1 and 26;4 years) who were also proficient in French and English read meaningful and nonsense text under DAF in their mother tongue and in the two later acquired languages. The existence of a language familiarity effect was confirmed. The participants required significantly more time and showed significantly more speech disruptions under DAF in the later acquired languages than in the mother tongue, and reading time and number of speech disruptions was significantly higher for the nonsense texts than for the meaningful text for each of the three languages. An additional question addressed was whether or not there were any gender differences in the susceptibility to DAF. Results did not reveal a clear gender difference. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) summarize the importance of language familiarity for the degree of speech disruption experienced by normally fluent multilingual speakers under delayed auditory feedback; and (2) describe gender differences in the susceptibility to delayed auditory feedback.

Adolescent↗

The effects of levodopa on word intelligibility in Parkinson's disease.

Dysarthria is a common manifestation in patients with idiopathic Parkinson's disease. This study investigated the effects of levodopa on intelligibility in patients with Parkinson's disease. Ten participants were tested during on- and off-states using the Yorkston and Beukelman intelligibility test (1980). Intelligibility as scored by a panel of speech therapists was significantly improved in the on-condition. No correlation was found, however, between intelligibility and overall severity of the disease or severity of the motor problems. EDUCATIONAL OUTCOMES: As a result of this activity the participant will be able to discuss the effects of levodopa on intelligibility in patients with Parkinson's disease.

Aged↗

A comparative investigation of the speech-associated coping responses reported by adults who do and do not stutter.

UNLABELLED: The Behavior Checklist, a self-report test procedure, was administered to 42 adults who stutter and 76 who do not in order to investigate the number, frequency of usage, type and nature of the responses that they reportedly employ to cope with the anticipation and/or presence of speech disruption. As a group, the participants who stutter reported a significantly greater number of speech-associated coping responses and a greater use of them than their nonstuttering peers did. Moreover, factor analysis made apparent fundamental between-group differences in the type and nature of certain forms of the coping responses reported by those who stutter and those who do not. This suggests that the quantitative and qualitative differences in the coping responses of those who do and do not stutter are potentially useful with respect to differential diagnostic and therapeutic decision making. EDUCATIONAL OBJECTIVES: (1) The reader will be able to describe differences in the number, frequency and types of coping behaviors used by PWS and PWNS. (2) The reader will be able to list similarities and differences in the type and nature of coping behaviors used by PWS and PWNS. (3) The reader will be able to discuss the features and use of the Behavior Checklist, a self-report procedure for assessing the responses used by adults to cope with the anticipation and occurrence of speech disruption.

Adaptation, Psychological↗

Multilingualism: an fMRI study.

To investigate the hypothesis that in multilingual speakers different languages are represented in distinct brain regions, 12 multilingual right-handed men performed a word fluency task, a picture naming task, a comprehension reading task, and their respective control tasks in three languages (Dutch, French, and English) while whole-head functional magnetic resonance imaging (fMRI) was applied. In general, all language tasks revealed predominantly overlapping regions of activation for the different languages. Cerebral activation during use of the foreign languages showed a tendency toward a more extensive recruitment of the areas activated in the native language and the activation of a greater number of regions. Word generation in the foreign languages elicited additional bilateral inferior frontal activation, including Broca's area and left middle temporal gyrus activation; in the native language, additional postcentral activation was found. Picture naming in the foreign languages recruited additional inferior-lateral and medial frontal regions predominantly on the left, and more posterior right hemispheric activation in the mother tongue. During comprehension reading there was more activation in medial posterior regions in the native language. Our results suggest that the performance of language tasks in different languages engages largely the same cerebral areas but that the brain, to perform at a comparable proficiency level, engages more neural substrates for later acquired languages. Our findings do not support the view that languages learned later in life entail more right hemispheric involvement. Finally, a consequent effect of language exposure was found for reading, where increased familiarity engages more occipital activation whereas decreased familiarity appears to be associated with increased left hemispheric inferior frontal activation.

Adult↗

fMRI of developmental stuttering: a pilot study.

The purpose of this investigation was to explore the feasibility of fMRI in the study of developmental stuttering. Speech contrasts (loud versus silent reading) and language contrasts (reading of semantically meaningful text versus nonsense words) of six developmental stutterers and six nonstutterers were compared using a commercial 1 Tesla MR-Scanner (Siemens Expert). Results indicate that mapping cortical function in persons who stutter is indeed feasible, even with a 1TMR-system. Compared to normals the stutterers seemed to employ different and particularly less differentiated auditory and motor feedback strategies in speech. They apparently rely on auditory processing and on cerebellar contribution as much during silent reading as during reading aloud. Moreover, they showed a greater involvement of the right hemisphere in language processing, activating not only the typical language areas on the left but also and with equal magnitude the right side homologues of these areas. In spite of the promising results, at present several practical problems such as possible movement artifacts and possible masking through scanner noise still hamper a more straightforward use of fMRI in the study of developmental stuttering.

Adult↗

Thalamic stuttering: a distinct clinical entity?

A 38-year-old right-handed male with no history of speech or language problems presented with neurogenic stuttering following an ischaemic lesion of the left thalamus. He stuttered severely in propositional speech (conversation, monologue, confrontation naming, and word retrieval) but only slightly in non-propositional speech (automatic speech, sound, word and sentence repetition, and reading aloud). It is suggested that thalamic stuttering may constitute a distinct clinical entity.

Brain↗

Lateralized effects of subthalamic nucleus stimulation on different aspects of speech in Parkinson's disease.

In this report, we have analyzed the effects of left and right STN stimulation separately on different aspects of speech. Significant differences were found between left and right stimulation. It appears that selective left-sided stimulation has a profoundly negative effect on prosody, articulation and hence intelligibility. Right-sided stimulation does not display this side-effect. There is no significant difference in speech characteristics between bilateral stimulation on and off. We suggest that a balanced tuning of bilateral basal ganglia networks is necessary for speech, and that the left circuit is probably dominant.

Adult↗

Acquired stuttering following right frontal and bilateral pontine lesion: a case study.

We report neurological information and experimental data regarding acquired neurogenic stuttering in a 57-year-old male following ischemic lesion to the orbital surface of the right frontal lobe and the pons. The experimental data consist of stuttering frequency measures under various conditions that are well known to enhance fluency in most individuals with developmental stuttering. Specifically, we report data for adaptation, unison reading, delayed auditory feedback (DAF), and frequency altered feedback (FAF). This work is the first published report of such a comprehensive examination of a variety of fluency-enhancing conditions in acquired stuttering. The patient read six 200-word texts under different conditions: Six solo readings (Text 1), five unison readings followed by five solo readings (Text 2), five readings with non-altered auditory feedback (Text 3), five readings with 50 ms delayed auditory feedback (Text 4), five readings with increased FAF (Text 5), and five readings with decreased FAF (Text 6). Results indicate that, unlike the typical situation for developmental stuttering, this individual with acquired neurogenic stuttering did not show increased fluency during an adaptation paradigm or under unison, DAF, and FAF conditions. We discuss possible implications of these findings and emphasize the need for further research on acquired neurogenic stuttering.

Acoustic Stimulation↗

The effects of levodopa on tongue strength and endurance in patients with Parkinson's disease.

The aim of this study is to investigate the effects of levodopa on measures of strength and endurance of tongue muscle contraction in patients with Parkinson's disease (PD). Ten patients with idiopathic PD were included. All patients were studied in practically defined on- and off-phases. They were asked to perform isometric tongue protrusions, which were registered by means of a calibrated tocograph. Results of on- and off-conditions were compared using non-parametric tests. Maximum force and contraction duration did not differ significantly between both conditions, but the integrated measurement of both (area under curve) was significantly larger in the on-state. The force decay slope was significantly lower in the on-state. No correlations were found with disease severity, disease stage or age. These findings fit the known pathophysiological effects on patterns of isometric muscle contraction in PD. It remains to be demonstrated if the effects of levodopa on tongue strength and endurance correlate with alterations in speech intelligibility, articulation and respiration.

Aged↗

Nasalance, nasality, voice, and articulation after uvulopalatopharyngoplasty.

OBJECTIVES/HYPOTHESIS: The main purpose of the study was to determine the impact of uvulopalatopharyngoplasty (UPPP) on nasalance and nasality. It was hypothesized that nasalance would change from the presurgical to the postsurgical condition because the surgical protocol involves removal of palatal tissue. An additional objective of the study was to provide objective and subjective data about changes in voice and articulation after UPPP. Because the surgical procedure of UPPP does not involve laryngeal tissue, it was hypothesized that the voice characteristics remain relatively stable. Because of removal of effective velar length, articulation problems of the uvular /R/ can occur in the Dutch language. STUDY DESIGN: Prospective study in which 26 men were studied before (1 week before UPPP) and after (3 weeks after UPPP) surgery. METHODS: The Nasometer was used to obtain nasalance scores. The mirror-fogging test, a perceptual evaluation of each subject's readings, and the Gutzmann and the Bzoch hypernasality tests were used for the assessment of nasality. For the assessment of articulation, a phonetic analysis was performed. Voice assessment included a perceptual rating of the voice and a determination of fundamental frequency. RESULTS: No significant differences were found between the conditions before and after surgery regarding nasalance (except for the vowel /i/), nasality, and voice. Regarding articulation, only 1 patient showed a derhotacized /R/. CONCLUSIONS: The findings of the study indicate that UPPP does not have an impact on nasality, voice, and articulation. Regarding nasalance, no significant nasalance change occurred after UPPP, except for the high vowel /i/.

Adult↗

Foreign accent syndrome: an organic disorder?

This paper reports the case of a 32-year-old Dutch speaking woman who presented with foreign accent syndrome (FAS). There are good reasons to believe that the speech disturbance in this patient was of psychogenic origin. This case suggests that attested brain damage is not a prerequisite for a speech disorder to qualify as FAS and that FAS is not necessarily linked to another neurogenic speech disorder. It is argued that FAS is not a syndrome in its own right but only exists in the ears of the beholder. LEARNING OUTCOME: Readers will be able to describe the features that are believed to be typical of the foreign accent syndrome. Readers will be able to summarize the arguments that can be adduced to consider the foreign accent syndrome as an epiphenomenona.

Adult↗

Articulation in Prader-Willi syndrome.

UNLABELLED: This study investigated articulation in 13 individuals with Prader-Willi syndrome (PWS), chronological age from 7; 0 to 29; 5, total IQ from 38 to 83. To elicit a speech sample a picture-naming test was used. Pictures were chosen so that, when named correctly, they yield a sample containing instances of all Dutch single speech sounds and clusters in all permissible syllable positions. All samples were transcribed phonetically by a stringent transcription procedure, and reliability of the transcription was assessed both by an intra-observer and inter-observer reliability check. The transcribed speech samples were subjected to several analyses as to characterize articulation from different perspectives. It was found that articulation in persons with PWS is usually impaired. Results suggest that the overall error rate is a function of IQ, and that with increasing age, phonological problems gradually resolve while phonetic difficulties become more evident. LEARNING OUTCOMES: The reader will learn about (1) clinical characteristics, etiology, incidence, and prevalence of Prader-Willi syndrome; (2) speech and language difficulties in Prader-Willi syndrome; (3) articulation characteristics in Prader-Willi syndrome.

Adolescent↗

Speech and language in Wolf-Hirschhorn syndrome: a case-study.

UNLABELLED: Wolf-Hirschhorn syndrome (WHS), a condition resulting from a distal deletion of the short arm of chromosome 4, is usually associated with a severe phenotypic expression including multiple malformations, delayed psychomotor development, and profound learning disabilities. As far as communicative development is concerned, speech is usually absent and comprehension is limited to simple orders or to a specific context. There is some suggestion, however, that the developmental outcome in WHS depends on deletion size. This paper reports on an individual with WHS illustrating that a smaller deletion may result in a milder phenotype with respect to communicative abilities. This 10-year-old girl developed speech and language to a considerable degree. Although most children with this syndrome are severely limited in communicative abilities, the school-based speech-language pathologist working with a special education caseload may encounter WHS children with smaller deletions (and thus less severe phenotypes) who may profit from speech language pathology services. LEARNING OUTCOMES: The reader will learn about the genetics, incidence, and clinical characteristics of Wolf-Hirschhorn syndrome, and about the communicative abilities and genotype/phenotype correlations in children with this syndrome.

Carrier Proteins↗

Delayed auditory feedback in the treatment of stuttering: clients as consumers.

PURPOSE: To investigate the effect of repeated exposure to delayed auditory feedback (DAF) during a 3-month period outside a clinical environment and with only minimal clinical guidance on speech fluency in people who stutter. METHOD: A pretest-post-test design was used with repeated exposure to DAF during 3 months as the independent variable. Nine stuttering individuals aged between 18 and 45 years served as subjects. Videotaped samples from different speech tasks were collected before and after 3 months' exposure to DAF, each time under two conditions: first during non-altered feedback (NAF) and subsequently during DAF. RESULTS: Before the repeated exposure to DAF, the percentage of stuttered words was significantly higher during NAF than during DAF. After 3 months' exposure to DAF, the percentage of stuttered words during NAF had dropped to a non-significant level in comparison with the DAF condition. Comparison of the percentage of stuttered words during NAF before and after repeated exposure to DAF showed significantly less stuttering after the repeated exposure to DAF. The percentage of stuttered words during DAF was generally somewhat higher, but not significantly so, after the 3 months' repeated exposure to DAF than before the exposure to DAF. CONCLUSIONS: Results confirm that DAF is an effective means of reducing stuttering even when employed as the only treatment approach outside a therapeutic environment. They also suggest that DAF continues to promote fluency when used over a longer period, but also that length of exposure and fluency enhancement are probably not in a linear relationship.

Adolescent↗

Voice and resonance disorders in genetic syndromes: a meta-analysis.

It is well known that many genetic syndromes are associated with communication disorders and especially with disorders of voice and resonance. This paper reports the results of a meta-analysis with the aim of documenting the occurrence of voice and resonance disorders in genetic syndromes. The analysis studied the occurrence of voice and resonance disorders in general, the occurrence in different etiological subtypes of syndromes and the association with other disorders, in particular clefting, a cognitive impairment and hearing problems. The database for the analysis was a list by Sphrintzen of 299 different syndromes all of which have been reported to entail communication disorders. Major findings are that disorders of voice and resonance in genetic syndromes are only rarely isolated problems, that causal mechanisms are not a major factor in determining the presence of voice and resonance disorders and, foremost, that voice and resonance disorders in genetic syndromes constitute an underresearched area.

Cognition Disorders↗

Another case of word-final disfluencies.

It has commonly been thought that stuttering and related disfluencies do not occur at the end of words. However, word-final disfluencies have been documented in the literature and may be underreported at present. This study investigated word-final disfluencies as they occurred in a 12-year-old boy. Word-final disfluencies constituted the major type of disfluencies in this individual and most often involved repetition of a linguistic unit larger than a singleton consonant. They occurred more frequently on content words than on function words, more frequently on multisyllabic words than on monosyllabic words, and more frequently at the end of a phrase than in initial or medial position. A direct therapy approach, aimed first at identification and then at suppression of the final repetitions, resulted in complete elimination of these repetitions. The origin of these word-final disfluencies and their resemblance to palilalia are discussed.

Awareness↗