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Objectives: This study conducts a comparative analysis of the temporal facets of velopharyngeal coarticulation in Persian-speaking adults, differentiating between subjects with and without cleft palate, across three distinct vowel contexts. Methods: The study included 14 adults who had undergone cleft palate repair, with or without cleft lip and presented moderate to severe hypernasality. Another 14 adults without cleft palate were included in the study. The age range of participants was 18 to 50 years. By utilizing the Praat software, version 6.1.50, the study obtained data for the four temporal parameters by analyzing acoustic waveforms and spectrograms within three distinct vowel contexts. The analysis included the calculation of ratios of nasalization duration to neutralize the influence of speech rate variations between the cleft palate and control groups. Results: The results revealed that adults with cleft palate exhibited significantly extended durations for the four temporal parameters compared to the control group (P

Introduction. Up to date, various mobile medical apps were proposed, including digital platforms for diagnoses of speech impairment. The review aims to assess the effectiveness of mobile health (m-Health) platforms for patients with speech and voice disorders. Material and methods. We conducted a systematic review of studies published between 2008 and 2021. 234 articles from PubMed, Web of Science, and Cochrane Library databases were pre-selected for the review. Only articles related to the use of medical applications for smartphones, tablets, or computer devices studies were included in the analysis. Results. A total of 111 full-text articles were assessed for eligibility, and 37 were included in this study. The selected reports cover research on the use of mobile applications for therapy, rehabilitation assistance, and diagnoses. In terms of application, mobile apps have been developed for patients (children and adults) with speech disorders caused by autism, neuro-developmental speech impairment, Parkinson’s disease, aphasia, voice disorders, etc. Conclusions. The analysis showed that the m-Health market offers various mobile applications for persons with speech impairments (as an adjuvant tool for therapy and rehabilitation). Despite the existence of a range of m-Health applications for patients with speech disorders, there is a need for further large-scale studies aimed at studying their effectiveness, safety, and reliability.

Introduction: The voice is an unique communication tool, characteristic of each person alone. Lacking the ability to communicate through it, can negatively affect mental health. It turns out that voice and speech rehabilitation after surgery is widely used and allows patients to improve their functioning, giving them a chance to live a normal life. Aim of the study: The purpose of the study was to review the knowledge of voice and speech rehabilitation options for patients after laryngectomy and the results of the methods used. The text is intended to educate professionals and patients who are undergoing surgical treatment and experience concerns about their future functioning. Materials and Methods: Scientific articles were reviewed using the PubMed database using the keywords: voice rehabilitation; total laryngectomy; speech disorders. State of the art: Prevalent methods of voice and speech rehabilitation in patients after total laryngectomy include the teaching of esophageal speech, tracheoesophageal speech and the use of an artificial larynx. Of these, esophageal speech appears to be the least effective method. Under certain circumstances, an artificial larynx may be the optimal choice among certain groups of patients. Numerous studies cited prove tracheoesophageal speech to achieve the best results measurable by commonly used indicators. Summary: Total laryngectomy is not a sentence for patients. Effective rehabilitation significantly improves the quality of life and communication. It is difficult to unequivocally indicate which method of voice and speech rehabilitation is most beneficial for patients - the choice should be tailored to the individual and its preferences and chances. In his work, the specialist should seek a compromise between obtaining the best acoustic results and acceptance of the method by the patient.

Objectives. The study aims to conduct a meta-analysis on the existence of solid experimental evidence to highlight the effectiveness of interventions in the improvement of speech disorders in patients who have suffered a stroke. It is desired to identify those moderating variables that can influence the effectiveness of these interventions over time, or that demonstrate the extent to which chronicity of stroke may lead to inferior results in speech improvement. Materials and methods. A search was conducted in three databases: Cochrane Library, Web of Science and PubMed, to identify those studies that meet the criterion for intervention, starting with the first records and until now. The qualitative analysis of the studies was performed using Risk of Bias, and the quantitative analysis through Comprehensive Meta-Analysis. Results. As a result of selection, 31 randomized clinical studies were included in the current research, out of the 1923 existing studies. These have been the subject of investigation on aphasia and dysphagia, with a wide range of types and methods of intervention. The results show that the difference in averages between the intervention group and the post-test control group is a significant one (g = 0.528; 95% CI 0.067; 0.004; p = 0.000), while the moderation analysis did not record a statistical significance. Conclusions. Non-pharmacological interventions based on the recovery of speech disorders as a result of stroke have been shown to be effective in many of the researches in specialized literature. Their results show that, as a result of therapies, patients experience improvements in quality of life, communication and many psychiatric disorders. However, it is not clear how effective these interventions are in recovering or ameliorating speech disorders.

Introduction : Dialogue, or conversation, is the ability to speak as well as listen. It plays a very important role in interpersonal relations.Speech disorders are a group of of disorders that includes various types of speech production difficulties. Speech production depends on the coordination of several motor acts: respiration, phonation, articulation, resonance and prosody. Phonation is the complex activity of producing sound by vibration of the vocal cords. Resonance is the amplification of sounds at specific frequencies through vibration in the chest, throat and sinuses. Prosody includes a set of phonetic features, such as tone, loudness, tempo, and the overall timbre of speech, which are designed to intended to preserve the meaning and character of speech. Disruption of any of these related elements results in motor speech disorders. Material and method : An overview is presented of language disorders in diseases neurodegenerative diseases such as Parkinson's disease(PD) and Friedreich's ataxia (FRDA). Their impact on the conversation process and the patient's quality of life assessment was evaluated. The paper was based on scientific publications posted on the PubMed scientific platform. Results : Speech and language disorders are the main symptoms of FRDA, which significantly affect the patients' quality of life. Patients often present with dysarthria, resulting from causes of central and peripheral and additional primary language disorders. The classic speech disorder in PD is hypokinetic dysarthria, manifested by hypophonia; monotonous, uneven and strained speech; reduced prosody (melodic voice); crowded articulation; inadequate pauses in speech; freezing of speech, unclear articulation. Conclusions : The described disease entities show a significant impact on the deterioration of the process of of conversation by the patient, thus showing a significantly negative impact on the patients' quality of life.

Introduction : Primary progressive aphasia (PPA) is a group of neurodegenerative disorders whose main feature is speech and language dysfunction. There are three main forms of PPA - non-fluent variant - agrammatic (nfvPPA), semantic variant (svPPA) and logopenic variant (lvPPA). These include the canonical syndromes currently recognized by consensus diagnostic criteria. . Material and method : An overview of language disorders in primary progressive aphasia is presented. The impact on the conversation process and the patient's quality of life assessment was evaluated. The work was based on scientific publications posted on the scientific platform PubMed. Results : In order to diagnose PPA, criteria must be met, i.e., language difficulties are the main feature of the clinical picture, language difficulties are the main cause of disability in daily life, and that aphasia is the most significant disorder in the initial period of the disease. Conclusions : PPA significantly affects both the production and comprehension of speech. It affects the idea, content, construction and delivery of the patient's speech. In addition, it causes significant difficulties in the repetition of speech, both full sentences and words alone. Keywords : "speech disorders", "aphasia", "dysarthria", "primary progressive aphasia".

Statistics of rescued people after head-brain injuries are constantly increasing and therefore we are forced to seek effective therapeutic procedures. Up to 90 % of people after a brain injuries will cure physically within one year, although severe mobility and speech disorders or other associated disease, such as epilepsy, persist. In the described case we focus on a young patient whose chances of survival were minimal and whose brain damage caused changes not only in the areas of motor, cognitive and swallowing but also changes in his perception of touch, smell, taste, sight and change in thermoregulation.

Dysarthria are speech disorders that result from neurologic impairments associated with weakness, slowness, or incoordination of the musculature used to produce speech. Domestic studies on this speech disorder are mostly limited to acupuncture, electrical stimulation and other therapeutic effects, and the evaluation of the therapeutic effect is mostly subjective, involving the lack of acoustic analysis. In this paper, the acoustic features of vowels with dysarthria were analyzed, such as resonant frequency, vowel space area, formant centralization ratio, vowel duration, vowel articulation index, jitter, shimmer, normalizednoise energy, standard deviation of F0, vowel dispersion, vowel overlap, vowel triangle area, acoustic distance and so on. In dysarthria, movement patterns change of articulators lead to obscure pronunciation and decline of the listening comprehension. Doctors and therapists can find the pathology differences of acoustic features between patients and normal speech and understand the internal mechanism through extracting acoustic parameters with the technique of linear predictive coding with computer. Some differences of the acoustic features of vowels with dysarthria were found compared with healthy adults. The vowel formant of the patients with dysarthria showed a centralized tendency, frequency deviation and inaccuracy (the change of frequency and amplitude was higher than that of the control group), vowel space area and vowel articulation index (VAI) were significantly reduced, and the size of vowel space was positively correlated with the speaker's understandability. The degree of vowel dispersion and overlap can indicate the severity of speech disorders. Also, the duration of vowels was longer than that of the normal control group. These abnormalities show that there are inaccuracies and abnormal movements in articulation movement in patients with dysarthria. These found of the above the acoustic features of vowels with dysarthria are conducive to the effective evaluation of clinical dysarthria through objective methods and can direct the accurate training in speech rehabilitation.

Objective To evaluate correlations between values of articulation tests and language tests for children with articulation disorder in Korea. Methods Data of outpatients with chief complaint of an articulation problem were retrospectively collected. Patients who underwent Urimal Test of Articulation and Phonation (U-TAP) with Assessment of Phonology and Articulation for Children (APAC), Preschool Receptive-Expressive Language Scale (PRES), or Receptive and Expressive Vocabulary Test (REVT) simultaneously were identified. Patients whose word-level percentages of correct consonants in U-TAP (UTAP_wC) were more than 2 standard deviations below the mean as diagnostic criteria for articulation disorder were selected. Those whose receptive language age (P_RLA), expressive language age (P_ELA), or combined language age (P_CLA) in PRES was delayed more than 24 months compared to their chronological age in months as diagnostic criteria for language disorder were excluded. Results Thirty-three children aged 3–6 years were enrolled retrospectively. PRES and U-TAP showed significant correlations for most of value relationships. PRES and APAC showed significant correlations for all value relationships except for receptive language age. All values of REVT were significantly correlated with all values from U-TAP, but not with any value from APAC. Articulation tests U-TAP and APAC showed significant correlations between percentages of correct consonants. Language tests PRES and REVT showed significant correlations for all value relationships. Conclusion This study suggests that articulation abilities and language abilities might be correlated in children with articulation disorder.

Currently, there is a tendency in Ukraine to increase the number of children with speech disorders. One of the most common disorders of speech function is dyslalia. Speech therapists are the main form of correctional training, children are assigned certain and consistent stages of speech therapy. Along with that, various individual and standard devices are used. The aim of the study – to conduct logopedic correction of speech disorders in patients with physiologic occlusion using the in-house designed device according to the proposed algorithm. Materials and Methods. A survey was conducted on 73 children (24 – aged 3 to 6 years, 49 – from 6 to 12 years old) without significant orthodontic pathology in the presence of speech impairment with normal hearing and intelligence and speech correction. In addition to logopedic exercises, it was recommended to use vestibular plates Dr. Hinz - MUPPY-P with beads, removable orthodontic devices with beads, Bluegrass appliances, devices for elimination and prevention of unhealthy tongue habits. In order to identify early risk factors for major dental diseases, the hygienic state of the cavity of the mouth, the intensity of caries, the presence or absence of inflammatory processes in the tissues of periodontal disease were determined. Results and Discussion. The first step in the algorithm for successful correction of speech disorders were to explain its necessity. The second stage involved the phonetic diagnosis of all aspects of speech, logic, intelligence, memory and thinking. Polymorphic dyslalia was diagnosed in all subjects of reporting panel. The third stage of the algorithm is to carry out work to overcome the abnormalities of the phonetic side of speech was a direct speech correction. The proposed device for elimination and prevention of unhealthy tongue habits was used in 6 cases. Conclusions. After the speech therapy correction correct articulation and sound were formed. The proposed device for the elimination and prevention unhealthy tongue habits should be used in conjunction with speech therapy, in particular, dyslalia. In addition to the positive logopedic effect of the proposed therapeutic and prophylactic measures, we have also received improvement of the hygienic state of the oral cavity, the absence of an increase in the intensity of the caries of permanent teeth and increased motivation in patients.

ABSTRACT BACKGROUND: Pneumo-phono-articulatory coordination is often impaired in dysarthric patients. Because all speech is produced upon exhalation, adequate respiratory support and coordination are essential for communication. Nevertheless, studies investigating respiratory parameters for speech are scarce. The objectives of the present study were to analyze and compare the numbers of words and syllables (universal measurement) per exhalation among healthy and dysarthric speakers, in different speech tasks. DESIGN AND SETTING: A cross-sectional analytical study with a control group was conducted at the Department of Speech, Language and Hearing Sciences at UNIFESP. METHODS: The study sample consisted of 62 individuals: 31 dysarthric patients and 31 healthy individuals matched for sex, age and education level. All participants performed number counting and text reading tests in which the numbers of words and syllables per exhalation were recorded. All measurements obtained from the two groups were compared. RESULTS: Statistically significant differences between the dysarthric and healthy groups were found in the two tasks (counting of syllables and words per exhalation) (P < 0.001). In contrast, the performance of the dysarthric patients did not vary according to the task: reading and number counting in syllables/exhalation (P = 0.821) or words/exhalation (P = 0.785). CONCLUSIONS: The mean numbers of words and syllables per exhalation among dysarthric subjects did not vary according to the speech task used but they clearly showed differences between dysarthric patients and normal healthy subjects. The study also made it possible to obtain preliminary data on the average numbers of words and syllables per expiration produced by healthy individuals during their speech production.

Abstract Introduction Computerized auditory training (CAT) has been building a good reputation in the stimulation of auditory abilities in cases of auditory processing disorder (APD). Objective To measure the effects of CAT in students with APD, with typical or atypical phonological acquisition, through electrophysiological and subjective measures, correlating them pre- and post-therapy. Methods The sample for this study includes14 children with APD, subdivided into children with APD and typical phonological acquisition (G1), and children with APD and atypical phonological acquisition (G2). Phonological evaluation of children (PEC), long latency auditory evoked potential (LLAEP) and scale of auditory behaviors (SAB) were conducted to help with the composition of the groups and with the therapeutic intervention. The therapeutic intervention was performed using the software Escuta Ativa (CTS Informática, Pato Branco, Brazil) in 12 sessions of 30 minutes, twice a week. For data analysis, the appropriate statistical tests were used. Results A decrease in the latency of negative wave N2 and the positive wave P3 in the left ear in G1, and a decrease of P2 in the right ear in G2 were observed. In the analysis comparing the pre- and post-CAT groups, there was a significant difference in P1 latency in the left ear and P2 latency in the right ear, pre-intervention. Furthermore, eight children had an absence of the P3 wave, pre-CAT, but after the intervention, all of them presented the P3 wave. There were changes in the SAB score pre- and post-CAT in both groups. The presence of correlation between the scale and some LLAEP components was observed. Conclusion The CAT produced an electrophysiological modification, which became evident in the effects of the effects of neural plasticity after CAT. The SAB proved to be useful in measuring the therapeutic effects of the intervention. Moreover, there were behavioral changes in the SAB (higher scores) and correlation with LLAEP.

Abstract Background Anti-N-methyl-D-aspartate receptor encephalitis is a rare autoimmune disease characterized by severe neurological and psychiatric symptoms and a difficult diagnosis. The disease is often secondary to a neoplastic lesion, seldom diagnosed years later. Psychiatric symptoms are prevalent in adults; neurologic symptoms are more evident in children, who typically present primarily with neurological symptoms. To the best of our knowledge, the association with juvenile idiopathic arthritis has not been described. Case presentation We report the cases of two caucasian girls with an atypical presentation. The first patient was an 8-year-old girl with normal psychomotor development. Over a 4-month period she developed behavioral problems, speech impairment, and deterioration in academic skills. Within 8 months from the onset of symptoms, choreic movements gradually appeared. Hematological, neuroradiological, and neurophysiological examinations were negative; however, her symptoms worsened and treatment with prednisone was started. Although her choreic movements improved within 1 month, her neuropsychological and behavioral symptoms continued. Anti-N-methyl-D-aspartate receptor antibodies in cerebrospinal fluid and in blood were detected. Therapy with intravenously administered immunoglobulins was administered, without improvement of symptoms. After 2 months of steroid treatment, she suddenly started to pronounce some words with a progressive improvement in language and behavior. The second patient was a 14-year-old girl with classic anti-N-methyl-D-aspartate receptor encephalitis, treated successfully with intravenously administered immunoglobulins and methylprednisolone, followed by orally administered prednisone, who developed chronic arthritis of the hip. The arthritis was confirmed by magnetic resonance imaging and associated to antinuclear antigen antibody positivity. One year after the encephalitis presentation, an ovarian cystic mass was identified as a teratoma. The surgical resection of the mass was followed by the resolution of the psychotic spectrum and arthritis. Conclusions Anti-N-methyl-D-aspartate receptor encephalitis in pediatric patients can present initially with neuropsychological and behavioral symptoms. In the literature, the association of anti-N-methyl-D-aspartate receptor encephalitis with juvenile idiopathic arthritis is not yet described: to the best of our knowledge, this is the first case reported. The link to a neoplastic lesion can explain the favorable course of encephalitis and arthritis, after the surgical resection of the mass. Early diagnosis and treatment can improve the patient’s outcome.

Background: Parkinson's disease (PD) is a neurological disorder caused by decreasing dopamine in the brain. Speech is one of the first functions that are disrupted. Accordingly, speech features are a promising indicator in PD diagnosis for telemedicine applications. The purpose of this study is to investigate the impact of Parkinson's disease on a minimal set of Jitter and Shimmer voice indicators and studying the difference between male and female speech features in noisy/noiseless environments. Materials and Methods: Our data includes 47 samples from nursing homes and neurology clinics, with 23 patients and 24 healthy individuals. The optimal feature for each category is studied separately for the men's and women's samples. The focus here is on the phonation in which the vowel/a/is expressed by the participants. The main features, including Jitter and Shimmer perturbations, are extracted. To find an optimal pair under both noisy and noiseless circumstance, we use the Relief feature selection strategy. Results: This research shows that the Jitter feature for men and women with Parkinson's is 21 and 33.4, respectively. While the Shimmer feature is 0.1 and 0.06. In addition, by using these two features alone, we reach a correct diagnosis rate of 79% and 81% for noisy and noiseless states, respectively. Conclusion: The PD effects on the speech features can be accurately identified. Evaluating the extracted features suggests that the absolute value of the selected feature in men with PD is higher than for healthy ones. Whereas, in the case of women, this is the opposite.

Abstract Background: The speech disorders may produce irreparable damage to childs speech and language development in the psychosocial view. The voice, speech sound production and fluency disorders are speech disorders, that may result from delay or impairment in speech motor control mechanism, central neuron system disorders, improper language stimulation or voice abuse. Materials and Methods: This study examined the prevalence of speech disorders in 1393 Arakian students at 1 to 6th grades of primary school. After collecting continuous speech samples, picture description, passage reading and phonetic test, we recorded the pathological signs of stuttering, articulation disorder and voice disorders in a special sheet. Results: The prevalence of articulation, voice and stuttering disorders was 8%, 3.5% and%1 and the prevalence of speech disorders was 11.9%. The prevalence of speech disorders was decreasing with increasing of student’s grade. 12.2% of boy students and 11.7% of girl students of primary school in Arak had speech disorders. Conclusion: The prevalence of speech disorders of primary school students in Arak is similar to the prevalence of speech disorders in Kermanshah, but the prevalence of speech disorders in this research is smaller than many similar researches in Iran. It seems that racial and cultural diversity has some effect on increasing the prevalence of speech disorders in Arak city.

Introduction Dysarthria is a motor speech disorder. It occurs due to paralysis, weakness, or incoordination of the speech musculature. The authors with this study want to enrich clinical understanding of the difference of the aerodynamic characteristics in normophonic and dysarthric population. Materials and method The aerodynamic characteristics in normophonics and in dysarthric population were compared and documented using Voice Function Analyzer (Aerophone II®). Forty male individuals within the age range of thirty five to fifty five years participated in this study. The control group had twenty normophonic cases with no history of neurological disorder. The second group had twenty cases with dysarthria. Result Significant difference was found between the two groups in peak flow, forced volume and duration, vital capacity and fast adduction-abduction measurements. Discussion The difference in results from both the groups and their implications are discussed based on these findings. Conclusion The present study has assessed the parameters of speech and voice disorder in male dysarthric individuals. It suggests inclusion of aerodynamic measurement in test protocol and for evidence based research and prognosis documentation. Measurement of laryngeal or vocal tract resistance may be useful in documenting a variety of the perceptual voice characteristics.

Introduction: There is a lack of knowledge on the International Classification of Functioning, Disability, and Health (ICF) framework in Iran. Thus, the aim of the present study was to familiarize speech and language pathologists with this framework and the quality of previous studies in this respect through a purposive review of published studies on the application of the ICF framework regarding speech and language impairments in preschool children. Materials and Methods: The keywords used included ICF and communication disorder, ICF and language impairment, and ICF and speech impairment. The main data banks searched included PubMed and Web of Knowledge and the search limit consisted of studies published between the years 2005 and 2015. Results: Based on inclusion/exclusion criteria, 6 of the 96 published documents were eligible to be reviewed. All studied papers asserted that the ICF framework, through providing a comprehensive view, provides a concept of children’s speech and language impairment which can create a coherent interaction between empirical evidence and clinical observations. Therefore, it evaluates all obstacles and facilitators of communication for the child. This will result in a more effective and targeted assessment and treatment of speech and language impairments in children. Of all the themes present in the ICF framework, 735 themes were used in the reviewed articles, most of which were related to the activities and participation domains. Conclusion: Due to its components and their interaction, the ICF framework prevents the sole focusing of physicians, in a traditional and medical sense, on the structure and function of body organs. It provides a comprehensive view on the performance, function, and coordination of individual and environmental factors for the child. The review of these texts shows that they also emphasize the application of this comprehensive approach in the accurate assessment and treatment of speech and language impairments. The quality analysis of the studies showed that the majority of the studies regarding this topic were published in a non-experimental and non-research format. Moreover, very few experimental studies have been performed in this regard, which did not surpass descriptive studies in terms of quality.

Background: Stuttering is a kind of speech disorder that affects about 1% of total population. As the origin of this disorder is not obviously diagnosed yet, various remedies have been practiced and among them different medicines have been studied, but unfortunately no significant effective drugs have been recognized yet. As stuttering imposes a great social and mental costs to the patients and their families, finding an effective medicine will help significantly. In this study we have focused on the effects of levetiracetam (LEV) treatment on children suffering from stuttering. Methods: In this clinical trial study, 30 children aged > 3 years (median 3.8 years) with stuttering and abnormal sleep electroencephalogram (EEG) were treated by LEV and followed-up for a minimum period of 6 weeks. The starting dose of 20 mg/kg/day was increased at an interval of 1 week by 20 mg/kg/day, if necessary, up to maximum dose of 60 mg/kg/day. Results: Overall LEV was effective in 70% of patients, decreasing stuttering to at least 50%. Three children (10%) became stuttering-free and only in one (3.3%) child an increase in stuttering was observed. There were statistically significant differences for efficacy in the presence of variables such as age groups, seizure, stuttering family history, and EEG data. Conclusions: LEV is an effective drug for treatment of childhood stuttering in those that have abnormal sleep EEG.