| 1. |
- Hägglund, Patricia, et al.
(författare)
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The Timed Water Swallow Test (TWST) : normative data on swallowing capacity for healthy people aged 60 years and older
- 2023
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Ingår i: International Journal of Speech-Language Pathology. - : Taylor & Francis. - 1754-9507 .- 1754-9515. ; 25:4, s. 479-485
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To provide normative data on swallowing capacity (mL/s) in people older than 60 years using the Timed Water Swallow Test (TWST), stratified by sex. Intra- and inter-rater reliability for swallowing time in TWST was further investigated.Method: A total of 165 participants, aged 60 years and above, were included in the study. The time taken to consume 150 mL of tap water and the swallowing capacity (mL/s) was observed in a clinical context using the TWST. Video recordings of the performances were collected for 118 of the 165 participants for inter-rater reliability testing, of which a random set of 25 performances were assessed for intra-rater reliability. Analysis of the agreement between TWST rated by an in-person clinician and rated from a video recording was further evaluated.Result: There were significant age and sex effects observed for swallowing capacity. The average reduction in swallowing capacity in the investigated age range (60-92 years) was 8.8 and 7.3 mL/s for women and men respectively. The results showed high inter-and intra-rater reliability and agreement between the clinical assessment and the video recording.Conclusion: The presented measurements indicate a clear effect of age on swallowing capacity and that women may be expected to have lower capacity scores than men when tested using TWST. The provided norms can be used as reference points in the clinical identification of people at risk of dysphagia in the older population.
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| 2. |
- Mirkoska, Vesna, et al.
(författare)
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Detection of subclinical motor speech deficits after presumed low-grade glioma surgery
- 2023
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Ingår i: Brain Sciences. - : MDPI. - 2076-3425 .- 2076-3425. ; 13:12
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Tidskriftsartikel (refereegranskat)abstract
- Motor speech performance was compared before and after surgical resection of presumed low-grade gliomas. This pre- and post-surgery study was conducted on 15 patients (mean age = 41) with low-grade glioma classified based on anatomic features. Repetitions of /pa/, /ta/, /ka/, and /pataka/ recorded before and 3 months after surgery were analyzed regarding rate and regularity. A significant reduction (6 to 5.6 syllables/s) pre- vs. post-surgery was found in the rate for /ka/, which is comparable to the approximate average decline over 10–15 years of natural aging reported previously. For all other syllable types, rates were within normal age-adjusted ranges in both preoperative and postoperative sessions. The decline in /ka/ rate might reflect a subtle reduction in motor speech production, but the effects were not severe. All but one patient continued to perform within normal ranges post-surgery; one performed two standard deviations below age-appropriate norms pre- and post-surgery in all syllable tasks. The patient experienced motor speech difficulties, which may be related to the tumor’s location in an area important for speech. Low-grade glioma may reduce maximum speech-motor performance in individual patients, but larger samples are needed to elucidate how often the effect occurs.
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| 3. |
- Holmberg, Jenny, et al.
(författare)
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Exploring motives and perceived barriers for voice modification : the views of transgender and gender-diverse voice clients
- 2023
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Ingår i: Journal of Speech, Language and Hearing Research. - : American Speech Language Hearing Association. - 1092-4388 .- 1558-9102. ; 66:7, s. 2246-2259
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To date, transgender and gender-diverse voice clients' perceptions and individual goals have been missing in discussions and research on gender-affirming voice therapy. Little is, therefore, known about the client's expectations of therapy outcomes and how these are met by treatments developed from views of vocal gender as perceived by cisgender persons. This study aimed to explore clients' individual motives and perceived barriers to undertaking gender-affirming voice therapy.Method: Individual, semistructured interviews with 15 transgender and gender-diverse voice clients considering voice therapy were conducted and explored using qualitative content analysis.Results: Three themes were identified during the analysis of the participants' narratives. In the first theme, “the incongruent voice setting the rules,” the contribution of the voice on the experienced gender dysphoria is put in focus. The second theme, “to reach a voice of my own choice,” centers around anticipated personal gains using a modified voice. The third theme, “a voice out of reach,” relates to worries and restricting factors for not being able to reach one's set goals for voice modification.Conclusions: The interviews clearly indicate a need for a person-centered voice therapy that starts from the individuals' expressed motives for modifying the voice yet also are affirmative of anticipated difficulties related to voice modification. We recommend that these themes should form the basis of the pretherapy joint discussion between the voice client and the speech-language pathologist to ensure therapy goals that are realistic and relevant to the client.
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| 4. |
- Hägglund, Patricia, et al.
(författare)
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The Test of Masticating and Swallowing Solids (TOMASS) : Normative data for two crackers available in the Scandinavian and international markets
- 2021
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Ingår i: International Journal of Speech-Language Pathology. - : Taylor & Francis. - 1754-9507 .- 1754-9515. ; 23:3, s. 329-337
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To establish normative data of crackers common in the Scandinavian and international markets for use in the Test of Masticating and Swallowing Solids (TOMASS), and to investigate possible sex and age effects on masticatory performances.Method: 234 healthy participants (>20 years of age) were asked to either ingest the Göteborgskex Guld Marie™ cracker (n = 234) or to ingest both a Guld Marie cracker and a Tuc Original™ cracker (n = 115). Quantifiable measures of masticatory performance (number of bites, number of chewing cycles, number of swallows, and total time) were observed during TOMASS for each participant, directly on-site or by video recording.Result: There were no significant differences in masticatory performances between the crackers. Significant age effects were observed for all masticatory measurements, except for the number of swallows. The results showed insufficient support for an effect of sex, and that results obtained on-site and from video recordings were highly correlated.Conclusion: These findings suggest that similar masticatory performance is to be expected when performing TOMASS using the evaluated crackers. The age of the participant affects TOMASS performance, but the effect of sex is considerably smaller.
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| 5. |
- Karlsson, Fredrik, Docent, 1975-, et al.
(författare)
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A within-subject comparison of face-to-face and telemedicine screening using the timed water swallow test (TWST) and the test of mastication and swallowing of solids (TOMASS)
- 2023
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Ingår i: Dysphagia (New York. Print). - : Springer. - 0179-051X .- 1432-0460. ; 38, s. 483-490
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Tidskriftsartikel (refereegranskat)abstract
- The Timed Water Swallow Test (TWST) and the Test of Mastication of Solids (TOMASS) are dysphagia screening procedures that have been shown to be reliably assessed from video. The reliability of the procedures performed over telemedicine has not previously been assessed. TWST and TOMASS outcomes in two situations (both face-to-face and over telemedicine) were compared for 48 participants (aged 60-90; 27 with clinical conditions and 21 older persons). Both testing situation and test performed order were randomized, and all assessment procedures were performed within 3 h of each other. The results indicated a high level of agreement between face-to-face and telemedicine screening outcomes for TWST and TOMASS, respectively. The assessments indicated an 83% and 76% agreement in classifications of individual participants as within or outside normal limits for the TWST and TOMASS for the two test situations. The TWST showed a balanced distribution in differing classification in telemedicine (0.16-0.19 error rates). The TOMASS procedure classified more participants as outside normal limits over telemedicine compared to face-to-face administration. Agreement in the observed number of swallows was substantially lower than other outcome measures, which is attributed to increased difficulty in observing this property over video. Most participants (60%) reported that they would prefer telemedicine over face-to-face assessments, and 90% viewed the procedure as more accessible than expected. All participants were satisfied with the telemedicine procedures. The results suggest that clinical assessment of dysphagia over telemedicine using the TWST and TOMASS are viable alternatives to face-to-face administration of the procedures.
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| 6. |
- Karlsson, Fredrik, Docent, 1975-, et al.
(författare)
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Assessment of speech impairment in patients with Parkinson's disease from acoustic quantifications of oral diadochokinetic sequences
- 2020
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Ingår i: Journal of the Acoustical Society of America. - : Acoustical Society of America (ASA). - 0001-4966 .- 1520-8524. ; 147:2, s. 839-851
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Tidskriftsartikel (refereegranskat)abstract
- This investigation aimed at determining whether an acoustic quantification of the oral diadochokinetic (DDK) task may be used to predict the perceived level of speech impairment when speakers with Parkinson's disease (PD) are reading a standard passage. DDK sequences with repeated [pa], [ta], and [ka] syllables were collected from 108 recordings (68 unique speakers with PD), along with recordings of the speakers reading a standardized text. The passage readings were assessed in five dimensions individually by four speech-language pathologists in a blinded and randomized procedure. The 46 acoustic DDK measures were merged with the perceptual ratings of read speech in the same recording session. Ordinal regression models were trained repeatedly on 80% of ratings and acoustic DDK predictors per dimension in 10-folds, and evaluated in testing data. The models developed from [ka] sequences achieved the best performance overall in predicting the clinicians' ratings of passage readings. The developed [pa] and [ta] models showed a much lower performance across all dimensions. The addition of samples with severe impairments and further automation of the procedure is required for the models to be used for screening purposes by non-expert clinical staff.
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| 7. |
- Karlsson, Fredrik, Docent, 1975-, et al.
(författare)
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How Well Does Diadochokinetic Task Performance Predict Articulatory Imprecision? : Differentiating Individuals with Parkinson's Disease from Control Subjects
- 2019
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Ingår i: Folia Phoniatrica et Logopaedica. - : S. Karger. - 1021-7762 .- 1421-9972. ; 71:5-6, s. 251-260
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether syllables produced in an oral diadochokinetic (DDK) task may be quantified so that persons with Parkinson's disease (PD) perceived to have reduced articulatory precision when reading may be correctly identified using that quantification.PATIENTS AND METHODS: Syllable sequences from 38 speakers with PD and 38 gender- and age-matched control speakers (normal controls [NC]) were quantified acoustically and evaluated in terms of (1) the speakers' ability to accurately predict speaker group membership (PD or NC) and (2) their ability to predict reduced/non-reduced articulatory precision.RESULTS: A balanced accuracy of 80-93% in predicting speaker group membership was achieved. The best measures were related to the proportion of a syllable made up of a vowel, amplitude slope and syllable-to-syllable variation in duration and amplitude. The best material was that based on /ka/. Reduced articulatory precision was accurately predicted from DDK measures in 89% of the samples. Release-transient prominence and voicing during the onset of plosives were particularly strong predictors.CONCLUSIONS: DDK sequences can predict articulatory imprecision as observed in another speech task. The linking of performance across speech tasks probably requires measures of stability in syllable durations and amplitudes, as well as measures of subsyllabic acoustic features.
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| 8. |
- Karlsson, Fredrik, Docent, 1975-, et al.
(författare)
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On the Primary Influences of Age on Articulation and Phonation in Maximum Performance Tasks
- 2021
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Ingår i: LANGUAGES. - : MDPI AG. - 2226-471X. ; 6:4
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Tidskriftsartikel (refereegranskat)abstract
- Maximum performance tasks have been identified as possible domains where incipient signs of neurological disease may be detected in simple speech and voice samples. However, it is likely that these will simultaneously be influenced by the age and sex of the speaker. In this study, a comprehensive set of acoustic quantifications were collected from the literature and applied to productions of sustained [a] productions and Alternating Motion Rate diadochokinetic (DDK) syllable sequences made by 130 (62 women, 68 men) healthy speakers, aged 20-90 years. The participants were asked to produce as stable (sustained [a] and DDK) and fast (DDK) productions as possible. The full set of features were reduced to a functional subset that most efficiently modeled sex-specific differences between younger and older speakers using a cross-validation procedure. Twelve measures of [a] and 16 measures of DDK sequences were identified across men and women and investigated in terms of how they were altered with increasing age of speakers. Increased production instability is observed in both tasks, primarily above the age of 60 years. DDK sequences were slower in older speakers, but also altered in their syllable and segment level acoustic properties. Increasing age does not appear to affect phonation or articulation uniformly, and men and women are affected differently in most quantifications investigated.
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| 9. |
- Karlsson, Fredrik, Docent, 1975-
(författare)
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'superassp' and the need for a sparse signaltrack data format
- 2021
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Ingår i: Proceedings of Fonetik 2021. - Lund : Centre for Languages and Literature. ; , s. 23-26
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The digital processing of phonetic data has long been based on the same basic data structures and consequently been stored in essentially the same manner. The transition to structured database-based workflows and the development of more complex analyses challenge the established data structures and storage models. I propose a sparsely defined data track model for structured storing of locally define signal information and suggest an implementation. The use of sparse data created by the amalgamating signal processing library ‘superassp’ is discussed within a speech database management system.
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| 10. |
- Karlsson, Fredrik, 1975-
(författare)
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The acquisition of contrast : a longitudinal investigation of initial s+plosive cluster development in Swedish children
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This Thesis explores the development of word-initial s+plosive consonant clusters in the speech of Swedish children between the ages of 1;6 and 4;6. Development in the word-initial consonant clusters is viewed as being determined by 1) the children’s ability to articulate the target sequence of consonants, 2) the level of understanding of which acoustic features in the adult model production are significant for the signalling of the intended distinction, and 3) the children’s ability to apply established production patterns only to productions where the acquired feature agrees with the adult target, to achieve a contrast between rival output forms. This Thesis employs a method where output forms are contrasted with attempted productions of potential homonym target words. Thus, development is quantified as an increase in the manifestations of phonetic features where it agrees with the adult norm, coupled by a decrease in the same feature in output forms where it is inappropriate according to the specifications of the phonological system of the ambient language. Acoustic investigations of cues of voicing, aspiration, place of articulation and syllable onset complexity, and auditory investigations of place, manner and syllable onset complexity were conducted. The Thesis has four outcomes. One, a description of the perceptual quality of the productions in terms of place, manner, voicing and syllable onset complexity is presented. Two, a developmental sequence of stable acquisition of these features is proposed; manner is shown to be acquired first, followed by syllable onset complexity and place of articulation. Evidence is provided that the voiced/aspirated distinction is still being acquired at the end of the investigated age period. Three, the developmental use of acoustic cues of place and voicing are described. Voice Onset Time and Spectral Skewness are shown to be used by children in order to increase the likeness to the adult target in terms of voicing and place of articulation. Aspiration Amplitude is shown to be used as an auxiliary cue to Voice Onset Time. The place cues Spectral Tilt Change, F2, Spectral Mean and Spectral Variance were shown to be used in order to refine already produced consonants rather than approach the adult target model. Four, the Thesis provides evidence of periods of confusions in the output of children. With the reductions of these patterns of confusion, evidence is provided of children’s re-organisation of their internal representation of the consonant to be produced.
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