Background The health-related quality of life (HRQOL) of tonsillar carcinoma survivors was explored to investigate any HRQOL differences associated with tumor stage and treatment. The survivors HRQOL was also compared to reference scores from the population. Methods In this exploratory cross-sectional study patients were invited 15 months after their diagnosis and asked to answer two quality of life questionnaires (EORTC QLQ- C30, EORTC QLQ- HN35), 405 participated. Results HRQOL was associated with gender, with males scoring better than females on a few scales. Patients HRQOL was more associated with treatment than tumor stage. Patients HRQOL was worse than that in an age- and sex-matched reference group from the normal population, the largest differences were found for problems with dry mouth followed by problems with sticky saliva, senses, swallowing and appetite loss. Conclusions The tonsillar carcinoma patients had a worse HRQOL compared to the general population one year after treatment.

Prosody can be defined as the rythmic, dynamic and melodic aspects of speech. Without prosody, speech would sound monotonous and communication could be obstructed. The aim of the present study was to examine prosodic aspects of nonword repetition by children with cochlear implants and children with language impairment. Previous studies of prosody in these groups have not in detail described what kinds of errors that occur and therefore this is interesting to investigate.

The present study is based on previously collected data of nonword repetition among a total of 41 children, all participating in previous studies. Of these children, 27 were children with language impairment aged between 4:6-7:6 years. Fourteen were children with CI aged between 3:0-13:4. The recorded data was transcribed and analyzed group wise and the mean value of the groups were calculated.

Children with CI showed prosodic problems in nonword repetition to a greater extent than children with language impairment did. Both children with language impairment and children with CI had difficulties with number of syllables, stress, tonal word accent and quantity of vowel. However, the children with CI generally made errors to a greater extent as well as more types of errors, compared to the children with language impairment. All children with CI made some type of prosodic error whilst 11 out of 27 of the language impaired children produced all the words prosodically correct. Children who were implanted at an older age showed greater difficulties with prosody than children who were implanted at a younger age.

The term elderspeak refers to the adjustments of communication towards elderly people which are similar to those made towards young children. The adjustments are made within several language domains, and are a part of the communicative environment of the elders. The subject is relatively uninvestigated, and few, if any, studies have been conducted on the subject in Sweden. Thus the aim of the present study was to investigate the possible occurrence of elderspeak, and to describe its characteristics.

The present study is based upon five participants working at different forms of geriatric institutions. Conversations between a caregiver and a resident and conversations between a caregiver and a colleague were recorded and broadly transcribed. The recordings were cut into separate files according to the purpose of respective analysis. The study was carried out with a data-driven perspective and previously established aspects of elderspeak and child directed speech was searched for.

The present study established that caregivers to a varying extent adjusted their communication within several language domains. The adjustments mainly took place within the prosodic domain but they also took place within the grammatical domain. Adjustments within the pragmatic domain were found to some extent, but no adjustments within the semantic domain were found. Tendencies to adjustments of the speech were present in the majority of the participants. The present study suggests the following additions to the aspects of the elderspeak phenomenon; frequent use of name, less hesitation phenomena and less frequent simultaneous speech. 

Continuous positive airway pressure is a common and effective treatment for obstructive sleep apnea, but adherence remains an issue. Both obstructive sleep apnea and oral diseases are associated with cardiovascular diseases, and as oral dryness contributes to treatment abandonment, oral health is of importance for this patient group. The aim was therefore to explore how persons with continuous positive airway pressure-treated obstructive sleep apnea experience situations associated with their oral health, and which actions they take to manage these. An explorative and descriptive design was adopted using the critical incident technique. Based on a purposeful selection, 18 adults with long-term experience of continuous positive airway pressure-treatment were interviewed using a semi-structured interview guide. Both negative and positive situations were described. Negative situations consisted of challenges with breathing, including mouth-breathing, choking sensations, problems with night-time and daytime oral dryness, changes in the saliva composition, and deteriorating oral health. Positive situations included experiences of reduced mouth-breathing and oral dryness. The situations were often successfully managed by mimicking daytime movements, changing sleeping position, adjusting the CPAP-device and mask, increasing oral hygiene efforts, drinking water, using a humidifier or chinstrap, or contacting their oral healthcare clinic. Long-term experience of persons with continuous positive airway pressure-treated obstructive sleep apnea regard situations and actions from everyday life. Successful management can contribute to long-term adherence and decrease negative effects on oral health. More interdisciplinary collaborations could enable identification and adequate recommendations for persons who experience negative situations during their continuous positive airway pressure treatment.

Speech comprehension depends on the successful operation of a network of brain regions. Processing of degraded speech is associated with different patterns of brain activity in comparison with that of high-quality speech. In this exploratory study, we studied whether processing degraded auditory input in daily life because of hearing impairment is associated with differences in brain volume. We compared TI-weighted structural magnetic resonance images of 17 hearing-impaired (HI) adults with those of 17 normal-hearing (NH) controls using a voxel-based morphometry analysis. HI adults were individually matched with NH adults based on age and educational level. Gray and white matter brain volumes were compared between the groups by region-of-interest analyses in structures associated with speech processing, and by whole-brain analyses. The results suggest increased gray matter volume in the right angular gyrus and decreased white matter volume in the left fusiform gyrus in HI listeners as compared with NH ones. In the HI group, there was a significant correlation between hearing acuity and cluster volume of the gray matter cluster in the right angular gyrus. This correlation supports the link between partial hearing loss and altered brain volume. The alterations in volume may reflect the operation of compensatory mechanisms that are related to decoding meaning from degraded auditory input.

Background and Objectives: Patellar tendinopathy is difficult to treat, and when combined with partial rupture, there are additional challenges. The aim of this study was to evaluate the subjective outcome and return-to-sport status after ultrasound (US)- and colour doppler (CD)-guided wide awake local anaesthetic no tourniquet (WALANT) arthroscopic shaving in elite athletes. Material and Methods: Thirty Swedish and international elite athletes (27 males) with a long duration (>1 year) of persistent painful patellar tendinopathy in 35 patellar tendons, not responding to non-surgical treatment, were included. All patients were treated with the same protocol of arthroscopic shaving, including bone removal and debridement of partial rupture, followed by at least 3 months of structured rehabilitation. The VISA-P score and a study-specific questionnaire evaluating physical activity level and subjective satisfaction with the treatment were used for evaluation. Results: At the 2-year follow-up (mean 23, range 8-38 months), 25/30 patients (29/35 tendons) were satisfied with the treatment result and had returned to their pre-injury sport. The mean VISA-P score increased from 37 (range 7-69) before surgery to 80 (range 44-100) after surgery (p < 0.05). There was one drop-out (one tendon). There were no complications. Conclusions: US- and CD-guided WALANT arthroscopic shaving for persistent painful patellar tendinopathy, including bone removal and debridement of partial rupture, followed by structured rehabilitation showed good clinical results in the majority of the elite-level athletes.

Background The vestibular evoked myogenic potential (VEMP) is a technique used to assess vestibular function. Cervical VEMPs (cVEMPs) are obtained conventionally from the sternocleidomastoid (SCM) muscle; however, the dorsal neck muscle splenius capitis (SPL) has also been shown to be a reliable target alongside the SCM in young subjects. Objective This study aimed to compare cVEMPs from the SCM and SPL in two positions across young, older, and Parkinsons disease (PD) patients. Method Experiments were carried out using surface EMG electrodes placed over the SCM and SPL. cVEMPs were measured using a 30 s, 126 dB sound stimulus with 222 individual tone bursts, while subjects were in a supine and head-turned posture (also known as the head elevation method), and in a seated head-turned posture. Results When comparing cVEMPs across positions, the incidence of supine and seated SCM-cVEMPs diminished significantly in older and PD patients in comparison with young subjects. However, no statistically significant differences in incidences were found in seated SPL-cVEMPs when comparing young, older and PD patients. SPL-cVEMPs were present significantly more often than seated SCM-cVEMPs in PD patients. Conclusions SPL-cVEMPs are not altered to the same extent that SCM-cVEMPs are by aging and disease and its addition to cVEMP testing may reduce false-positive tests for vestibulopathy.

Attending to the speech stream of interest in multi-talker environments can be a challenging task, particularly for listeners with hearing impairment. Research suggests that neural responses assessed with electroencephalography (EEG) are modulated by listener's auditory attention, revealing selective neural tracking (NT) of the attended speech. NT methods mostly rely on hand-engineered acoustic and linguistic speech features to predict the neural response. Only recently, deep neural network (DNN) models without specific linguistic information have been used to extract speech features for NT, demonstrating that speech features in hierarchical DNN layers can predict neural responses throughout the auditory pathway. In this study, we go one step further to investigate the suitability of similar DNN models for speech to predict neural responses to competing speech observed in EEG. We recorded EEG data using a 64-channel acquisition system from 17 listeners with normal hearing instructed to attend to one of two competing talkers. Our data revealed that EEG responses are significantly better predicted by DNN-extracted speech features than by hand-engineered acoustic features. Furthermore, analysis of hierarchical DNN layers showed that early layers yielded the highest predictions. Moreover, we found a significant increase in auditory attention classification accuracies with the use of DNN-extracted speech features over the use of hand-engineered acoustic features. These findings open a new avenue for development of new NT measures to evaluate and further advance hearing technology.

Recent studies of selective auditory attention have demonstrated that neural responses recorded with electroencephalogram (EEG) can be decoded to classify the attended talker in everyday multitalker cocktail-party environments. This is generally referred to as the auditory attention decoding (AAD) and could lead to a breakthrough for the next-generation of hearing aids (HAs) to have the ability to be cognitively controlled. The aim of this paper is to investigate whether cepstral analysis can be used as a more robust mapping between speech and EEG. Our preliminary analysis revealed an average AAD accuracy of 96%. Moreover, we observed a significant increase in auditory attention classification accuracies with our approach over the use of traditional AAD methods (7% absolute increase). Overall, our exploratory study could open a new avenue for developing new AAD methods to further advance hearing technology. We recognize that additional research is needed to elucidate the full potential of cepstral analysis for AAD.

Background: 

To approach isolated anterior frontal bone fracture, coronal incision is the common surgical access of choice. This approach has complications such as aesthetically undesirable scarring and alopecia along the incision line. An alternative approach to these fractures is through a supratarsal incision. The aim of the present study was to correct the frontal bone fracture, through supratarsal approach.

Methods: 

Six consecutive patients with frontal bone fracture were operated through supratarsal incision and evaluated regarding: patient cosmetic satisfaction, forehead contour, scarring, sensibility and motility in forehead and upper eyelids.

Results: 

Seven months (6–12) postoperatively, all the patients had normal mobility in the forehead and the upper eyelids and 17% (n = 1) had hypoesthesia of superior orbital nerve. The forehead contour was excellent in all patients. About 83% (n = 5) of the patients were very satisfied and 17% (n = 1) were satisfied with the surgical result.

Conclusion: 

Correction of anterior frontal bone fracture through a supratarsal approach appears to be safe and offers a sufficient exposure to the frontal bone fracture correction with excellent contouring results and no noticeable scarring.

The population over 65 years of age is increasing and health in elderly has been a subject of research for decades but voice function and vocal health has not been prioritized. The purpose of this study is to obtain reference value for the Swedish version of Voice Handicap Index (RHI) and the Throat Scale among people over 65 years of age and assess voice function and vocal health for this age group. The questions were as followed:

1) What is the reference value of RHI for people over 65 years of age? 2) What is the reference value of the Throat Scale for people over 65 years of age? 3) Is there a correlation between a self-rated VA-scale on the perceived degree of voice problems, and the self-rated RHI-/Throat Scale result? 4) Does age, gender or previous profession matter for the self-perceived voice?

In total 100 individuals participated in the study, 50 women and 50 men, between 65 and 92 years old. The reference value of RHI for people over 65 years of age was 13,4 points and the reference value for the Throat Scale was 7,7 points. Both reference values are higher than reference values for younger people. The reference value of RHI is mainly described from the high points of the participants over 85 years of age. There was a correlation between the results of the RHI/the Throat Scale and the VA-scale concerning the perceived degree of voice problems, p < .01. Age is a significant factor for self-perceived voice problems. The older the subject, the higher points scored, both on the RHI, p < .05 and the Throat Scale. The results of the Throat Scale, however, were not significant. Even though most of the participants were active the reference value of RHI and the Throat Scale was higher than the reference value for younger people. The conclusion is that the voice changes in elderly affect voice experience.

I samhället kommer vi ofta i kontakt med tvåspråkighet, så även på logopedmottagningar runt om i landet. Det kan vara svårt att genomföra språkbedömningar på barn med flera modersmål eller annat modersmål än svenska. Syftet med uppsatsen var att översätta benämningstestet "Ordracet" till arabiska och sedan använda det för att testa aktivt ordförråd. Passivt ordförråd testades med Peabody Picture Vocabulary Test III. Fonologiskt och semantiskt ordflöde testades med ordflödestestet FAS. Frågeställningarna var: Hur skiljer sig de två ordförråden hos simultant tvåspråkiga barn från ordförrådet hos enspråkiga barn? Hur skiljer sig det svenska ordförrådet från det arabiska ordförrådet inom gruppen tvåspråkiga barn? Hur ser sambandet mellan fonologiskt och semantiskt ordflöde och ordförråd ut? De tvåspråkiga barnen hade lägre resultat på arabiska än vad de enspråkiga barnen hade på svenska, både vad gäller förståelse och produktion. På svenska presterade de tvåspråkiga barnen praktiskt taget lika högt som de enspråkiga, de var alltså bättre på svenska än på arabiska. Det fanns en stor skillnad mellan grupperna på delen fonologi svenska, där de tvåspråkiga barnen fick signifikant högre resultat än de enspråkiga barnen.

Tinnitus innebär ljudperception utan extern ljudkälla. Med objektivt tinnitus avses fysikaliskt ljud eller vibrationer som alstras i huvudet, t ex på grund av turbulent flöde i ett blodkärl nära örat eller på grund av spasmer eller tremor i öronnära muskler. Objektiv kan ofta höras genom auskultation med stetoskop eller registreras med probmikrofon i hörselgången. Subjektiv tinnitus representerar den variant då hörselupplevelsen uppstår i sinnesorganets sensorineurala delar och därmed inte kan registreras objektivt. Detta är den vanligaste formen av tinnitus och uppträder som inslag i många hörselskador med helt olika orsak: vaxpropp i hörselgången, mellanöresjukdomar såsom otoskleros, cochleära skador beroende på åldersförändringar, buller eller Meniers sjukdom, och retrocochleära skador bl a ponsvinkelåkommor.

A cochlear implant (CI) is a hearing device that makes it possible for individuals who are deaf or has a severe hearing impairment to receive auditory information and develop spoken language. The pragmatic ability may be affected. In short, pragmatics may be described as the study of language use in social contexts. Pragmatic ability can be seen as the result of the individual‟s behavior as well as the underlying causes.

The aim of the present study was to describe the pragmatic ability in children with CI. An approach inspired by Conversation Analysis (CA) was used in order to highlight the various phenomena that occurred in the interaction.

Seven children with CI participated in the study, five girls and two boys. Each conversation consisted of either a child with CI interacting with a peer, or a child with CI interacting with a parent or a teacher. A total of 14 conversations were analyzed and phenomena relevant to the study were examined. To gather further information regarding the children‟s communicative behavior, Children’s Communication Checklist was filled in by parents and teachers.

The children who participated in the study constitute a heterogeneous group and there was no clear pattern when it comes to hearing-impairment and pragmatic ability. The result showed that children with CI used both specific and non-specific requests for clarification. It seems as if intelligibility on the sentence level may reflect how efficient the interaction turns out, as the children with high intelligibility were the ones who managed to solve misunderstandings the best in the conversations. Furthermore, the result demonstrated that the adult participants used a higher rate of specific requests for clarification in contrast to children with CI.

Tal är det akustiska resultatet av rörelser i talapparaten med avsikt att förmedla ett språkligt budskap (Kent, 2000). Oralmotorisk funktion är en grundläggande förutsättning för talkommunikation (Sjögreen & Lohmander, 2008). Om tal- eller oralmotoriska problem uppstår kan en tal- eller oralmotorisk diagnos ställs utifrån en utredning över dessa funktioner (McAllister, 2008). Nordiskt Orofacialt Test – Screening (NOT-S) är ett screeningmaterial som testar den oro-faciala funktionen (Bakke, Bergendal, McAllister, Sjögreen & Åsten, 2007). Materialet består av en intervju- och en undersökningsdel som är uppdelade i sex domäner vardera. En av domänerna i undersökningsdelen är tal och består av tre uppgifter A. Talar inte, B. Räkna högt till tio och C. Säg ”pataka pataka pataka”. Syftet med föreliggande studie är att undersöka om den information som erhålls i prövning med taldelen i NOT-S överensstämmer med den information som en bedömning med ett fonologiskt test ger. I studien analyserades inspelningar av 61 ljudfiler där barn i åldern 6:0-8:0 år testas med taldelen i NOT-S och kortversionen av Stora fonemtestet. Resultatet av fonemtestet transkriberades fonetiskt och utifrån dessa beräknades Percentage of Phonemes Correct. Ett gränsvärde sattes upp för att avgöra vilka som befann sig inom normalvariationen. Dessa resultat jämfördes sedan med barnens resultat på taldelen i NOT-S. Det visade sig att åtta (13,1 %) barn hamnade under gränsvärdet för normalvariation på fonemtestet vilket står i kontrast till 22 (36 %) barn som bedömdes som avvikande på NOT-S taldel enligt de fastställda kriterierna för testet. De båda delarna i NOT-S taldel fångade tillsammans upp 100 % av de som identifierades som avvikande i fonemtestet. Därutöver fångade NOT-S upp 23 % (14 barn) som inte bedömdes som avvikande i fonemtestet. Vid beräkning av taldelen i NOT-S utan den diadochokinetiska uppgiften fångades 62,5 % upp av dem som identifierades av fonemtestet. Alla de barn som fick felfria resultat på fonemtestet fick även det på NOT-S taldel. Utifrån dessa resultat bedöms NOT-S taldel och kortversionen av Stora fonemtestet inte fullt ut ge samma information om barns talavvikelser. 

Different abilities are of importance to pragmatics, there among hearing. Hearing impairment can affect language development and also pragmatic ability. The aim of the present paper was to study the pragmatic ability in terms of request for clarification in children with Hearing Impairment (HI) in conversation with children with no known hearing impairment, henceforth normally hearing (NH). The present study also describes requests for clarification sequentially in detail, and also highlights points where there may be observable differences between children with and without hearing impairment. Eight conversational pairs consisting of one child with HI and one NH child were studied. Children’s Communication Checklist (CCC) was filled out by the parents and teachers of the children with HI in order to complement the description of the pragmatic ability in children with HI. Conversation Analysis was used in order to make the study of interaction as open-minded as possible. The conversation extracts were grouped according to task or non-task oriented interaction based on the activities that occurred.

The results of the present study showed that the children with HI and NH both used non-specific and specific requests for clarification, and that these types of requests were used in both task and non-task oriented interaction. Children with HI used the non-specific request "sorry?" to greater extent in the extracts than children with NH did. In general, no differences in occurrence of specific requests were seen between children with HI and children with NH. As regards to what happened before and after requests for clarifications, no distinct differences could be established between children with HI and children with NH. In conclusion, it is not certain if and how a hearing impairment have affected the pragmatic ability, although tendencies in the conversation extracts indicated that hearing impairment sometimes affected the interaction.

The capacity to process and to remember information is a basic condition for language ability and for coming reading ability. Reading ability is strongly connected to phonological awareness, receptive vocabulary knowledge and working memory capacity. In what way hearing impairment in children affects development of cognitive skills and later on reading ability is an area that has attracted minor attention for research.

The aim with this study was to investigate changes in cognitive skills and reading ability in children with mild or moderate hearing impairment after one year of progress and furthermore if any connections between any increases of the abilities were to be found. Comparisons were made with results from age adequate normal hearing children. Moreover prosodic ability on word-level was tested this year. Eleven Swedish children aged 7:6-10:10 years participated in this study. To illustrate progress of the abilities mentioned the SIPS computer test battery and furthermore some manually given tests for reading and prosodic abilities were used.

The results show a developmental trend for the children with hearing impairment on tests of working memory and reading comprehension. The least degree of development was found in the area of phonological skills. The children with hearing impairment showed in general the same capacity as normal hearing children on tests for the different abilities. In the area of working memory the children with hearing impairment had significant lower results on half of the tests than age adequate normal hearing children. Several strong connections were present for children with hearing impairment this year than last year, in-between cognitive skills and reading ability. Correlation appeared between age for insertion of hearing aid and test for decoding ability. Results on tests for prosodic ability reached ceiling effect.

The oral sensory ability in children can be assessed through test of intraoral stereognosis and two-point discrimination. Currently, these two tests are not frequently used in clinical settings, and normative data are not always available. The aim of this study was to establish normative data for these two tests in children aged 5;6 to 7;0 years. Further, intention was to compare the results with respect to age and gender. In total 103 children participated, 49 boys and 54 girls. The participants were divided into three age-groups. The results regarding intraoral stereognosis showed significant differences between genders, where boys performed poorer than girls. Differences between two of the three age-groups could also be established. The results show that an improvement can be expected in children six years and older.

Regarding two-point discrimination 73 of the 103 children performed perfectly. The remaining children’s scores were also consistently high. No differences between gender and age were found.

There was no correlation between the test results of intraoral stereognosis and two-point discrimination. Therefore it would be necessary to perform both these tests in assessment, since they probably examine two separate aspects of the oral sensory ability.

Breathing, swallowing, chewing, facial expressions and articulation are aspects of orofacial function (Bakke, Bergendal, McAllister, Sjogreen, & Asten, 2007). Oral motor function is important for speech production as well as eating

(Lundeborg Hammarström, 2010). The Nordic Orofacial Test –Screening (NOT-S) is a screening instrument for orofacial dysfunction (Bakke et al., 2007). The purpose of this study was to collect data about how typically developed children aged 6:0-8:0 years perform on NOT-S, and also to examine if there were any age or gender differences in the results. A total of 80 children and their caretakers participated in the study. There were 30 children aged six and 50 aged seven. The children were tested in their schools and their parents were interviewed by telephone. The results showed that children aged 6:0- 8:0 years had a mean score of 1,44 ± 1,16 on NOT-S. For children at age six the mean score was 1,63 ± 1,16 and for the children at age seven, the mean score was 1,32 ± 1,15. No significant age or gender differences were found in the results except in the interview section, where a significant gender difference between children at age seven was measured. Boys had more orofacial problems than girls. Results may be used as norm data when using the NOT-S in clinical practice.

Speech production requires cooperation between cognitive, linguistic and motor processes. It also requires spatial and temporal control of muscles, as well as simultaneous and coordinated activity of respiration, phonation and articulation (Cheng, Murdoch, Goozée & Scott, 2007; Yorkston, Beukelman, Strand & Bell, 1999; Raphael, Borden & Harris, 2011). Voice Onset Time (VOT) reflects the timing between phonation and articulation (Hoit-Dalgaard, Murry & Kopp, 1983). VOT is the most reliable acoustic cue for distinguishing between voiceless or voiced plosives (Auzou et al. 2000). Studies of English-speaking children with phonological impairment have shown atypical VOT-patterns (Bond & Wilson, 1980). The aim of the present study was to investigate Voice Onset Time (VOT) among Swedish children with phonological impairment and to examine if their VOT-values differ from typically developed Swedish children. Participants were 38 children aged 4;2−11;6 distributed over eight age- groups and five developmental stages of phonology. Audio recordings of minimal pairs were made at preschools, schools or at speech pathology clinics. The results indicated that children with phonological impairment produced VOT with deviant values and with a great variability. A marked acoustic difference between voiceless and voiced stop consonants was present, but not in all cases. Since the VOT-values were distributed over the group of children with phonological impairment, no developmental trend toward adult-like values that could be related to increasing age was found for either the acquisition of producing VOT or the acquisition of producing voicing lead. No differences in VOT were seen between the children in different phonological developmental stages or ages. No correlation between the degree of deviance of VOT and the proportion of Procent Phonemes Correct (PPC), age or phonological processes were found. From the results the conclusion can be drawn that children with phonological impairment have deviant VOT-values that could be caused by lack of phonological knowledge, but in particular since the variability did not decrease with increased age, have difficulties with motor execution. 

Cochlear implants (CI) are one of the most important medical innovations in the last 20 years. A CI can enable hearing and spoken language in children with severe hearing impairment or deafness. However, many children with CIs do not reach the expected level of language. The reasons for this are not yet fully understood and further research is therefore necessary. In the present study 9 children, 6;7-12;4 years old with CIs participated. The purpose of this study was to investigate cognitive and language abilities with focus on working memory and receptive lexicon in children with CI. For this purpose selected parts of the computer based test battery SIPS (Sound Information Processing System) and PPVT (Peabody Picture Vocabulary Test) were used. The test results were analysed on group level and on individual level. In addition the results were compared to results from a control group of children with normal hearing.

The children with CIs achieved lower results than the control group did, measured on a group level. A few individuals though performed at the same level as the children in the control group which implies that it is possible for children with CIs to reach good results on the examined aspects. The results of this study also indicate that late implantation is not necessarily an obstacle for good language development. Correlations between working memory and lexicon were found both in the children with CIs and in the control group. No correlation between the investigated demographic factors and test results was found.

The purpose with this study was to systematically examine scientific studies of audiologic group rehabilitation. The definition of audiological rehabilitation was explored, different variables that influence the result and how the outcome measures should be done and its relationship with the goals of audiologic rehabilitation.   

The method used was a literature study. Pubmed and Cinahl were used for the search of literature. Some articles were searched from scientific studies reference lists and also advice from the supervisor.  

The result from the different studies shows that the effect of rehabilitation varies as there are many aspects that have an affect on the outcome measure. Rehabilitation should be seen as a patient centered problem solving process in order to reach the goals of all the individuals. When the patient is more active in the outcome measure procedure the goals also comply with the group rehabilitation. Consideration must be taken to social background of each and every individual in order to create an audiological rehabilitation program that meets their hearing and communication requirements.  The lifestyle, communication habits and singularity of the individual interact with physical conceptions as well as the grade and shape of the hearing impairment.  

Audiological group rehabilitation is a mean to improve or relieve problems due to hearing impairment and the different studies show that the result varies. The goals of group rehabilitation should meet the need of the patient. In doing so there is a need of outcome measures that are person centered and problem solving. Using open questionnaires is a method to reach that criterion.    

Binaural hearing provides advantages over monaural in several ways, particularly in difficult listening situations. For a person with bilateral hearing loss, the bilateral fitting of hearing aids thus seems like a natural choice. However, surprisingly few studies have been reported in which the additional benefit of bilateral versus unilateral hearing aid use has been investigated based on real-life experiences. Therefore, a project has been designed to address this issue and to find tools to identify people for whom the drawbacks would outweigh the advantages of bilateral fitting. A project following this design is likely to provide reliable evidence concerning differences in benefit between unilateral and bilateral fitting of hearing aids by evaluating correlations between entrance data and outcome measures and final preferences. © 2008 Sage Publications.

A then test technique was used to investigate the possibility of a response shift in the Glasgow hearing aid benefit profile (GHABP). Following completion of part 1 of the GHABP, 16 adults were invited for hearing-aid follow up appointments. In accordance with then-test technique, participants were asked to think back to before they had their hearing-aids fitted and the GHABP part 1 was completed again to re-establish the disability and handicap scores. These scores were then compared with the initial GHABP part I scores. Paired T testing and Wilcoxon Rank tests were carried out to investigate the statistical significance of the response shift effect. Statistically significant differences were seen between initial and retrospective GHABP (disability) scores using t test. No significant differences could be seen between the initial and retrospective handicap scores. Results suggest participants may have demonstrated a possible response shift phenomenon with the disability construct of the GHABP questionnaire, related to a possible re-calibration effect or a denial of disability effect. This exploratory study suggests that the GHABP questionnaire may be subject to a response shift phenomena. We suggest that further more robust studies are completed to verify this and recommend that this could have psychological impact on participants when explaining the results of the outcome measure and may affect hearing aid use. There is also potential for this phenomenon to affect global GHABP scores specifically when demonstrating to stakeholders the overall success of an audiology service.

It is not uncommon for math difficulties and reading difficulties to occur simultaneously. Despite this, math and reading difficulties are thought to have different cognitive profiles where math difficulties are linked to number sense; an innate ability to understand, approximate and manipulate both quantities and numerical information, whereas reading difficulties are linked to phonological ability; an innate ability to understand, create representations of and manipulate phonological information. A possible link between the difficulties is that phonological abilities also could affect mathematical ability. Support for this comes from studies where comorbid math and reading difficulties are associated with more severe difficulties in arithmetic ability compared to those with isolated math difficulties. The purpose of this study is to examine whether isolated math difficulties, isolated reading difficulties and comorbid math and reading difficulties can be linked to deficits in number sense, phonological ability or both of these, and whether comorbid math and reading difficulties differ in performance in mathematical tasks compared to isolated math difficulties for children in second grade. The study was carried out by testing 161 second grade children in arithmetic performance, reading performance, number sense and phonological ability. Based on performance in arithmetic and reading participants were divided into four groups: math difficulties (MD), reading difficulties (LD), comorbid math and reading difficulties (MD/LD) and control group. Statistical comparisons between groups were calculated by use of ANCOVAs, with non-verbal intelligence as covariate, and by independent t-test. Results gave partial support for the proposed core deficits for math and reading difficulties respectively, mainly concerning math difficulties and number sense deficits. The MD group performed significantly poorer in the non-symbolic number sense test.The group LD did not perform significantly poorer in respect to any task. The group MD/LD performed significantly poorer regarding subtraction, symbolic number sense tests and phonological awareness. Based on these results it can be discussed whether a link between number sense deficits and phonological awareness deficits may cause difficulty with learning and manipulating symbolic digit number.

Objective: To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization. Design: Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing. Study sample: Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data. Results: For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization. Conclusions: A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience.

Previous research has shown that children with multiple disabilities have been able to learn to make choices. Practising choice making is a good way to introduce an intervention using Alternative and Augmentative Communication (AAC). Choice making with objects should then be trainded before choice making with pictures. The present study is a single subject experimental design and was accomplished at a center for children with disabilities in Tanzania during 12 weeks. The primary purpose was to examine if the number of choices made by two boys with cerebral palsy increased after communicationintervention with objects and pictures. The participants were trained to make choices over two intervention phases and the staff were given lectures on two occasions and through tuitions. The number of choices made by the participants as well as the choices offered by the staff, were measured continuously at predetermined activities. The results show that the number of choices with objects and pictures increased in both participants. It was also observed that the interaction between the children and the staff increased. Aspects that are discussed are whether the staff’s ability to offer choices affects the result and that the factors which separate what a “none-choice” is could be defined more clearly.

Comprehension of speech in noise is a challenge for hearing-impaired (HI) individuals. Electroencephalography (EEG) provides a tool to investigate the effect of different levels of signal-to-noise ratio (SNR) of the speech. Most studies with EEG have focused on spectral power in well-defined frequency bands such as alpha band. In this study, we investigate how local functional connectivity, i.e. functional connectivity within a localized region of the brain, is affected by two levels of SNR. Twenty-two HI participants performed a continuous speech in noise task at two different SNRs (+3 dB and +8 dB). The local connectivity within eight regions of interest was computed by using a multivariate phase synchrony measure on EEG data. The results showed that phase synchrony increased in the parietal and frontal area as a response to increasing SNR. We contend that local connectivity measures can be used to discriminate between speech-evoked EEG responses at different SNRs.

The auditory brainstem response (ABR) is a valuable clinical tool for objective hearing assessment, which is conventionally detected by averaging neural responses to thousands of short stimuli. Progressing beyond these unnatural stimuli, brainstem responses to continuous speech presented via earphones have been recently detected using linear temporal response functions (TRFs). Here, we extend earlier studies by measuring subcortical responses to continuous speech presented in the sound-field, and assess the amount of data needed to estimate brainstem TRFs. Electroencephalography (EEG) was recorded from 24 normal hearing participants while they listened to clicks and stories presented via earphones and loudspeakers. Subcortical TRFs were computed after accounting for non-linear processing in the auditory periphery by either stimulus rectification or an auditory nerve model. Our results demonstrated that subcortical responses to continuous speech could be reliably measured in the sound-field. TRFs estimated using auditory nerve models outperformed simple rectification, and 16 minutes of data was sufficient for the TRFs of all participants to show clear wave V peaks for both earphones and sound-field stimuli. Subcortical TRFs to continuous speech were highly consistent in both earphone and sound-field conditions, and with click ABRs. However, sound-field TRFs required slightly more data (16 minutes) to achieve clear wave V peaks compared to earphone TRFs (12 minutes), possibly due to effects of room acoustics. By investigating subcortical responses to sound-field speech stimuli, this study lays the groundwork for bringing objective hearing assessment closer to real-life conditions, which may lead to improved hearing evaluations and smart hearing technologies.

The aim of this paper is to study the long-term effects of stuttering treatment according to the Lidcombe Program in Sweden and to answer questions whether underlying factors may have affected the treatment results. Participants were seven children, one girl and six boys aged 7:10-14:2, who all completed Stage 1 of the program approximately 2-7 years ago.The children were video recorded during a conversation with one of the authors and while reading aloud. Before the recording, their parents estimated the level of stuttering according to a Severity Range (SR) Scale. The evaluations were used as reference for determining whether the recordings were representative for the children´s current speech fluency. Proportions of stuttered syllables (%SS) were calculated from the video recorded material and compared with the proportions of stuttered syllables (%SS) at the time when the first stage of the program was initiated.The results showed that the Lidcombe Program had a significant (z=-2.37, p=0.02) long term effect on stuttering treatment for the participants in this study. The effect size was calculated to 1.05, which indicates a large effect. No correlation between underlying factors and treatment results could be established at group level. However, the results showed differences among the participants and underlying factors as age at stuttering onset and age when treatment was introduced may have affected the treatment results.This is one of the very first long term follow-ups on Swedish preschool children that have been treated according to the Lidcombe Program and the authors hope to see further research.

Tinnitus: A Multidisciplinary Approachprovides a broad account of tinnitus and hyperacusis, detailing the latest research and developments in clinical management, incorporating insights from audiology, otology, psychology, psychiatry and auditory neuroscience. It promotes a collaborative approach to treatment that will benefit patients and clinicians alike.

The 2nd edition has been thoroughly updated and revised in line with the very latest developments in the field. The book contains 40% new material including two brand new chapters on neurophysiological models of tinnitus and emerging treatments; and the addition of a glossary as well as appendices detailing treatment protocols for use in an audiology and psychology context respectively.

The aim was to develop a comprehensive screening instrument for evaluation of orofacial dysfunction that was easy to perform for different health professionals without special equipment. The Nordic Orofacial Test - Screening (NOT-S), consisting of a structured interview and clinical examination, was developed with a picture manual illustrating the different tasks in the examination. It was first tested in a Swedish version, and later translated to other Nordic languages, and to English.

         The interview reflected six domains, (I) Sensory function, (II) Breathing, (III) Habits, (IV) Chewing and swallowing, (V) Drooling, and (VI) Dryness of the mouth, and the examination included six domains representing (1) The face at rest, and tasks regarding (2) Nose breathing, (3) Facial expression, (4) Masticatory muscle and jaw function, (5) Oral motor function, and (6) Speech. One or more “yes” for impairment in a domain resulted in one point (maximum NOT-S score 12 points).

         The mean NOT-S score (±SD) in 120 patients (3-86 yr), referred to five centers for specialized dental care or speech and language pathology in Sweden, Norway and Denmark, was 4.1±2.6, and 0.4±0.6 in 60 control subjects (3-78 yr). The screening was easy to administer and the time spent 5-13 min. The scores from the clinic-referred sample differed significantly from the controls, and the sensitivity of the screening was 0.96 and specificity 0.63. Repeated evaluations of videotapes of 20 patients by 3 examiners, speech-language pathologists and dentists, with at least two-week intervals, showed inter- and intraexaminer agreement on the points given in the domains at respectively 83% and 92-95% which increased after recalibration to 85% and 95-99%. Kappa values for interexaminer agreement on the NOT-S scores were 0.42-0.44 (i.e. fair), and the method error was 5.3%. To conclude, NOT-S gave a reliable and valid screening for orofacial dysfunction.



Studies have shown that patients receiving mechanical ventilation in an intensive care unit (ICU), who are entirely dependent on the nursing staff, often experience frustration due to a temporary loss of the voice source. Limited communication is an important factor contributing to patient discomfort. Nursing staff also report communication as frustrating and difficult.

The aim of the present study is to introduce a neck-type electrolarynx as a communication aid in an ICU, to study the nursing staff experiences of communication with tracheotomized patients receiving mechanical ventilation, and to examine the patient´s experiences regarding communicative abilities. Communication between a ventilator treated, tracheotomized patient and members of the nursing staff was recorded and analyzed according to principles of Conversation Analysis (CA).

The results show that several members of the nursing staff experience difficulties communicating with tracheotomized patients receiving mechanical ventilation. A majority believe that the conditions for communication could be improved. The results of CA also indicate that an electrolarynx may be an effective and appropriate communication aid for ventilator treated, tracheostomized patients. Further research is needed to broaden the knowledge of the electrolarynx as a communication aid for these patients.

Keywords: communication, mechanical ventilation, electrolarynx, patient experience, nursing staff experience, Conversation Analysis (CA).

The Oticon Medical Neuro cochlear implant system includes the modes Opti Omni and Speech Omni, the latter providing beamforming (i.e., directional selectivity) in the high frequencies. Two studies compared sentence identification scores of adult cochlear implant users with Opti Omni and Speech Omni. In Study 1, a double-blind longitudinal crossover study, 12 new users trialed Opti Omni or Speech Omni (random allocation) for three months, and their sentence identification in quiet and noise (+10 dB signal-to-noise ratio) with the trialed mode were measured. The same procedure was repeated for the second mode. In Study 2, a single-blind study, 11 experienced users performed a speech identification task in quiet and at relative signal-to-noise ratios ranging from -3 to +18 dB with Opti Omni and Speech Omni. The Study 1 scores in quiet and in noise were significantly better with Speech Omni than with Opti Omni. Study 2 scores were significantly better with Speech Omni than with Opti Omni at +6 and +9 dB signal-to-noise ratios. Beamforming in the high frequencies, as implemented in Speech Omni, leads to improved speech identification in medium levels of background noise, where cochlear implant users spend most of their day.

Electrophysiological feedback on activity in the auditory pathway may potentially advance the next generation of hearing aids. Conventional electroencephalographic (EEG) systems are, however, impractical during daily life and incompatible with hearing aids. Ear-EEG is a method in which the EEG is recorded from electrodes embedded in a hearing aid like earpiece. The method therefore provides an unobtrusive way of measuring neural activity suitable for use in everyday life. This study aimed to determine whether ear-EEG could be used to estimate hearing thresholds in subjects with sensorineural hearing loss. Specifically, ear-EEG was used to determine physiological thresholds at 0.5, 1, 2, and 4 kHz using auditory steady-state response measurements. To evaluate ear-EEG in relation to current methods, thresholds were estimated from a concurrently recorded conventional scalp EEG. The threshold detection rate for ear-EEG was 20% lower than the detection rate for scalp EEG. Thresholds estimated using in-ear referenced ear-EEG were found to be elevated at an average of 5.9, 2.3, 5.6, and 1.5 dB relative to scalp thresholds at 0.5, 1, 2, and 4 kHz, respectively. No differences were found in the variance of means between in-ear ear-EEG and scalp EEG. In-ear ear-EEG, auditory steady-state response thresholds were found at 12.1 to 14.4 dB sensation level with an intersubject variation comparable to that of behavioral thresholds. Collectively, it is concluded that although further refinement of the method is needed to optimize the threshold detection rate, ear-EEG is a feasible method for hearing threshold level estimation in subjects with sensorineural hearing impairment.

Purpose: The purpose of this study was to introduce a method of eliciting conversational behavior with many aspects of realism, which may be used to study the impacts of hearing impairment and noise on verbal communication; to describe the characteristics of speech and language participants produced during the task; and to assess participants' engagement and motivation while completing the task.

Method: Twenty young adults with normal hearing and 20 older adults with hearing impairment took part in face-to-face conversations while completing a referential communication puzzle task designed to elicit natural conversational speech production and language with a number of realistic characteristics. Participants rated the difficulty and relevance of acoustic scenes for communication and their engagement in conversations.

Results: The communication task elicited speech production in a natural conversational register and language with many realistic characteristics, including complex linguistic constructions and typical disfluencies found in everyday speech, and approximately balanced contributions within dyads. Subjective ratings suggest that the task is robust to learning and fatigue effects and that participants remained highly engaged throughout the experiment. All participants were able to maintain successful communication regardless of background noise level and degree of hearing impairment.

Conclusions: The communication task described here may be used as part of a functional assessment of the ability to communicate in the presence of noise and hearing impairment. Although existing speech assessments have many strengths, they do not take into account the inherently interactive nature of spoken communication or the effects of motivation and engagement.

Objectives

This study investigates the hypothesis that hearing aid amplification reduces effort within conversation for both hearing aid wearers and their communication partners. Levels of effort, in the form of speech production modifications, required to maintain successful spoken communication in a range of acoustic environments are compared to earlier reported results measured in unaided conversation conditions.

Design

Fifteen young adult normal-hearing participants and 15 older adult hearing-impaired participants were tested in pairs. Each pair consisted of one young normal-hearing participant and one older hearing-impaired participant. Hearing-impaired participants received directional hearing aid amplification, according to their audiogram, via a master hearing aid with gain provided according to the NAL-NL2 fitting formula. Pairs of participants were required to take part in naturalistic conversations through the use of a referential communication task. Each pair took part in five conversations, each of 5-min duration. During each conversation, participants were exposed to one of five different realistic acoustic environments presented through highly open headphones. The ordering of acoustic environments across experimental blocks was pseudorandomized. Resulting recordings of conversational speech were analyzed to determine the magnitude of speech modifications, in terms of vocal level and spectrum, produced by normal-hearing talkers as a function of both acoustic environment and the degree of high-frequency average hearing impairment of their conversation partner.

Results

The magnitude of spectral modifications of speech produced by normal-hearing talkers during conversations with aided hearing-impaired interlocutors was smaller than the speech modifications observed during conversations between the same pairs of participants in the absence of hearing aid amplification.

Conclusions

The provision of hearing aid amplification reduces the effort required to maintain communication in adverse conditions. This reduction in effort provides benefit to hearing-impaired individuals and also to the conversation partners of hearing-impaired individuals. By considering the impact of amplification on both sides of dyadic conversations, this approach contributes to an increased understanding of the likely impact of hearing impairment on everyday communication. 

Purpose

This article describes patterns of speech modifications produced by talkers as a function of the degree of hearing impairment of communication partners during naturalistic conversations in noise. An explanation of observed speech modifications is proposed in terms of a generalization of the concept of effort. This account complements existing theories of listening effort by extending the concept of effort to the domain of interactive communication.

Method

Twenty young adult normal hearing participants and 20 older adult hearing-impaired participants were tested in pairs. Each pair consisted of 1 young normal hearing participant and 1 older hearing-impaired participant. Pairs of participants took part in naturalistic conversations through the use of a referential communication task. Each pair completed a 5-min conversation in each of 5 different realistic acoustic environments.

Results

Talkers modified their speech, in terms of level and spectrum, in a gradient manner reflecting both the acoustic environment and the degree of hearing impairment of their conversation partner. All pairs of participants were able to maintain communication across all acoustic environments regardless of degree of hearing impairment and the level of environmental noise. Contrasting effects of noise and hearing impairment on speech production revealed distinct patterns of speech modifications produced by normal hearing and hearing-impaired talkers during conversation. This may reflect the fact that only the speech modifications produced by normal hearing talkers functioned to compensate for the hearing impairment of a conversation partner.

Conclusions

The data presented support the concept of communication effort as a dynamic feedback system between conversation participants. Additionally, these results provide insight into the nature of realistic speech signals, which are encountered by people with hearing impairment in everyday communication scenarios. 

Background. Thyroidectomy is a commonly performed surgical procedure that is offered for different thyroid pathologies. The most frequent complication after total thyroidectomy is transient or permanent hypoparathyroidism followed by transient or permanent recurrent laryngeal nerve palsy. Patients may experience voice impairment despite intact laryngeal nerve function. These patients are of special interest because they experience subjective symptoms which are difficult to measure and therefore to treat. Summary. The Voice Handicap Index (VHI) and VHI-10 are the most commonly used subjective questionnaires. Their results correlate with objective findings. Female sex, in particular after menopause, is a dominant factor for developing voice impairment after thyroidectomy. The extent of neck surgery and the weight and volume of the removed thyroid correlates directly with both objective and subjective voice impairment after surgery. Videolaryngostroboscopy should be considered to examine vocal cord pathologies in this patient group. Surprisingly, there are no studies showing that speech and voice therapy are beneficial for patients with voice alterations but with intact laryngeal nerves. Conclusions. While recurrent laryngeal nerve (RLN) paralysis can be evaluated by objective exams postoperatively, we are still left with the issue of possible partial or complete external branch of superior laryngeal nerve (EBSLN) injury. It is therefore quite difficult to segregate neural (RLN and EBSLN) and non -neural voice change populations, regardless of the method of literature evaluation. Perhaps patients' perspectives on how they experience voice functionality should play a superior role in deciding which patients should be investigated further with laryngoscopy, acoustic or perceptual analysis, and which patients should be offered treatment.

On children born with a complete cleft lip and palate (CLP) the repair of the alveolar ridge doesn´t take place before the children are about ten years old. This results in that they have a residual cleft in the alveolar ridge during their early childhood. This residual cleft, and the oronasal fistulas that may appear after the repair of the hard palate, can result in a negative influence on the speech of the children. Thereby it may be necessary with cover for examplewith a palatal plate or an obturator. At the Department of Orthodontics, at Linköping University Hospital, Sweden, some of the children with CLP undergo treatment with sustained palatal fistula obturation in order to cover fistulas or residual clefts. The aim of this study was to evaluate which effect this treatment has on the speech of the children. Outcome measures used were speech and caregivers opinion of the treatment. Potential relevant background factors as fistula size and timing of the treatment were investigated. This study included medical records, recordings of the speech of the children and dental study models of the maxilla from eleven children which had received treatment with sustained palatal fistula obturation. The parents of the children answered a parental report. In the perceptual evaluations of the speech recordings the results indicated that the articulation was improved after treatment in 81.8 % of the children and that the most common types of articulation errors before and after the orthodontic treatment were weak pressure consonants and retraction of dental plosives. It also appeared to be a connection between the age at which the children first had their obturator and how the speech was influenced. Regarding the parents ten of a total of eleven parents reported an improvement of their children´s speech- and/or eating ability and all of the parents would choose to let their children undergo the treatment again if they had the opportunity to choose. Conclusions drawn from this study is that treatment with sustained palatal fistula obturation is an applicable method for children with fistulas/residual clefts since most treated children´s speech benefitted from it.

Communicative recycling, to repeat utterances uttered by oneself or others, is a common phenomenon in all societies and languages. The talk of persons with autism often features recycling. The aim of this study was to identify different forms of recycling in communication involving a boy with autism and to describe its functions. Communication between the boy with autism, who used Picture Exchange Communication System (PECS) to communicate, and his parents and teachers was videotaped. The conversations took place in familiar settings, in the boy’s home and at his pre-school. The theoretical approach in the present study was Conversation Analysis (CA). The results provide further support for other studies in that recycling is an important interactional resource for children with limited linguistic capacities. The boy recycled the conversational frames taught in PECS and accommodated these to fit the context. The use of frames also enabled him to communicate with sentences. The transcribed examples exhibited diect as well as delayed recycling of other persons utterances made by the boy. The communicative recycling found in this study fulfilled all parts of the five-folded definition of functions presented by Tannen (1987): facilitating production and comprehension, creating a sense of connection, being a communicative resource enabling interaction and creating coherence as interpersonal involvement. The communicative recycling enabled the boy and his conversational partners to share communicative conventions. The use of recycling in conversations by people with autism may be a step towards a more generative use of language.

The audiogram predicts amp;lt;30% of the variance in speech-reception thresholds (SRTs) for hearing-impaired (HI) listeners fitted with individualized frequency-dependent gain. The remaining variance could reflect suprathreshold distortion in the auditory pathways or nonauditory factors such as cognitive processing. The relationship between a measure of suprathreshold auditory function-spectrotemporal modulation (STM) sensitivity-and SRTs in noise was examined for 154 HI listeners fitted with individualized frequency-specific gain. SRTs were measured for 65-dB SPL sentences presented in speech-weighted noise or four-talker babble to an individually programmed master hearing aid, with the output of an ear-simulating coupler played through insert earphones. Modulation-depth detection thresholds were measured over headphones for STM (2cycles/octave density, 4-Hz rate) applied to an 85-dB SPL, 2-kHz lowpass-filtered pink-noise carrier. SRTs were correlated with both the high-frequency (2-6 kHz) pure-tone average (HFA; R-2 = .31) and STM sensitivity (R-2 = .28). Combined with the HFA, STM sensitivity significantly improved the SRT prediction (Delta R-2 = .13; total R-2 = .44). The remaining unaccounted variance might be attributable to variability in cognitive function and other dimensions of suprathreshold distortion. STM sensitivity was most critical in predicting SRTs for listenersamp;lt;65 years old or with HFA amp;lt;53 dB HL. Results are discussed in the context of previous work suggesting that STM sensitivity for low rates and low-frequency carriers is impaired by a reduced ability to use temporal fine-structure information to detect dynamic spectra. STM detection is a fast test of suprathreshold auditory function for frequencies amp;lt;2 kHz that complements the HFA to predict variability in hearing-aid outcomes for speech perception in noise.

Manual signs are an augmentative and alternative communication mode which enables and facilitates communication for persons with impairments in speech, language and hearing. There are different ways of teaching signs to persons with intellectual disabilities. One of them is milieu teaching, which is a method where the teaching takes place in natural settings. This method has proven to give good results in generalization and maintenance. Teaching signs to staff in groups has been shown to be effective. The purpose of the present study was to investigate whether sign intervention affected the number of signs and the number of different signs, used by two persons with Down’s syndrome and eleven staff on a day center. The study was carried out as a single-subject design. A sign intervention was conducted at the day center with the two participants with Down’s syndrome. They were educated individually with a procedure inspired by milieu teaching. When the intervention with the two participants was terminated, the staff was educated in a group format. The number of signs and the number of different signs used by the two participants with Down’s syndrome and the staff were registered. The sign intervention with the two participants led to an increased use of signs for one of them and the sign intervention with the staff led to an increased use of signs for the staff together with one of the participants. The main reason for why the sign intervention was effective for one of the two participants with Down’s syndrome and for one group of staff, but not for the other participant or the other group of staff, seems to be that the participants use of signs had an impact on each other. One of the participants with Down’s syndrome and one group of staff seems to have had a positive impact on each others use of signs. The intervention also seems to have been too short and therefore has not given effect for all of the participants.

Objective

The aim of this study was to gain insights related to positive experiences reported by adults with tinnitus living in the United Kingdom.

Design

A cross‐sectional survey design was used in a sample of adults with tinnitus who were interested in undertaking an Internet‐based intervention for tinnitus.

Setting

The study was UK wide and data collection was online.

Participants

Participants consisted of 240 adults (137 males, 103 females), with an average age of 48.16 years and average tinnitus duration of 11.52 years (SD: 11.88).

Main outcome measures

Tinnitus severity was measured by means of the Tinnitus Functional Index. To evaluate the secondary effects of tinnitus, the Insomnia Severity Index, the Hearing Handicap Inventory for Adults‐Screening Version and the Cognitive Failures Questionnaires were administered. Positive experiences related to tinnitus were explored using an open‐ended question format.

Results

Around a third of participants (32.5%) reported positive experiences associated with tinnitus. The number of positive responses ranged from one to eight responses per participant, although there were fewer participants with more than one positive response. The predominant themes concerned for (i) coping; (ii) personal development; (iii) support, and to a lesser extent (iv) outlook. Younger participants, those with a lower hearing disability and those with fewer cognitive failures were more likely to report positive experiences associated with having tinnitus.

Conclusions

This study has identified that personal development and a positive outlook are possible despite experiencing tinnitus. Ways to facilitate positive experiences related to tinnitus should be promoted, as these may reduce the negative consequences associated with tinnitus. The most prevalent positive theme was the ability to cope with tinnitus. Positive experiences were also drawn from having clinical and other support networks. This highlights the importance of providing tinnitus interventions that can assist people in coping with tinnitus, particularly to those less likely to relate tinnitus to any positive experiences. Those most likely to be helped include those who are older with greater cognitive difficulties and a greater hearing disability.

Background: This study aimed to investigate whether Internet-based cognitive behavioural therapy intervention (ICBT) for individuals with tinnitus had an indirect effect on the third-party disability noticed by significant others (SOs). Methods: Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. Results: In total, 194 pairs of individuals with tinnitus and their SOs participated. The impact of third-party disability experienced by SOs was significantly reduced after individuals with tinnitus undertook the ICBT intervention (d = 0.41). This reduced SOs with severe difficulties from 52% to 35%. The remaining impact was mild for 30% and moderate for 35%. SOs with higher baseline difficulties and SOs who were partners (e.g., spouses) were less likely to notice indirect benefits from intervention undertaken by their family members. There was a moderate positive correlation between the post-intervention CTSOQs and the clinical variables of tinnitus severity and depression. Conclusions: Third-party disability may be reduced as an indirect effect of individuals with tinnitus undertaking ICBT. Including SOs of individuals with tinnitus within the rehabilitation process may add additional benefits, and such involvement should be encouraged.

There is currently increasing awareness of third-party disability, defined as the disability and functioning of a significant other (SO) due to a health condition of one of their family members. The effects of third-party disability on the SOs of individuals with tinnitus has received little attention. To address this knowledge gap, this study investigated third-party disability in the significant others (SOs) of individuals with tinnitus. A cross-sectional survey design included 194 pairs of individuals from the USA with tinnitus and their significant others. The SO sample completed the Consequences of Tinnitus on Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. The CTSOQ showed that 34 (18%) of the SOs were mildly impacted, 59 (30%) were significantly impacted, and 101 (52%) were severely impact. The clinical variables of tinnitus severity, anxiety, and hyperacusis in individuals with tinnitus were the best predictors of the impact of tinnitus on SOs. These results show that the SOs of individuals with tinnitus may experience third-party disability. The effect of the individuals tinnitus on their SO may be greater when the individual with tinnitus has a higher level of tinnitus severity, anxiety, and hyperacusis.

Internet-based interventions have been developed to improve access to audiovestibular health care. This review aimed to identify outcomes of Internet interventions for adults with hearing loss, tinnitus, and vestibular disorders. Electronic databases and manual searches were performed to identify studies meeting eligibility for inclusion. Fifteen studies (1,811 participants) met the inclusion criteria, with nine studies targeting tinnitus distress, five considering hearing loss, and one for vestibular difficulties. Only the tinnitus and hearing loss Internet intervention studies were eligible for data synthesis. Internet-based interventions for hearing loss were diverse. Overall, they showed no significant effects, although a statistically significant moderate effect (d = 0.59) was found after removing the study with the highest risk of bias (as a result of high attrition). Most Internet-based interventions for tinnitus provided cognitive behavioural therapy. They yielded statistically significant mean effect sizes for reducing tinnitus distress compared with both inactive (d = 0.59) and active controls (d = 0.32). Significant effects were also present for the secondary outcomes of anxiety, depression, insomnia, and quality of life (combined effect d = 0.28). Only Internet-based interventions for tinnitus evaluated the 1-year postintervention effects indicated that results were maintained long term (d = 0.45). Scientific study quality was appraised using the Grading of Recommendations Assessment, Development and Evaluation approach and found to vary from very low to moderate. This review indicates the potential of Internet interventions for tinnitus to provide evidence-based accessible care. There is a need for additional high-quality evidence before conclusive results can be established regarding the effects of audiovestibular Internet interventions.

Formal literacy education in Sweden begins in first grade. How reading and writing education is conducted may differ between classes. Trageton (2005) has developed a literacy learning method in which the computer plays a significant role.

The aim of this study was to examine and evaluate how a number of literacy and language abilities are affected by computer based literacy learning developed by Trageton, compared to traditional literacy learning.

In the present study, 26 students in first grade from a school in Östergötland participated. The computer based group consisted of 13 students who attended a class in which computer based literacy learning was used. The control group consisted of 13 students who attended a class in which traditional literacy learning was used. A number of literacy and language tests were administrated in both fall and spring time.

The results showed that more participants in the computer based group, than in the control group, qualified for reading tests at all levels. The results in the writing test showed that the control group performed better in handwriting while the computer based group performed better in written narratives on the computer.

The results of the present study indicate that both literacy learning methods have an effect on reading and writing skills in students in first grade. The results also indicate that each of the learning methods improve various reading and writing skills.