The effect of speech rate on overall intelligibility in Parkinson's Disease (PD) is still a m... more The effect of speech rate on overall intelligibility in Parkinson's Disease (PD) is still a matter of debate. A comparison of the results of previous studies on speech rate in PD is hampered by methodological differences. In this study, we evaluated the effects of levodopa on speech rate and on its variability in a standardized reading task. Twenty-five patients were studied before and after levodopa administration while reading a standardized text. In accordance with previous studies, no significant improvement of speech rate was found. Rather an increased variability of speech rate in the on-medication state could be demonstrated. It is possible that this increased variability may be the consequence of respiratory deficits due to levodopa-induced dyskinesia or an increase of dysfluencies. However, the effects of defective auditory feedback and disturbed executive function cannot be ruled out.
International Journal of Speech-Language Pathology, 2010
Previous research has indicated that in Parkinson&amp... more Previous research has indicated that in Parkinson's disease (PD) some motor speech characteristics are changed by levodopa administration, while others are not. In advanced PD, the time course of these changes and the correlations with motor performance have not been sufficiently investigated. The purpose was to investigate the sequential changes of respiratory, articulatory, and phonatory speech characteristics across a levodopa drug cycle, using spirometry, acoustic, and motor speech analysis. Seven patients with advanced PD were included. All patients were evaluated sequentually at 15 minute intervals before and following levodopa intake. Data were analysed using repeated measures ANOVA and non-parametric analysis. Significant changes were found in motor function, vital capacity, and standard deviation of the diadochokinetic period. A trend was present for shimmer and frequency of the first formant. Significant inter-individual differences in the sequential changes were demonstrated for nearly all evaluated parameters. The conclusion is that, in advanced PD, the evaluation of speech characteristics at one moment after levodopa administration is not representative of an entire drug cycle and that an individualized evaluation of an entire drug cycle is warranted before initiation of a speech-language pathology program.
The results are reported of a questionnaire study into the awareness of stuttering of lay persons... more The results are reported of a questionnaire study into the awareness of stuttering of lay persons in part of Belgium. 1,362 subjects were interviewed. Questions pertained to various aspects of stuttering including prevalence, onset, gender distribution and occurrence in different cultures, cause, treatment, intelligence and hereditariness. Although most respondents were to some extent familiar with stuttering, their overall knowledge of the disorder appeared generally limited.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2009
OBJECTIVE The purpose of the present study was to document the possible impact of tongue piercing... more OBJECTIVE The purpose of the present study was to document the possible impact of tongue piercing on speech. STUDY DESIGN A questionnaire study and a listener experiment were conducted. METHODS Eight participants with a barbell-type piercing placed dorsoventral in the midline of the tongue completed a questionnaire inquiring about possible pre-existing speech-language problems and about the participants' history and experience with the piercing. Three graduate speech-language pathologists evaluated the articulation of the participants. They scored speech samples of the participants reading a text on a 9-point interval scale with "seriously disturbed articulation" (score 1) and "normal articulation" (score 9) as left and right extremes, respectively, once with the piercing in place and once with the piercing removed. RESULTS All participants reported having experienced articulation problems immediately after placement of the tongue piercing. These problems las...
Audio tapes are often used as evidence in courtrooms. This report is about a case of threatening ... more Audio tapes are often used as evidence in courtrooms. This report is about a case of threatening telephone calls. Tape authentication was done by visual and statistical analysis of pitch and loudness contours. Voice identification was done by means of a “voice line-up”, i.e. judging differences and similarities in a series of matched voices (including the defendants’ voice) and the voice on the exhibit recording. Methods for authentication and identification are described in detail.
Speech-language pathologists nowadays are more and more confronted with clients who speak a langu... more Speech-language pathologists nowadays are more and more confronted with clients who speak a language different from their own mother tongue. The assessment of persons who speak a foreign language poses particular challenges. The present study investigated the possible role and interplay of factors involved in the identification of stuttering severity in a foreign language. Nineteen speech-language pathologists from five different countries (i.e. Iceland, Sweden, Norway, Finland, and Belgium) rated stuttering severity of speech samples featuring persons who stutter speaking Icelandic, Swedish, Norwegian, or Dutch. Additionally, they were asked to score how easy they found it to rate the samples. Accuracy of rating stuttering severity in another language appeared to be foremost determined by the client's stuttering severity, while experienced ease of rating stuttering severity was essentially related to closeness of the language of the clinician to that of the client and familiari...
A neural hallmark of developmental stuttering is abnormal articulatory programming. One of the ne... more A neural hallmark of developmental stuttering is abnormal articulatory programming. One of the neurophysiological substrates of articulatory preparation is the contingent negative variation (CNV). Unfortunately, CNV tasks are rarely performed in persons who stutter and mainly focus on the effect of task variation rather than on interindividual variation in stutter related variables. However, variations in motor programming seem to be related to variation in stuttering frequency. The current study presents a case report of acquired stuttering following stroke and stroke related surgery in the left superior temporal gyrus. A speech related CNV task was administered at four points in time with differences in stuttering severity and frequency. Unexpectedly, CNV amplitudes at electrode sites approximating bilateral motor and left inferior frontal gyrus appeared to be inversely proportional to stuttering frequency. The higher the stuttering frequency, the lower the activity for articulatory preparation. Thus, the amount of disturbance in motor programming seems to determine stuttering frequency. At right frontal electrodes, a relative increase in CNV amplitude was seen at the test session with most severe stuttering. Right frontal overactivation is cautiously suggested to be a compensation strategy. In conclusion, late CNV amplitude elicited by a relatively simple speech task seems to be able to provide an objective, neural correlate of stuttering frequency. The present case report supports the hypothesis that motor preparation has an important role in stuttering.
Objective: Facial exercises are a noninvasive alternative to medical approaches to facial rejuven... more Objective: Facial exercises are a noninvasive alternative to medical approaches to facial rejuvenation. Logopedists could be involved in providing these exercises. Little research has been conducted, however, on the effectiveness of exercises for facial rejuvenation. This study assessed the effectiveness of 4 exercises purportedly reducing wrinkles and sagging of the facial skin. Method: A control group study was conducted with 18 participants, 9 of whom (the experimental group) underwent daily training for 7 weeks. Pictures taken before and after 7 weeks of 5 facial areas (forehead, nasolabial folds, area above the upper lip, jawline and area under the chin) were evaluated by a panel of laypersons. In addition, the participants of the experimental group evaluated their own pictures. Evaluation included the pairwise presentation of pictures before and after 7 weeks and scoring of the same pictures by means of visual analogue scales in a random presentation. Results: Only one signifi...
The purpose of this study was to investigate to what extent lesbian women demonstrate pitch and p... more The purpose of this study was to investigate to what extent lesbian women demonstrate pitch and pitch variation that is different from that of heterosexual women. Static group comparison. The average pitch and pitch variation of a group of 34 self-identified lesbian women and an age-matched group of 68 heterosexual women were compared. The speech sample consisted of read speech. Acoustic analysis was performed by means of PRAAT. Mean fundamental frequency in the group of lesbian women was significantly lower than that of the group of heterosexual women. The lesbian woman also showed significantly less pitch variation. Lesbian women tend to demonstrate a lower average pitch and less pitch variation than heterosexual women, but this does not mean a confirmation of the popular stereotype that lesbian women are masculine women. In their assessment of clients with voice disorders, clinicians should reckon with the sociophonetic variation that is associated with sexual orientation.
Traditional neurologic tenets claim that the clinical picture of acquired childhood aphasia is no... more Traditional neurologic tenets claim that the clinical picture of acquired childhood aphasia is nonfluent irrespective of lesion location. In the past 20 years, however, several case studies have shown that fluent aphasic patterns can be observed in children with acquired childhood aphasia. But the question remains open as to whether the pattern of their speech characteristics is similar to the one described in adult aphasics as studies addressing spontaneous speech fluency characteristics in larger series of children with acquired childhood aphasia are scarce. The objective of this study was to investigate whether an analysis of spontaneous speech fluency as has previously been performed in adult aphasics by other investigators would also yield two distinct groups of aphasic children and, if so, whether the distribution of the different speech characteristics in both groups would reflect the rank order found in adults, that is, whether nonfluent verbal output characteristics would p...
Transsexualism implies that an anatomically normal individual feels that he or she is actually a ... more Transsexualism implies that an anatomically normal individual feels that he or she is actually a member of the opposite sex. Treatment usually includes real-life experience along with hormone therapy and sex reassignment surgery. Voice modification surgery may be necessary, as pass ability in general is still in a large extent dependent on the aspects of voice in transsexual people. Often
Women and girls with complete androgen insensitivity syndrome (CAIS) invariably have a female typ... more Women and girls with complete androgen insensitivity syndrome (CAIS) invariably have a female typical core gender identity. In this case report, we describe the first case of male gender identity in a CAIS individual raised female leading to complete sex reassignment involving both androgen treatment and phalloplasty. CAIS was diagnosed at age 17, based on an unambiguously female phenotype, a 46,XY karyotype, and a 2660delT androgen receptor (AR) gene mutation, leading to a premature stop in codon 807. Bilateral gonadectomy was performed but a short period of estrogen treatment induced a negative emotional reaction and treatment was stopped. Since the age of 3, childhood-onset cross gender behavior had been noticed. After a period of psychotherapy, persisting male gender identity was confirmed. There was no psychiatric co-morbidity and there was an excellent real life experience. Testosterone substitution was started, however without inducing any of the desired secondary male characteristics. A subcutaneous mastectomy was performed and the patient received phalloplasty by left forearm free flap and scrotoplasty. Testosterone treatment was continued, without inducing virilization, and bone density remained normal. The patient qualifies as female-to-male transsexual and was treated according to the Standards of Care by the World Professional Association for Transgender Health with good outcome. However, we do not believe that female sex of rearing as a standard procedure should be questioned in CAIS. Our case challenges the role of a functional AR pathway in the development of male gender identity.
The effect of speech rate on overall intelligibility in Parkinson's Disease (PD) is still a m... more The effect of speech rate on overall intelligibility in Parkinson's Disease (PD) is still a matter of debate. A comparison of the results of previous studies on speech rate in PD is hampered by methodological differences. In this study, we evaluated the effects of levodopa on speech rate and on its variability in a standardized reading task. Twenty-five patients were studied before and after levodopa administration while reading a standardized text. In accordance with previous studies, no significant improvement of speech rate was found. Rather an increased variability of speech rate in the on-medication state could be demonstrated. It is possible that this increased variability may be the consequence of respiratory deficits due to levodopa-induced dyskinesia or an increase of dysfluencies. However, the effects of defective auditory feedback and disturbed executive function cannot be ruled out.
International Journal of Speech-Language Pathology, 2010
Previous research has indicated that in Parkinson&amp... more Previous research has indicated that in Parkinson's disease (PD) some motor speech characteristics are changed by levodopa administration, while others are not. In advanced PD, the time course of these changes and the correlations with motor performance have not been sufficiently investigated. The purpose was to investigate the sequential changes of respiratory, articulatory, and phonatory speech characteristics across a levodopa drug cycle, using spirometry, acoustic, and motor speech analysis. Seven patients with advanced PD were included. All patients were evaluated sequentually at 15 minute intervals before and following levodopa intake. Data were analysed using repeated measures ANOVA and non-parametric analysis. Significant changes were found in motor function, vital capacity, and standard deviation of the diadochokinetic period. A trend was present for shimmer and frequency of the first formant. Significant inter-individual differences in the sequential changes were demonstrated for nearly all evaluated parameters. The conclusion is that, in advanced PD, the evaluation of speech characteristics at one moment after levodopa administration is not representative of an entire drug cycle and that an individualized evaluation of an entire drug cycle is warranted before initiation of a speech-language pathology program.
The results are reported of a questionnaire study into the awareness of stuttering of lay persons... more The results are reported of a questionnaire study into the awareness of stuttering of lay persons in part of Belgium. 1,362 subjects were interviewed. Questions pertained to various aspects of stuttering including prevalence, onset, gender distribution and occurrence in different cultures, cause, treatment, intelligence and hereditariness. Although most respondents were to some extent familiar with stuttering, their overall knowledge of the disorder appeared generally limited.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2009
OBJECTIVE The purpose of the present study was to document the possible impact of tongue piercing... more OBJECTIVE The purpose of the present study was to document the possible impact of tongue piercing on speech. STUDY DESIGN A questionnaire study and a listener experiment were conducted. METHODS Eight participants with a barbell-type piercing placed dorsoventral in the midline of the tongue completed a questionnaire inquiring about possible pre-existing speech-language problems and about the participants' history and experience with the piercing. Three graduate speech-language pathologists evaluated the articulation of the participants. They scored speech samples of the participants reading a text on a 9-point interval scale with "seriously disturbed articulation" (score 1) and "normal articulation" (score 9) as left and right extremes, respectively, once with the piercing in place and once with the piercing removed. RESULTS All participants reported having experienced articulation problems immediately after placement of the tongue piercing. These problems las...
Audio tapes are often used as evidence in courtrooms. This report is about a case of threatening ... more Audio tapes are often used as evidence in courtrooms. This report is about a case of threatening telephone calls. Tape authentication was done by visual and statistical analysis of pitch and loudness contours. Voice identification was done by means of a “voice line-up”, i.e. judging differences and similarities in a series of matched voices (including the defendants’ voice) and the voice on the exhibit recording. Methods for authentication and identification are described in detail.
Speech-language pathologists nowadays are more and more confronted with clients who speak a langu... more Speech-language pathologists nowadays are more and more confronted with clients who speak a language different from their own mother tongue. The assessment of persons who speak a foreign language poses particular challenges. The present study investigated the possible role and interplay of factors involved in the identification of stuttering severity in a foreign language. Nineteen speech-language pathologists from five different countries (i.e. Iceland, Sweden, Norway, Finland, and Belgium) rated stuttering severity of speech samples featuring persons who stutter speaking Icelandic, Swedish, Norwegian, or Dutch. Additionally, they were asked to score how easy they found it to rate the samples. Accuracy of rating stuttering severity in another language appeared to be foremost determined by the client's stuttering severity, while experienced ease of rating stuttering severity was essentially related to closeness of the language of the clinician to that of the client and familiari...
A neural hallmark of developmental stuttering is abnormal articulatory programming. One of the ne... more A neural hallmark of developmental stuttering is abnormal articulatory programming. One of the neurophysiological substrates of articulatory preparation is the contingent negative variation (CNV). Unfortunately, CNV tasks are rarely performed in persons who stutter and mainly focus on the effect of task variation rather than on interindividual variation in stutter related variables. However, variations in motor programming seem to be related to variation in stuttering frequency. The current study presents a case report of acquired stuttering following stroke and stroke related surgery in the left superior temporal gyrus. A speech related CNV task was administered at four points in time with differences in stuttering severity and frequency. Unexpectedly, CNV amplitudes at electrode sites approximating bilateral motor and left inferior frontal gyrus appeared to be inversely proportional to stuttering frequency. The higher the stuttering frequency, the lower the activity for articulatory preparation. Thus, the amount of disturbance in motor programming seems to determine stuttering frequency. At right frontal electrodes, a relative increase in CNV amplitude was seen at the test session with most severe stuttering. Right frontal overactivation is cautiously suggested to be a compensation strategy. In conclusion, late CNV amplitude elicited by a relatively simple speech task seems to be able to provide an objective, neural correlate of stuttering frequency. The present case report supports the hypothesis that motor preparation has an important role in stuttering.
Objective: Facial exercises are a noninvasive alternative to medical approaches to facial rejuven... more Objective: Facial exercises are a noninvasive alternative to medical approaches to facial rejuvenation. Logopedists could be involved in providing these exercises. Little research has been conducted, however, on the effectiveness of exercises for facial rejuvenation. This study assessed the effectiveness of 4 exercises purportedly reducing wrinkles and sagging of the facial skin. Method: A control group study was conducted with 18 participants, 9 of whom (the experimental group) underwent daily training for 7 weeks. Pictures taken before and after 7 weeks of 5 facial areas (forehead, nasolabial folds, area above the upper lip, jawline and area under the chin) were evaluated by a panel of laypersons. In addition, the participants of the experimental group evaluated their own pictures. Evaluation included the pairwise presentation of pictures before and after 7 weeks and scoring of the same pictures by means of visual analogue scales in a random presentation. Results: Only one signifi...
The purpose of this study was to investigate to what extent lesbian women demonstrate pitch and p... more The purpose of this study was to investigate to what extent lesbian women demonstrate pitch and pitch variation that is different from that of heterosexual women. Static group comparison. The average pitch and pitch variation of a group of 34 self-identified lesbian women and an age-matched group of 68 heterosexual women were compared. The speech sample consisted of read speech. Acoustic analysis was performed by means of PRAAT. Mean fundamental frequency in the group of lesbian women was significantly lower than that of the group of heterosexual women. The lesbian woman also showed significantly less pitch variation. Lesbian women tend to demonstrate a lower average pitch and less pitch variation than heterosexual women, but this does not mean a confirmation of the popular stereotype that lesbian women are masculine women. In their assessment of clients with voice disorders, clinicians should reckon with the sociophonetic variation that is associated with sexual orientation.
Traditional neurologic tenets claim that the clinical picture of acquired childhood aphasia is no... more Traditional neurologic tenets claim that the clinical picture of acquired childhood aphasia is nonfluent irrespective of lesion location. In the past 20 years, however, several case studies have shown that fluent aphasic patterns can be observed in children with acquired childhood aphasia. But the question remains open as to whether the pattern of their speech characteristics is similar to the one described in adult aphasics as studies addressing spontaneous speech fluency characteristics in larger series of children with acquired childhood aphasia are scarce. The objective of this study was to investigate whether an analysis of spontaneous speech fluency as has previously been performed in adult aphasics by other investigators would also yield two distinct groups of aphasic children and, if so, whether the distribution of the different speech characteristics in both groups would reflect the rank order found in adults, that is, whether nonfluent verbal output characteristics would p...
Transsexualism implies that an anatomically normal individual feels that he or she is actually a ... more Transsexualism implies that an anatomically normal individual feels that he or she is actually a member of the opposite sex. Treatment usually includes real-life experience along with hormone therapy and sex reassignment surgery. Voice modification surgery may be necessary, as pass ability in general is still in a large extent dependent on the aspects of voice in transsexual people. Often
Women and girls with complete androgen insensitivity syndrome (CAIS) invariably have a female typ... more Women and girls with complete androgen insensitivity syndrome (CAIS) invariably have a female typical core gender identity. In this case report, we describe the first case of male gender identity in a CAIS individual raised female leading to complete sex reassignment involving both androgen treatment and phalloplasty. CAIS was diagnosed at age 17, based on an unambiguously female phenotype, a 46,XY karyotype, and a 2660delT androgen receptor (AR) gene mutation, leading to a premature stop in codon 807. Bilateral gonadectomy was performed but a short period of estrogen treatment induced a negative emotional reaction and treatment was stopped. Since the age of 3, childhood-onset cross gender behavior had been noticed. After a period of psychotherapy, persisting male gender identity was confirmed. There was no psychiatric co-morbidity and there was an excellent real life experience. Testosterone substitution was started, however without inducing any of the desired secondary male characteristics. A subcutaneous mastectomy was performed and the patient received phalloplasty by left forearm free flap and scrotoplasty. Testosterone treatment was continued, without inducing virilization, and bone density remained normal. The patient qualifies as female-to-male transsexual and was treated according to the Standards of Care by the World Professional Association for Transgender Health with good outcome. However, we do not believe that female sex of rearing as a standard procedure should be questioned in CAIS. Our case challenges the role of a functional AR pathway in the development of male gender identity.
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