Clinical notes: Masking devices and The Edinburgh Masker—Clinical applications within a prison setting

This paper outlines portions of the writer's therapeutics in the field of stuttering with emphasis upon use of masking the hearing of stutterers as a part of a total therapeutic approach. Commencing with devices providing continuous noise to override the voice of the stutterer so that he cannot hear himself and, thus, eliciting fluency. Described is the use of the voice actuated Edinburgh Auditory Masker within an intensive stuttering program in a prison setting since September 1978. It is concluded that the use of masking and the Edinburgh device has been helpful and productive with severe stutterers.     

Language performance on visual processing tasks in right hemisphere lesion cases

Seven language tests were constructed or adapted to assess the performance of three groups of 10 right-handed adult subjects: a right hemisphere lesion (RHL) group, a left hemisphere lesion (LHL) group, and a neurologically normal (NN) control group. Both the LHL and RHL groups produced poorer scores than the NN group on six of the seven tests. On two of the six significant tests, the RHL performed more poorly than the NN group. Analyses of words uttered during an oral story telling test indicated that the RHL group told significantly fewer complete stories using significantly more nouns, adjectives, and conjunctions than the NN group. On a 7-point scale, three judges rated the overall communication abilities of the RHL group as having “mild problems,” a significantly different rating than the ratings of the LHL and NN groups. The findings suggest that underlying visual spatial and perceptual deficits may be accompanied by clearly recognizable language differences in certain subjects.     

Self-monitoring behavior in a case of severe auditory agnosia with aphasia

This case report describes an unusual combination of speech and language deficits secondary to bilateral infarctions in a 62-year-old woman. The patient was administered an extensive series of speech, language, and audiologic tests and was found to exhibit a fluent aphasia in which reading and writing were extremely well preserved in comparison to auditory comprehension and oral expression, and a severe auditory agnosia. In spite of her auditory processing deficits, the patient exhibited unexpected self-monitoring ability and the capacity to form acoustic images on visual tasks. The manner in which she corrected and attempted to correct her phonemic errors, while ignoring semantic errors, suggests that different mechanisms may underlie the monitoring of these errors.     

Vibrotactile magnitude production scaling: A method for studying sensory-perceptual responses of stutterers and fluent speakers

The method of vibrotactile mangitude production scaling was used to determine the tactile sensory-perceptual integrity for the dorsum of the tongue and thenar eminence of the right hand for 10 fluent speakers and 10 stutterers. It was discovered that both groups performed the task in a similar manner for the thenar eminence of the hand (a nonoral structure) but in a dissimilar manner for the tongue (an oral structure). From these data, it is suggested that the stutterers may maintain a different internal sensory-perceptual process for the tactile system involved in the speech process. The possibility exists that stuttering, for some, may be an “internal disorder” of the tactile-proprioceptive feedback mechanism that is directly involved in speech production.     

Linguistic analysis of a bilingual stutterer

The ultimate test of the adequacy of linguistic models of fluency breakdown is the degree to which they may account for patterns of dysfluency in the speech of a stutterer who is fluent in more than one language. We present the case of an adult bilingual stutterer (Spanish-English), whose spontaneous language in both Spanish and English was structurally analyzed to assess the relationships of phonological and syntactic structure to the frequency and location of fluency breakdown. Our findings suggest that syntax is probably a greater determinant of stuttered moments than is phonology. Additionally, similarities and differences between English and Spanish sentence structure were associated with similarities and differences in the loci of dysfluencies across the two languages. The need for crosslinguistic research utilizing monolingual and bilingual speakers of languages other than English is emphasized.     

The Sound of Grasp Affordances: Influence of Grasp‐Related Size of Categorized Objects on Vocalization

Previous research shows that simultaneously executed grasp and vocalization responses are faster when the precision grip is performed with the vowel [i] and the power grip is performed with the vowel [ɑ]. Research also shows that observing an object that is graspable with a precision or power grip can activate the grip congruent with the object. Given the connection between vowel articulation and grasping, this study explores whether grasp‐related size of observed objects can influence not only grasp responses but also vowel pronunciation. The participants had to categorize small and large objects into natural and manufactured categories by pronouncing the vowel [i] or [ɑ]. As predicted, [i] was produced faster when the object's grasp‐related size was congruent with the precision grip while [ɑ] was produced faster when the size was congruent with the power grip (Experiment 1). The effect was not, however, observed when the participants were presented with large objects that are not typically grasped by the power grip (Experiment 2). This study demonstrates that vowel production is systematically influenced by grasp‐related size of a viewed object, supporting the account that sensory‐motor processes related to grasp planning and representing grasp‐related properties of viewed objects interact with articulation processes. The paper discusses these findings in the context of size–sound symbolism, suggesting that mechanisms that transform size‐grasp affordances into corresponding grasp‐ and articulation‐related motor programs might provide a neural basis for size‐sound phenomena that links small objects with closed‐front vowels and large objects with open‐back vowels.     

Special Considerations in the Adaptation of Cognitive Behavioral Therapy for Insomnia With Active-Duty U.S. Army Personnel

Insomnia is highly prevalent among active-duty military service members. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a well-established and effective treatment; however, research and treatment recommendations have primarily focused on civilian or veteran populations. A multitude of military-specific factors directly impact service members’ sleep and the subsequent treatment recommendations. This article provides treatment considerations for the use of CBT-I with active-duty U.S. Army personnel. First, an overview of the theoretical model of insomnia, including military-specific predisposing, precipitating, and perpetuating factors, is presented, followed by a review of common comorbid conditions among service members with insomnia. Finally, discussion focuses on considerations and strategies for implementing components of CBT-I with service members, managing sleep during deployments, and adjusting sleep to accommodate overnight duties. Additional training resources and supplemental video examples (with actors) are provided.     

The Caregivers' Attachment and Relationship Education Class: A New and Promising Group Therapy for Caregivers of Individuals with Parkinson's Disease

The authors examined whether a newly developed group therapy, based on principles of attachment theory and emotionally focused couples therapy, can potentially address the unique mental health and relationship difficulties in caregivers of individuals with Parkinson's disease. A comprehensive outreach effort, involving a review of 251 military veterans' medical records, yielded enrollment of seven spousal caregivers in the group therapy. At 1-month follow-up, caregivers who initially reported mild or greater levels of caregiver burden demonstrated statistically reliable declines in psychological distress, relationship distress, or both. Posttreatment surveys indicated positive perceptions in overall helpfulness of treatment goals, as well as positive changes in insight (e.g., greater understanding of the patient's attachment needs) and behaviors (e.g., greater social contact and self-care of the caregiver). Results are considered in the context of inadequate access to treatment for caregivers of spouses with Parkinson's disease or other major medical issues.     

Tone of voice guides word learning in informative referential contexts

Listeners infer which object in a visual scene a speaker refers to from the systematic variation of the speaker's tone of voice (ToV). We examined whether ToV also guides word learning. During exposure, participants heard novel adjectives (e.g., “daxen”) spoken with a ToV representing hot, cold, strong, weak, big, or small while viewing picture pairs representing the meaning of the adjective and its antonym (e.g., elephant–ant for big–small). Eye fixations were recorded to monitor referent detection and learning. During test, participants heard the adjectives spoken with a neutral ToV, while selecting referents from familiar and unfamiliar picture pairs. Participants were able to learn the adjectives' meanings, and, even in the absence of informative ToV, generalize them to new referents. A second experiment addressed whether ToV provides sufficient information to infer the adjectival meaning or needs to operate within a referential context providing information about the relevant semantic dimension. Participants who saw printed versions of the novel words during exposure performed at chance during test. ToV, in conjunction with the referential context, thus serves as a cue to word meaning. ToV establishes relations between labels and referents for listeners to exploit in word learning.