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Speech-in-speech recognition can be challenging, and listeners vary considerably in their ability to accomplish this complex auditory-cognitive task. Variability in performance can be related to intrinsic listener factors as well as stimulus factors associated with energetic and informational masking. The current experiments characterized the effects of short-term audibility of the target, differences in target and masker talker sex, and intrinsic listener variables on sentence recognition in two-talker speech and speech-shaped noise. Participants were young adults with normal hearing. Each condition included the adaptive measurement of speech reception thresholds, followed by testing at a fixed signal-to-noise ratio (SNR). Short-term audibility for each keyword was quantified using a computational glimpsing model for target+masker mixtures. Scores on a psychophysical task of auditory stream segregation predicted speech recognition, with stronger effects for speech-in-speech than speech-in-noise. Both speech-in-speech and speech-in-noise recognition depended on the proportion of audible glimpses available in the target+masker mixture, even across stimuli presented at the same global SNR. Short-term audibility requirements varied systematically across stimuli, providing an estimate of the greater informational masking for speech-in-speech than speech-in-noise recognition and quantifying informational masking for matched and mismatched talker sex.

Articles in this issue examine (1) the primary sources of variability in reading and language achievement among Spanish-speaking English learners (ELs) in the United States, (2) the extent to which poor performance at the end of grade 2 is identifiable in developmental trajectories beginning in kindergarten, (3) the relations among core reading constructs of phonological awareness and decoding in both English and Spanish and the factors that affect their relationship, (4) the performance of different approaches to identification and the factors that influence how well they work, as well as (5) the growing literature focused on intervention for reading problems in this population. This article examines the literature on language minority students and disability identification and analyzes a large-scale longitudinal dataset (>4,000 ELs; >15,000 observations) to systematically characterize and describe the oral language and reading development of Spanish-speaking children designated as ELs from kindergarten to second grade, considering a range of factors that may potentially contribute to that characterization and its relation to academic performance. This systematic characterization should facilitate the development of an empirical basis for a theoretically grounded framework of typical development in ELs in order to more precisely identify those children with language and learning disabilities.

This study investigated early indicators of Spanish-speaking English learners (ELs) at risk for reading difficulties at the end of Grade 2 by examining their early bilingual oral language development, taking into account language of academic instruction. Standardized measures of reading and narrative samples were collected in English and Spanish from kindergarten to Grade 2 from 1,243 ELs primarily instructed in English or Spanish. Conditional growth curve models yielded four primary findings of reading and oral language development. First, ELs with low reading achievement at the end of Grade 2 demonstrated early reading difficulties during kindergarten. Second, although ELs demonstrated overall higher reading achievement in their instructed language, this difference decreased over time. Third, ELs with low reading achievement at the end of Grade 2 demonstrated lower oral language skills in each language over time. Fourth, ELs demonstrated overall higher oral language skills in their instructed language, yet these differences varied over time. The study provided a detailed description of the longitudinal relations among the bilingual reading and oral language skills of Spanish-speaking ELs during the early school years. These findings help to inform the processes of early identification and intervention for Spanish-speaking ELs who are likely to demonstrate reading achievement difficulties.

Purpose: Changes in voice quality after consuming food or drink have been used as a clinical indicator of dysphagia during the clinical swallowing evaluation (CSE); however, there is conflicting evidence of its efficacy. This study investigated if dysphonia and/or voice change after swallowing are valid predictors of penetration, aspiration, or pharyngeal residue. Our approach aimed to improve current methodologies by collecting voice samples in the fluoroscopy suite, implementing rater training to improve interrater reliability and utilizing continuous measurement scales, allowing for regression analyses. Method: In this prospective study, 30 adults (aged 49–97 years) referred for a videofluoroscopic swallowing study (VFSS) were audio-recorded completing a sustained /i/ prior to VFSS and again after swallowing each bolus during the VFSS. Swallowing function was measured using the reorganized Penetration–Aspiration Scale and the Normalized Residue Ratio Scale. Following listener training, 84 voice samples were perceptually rated using the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Ordinal and logistic regression were used to determine whether voice quality and voice quality change after swallowing were predictors of airway invasion and pharyngeal clearance. Results: Results indicated that the presence of dysphonia at baseline during a sustained /i/ task as measured by the CAPE-V predicted airway invasion but not pharyngeal residue. Voice change after swallowing associated with vowel /i/ production as measured by the CAPE-V did not predict either dysphagia measure. Conclusion: These results indicate that voice change during a sustained /i/ after swallowing appears unrelated to airway invasion or pharyngeal residue; however, in the absence of known laryngeal pathology, dysphonia prior to a CSE should alert speech-language pathologists of a possible comorbid dysphagia.

Quantifying the factors that predict variability in speech-in-speech recognition represents a fundamental challenge in auditory science. Stimulus factors associated with energetic and informational masking (IM) modulate variability in speech-in-speech recognition, but energetic effects can be difficult to estimate in spectro-temporally dynamic speech maskers. The current experiment characterized the effects of short-term audibility and differences in target and masker location (or perceived location) on the horizontal plane for sentence recognition in two-talker speech. Thirty young adults with normal hearing (NH) participated. Speech reception thresholds and keyword recognition at a fixed signal-to-noise ratio (SNR) were measured in each spatial condition. Short-term audibility for each keyword was quantified using a glimpsing model. Results revealed that speech-in-speech recognition depended on the proportion of audible glimpses available in the target + masker keyword stimulus in each spatial condition, even across stimuli presented at a fixed global SNR. Short-term audibility requirements were greater for colocated than spatially separated speech-in-speech recognition, and keyword recognition improved more rapidly as a function of increases in target audibility with spatial separation. Results indicate that spatial cues enhance glimpsing efficiency in competing speech for young adults with NH and provide a quantitative framework for estimating IM for speech-in-speech recognition in different spatial configurations. © 2023 Acoustical Society of America.

Aphasia is a language disorder that occurs as a result of brain damage. It affects auditory comprehension, verbal expression, reading, and writing due to the disruption of specific language components such as phonology, semantics, and/or syntax. A hallmark characteristic of aphasia is anomia, or impaired word retrieval. This may occur in the context of fluent speech (normal rate, rhythm and prosody) or nonfluent speech (hesitant and agrammatic verbal output). Other characteristics of aphasia vary depending on the specific location and extent of brain damage. Alexia and agraphia are acquired impairments in reading and writing, respectively. These deficits may occur in isolation but more commonly co-occur with aphasia. Assessment and treatment of aphasia, alexia, and agraphia focuses on identifying and restoring impaired function as well as determining the impact of the impairment of quality of life and developing compensatory strategies to manage persisting deficits. This article describes the symptoms associated with aphasia, alexia, and agraphia, the subtypes and neurological correlates of each impairment, the general trajectory of recovery, and assessment and treatment approaches. © 2023 Elsevier Inc. All rights reserved.

The aim of this study is to describe a measured return to instrumental dysphagia assessments for our vulnerable surgical patient population, such that best practice patterns could be resumed and our staff kept safe from transmission of COVID-19. A retrospective medical record review provided data on clinical practice patterns of swallowing assessment in an at-risk surgical patient population. Outcomes of this study support protocols that allow clinicians to safely resume the use of instrumental assessment and return to best practice in dysphagia assessment for our surgical patient population.

The purpose of the sabbatical leave was to (a) review the extensive body of research and clinical literature on code-based reading difficulties and (b) prepare a journal manuscript and conference presentation to disseminate clinical information to a wide audience of school-based speech-language pathologists.

Purpose This study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of typically developing Spanish-English bilingual children. Method A cross-sectional sample of 106 bilingual children (50 boys; 56 girls) enrolled in kindergarten through Grade 4, produced a total of 212 narrative retell language samples in English and Spanish. A specialized fluency coding system was implemented to index the percentage of total (%TD) and stuttering-like disfluencies (%SLD) in each language. Large-scale reference databases were used to classify children’s dual language proficiency profiles (balanced, English dominant, Spanish dominant) based on language sample analysis measures of morphosyntax and lexical diversity. Results The bilingual Spanish-English children in this study did not demonstrate significant cross-linguistic differences for mean %TD or %SLD. However, the mean %TD and %SLD in both languages exceeded the risk threshold based on monolingual English-speaking norms. English dominant bilingual children demonstrated significantly lower %TD in English than Spanish. Spanish dominant children demonstrated significantly lower %SLD in Spanish than English. Conclusions This study included the largest sample size of bilingual Spanish-English children investigated to date from a fluency perspective. The frequency of disfluencies was found to be variable across participants and change dynamically as a function of grade and dual language proficiency profiles, indicating the need for studies that employ larger sample sizes and longitudinal designs.

This investigation assessed the effect of side-lying position on infant oropharyngeal swallow physiology. Infant modified barium swallow studies (MBS) recordings were retrospectively examined in matched-pairs comparing at-risk infants swallowing in both an upright/cradled position and a side-lying position. Swallow parameters were measured independently and through a consensus coding approach. Infants fed in side-lying position showed a decrease in airway invasion severity as compared with when those same infants were fed in an upright/cradled position (P = .009). Bolus location at the time of swallow initiation was higher when infants were fed in side-lying position as compared with cradle position (P = .024), representing decreased risk of airway invasion. Infants fed in side-lying position demonstrated fewer swallows per breaths (P = .032). This pilot study validates the need for additional research to further define the mechanisms related to this improvement, and to determine how diagnosis and medical stability moderate these findings.

Background Patients with schizophrenia present with both cognitive impairment as well as language difficulties. There are similarities in the language output of patients with schizophrenia and patients with aphasia, thus a differential diagnosis of patients who present with a question of dual diagnoses can be a clinical challenge. This case report highlights the importance of an interdisciplinary approach to a patient with schizophrenia who benefitted from intervention from both psychiatry and speech–language pathology services due to the patient's unique verbal output. Aims The primary aim of this case report is to highlight the critical importance of interdisciplinary collaboration in this patient population. The secondary aim is to disseminate an interesting and unique clinical phenomenon whereby the patient demonstrated an awareness of two distinct speech patterns and the unique ability to ‘code switch’ between them, something not commonly appreciated in this clinical population. Methods & Procedures This case report describes a patient seen as part of routine clinical care. Information shared was solely observational and involved dissemination of information regarding case history, assessment and treatment plan. No interventions were implemented as a part of this study. Outcomes & Results Interprofessional communication was critical in order to diagnose a patient with schizophrenia with an atypical speech pattern. The patient's language output did not manifest as a true aphasia but rather as two distinct language patterns that the patient could use at will. This ability to ‘code switch’ between languages is a unique clinical profile that is atypical of patients with schizophrenia. WHAT THIS PAPER ADDS What is already known on this subject Contemporary literature discusses the similarities between the language patterns of patients with aphasia and those with schizophrenia. There has been debate about how to classify and identify the mechanism of schizophrenic language. It is unclear whether the tangential press of speech in schizophrenia is a consequence of a formal thought disorder, or whether it constitutes an actual disorder or expressive language. Additionally, the mechanism for this speech pattern is not well defined in the literature as there is no consensus on whether it is a breakdown in linguistic processing or simply a patient's disordered thoughts being put into words. A less robust literature exists that suggests that there is a cognitive mechanism responsible for these speech patterns, as tangential speech has been linked to poor goal maintenance in other types of cognitive tasks. What this paper adds to existing knowledge This study adds an important discussion about the critical importance of interprofessional collaboration when differentially diagnosing this complex patient population. It highlights the importance of the clinical exchange of information between the two disciplines of psychiatry and speech–language pathology about a patient population where clinical information is intertwined in the way described above. Regardless of the cause of the disordered output, what is lacking in the literature is evidence of how to address the complexities of the output of these patients and how to best manage the care of the patient. This study adds a practical clinical approach to collaborating on the assessment and management of this complex patient population. Importantly, it adds a description of a clinical manifestation of the language output of a patient with schizophrenia that we do not believe to have been previously published in the literature. What are the potential or actual clinical implications of this work? Implications of this study include a much-needed shift in the field in two regards. First, to include this patient population in the groups of patients that can benefit from interprofessional collaboration for differential diagnosis and consideration for speech and language therapy. Second, it offers a practical clinical approach to inter-professional management in this patient population, something the literature is currently lacking. Additionally, publication of this unique clinical manifestation provides foundational knowledge for other clinicians appreciating similar clinical patterns of language output. To our knowledge, this is the first published case in which a patient could volitionally inhibit certain speech characteristics and thus this case study may assist in future differential diagnosis of patients with schizophrenia.

Objectives The present study investigated the comprehension of subject and object who and which questions in children with cochlear implants (CI).Methods Growth Curve Analysis (GCA) was used to compare eye gaze fixations and gaze patterns to the appropriate subject or object nouns within a four-picture array between 16 children with CI and 31 children with typical hearing (aged 7;0-12;0) on wh-questions with and without added adjectives to increase length. Offline accuracy was also compared.Results Findings indicated children with typical hearing exhibited more fixations to the target noun across all conditions, supporting higher comprehension accuracy. Both groups of children demonstrated more fixations to the target noun in object questions and questions without added length. Patterns of eye movement were significantly different between groups, suggesting different patterns of eye gaze across the array before fixation on the target noun. Children with CI exhibited fewer fixations, slower speed to fixation, and differences in gaze patterns that may imply the presence of processing limitations. Error analyses also suggested that children with CI frequently fixated on a picture similar to the target noun.Conclusions Results indicate children with CI comprehend questions more slowly than their hearing peers, which may be related to limitations in working memory.

Paraeducators often support students with the most intensive academic, life, and behavioral needs, which includes students with intellectual and other developmental disabilities (IDD; e.g., autism spectrum disorder; ASD), yet they typically enter the classroom with inadequate preparation to perform their roles effectively. Using a multiple-baseline research design replicated across participants, we evaluated the effects of job-embedded bug-in-ear (BIE) coaching delivered by the teacher on paraeducators’ use of behavior specific praise (BSP) while teaching transition-age students with ASD. Findings confirmed each of the three paraeducators immediately increased the percentage of occurrence and rate per minute in which they offered BSP. They sustained these high levels during fading. Further, the special education teacher, who served as the eCoach, and the paraeducators reported BIE was an effective form of paraeducator professional development. Finally, changes in expressive social and communicative behaviors were observed in student participants as a result of the intervention. These results extend literature on BSP and also help establish BIE coaching as an evidence-based practice for paraeducators. © Division on Autism and Developmental Disabilities.