The precision fluency shaping program: Replication and evaluation

The purpose of this article is to present the results of a two-year project to evaluate the Precision Fluency Shaping Program (Webster, 1980) in a community speech and hearing center. Fifty stutterers participated in therapy. Results indicated that Precision Fluency Shaping was an effective therapy for the treatment of stuttering. In addition, stutterer's perception of their speech changed from pre to post therapy. Follow-up data are presented on 28 clients. Advantages of conducting Precision Fluency Shaping, meeting accountability standards, and procedures for collecting follow-up data are discussed.     

Disfluent speech associated with brain damage

The frequency and type of disfluencies in the spontaneous speech of 15 people with Broca's aphasia and right hemiplegia was studied. Two aged-matched control groups (15 nonaphasic stroke patients with left hemiplegia and 15 normals) were also studied. The frequency of disfluencies in the speech of aphasics was three times greater than that in the speech of either control group. However, most of the disfluencies uttered by aphasics were of the types commonly found in speech of normals.     

Validation of the Preschool and Early Childhood Functional Assessment Scale (PECFAS)

Efforts to determine the prevalence of serious emotional disturbance in preschool-aged children have been hampered by the lack of a validated measure. The Preschool and Early Childhood Functional Assessment Scale (PECFAS) is a multi-dimensional measure that assesses the psychosocial functioning of children aged 3–7 years. The concurrent validity and reliability of the PECFAS were assessed in a sample of 30 preschool-aged children in a large Head Start program in Ventura, California. PECFAS ratings based on in-depth interviews were significantly related to parental ratings that the children had mental health problems, psychiatric diagnoses, teacher ratings of the child's need for mental health evaluations, teacher ratings of behavior problems on a standardized screening inventory (DIAL-R), and actual referrals for mental health evaluations. Interrater reliability for the total PECFAS score was high (r = .90) as was internal consistency of the five subscales (alpha = .86). Using the PECFAS scores as a standard, the weighted prevalence of serious emotional disturbance in this West Coast Head Start program was 17%, at the lower end of the current estimated rate of SED for older children in low income samples (18–26%).     

What is chronic pain?

Chronic pain leads to individual suffering and to major costs for all developed countries. Previous studies suggest that both the incidence of disabling chronic pain and the amount of health care consumption due to chronic pain are rapidly increasing. Western medicine is not only often ineffective but may be one of the causes of this epidemic. This article will address the issue of chronic pain of unknown etiology and has the goals of: (1) identifying the factors which have led to our confusion about this topic, and (2) proposing alternative ways of conceptualizing chronic pain and its ensuing behaviors and social consequences. It is concluded that it is essential to discriminate between tissue damage, pain, suffering, pain behaviors, health care consumption, impairment and disability if one is to develop a meaningful conceptualization of the medical, social, economic and political problems of chronic pain. Successful treatment must be defined in behavioral terms such as restoration of normal activities. Disabling chronic pain is often a sign of overwhelming stress engendered by the individual's failure to cope with the demands of industrialized society.     

Development of clinical vignettes to assess healthcare decision-making capacity in elderly with mild cognitive impairment and Alzheimer's disease

IntroductionCognitive impairment can constrict healthcare decision-making capacity, as it affects the ability to understand, appreciate, and reason with information, as well as communication abilities. Therefore, decision-making capacity of elders with mild cognitive impairment or Alzheimer's disease should be carefully assessed when patients are asked to make decisions regarding their health. Vignettes are particularly relevant to assess healthcare decision capacity, since they can come close to real life situations and improve statistical reliability of capacity assessment instruments.ObjectiveThis paper describes the construction and development process of three hypothetical vignettes, to be included in a new Portuguese assessment tool of healthcare decision-making capacity (CAI-Health).MethodFor vignettes’ development, examples from other assessment tools were first reviewed to summarize their text length, language complexity and health information contained. Most prevalent causes of mortality and morbidity in Portuguese elders were then identified, in order to select the health issues to include in CAI-Health’ vignettes. Seven vignettes were developed, and three were selected to be included in CAI-Health. After vignette's selection, these were reviewed by three experienced medical experts, during a focus group.ConclusionVignettes final version include cases of increased complexity, presenting situations of mild cognitive impairment, lung tumor and knee arthrosis.     

Using a multi‐feature paradigm to measure mismatch responses to minimal sound contrasts in children with cochlear implants and hearing aids

Our aim was to explore whether a multi‐feature paradigm (Optimum‐1) for eliciting mismatch negativity (MMN) would objectively capture difficulties in perceiving small sound contrasts in children with hearing impairment (HI) listening through their hearing aids (HAs) and/or cochlear implants (CIs). Children aged 5–7 years with HAs, CIs and children with normal hearing (NH) were tested in a free‐field setting using a multi‐feature paradigm with deviations in pitch, intensity, gap, duration, and location. There were significant mismatch responses across all subjects that were positive (p‐MMR) for the gap and pitch deviants (F(1,43) = 5.17, p = 0.028 and F(1,43) = 6.56, p = 0.014, respectively) and negative (MMN) for the duration deviant (F(1,43) = 4.74, p = 0.035). Only the intensity deviant showed a significant group interaction with MMN in the HA group and p‐MMR in the CI group (F(2,43) = 3.40, p = 0.043). The p‐MMR correlated negatively with age, with the strongest correlation in the NH subjects. In the CI group, the late discriminative negativity (LDN) was replaced by a late positivity with a significant group interaction for the location deviant. Children with severe HI can be assessed through their hearing device with a fast multi‐feature paradigm. For further studies a multi‐feature paradigm including more complex speech sounds may better capture variation in auditory processing in these children.     

Dysexecutive syndrome in Parkinson’s disease: the GREFEX study

The objectives of this study were to characterize the frequencies and profiles of behavioral and cognitive dysexecutive syndromes in PD (based on validated battery and diagnostic criteria) and to develop a shortened diagnostic battery. Eighty-eight non-demented patients with a diagnosis of PD were examined with an executive validated battery. Using a validated framework, the patients’ test results were interpreted with respect to normative data from 780 controls. A dysexecutive syndrome was observed in 80.6% of the patients [95% confidence interval: 71.1–90.1]. The dysexecutive profile was characterized by prominent impairments in deduction, flexibility, inhibition and initiation in the cognitive domain, and by global hypoactivity with apathy and hyperactivity in the behavioral domain. This finding implies that patients with PD should be assessed with cognitive tests and a validated inventory for behavioral dysexecutive syndromes. A shortened battery (based on three cognitive tests and three behavioral domains) provided high diagnostic accuracy.     

The emergence of Cognitive Hearing Science

Cognitive Hearing Science or Auditory Cognitive Science is an emerging field of interdisciplinary research concerning the interactions between hearing and cognition. It follows a trend over the last half century for interdisciplinary fields to develop, beginning with Neuroscience, then Cognitive Science, then Cognitive Neuroscience, and then Cognitive Vision Science. A common theme is that an interdisciplinary approach is necessary to understand complex human behaviors, to develop technologies incorporating knowledge of these behaviors, and to find solutions for individuals with impairments that undermine typical behaviors. Accordingly, researchers in traditional academic disciplines, such as Psychology, Physiology, Linguistics, Philosophy, Anthropology, and Sociology benefit from collaborations with each other, and with researchers in Computer Science and Engineering working on the design of technologies, and with health professionals working with individuals who have impairments. The factors that triggered the emergence of Cognitive Hearing Science include the maturation of the component disciplines of Hearing Science and Cognitive Science, new opportunities to use complex digital signal-processing to design technologies suited to performance in challenging everyday environments, and increasing social imperatives to help people whose communication problems span hearing and cognition. Cognitive Hearing Science is illustrated in research on three general topics: (1) language processing in challenging listening conditions; (2) use of auditory communication technologies or the visual modality to boost performance; (3) changes in performance with development, aging, and rehabilitative training. Future directions for modeling and the translation of research into practice are suggested.     

Are errors differentiable from deceptive responses when feigning memory impairment? An fMRI study

Previous neuroimaging studies have suggested that the neural activity associated with truthful recall, with false memory, and with feigned memory impairment are different from one another. Here, we report a functional magnetic resonance imaging (fMRI) study that addressed an important but yet unanswered question: Is the neural activity associated with intentional faked responses and with errors differentiable? Using a word list learning recognition paradigm, the findings of this mixed event-related fMRI study clearly indicated that the brain activity associated with intentional faked responses was different to the activity associated with errors committed unintentionally. For intentional faked responses, significant activation was found in the ventrolateral prefrontal cortex, the posterior cingulate region, and the precuneus. However, no significant activation was observed for unintentional errors. The results suggest that deception, in terms of feigning memory impairment, is not only more cognitively demanding than making unintentional errors but also utilizes different cognitive processes.     

汉语发展性深层阅读障碍的个案研究

报告了一个发展性阅读障碍个案J,J的语音技能存在缺陷,音位、声调意识差,语音短时记忆能力弱,在汉字命名中产生大量语义错误、视觉错误和选择错误,表现出一系列深层阅读障碍症候群,是一例典型的深层阅读障碍个案。还讨论了汉语发展性阅读障碍亚类型的分类标准以及分布特点。