Speech and language therapy for aphasia following subacute stroke

The aim of this study was to investigate the time window, duration and intensity of optimal speech and language therapy applied to aphasic patients with subacute stroke in our hospital. The study consisted of 33 patients being hospitalized for stroke rehabilitation in our hospital with first stroke but without previous history of speech and language therapy. Sixteen sessions of impairment-based speech and language therapy were applied to the patients, 30-60 minutes per day, 2 days a week, for 8 successive weeks. Aphasia assess- ment in stroke patients was performed with Giilhane Aphasia Test-2 before and after treatment. Compared with before treatment, fluency of speech, listening comprehension, reading comprehension, oral motor evaluation, automatic speech, repetition and naming were improved after treatment. This suggests that 16 seesions of speech and language therapy, 30-60 minutes per day, 2 days a week, for 8 successive weeks, are effective in the treatment of aphasic patients with subacute stroke.

Assessment of outcomes of hearing and speech rehabilitation in children with cochlear implantation

Objectives:This study aimed to assess the effect of hearing and speech rehabilitation in patients with Nurotron■cochlear implants.Design:Ninety-eight paediatric patients with bilateral severe-to-profound sensorineural deafness who received cochlear implantation were divided into three groups according to age:group A(≤3 years),group B(4-7 years),and group C(8-16 years).All patients were followed up for one year for hearing and speech performance after the surgery.The comprehensive Auditory Perception Assessment,MAIS,CAP and SIR hearing and speech assessments and rating materials were used for assessment before the surgery and at 3,6,and 12 months after implant activation.Results:The scores of patients in the open-set speech assessment,Chinese Auditory Perception Assessment,MAIS,CAP and SIR significantly improved after cochlear implantation in all age groups.The younger the age at implantation,the better the results.Moreover,the hearing and speech performance of cochlear implant recipients gradually improved with the extension of rehabilitation time.Conclusions:Nurotron■Venus^TM cochlear implantation can improve the hearing and speech performance of patients with bilateral severe-to-profound sensorineural deafness.

The Importance of Teaching Ancient Greek Language in Speech Rehabilitation

This paper recounts the process by which a severely brain-damaged adult student,after a terrible car accident,taught herself to read and write Ancient Greek,and in so doing,improved her ability to read and write in Greek.Initially,Evangelia’s reading and writing were very slow and difficult;memory and word finding challenges were her constant companions.Numerous studies by Greek and foreign scientists have shown that the Ancient Greek language,besides being alive,is also therapeutic,since it has the possibility to heal various dysfunctions and learning difficulties.After nine months,the recovery process was so good that Evangelia found herself writing and reading more fluently in Greek.This paper seeks to contribute to our knowledge of how the Ancient Greek language has the possibility to heal various and serious speech and language disorders.

Effect of scalp acupuncture combined with language rehabilitation training in treating post-stroke motor aphasia:A systematic review and meta-analysis

Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Library were searched for published researches up to March,2021.Randomized controlled trials RCTs that focused on scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia were included.We managed the data analysis with RevMan 5.3 software.Results:A total of 16 RCTs with 1323 patients were involved.The results of meta-analysis showed that:①The effective rate of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia after stroke was significantly better than that of simple language rehabilitation training[OR=3.94,95%CI(2.73,5.68),P<0.00001];②In the evaluation of language function,compared with the language rehabilitation training,the scalp acupuncture combined with language rehabilitation training can significantly improve the reading ability of the patients with motor aphasia after stroke[MD=7.22,95%CI(3.55,10.89),P=0.0001],writing ability[MD=6.51,95%CI(3.61,9.41),P<0.0001],expressive ability[MD=4.13,95%CI(2.37,5.89),P<0.0001],retelling ability[MD=5.00,95%CI(2.38,7.63),P=0.0002],listening comprehension ability[MD=5.36,95%CI(3.12,7.61),P<0.00001]and naming ability[MD=5.60,95%CI(4.20,7.00),P<0.00001];③Compared with simple language rehabilitation training,scalp acupuncture combined with language rehabilitation can significantly improve the daily life language communication ability of patients with motor aphasia,and the difference was statistically significant[MD=30.01,95%CI(11.30,48.72),P=0.002].Conclusion:Scalp acupuncture combined with language rehabilitation training has a significant effect on motor aphasia.However,due to the small sample size,more RCTs are needed to confirm that.

Efficacy of acupuncture as an adjuvant to speech and language therapy for aphasia after ischemic stroke:a protocol of systematic review and meta-analysis

Background:Aphasia is one of the common complications of stroke.Speech and language therapy is a conventional treatment for aphasia following stroke.However,rehabilitation often remains unsatisfactory after speech and language therapy alone.Acupuncture may be effective for aphasia after stroke.We designed this systematic review to assess the efficacy and safety of acupuncture as an adjunct to speech and language therapy for aphasia following ischemic stroke.Methods:An extensive search will be performed in databases including Cochrane Central Register of Controlled Trials,PubMed,Web of Science,EMBASE,China National Knowledge Infrastructure,Sinomed,Wei Pu Date and Wan Fang Data.No limitation will be set in language,publication date or status of the study.The primary outcomes include scores of Western Aphasia Battery and Aphasia Quotient.The secondary outcomes include Scales of Clinical Rehabilitation Research Center Aphasia Examination,Communicative Abilities in Daily Living,Aphasia Battery of Chinese,Chinese Functional Communication Profile,adverse reactions,etc.Results:All of the data will be processed with Review Manager software.Cochrane‘risk of bias’tool will be used to assess the risk of bias.Conclusion:This study will contribute to the selection of appropriate therapies for aphasia after ischemic stroke and the development of clinical guidelines on this topic.

Outcome measures following tele-rehabilitation and conventional face to face rehabilitation in paediatric cochlear implant users during COVID-19 pandemic:A pilot study in a tertiary care setup

Background:Following the COVID-19 pandemic,majority of paediatric cochlear implantees(CI)lost follow ups for rehabilitation and tele-therapy was initiated.Present study thus compared the outcome measures of paediatric CI users on tele-therapy versus conventional face to face therapy following COVID-19 pandemic.Method:Twenty seven unilateral paediatric cochlear implantees in the age range of 2e11 years were divided into two groups based on the therapy modality,viz,tele-and face-to-face therapy.Based on the hearing age,participants were further divided into three groups,viz,0e2,2e4,and greater than four years.A complete the test battery comprising Integrated Scales of Development,Speech Intelligibility Rating scale,and Revised Categorical Auditory Perception were administered.The speech&language test battery was performed prior to initiating the rehabilitation and post 12 months of rehabilitation.Results:Results of the present study revealed that conventional rehabilitation had better outcomes compared to teletherapy.The rate of progress after one year of rehabilitation with respect to hearing-age showed a significant difference for the hearing-age group of 0e2 years across the domains of audition,speech and language.Conclusion:The present study indicates that conventional method of the speech-language and auditory rehabilitation is far better compared to the tele rehabilitation services especially for those visiting tertiary care hospitals as most of them belong to lower and middle socioeconomic status.From the results,it can be delineated that with lesser hearing experience,paediatric CI users always need to initially enroll for conventional therapy for better speech-language and auditory outcomes.

The role of community nursing in family rehabilitation of stroke patients with impaired spoken language

Objective To observe the role of community nursing in family rehabilitation of stro ke patients with impaired spoken lan guage.Methods34patients were divided into 17pair s according to similar principle.In each pair,patient went into control or rehabilitation group randomly.Patients in control group received nerve drug treatment,while patients in rehabilitation group r eceived spoken language training co urse as well as nerve drug treatment.The a ssessment was made after 6and 12mont hs of treatment.Results The capability of language expression and comprehension in training group were significantly improved than in control(P <0.01).Conclusions Community nursing plays an im-portant role in the rehabilitation o f stroke patients with impaired spok en language.

Design of a DSLM-based cerebral palsy action rehabilitation training system

Based on domain specified language mechanism(DSLM),the architecture of the robotic training system for the rehabilitation of children with cerebral palsy(CP)is designed.Application of human-computer interaction(HCI)motion recognition technology is combined with Kinect to improve the effect of cerebral palsy rehabilitation training.In this system,Kinect's bone recognition method is used to judge the patient's training movements,and the collected bone movement information is judged.The human-computer interaction function is based on the Microsoft foundation classes function of Visual Studio based on DSLM development,which can realize real-time interactive training and evaluation of people and actions,and record the training information of patients.The system combines the designed small game to train the upper limb movement ability and reaction ability of the cerebral palsy patient,and provides key technology for improving the cerebral palsy rehabilitation training system.

Analysis of Activities of Adults with Aphasia at Community-Based Rehabilitation Training

Aphasia is a higher brain dysfunction that affects the production or comprehension of speech and the ability to read or write. The purpose of this research is to establish support guidelines based on a questionnaire survey and a language activity analysis of rehabilitation training so that volunteers can more easily assist disabled persons with aphasia. The focus of this study was the non-profit community-based intervention group Yokohama Aphasia Partner Group, which consists of members with aphasia, their families, speech-language-and-hearing therapists, psychiatric social workers, and volunteers. The following results were obtained. (1) Members with aphasia participate in the Partner Group because they can meet others with aphasia on a regular basis as well as participate in the aphasia rehabilitation program with the recovery of language functions. In addition to medical treatment, the community-based support, which improves the environment and other life contextual factors, is important for rehabilitation. (2) An individual with aphasia shows different language actions, and so an individually different support system in accordance with language activity is necessary.

Strategies for Communicating with Deaf Patients in the Public Physical Rehabilitation Unit in the Central South Region of Rio de Janeiro State, Brazil

Deaf people face communication difficulties in health units because of the lack of preparedness of health care professionals to deal with these patients. Objective: To identify how physical rehabilitation professionals associated with a regional public unit in the south central region of Rio de Janeiro State, Brazil interact with deaf patients. Method: Data were analyzed through descriptive statistics in the Statistical Package for Social Sciences (SPSS) software version 18. Results: Results showed that: 15.1% (5) of the team members did not know the Brazilian Sign Language (Libras) and required help in their interaction with deaf patients;12.1% (4) never assisted deaf patients;18.2% (6) used writing and gestures;21.2% (7) resorted to lip-reading or gestures;3.1% (1) spoke slowly;6.1% (2) used mime;15.1% (5) used the Brazilian Sign Language;9.1% (3) did not respond. Conclusion: Most of these professionals are not prepared to satisfactorily interact with deaf patients. They use improvised strategies to assist the deaf clientele, demonstrating that the planning and implementation of regular courses in sign language are fundamental in order to assist these patients effectively.

Rehabilitation of anterior pituitary dysfunction combined with extrapontine myelinolysis: A case report

BACKGROUND Extramedullary myelinolysis is a rare demyelinating disease, often caused by rapid increases in serum sodium concentration in patients with hyponatremia.Clinical manifestations are neuropsychiatric symptoms, limb weakness, and dysarthria. Because of its poor prognosis and high disability rate, it poses a huge burden on the global economy, societies, and families. This article reports rehabilitation in a patient with pituitary dysfunction combined with extramedullary myelinolysis.CASE SUMMARY A 27-year-old Chinese man developed anorexia, vomiting, and limb weakness and was diagnosed with pituitary insufficiency. He had low serum sodium, slow movement, muscle weakness, and muscle tone abnormalities after sodium supplementation, involuntary limb shaking, ataxia, and dysarthria. According to the symptoms and signs and imaging reports, he was diagnosed with extramedullary myelinolysis. After treatment with hormone therapy and neurotrophic drugs, motor and speech function did not improve, so he was treated in the rehabilitation department for 4 wk. The patient's physical status was improved substantially during his stay at the rehabilitation department.CONCLUSION Patients with extramedullary myelinolysis who actively participate in rehabilitation intervention can significantly improve their activities of daily living.

Comparing Fine-Tuning, Zero and Few-Shot Strategies with Large Language Models in Hate Speech Detection in English

Large Language Models(LLMs)are increasingly demonstrating their ability to understand natural language and solve complex tasks,especially through text generation.One of the relevant capabilities is contextual learning,which involves the ability to receive instructions in natural language or task demonstrations to generate expected outputs for test instances without the need for additional training or gradient updates.In recent years,the popularity of social networking has provided a medium through which some users can engage in offensive and harmful online behavior.In this study,we investigate the ability of different LLMs,ranging from zero-shot and few-shot learning to fine-tuning.Our experiments show that LLMs can identify sexist and hateful online texts using zero-shot and few-shot approaches through information retrieval.Furthermore,it is found that the encoder-decoder model called Zephyr achieves the best results with the fine-tuning approach,scoring 86.811%on the Explainable Detection of Online Sexism(EDOS)test-set and 57.453%on the Multilingual Detection of Hate Speech Against Immigrants and Women in Twitter(HatEval)test-set.Finally,it is confirmed that the evaluated models perform well in hate text detection,as they beat the best result in the HatEval task leaderboard.The error analysis shows that contextual learning had difficulty distinguishing between types of hate speech and figurative language.However,the fine-tuned approach tends to produce many false positives.

Development of an Auditory Rehabilitation Training Programme for Hearing Impaired Adults in Saudi Arabia

Hearing impairment is one of the most common sensory disabilities, affecting millions of people worldwide. The current management of acquired hearing impairment in adults is usually in the form of hearing aids. An auditory rehabilitation programme may or may not be provided although literature suggests that such programmes may enhance hearing aid benefits. This study was conducted in an Arabic-speaking country, specifically Saudi Arabia, and is the first to develop an auditory rehabilitation intervention programme in the Arabic language that focuses on working age adults who are new hearing aid users. Randomised intervention study design. Thirty-five participants with mild to severe acquired hearing loss （intervention group n = 18, control group n = 17）. Significant changes were found in the performance of the intervention group in the Minimal Audible Capabilities （MAC） test, a lip reading test and the Glasgow Hearing Aid Benefit Profile （GHABP） questionnaire when compared with the control group. No significant difference was found in speech test scores between the two groups. A short individualised auditory rehabilitation intervention programme can yield a significant improvement in the performance of hearing impaired adults by enhancing the benefits of hearing aid use.

Acupuncture combined with speech rehabilitation training for post-stroke spasmodic dysphonia:a multicenter randomized controlled trial

Objective To observe the clinical efficacy of acupuncture combined with speech rehabilitation training for post-stroke spasmodic dysphonia and compare the differences in efficacy among the therapy of acupuncture combined with speech rehabilitation training and the monotherapy.Methods Two hundred and seventy cases of patients with post-stroke spasmodic dysarthria were randomly divided into three groups with the ratio of 1：1：1.Group A：acupuncture combined with speech rehabilitation training group（90 cases）,group B：acupuncture group（90 cases）,group C：speech rehabilitation training group（90 cases）.In the group B,acupuncture treatment was given at Baihui（百会 GV 20）,JTnjin（金津 EX-HN 12） and Yuye（玉液 EX-HN13） as well as tongue-three needles.In the group C,the treatment of speech rehabilitation training was provided.The two treatments mentioned above were combined in the group A.Patients were treated once a day for a month with improved Frenchay dysarthria rating scale as the indices of therapeutic effect evaluation.Results ① Group A：the cured and markedly effective rate was 88.7%,and total effective rate was 94.3%;group B：the cured and markedly effective rate was 44.2%and total effective rate was 81.4%;group C：the cured and markedly effective rate was 23.5%and total effective rate was 61.2%.Both the cured and markedly effective rate and the total effective rate in the group A were significantly higher than those in the group B or group C（all P0.05）;both the cured and markedly effective rate and the total effective rate in the group B were higher than those of group C（both P0.05）;② In comparison of functional recovery of tongue in accordance with the Frenchay dysarthria rating scale,the recovery rate of the tongue-stationary state was 71.74%in the group A,18.87%in the group B and 4.44%in the group C;the recovery rate of tongue lolling out was 66.23%in the group A,27.63%in the group B and 1.59%in the group C;the recovery rate of tongue up and down motion was 44.19%in the group A,4.94%in the group B and 1.35%in the group C;the recovery rate of lateral motion was 40.24%in the group A,7.59%in the group B and 0.00%in the group C;the recovery rate of alternating motion was 29.07%in the group A,7.14%in the group B and 1.23%in the group C;the recovery rate of speech was 29.07%in the group A,5.88%in the group B and 1.22%in the group C.In the three groups,the recovery rates of stationary state and tongue lolling out were superior to those of up and down movement,lateral movement,alternating movement and speech（all P0.05）.Conclusion The clinical efficacy of acupuncture combined with speech rehabilitation training for patients with post-stroke spasmodic dysarthria is significant,and the efficacy of acupuncture is superior to that of speech rehabilitation training;as for functional recovery of tongue like stationary state and tongue out,the therapy of acupuncture combined with speech rehabilitation training is effective.

Communicating with the non-dominant hemisphere:Implications for neurological rehabilitation

Aphasic syndromes usually result from injuries to the dominant hemisphere of the brain. Despite the fact that localization of language functions shows little interindividual variability, several brain areas are simultaneously activated when language tasks are undertaken. Mechanisms of language recovery after brain injury to the dominant hemisphere seem to be relatively stereotyped, including activations of perilesional areas in the acute phase and of homologues of language areas in the non-dominant hemisphere in the subacute phase, later returning to dominant hemisphere activation in the chronic phase. Plasticity mechanisms reopen the critical period of language development, more specifically in what leads to disinhibition of the non-dominant hemisphere when brain lesions affect the dominant hemisphere. The non-dominant hemisphere plays an important role during recovery from aphasia, but currently available rehabilitation therapies have shown limited results for efficient language improvement. Large-scale randomized controlled trials that evaluate well-defined interventions in patients with aphasia are needed for stimulation of neuroplasticity mechanisms that enhance the role of the non-dominant hemisphere for language recovery. Ineffective treatment approaches should be replaced by more promising ones and the latter should be evaluated for proper application. The data generated by such studies could substantiate evidence-based rehabilitation strategies for patients with aphasia.

Head Acupuncture Plus Schuell's Language Rehabilitation for Post-Stroke Aphasia:A Systematic Review and Meta-Analysis of 32 Randomized Controlled Trials

Objective:To evaluate the existing randomized controlled trials(RCTs)for evidence of the efficacy and safety of head acupuncture(HA)plus Schuell’s language rehabilitation(SLR)in post-stroke aphasia.Methods:Seven databases including Embase,PubMed,Cochrane Library,Technology Periodical Database,the China National Knowledge Infrastructure,SinoMed and Wanfang Data Information Site were searched for RCTs published from database inception until November 14,2021.RCTs that compared HA plus SLR with sham(or blank)control,acupuncture therapy alone,certain language rehabilitation therapy alone or other therapies for post-stroke aphasia were included.Data were extracted and assessed,and the quality of RCTs was evaluated.Fixed-effects model was used,with meta-influence analysis,meta-regression,and regression-based sub-group analyses applied for exploration of heterogeneity.Publication bias was estimated by funnel plots and Egger’s tests.Results:A total of 32 RCTs with1,968 patients were included and 51 comparisons were conducted classified as types of strokes and aphasia.(1)For patients with aphasia after ischemic stroke,HA plus PSA showed significantly higher accumulative markedly effective rate[relative risk(RR)=1.55,95% confidence interval(CI):1.19-2.02,I^(2)=0%]and accumulative effective rate(RR=1.22,95%CI:1.09-1.36,I^(2)=0%).(2)For patients with comprehensive types of stroke,HA plus PSA was more effective in increasing recovery rate(RR=1.89,95%CI:1.39-2.56,I^(2)=0%),accumulative markedly effective rate(RR=1.53,95%CI:1.36-1.72,I^(2)=9%)and accumulative effective rate(RR=1.14,95%CI:1.09-1.19,I^(2)=34%).(3)For patients with aphasia after stroke,HA plus PSA was superior to PSA alone with statistical significance in increasing recovery rate(RR=2.08,95%CI:1.24-3.46,I^(2)=0%),accumulative markedly effective rate(RR=1049,95%CI:1.24-1.78,I^(2)=0%)and accumulative effective rate(RR=1.15,95%CI:1.06-1.24,12=39%).(4)For patients with multiple types of aphasia,HA plus PSA also demonstrated significantly higher recovery rate(RR=1.86,95%CI:1.28-2.72,I^(2)=0%),accumulative markedly effective rate(RR=1.55,95%CI:1.35-1.78,I2=22%),and accumulative effective rate(RR=1.17,95%CI:1.11-1.23,I^(2)=41%).(5)For patients with motor aphasia after ischemic stroke,compared with PSA alone,HA plus PSA showed significantly higher accumulative markedly effective rate(RR=1.38,95%CI:1.06-1079,I^(2)=0%)and accumulative effective rate(RR=1.20,95%CI:1.05-1.37,I^(2)=0%).Meta-regression analyses were performed without significant difference,and publication bias was found in some comparisons.Conclusion:HA plus SLR was significantly associated with better language ability and higher effective rate for patients with post-stroke aphasia,and HA should be operated cautiously especially during acupuncture at eye and neck.(Registration No.CRD42020154475).

Clinical observation of scalp acupuncture plus speech rehabilitation for Broca's aphasia after cerebral stroke

Objective：To explore the clinical efficacy of scalp acupuncture plus speech rehabilitation in treating Broca＆#39;s aphasia after cerebral stroke, for providing novel evidences for the treatment. Methods：Ninety-one eligible patients with Broca＆#39;s aphasia after cerebral stroke were randomized into an observation group and a control group. Forty-six cases in the observation group were intervened by scalp acupuncture plus speech rehabilitation, while 45 cases in the control group were treated by speech rehabilitation alone. The aphasia battery of Chinese （ABC） and Boston diagnostic aphasia examination （BDAE） were adopted to evaluate the clinical efficacy. Results：After the treatment, the scores of oral expression, reading and writing and global score in the observation group were significantly higher than those in the control group （allP〈0.05）. There was a significant difference in comparing the BDAE grading between the two groups after the treatment （P〈0.05）. After intervention, the basically-recovered plus markedly-effective rate was 45.7% in the observation group versus 24.4% in the control group, and the between-group difference was statistically significant （P〈0.05）. Conclusion：Scalp acupuncture plus speech rehabilitation is effective in treating Broca＆#39;s aphasia after cerebral stroke, and worth promoting.

Impact of Languages and Accent on Perceived Speech Quality Predicted by Perceptual Evaluation of Speech Quality (PESQ) and Perceptual Objective Listening Quality Assessment (POLQA): Case of Moore, Dioula, French and English

Perceptual Objective Listening Quality Assessment (POLQA) and Perceptual Evaluation of Speech Quality (PESQ) are commonly used objective standards for evaluating speech quality. These methods were developed and trained on native speakers’ speech sequences of some western languages. One can then wonder how these methods perform if they are applied to other languages or if the speaker is non-native. This paper deals with the evaluation of PESQ and POLQA on languages that were not been considered when setting up these methods, with emphasis on Moore and Dioula, two local languages of Burkina Faso. Another aspect is the evaluation of these two methods in the case of non-native speakers. For this purpose, in the one hand, the Mean Opinion Score-Listening Quality Objective (MOS-LQO) of PESQ and POLQA, computed for Moore and Dioula, are compared to those of French and English. On the second hand, the MOS-LQO scores of French and English are compared for native and non-native speakers, to evaluate the effect of the accent of speakers.

Research on the Application of Second Language Acquisition Theory in College English Speech Teaching

The teaching of English speeches in universities aims to enhance oral communication ability,improve English communication skills,and expand English knowledge,occupying a core position in English teaching in universities.This article takes the theory of second language acquisition as the background,analyzes the important role and value of this theory in English speech teaching in universities,and explores how to apply the theory of second language acquisition in English speech teaching in universities.It aims to strengthen the cultivation of English skilled talents and provide a brief reference for improving English speech teaching in universities.

Speech,language,and hearing function in twins with Alport syndrome:A seven-year retrospective case report

Alport syndrome is an X-linked syndrome that results in nephritis, renal failure, sensorineural hearing loss, and eye deficits. As a result of sensorineural hearing loss, these individuals are likely to experience difficulties in the area of speech and language. While studies in the past have examined the speech and language characteristics of children with syndromic sensorineural hearing loss, to our knowledge there are no previous studies to have documented the speech and language characteristics of these children on a long-term basis. The current study addresses this limitation by reporting speech, language, hearing, and function of twin brothers with X-linked Alport syndrome across a seven-year period.Information was collected by examining the medical records of the participants as well as through a verbal interview with the participants' guardian. Results revealed that the participants' hearing abilities gradually deteriorated over the seven-year period which affected their speech and language development as well. The kidney function tests revealed significant presence of hematuria(blood in the urine) as well as proteinuria(protein in the urine) suggesting chronic kidney dysfunction. This longitudinal study demonstrates the functional relationship between the kidneys and the cochlea, although they appear to be independent of one another. As individuals with Alport syndrome exhibit systemic complications, interdisciplinary collaboration is essential among health care providers including audiologists, speech-language pathologists,nephrologists, and ophthalmologist to promote evidence-based practice.