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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Annan medicin och hälsovetenskap) hsv:(Övrig annan medicin och hälsovetenskap) > Hartelius Lena

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1.
  • Karlsson, Fredrik, Docent, 1975-, et al. (författare)
  • Assessment of speech impairment in patients with Parkinson's disease from acoustic quantifications of oral diadochokinetic sequences
  • 2020
  • Ingår i: Journal of the Acoustical Society of America. - : Acoustical Society of America (ASA). - 0001-4966 .- 1520-8524. ; 147:2, s. 839-851
  • 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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2.
  • Mirkoska, Vesna, et al. (författare)
  • Detection of subclinical motor speech deficits after presumed low-grade glioma surgery
  • 2023
  • Ingår i: Brain Sciences. - : MDPI. - 2076-3425 .- 2076-3425. ; 13:12
  • 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.
  • Behrns, Ingrid, 1961, et al. (författare)
  • A comparison between written and spoken narratives in aphasia
  • 2009
  • Ingår i: Clinical Linguistics & Phonetics. - London : Taylor & Francis. - 0269-9206 .- 1464-5076. ; 23:7, s. 507-528
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present study was to explore how a personal narrative told by a group of eight persons with aphasia differed between written and spoken language, and to compare this with findings from 10 participants in a reference group. The stories were analysed through holistic assessments made by 60 participants without experience of aphasia and through measurement of lexical and syntactic variables. The findings showed that the participants with aphasia generally received lower ratings than the reference group, but also that stories written by participants with aphasia were rated as easier to understand, more interesting, and more coherent than the group’s spoken stories. Regression analysis showed that syntax could predict several of the rated variables for the stories told by the participants with aphasia. Results point to the need to include writing training in language rehabilitation in order to increase the ability for persons with aphasia to participate in communicative situations in everyday life.
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5.
  • Johansson, K., et al. (författare)
  • Assessment of voice, speech and communication changes associated with cervical spinal cord injury
  • 2018
  • Ingår i: International Journal of Language & Communication Disorders. - : Wiley. - 1368-2822 .- 1460-6984. ; 53:4, s. 761-775
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundRespiratory muscle impairment following cervical spinal cord injury (CSCI) may lead to reduced voice function, although the individual variation is large. Voice problems in this population may not always receive attention since individuals with CSCI face other, more acute and life-threatening issues that need/receive attention. Currently there is no consensus on the tasks suitable to identify the specific voice impairments and functional voice changes experienced by individuals with CSCI. AimsTo examine which voice/speech tasks identify the specific voice and communication changes associated with CSCI, habitual and maximum speech performance of a group with CSCI was compared with that of a healthy control group (CG), and the findings were related to respiratory function and to self-reported voice problems. Methods & ProceduresRespiratory, aerodynamic, acoustic and self-reported voice data from 19 individuals (nine women and 10 men, aged 23-59 years, heights = 153-192 cm) with CSCI (levels C3-C7) were compared with data from a CG consisting of 19 carefully matched non-injured people (nine women and 10 men, aged 19-59 years, heights = 152-187 cm). Outcomes & ResultsDespite considerable variability of performance, highly significant differences between the group with CSCI and the CG were found in maximum phonation time, maximum duration of breath phrases, maximum sound pressure level and maximum voice area in voice-range profiles (all p = .000). Subglottal pressure was lower and phonatory stability was reduced in some of the individuals with CSCI, but differences between the groups were not statistically significant. Six of 19 had voice handicap index (VHI) scores above 20 (the cut-off for voice disorder). Individuals with a vital capacity below 50% of the expected for an equivalent reference individual performed significantly worse than participants with more normal vital capacity. Completeness and level of injury seemed to impact vocal function in some individuals. Conclusions & ImplicationsA combination of maximum performance speech tasks, respiratory tasks and self-reported information on voice problems help to identify individuals with reduced voice function following CSCI. Early identification of individuals with voice changes post-CSCI, and introducing appropriate rehabilitation strategies, may help to minimize development of maladaptive voice behaviours such as vocal strain, which can lead to further impairments and limitations to communication participation.
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6.
  • Johansson, K., et al. (författare)
  • Self-Reported Changes in Cognition, Communication and Swallowing in Multiple Sclerosis: Data from the Swedish Multiple Sclerosis Registry and from a National Survey
  • 2021
  • Ingår i: Folia Phoniatrica Et Logopaedica. - : S. Karger AG. - 1021-7762 .- 1421-9972. ; 73:1, s. 50-62
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The aim of this study was to investigate self-reported cognition, speech, communication and swallowing changes in a large sample of individuals with multiple sclerosis (MS) in Sweden. A second aim was to update information about speech and language pathology (SLP) services received by people with MS (pwMS). Method: Self-ratings of cognition, speech/communication and swallowing registered by pwMS between 2012 and 2018 were retrieved from the Swedish MS Registry. In addition, more detailed information about speech, communication, swallowing and provision of SLP services was collected using an online survey distributed via a national patient organization. Results: In total, entries from 5,289 pwMS were retrieved from the MS Registry. Nearly two thirds of the respondents reported that cognition was affected to some degree, whereas approximately one third perceived some difficulties with speech/communication. A smaller group reported swallowing problems. The majority of those who reported problems with speech/communication also reported problems with cognition. Among the 440 individuals who responded to the MS survey, word-finding difficulties were the most frequently self-reported problem related to communication, and the second most common problem was getting off topic. In all, close to four out of five respondents experienced at least one symptom related to speech and communication, such as speech-related fatigue or imprecise articulation. Swallowing difficulties were reported by one out of four respondents in the MS survey. As a result of their speech difficulties, up to one in three experienced changes in professional or social roles and participation. A limited number of respondents had received SLP services, the most common intervention being voice training. Conclusions: In MS, changes associated with cognition as well as speech/communication are frequent, cognitive-linguistic symptoms being the most common. Swallowing difficulties are also relatively prevalent. Access to SLP services seems to be insufficient compared to prevalence of perceived symptoms. Considering that the majority of pwMS are part of the working-age population, access to SLP services must be more highly prioritized and must address cognitive-linguistic problems as well as voice, speech and swallowing dysfunction. (c) 2020 S. Karger AG, Basel
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7.
  • Karlsson, Fredrik, et al. (författare)
  • How well does DDK task performance predict fluent speech articulation?
  • 2018
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • The oral diadokochinesia (DDK) task is an established tool for assessing speech motor control that has been used across a range of conditions. The predominant outcome measure reported after the patient have performed the task is the maximum syllable rate achieved by the patient. More recent reports have also highlighted stability in pace of the sequence as quantifications that may be indicative of speech impairment. While the DDK task affords quick and easy administration, concerns have been raised regarding the strength of association between DDK task performance and patients’s articulation in fluent speech. It may not be assumed that a reduced DDK rate or rate stability will cause fluent speech also to be perceived as slowed or dysrhythmic. And, patients may well improve their syllable rate at the expense of articulatory quality, which is currently not easily captured in an objective outcome measure.We report here on an effort to assess to what degree information from an expanded quantification of DDK sequences may be used identify patients with dysarthria and to model clinical assessments of fluent speech. Acoustic quantifications of the consonant and consonant-vowel relationship are combined with previously used measures, and applied to manually processed DDK sequences produced by patients with Parkinson’s disease and normal control speakers. We observe how well these quantifications may form the basis for accurate identification of patients among normal controls, and predict the outcome of blinded and randomized clinical assessments of patients’ production of fluent speech.Rapid repetition of CV syllables (oral diadochokinesis, DDK) puts pressure on the speech motor system in order to afford detection of a deteriorating articulatory ability.This study assessed how well objective quantifications of DDKsequences can be used to identify PD speakersamong age matched controls (NC), andhow well a reduced articulatory ability in PDspeakers may be predicted using quantifications of DDK sequences performed in the same recording session.The comprehensive DDK sequence quantification achieved a 93% classification accuracy for speaker group and a 79% accuracy for reduced fluent speech articulatory quality. 
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8.
  • Karlsson, Fredrik, Docent, 1975-, et al. (författare)
  • How Well Does Diadochokinetic Task Performance Predict Articulatory Imprecision? : Differentiating Individuals with Parkinson's Disease from Control Subjects
  • 2019
  • Ingår i: Folia Phoniatrica et Logopaedica. - : S. Karger. - 1021-7762 .- 1421-9972. ; 71:5-6, s. 251-260
  • 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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9.
  • Karlsson, Fredrik, Docent, 1975-, et al. (författare)
  • On the Primary Influences of Age on Articulation and Phonation in Maximum Performance Tasks
  • 2021
  • Ingår i: LANGUAGES. - : MDPI AG. - 2226-471X. ; 6:4
  • 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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10.
  • Laakso, Katja, et al. (författare)
  • Communicating with individuals receiving home mechanical ventilation : the experiences of key communication partners
  • 2014
  • Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 36:11, s. 875-883
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The aim of the study was to explore the communication experiences of key communications partners (CPs) of individuals receiving home mechanical ventilation (HMV), with particular emphasis on the possibilities, difficulties and limitations CPs experienced in communication, possible support given to facilitate communication and exploring what made a skilled communicator. Method: A qualitative research design using interviews was used. The participants included 19 key CPs of individuals receiving HMV. Results: The analysis resulted in five themes: Encountering communication limitations, Functional communication strategies, Being a communication facilitator, Role insecurity and Emotional reactions and coping. The findings revealed that CPs needed to develop partly new reference frames for communication. In particular, participants emphasised the need to understand and interpret subtle details in the communicative interaction. Conclusions: The findings are discussed in the light of previous research, in particular an earlier study exploring another perspective; the ventilator-supported individuals' experiences of communication. Issues relating to the educational needs of CPs of individuals receiving HMV are discussed. The results are intended to enhance understanding of the challenges that individuals receiving HMV and their CPs face with communication, which should be of relevance not only to speech therapists, but for all healthcare practitioners in the field of HMV.
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