An Intervention Study of Language Cognition and Emotional Speech Community Method for Children’s Speech Disorders

Speech disorders are a common type of childhood disease.Through experimental intervention,this study aims to improve the vocabulary comprehension levels and language ability of children with speech disorders through the language cognition and emotional speech community method.We also conduct a statistical analysis of the inter-ventional effect.Among children with speech disorders in Dongguan City,224 were selected and grouped accord-ing to their receptive language ability and IQ.The 112 children in the experimental group(EG)received speech therapy with language cognitive and emotional speech community,while the 112 children in the control group(CG)only received conventional treatment.After six months of experimental intervention,the Peabody Picture Vocabulary Test-Revised(PPVT-R)was used to test the language ability of the two groups.Overall,we employed a quantitative approach to obtain numerical values,examine the variables identified,and test hypotheses.Further-more,we used descriptive statistics to explore the research questions related to the study and statistically describe the overall distribution of the demographic variables.The statistical t-test was used to analyze the data.The data shows that after intervention through language cognition and emotional speech community therapy,the PPVT-R score of the EG was significantly higher than that of the CG.Therefore,we conclude that there is a significant difference in language ability between the EG and CG after the therapy.Although both groups improved,the post-therapy language level of EG is significantly higher than that of CG.The total effective rate in EG is higher than CG,and the difference is statistically significant(p<0.05).Therefore,we conclude that the language cogni-tion and emotional speech community method is effective as an interventional treatment of children’s speech dis-orders and that it is more effective than traditional treatment methods.

Verbal Short-Term Memory as Language Predictor in Children with Autism Spectrum Disorder

Verbal short-term memory (vSTM) has been shown to be associated with language development in typical and atypical populations. In this study, we investigated cognitive and language skills in 33 school-aged children with ASD (6 - 12 years old) with both typical and low levels of intelligence (18 with typical non-verbal IQ [>80 in Raven] and 15 with low non-verbal IQ [p p < 0.05). Regression analysis showed that expressive vocabulary was predicted by non-verbal IQ and vSTM, syntactic production was predicted by vSTM and picture comprehension was predicted by non-verbal IQ. Conversely, expressive vocabulary could predict non-verbal IQ, vSTM, immediate visual memory, delayed visual memory, and visual information recall. It seems that vSTM is a strong predictor of language skills for children with ASD, just like it is for other typical and atypical populations. Finally, dissociations exist in individual performances between non-verbal IQ and memory on the one hand and language skills (expressive vocabulary, syntactic production) on the other hand. We discuss the significance of these findings in terms of previous results reported in ASD literature as well as in terms of clinical implications and intervention in ASD individuals.

Application value research of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke

BACKGROUND Stroke is a common disabling disease,whether it is ischemic stroke or hemorrhagic stroke,both can result in neuronal damage,leading to various manifestations of neurological dysfunction.AIM To explore of the application value of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke.METHODS This study selected 86 patients with swallowing disorders after stroke admitted to our rehabilitation department from February 2022 to December 2023 as research subjects.They were divided into a control group(n=43)and an observation group(n=43)according to the treatment.The control group received swallowing rehabilitation training,while the observation group received swallowing treatment device in addition to the training.Both groups underwent continuous intervention for two courses of treatment.RESULTS The total effective rate in the observation group(93.02%)was higher than that in the control group(76.74%)(P=0.035).After intervention,the oral transit time,swallowing response time,pharyngeal transit time,and laryngeal closure time decreased in both groups compared to before intervention.In the observation group,the oral transit time,swallowing response time,and pharyngeal transit time were shorter than those in the control group after intervention.However,the laryngeal closure time after intervention in the observation group was compared with that in the control group(P=0.142).After intervention,average amplitude value and duration of the genioglossus muscle group during empty swallowing and swallowing 5 mL of water are reduced compared to before intervention in both groups.After intervention,the scores of the chin-tuck swallowing exercise and the Standardized Swallowing Assessment are both reduced compared to pre-intervention levels in both groups.However,the observation group scores lower than the control group after intervention.Additionally,the Functional Oral Intake Scale scores of both groups are increased after intervention compared to pre-intervention levels,with the observation group scoring higher than the control group after intervention(P<0.001).The cumulative incidence of complications in the observation group is 9.30%,which is lower than the 27.91%in the control group(P=0.027).CONCLUSION The combination of swallowing therapy equipment with swallowing rehabilitation training can improve the muscle movement level of the genioglossus muscle group,enhance swallowing function,and prevent the occurrence of swallowing-related complications after stroke.

Use of Clostridium botulinum toxin in gastrointestinal motility disorders in children

More than a century has elapsed since the identification of Clostridia neurotoxins as the cause of paralytic diseases. Clostridium botulinum is a heterogeneous group of Gram-positive, rod-shaped, spore-forming, obligate anaerobic bacteria that produce a potent neurotoxin. Eight different Clostridium botulinum neurotoxins have been described(A-H) and 5 of those cause disease in humans. These toxins cause paralysis by blocking the presynaptic release of acetylcholine at the neuromuscular junction. Advantage can be taken of this blockade to alleviate muscle spams due to excessive neural activity of central origin or to weaken a muscle for treatment purposes. In therapeutic applications, minute quantities of botulinum neurotoxin type A are injected directly into selected muscles. The Food and Drug Administration first approved botulinum toxin(BT) type A in 1989 for the treatment of strabismus and blepharospasm associated with dystonia in patients 12 years of age or older. Ever since, therapeutic applications of BT have expanded to other systems, including the gastrointestinal tract. Although only a single fatality has been reported to our knowledge with use of BT for gastroenterological conditions, there are significant complications ranging from minor pain, rash and allergic reactions to pneumothorax, bowel perforation and significant paralysis of tissues surrounding the injection(including vocal cord paralysis and dysphagia). This editorial describes the clinical experience and evidence for the use BT in gastrointestinal motility disorders in children.

Tongue dysfunction in neurological and neuromuscular disorders: A narrative literature review

Evaluation of oral function is useful for tracking longitudinal changes in swallowing function. Using videofluoroscopic(VF) images, we can evaluate swallowing function, but it is extremely difficult to quantitatively evaluate the oral phase. Recently, several studies have tried to quantitatively assess tongue function by analyzing tongue movement on VF images, to measure tongue thickness by ultrasonography, and to measure tongue pressure as surrogate for tongue strength. In this review article,the current state of quantitative assessments of tongue function for identification and management of dysphagia in patients with neuromuscular and other neurological disorders(NNMD) has been outlined. Disturbed bolus transport in patients with NNMD has been quantitatively measured on VF images by analyzing tongue base movement and bolus transport from the mouth to the pharynx. Enlarged tongue in Duchenne muscular dystrophy patients were observed by measuring the transverse width of the tongue on ultrasound. Tongue pressures that were measured using a handheld probe in NNMD patients were less than half of those in healthy subjects. More studies are needed to develop guidelines what types of tongue dysfunction give an indication of adjusting diet and introducing tube feeding to NNMD patients.

Profile of Patients with Stroke and Disorders of the Vocal Tract

Background: The present work aims to characterize the profile of patients with stroke treat at a hospital located in the Region of the Mata of Minas Gerais, Brazil, considering the findings of the clinical vocal tract, kind of stroke, age and gender of such patients. Methodology: To obtain data, the clinical profile of 133 patients with a clinical or tomography diagnosis of stroke was analyzed, and the results were presented in percentage. For quantitative data average and analysis the tests were done with associations that held χ2 test, and for significance it was considered p Results: From the total of patients, 63 were women, accounting for 47.4% and the other 52.6% were males. Clinically, they were characterized with the highest percentage for ischemic stroke (89.4%) compared to the hemorrhagic type (10.6%). Most of them were referred for computed tomography (86.5%) and remained hospitalized for an average of 6.496 ± 7.372 days. Similar percentages were obtained in the analysis of the population in question, when considering if they had (54.1%) or not (49.6%) any damage in their speech, language skills or swallowing. There were different types of disabilities in patients with stroke. Men with an average age of 69.8 ± 13.9 presents mostly ischemic stroke, and the majority of patients with stroke had hemiplegia and abnormalities of the vocal tract, dysphasia, and aphasia. While older patients had an ischemic stroke and were presented with left hemiplegia, the younger ones suffered from hemorrhagic strokes that caused a disability characterized as right hemiplegic. Conclusion: Our results show important conclusions regarding the clinical evolution of the vocal tract of patients who suffered strokes during the period of the analysis, being useful for better comprehension of how the vocal tract from these patients evolved according to the kind of stroke, sex and age also allowing a contraposition with other future statistics periods available in literature. It can also be pointed out the difficulties in diagnosing the stroke and the concern with the immediate care, but not with its continuance or with its multidisciplinary approach, giving an evident life risk through dysphasia and the increase of permanent damage when there isn’t an appropriate work done with the patients.

Management of a Cluster of Foreign Body Ingestion Incidents in Patients with Borderline Personality Disorder

Objective: Deliberate foreign body ingestion (DFBI) has been reported in patients with personality disorders as part of a spectrum of self-harming behaviours, however the published literature is small (15 case reports). Method: This was a retrospective audit of medical and psychological management of a cluster of 12 DFBI incidents over 9 months in 4 young female patients with Borderline Personality Disorder (BPD). Results: All four patients knew one another from outpatient psychotherapy programmes. DFBI was associated with substance use in 5/12 incidents, and with precipitants (experiencing strong emotions, witnessing self-harm) in 4/12 incidents. Most DFBI involved sharp objects (razor blades, glass, safety pins). Medical intervention was initially active (endoscopy/surgery) but progressed to a more conservative, observational approach. Psychological management was initially restrictive, but also changed over time to focus on identifying distress, enhancing coping mechanisms and patient responsibility. Co-ordination of patient care management involvedintensive liaison (provision of interdisciplinary support and education) between medical, surgical and psychiatric teams. Conclusion: Management of DFBI in patients with BPD requires high levels of interdisciplinary collaboration. In this cluster of DFBI incidents, effective management was achieved with conservative medical/surgical methods (observation) and non-restrictive psychological approaches that enhanced patient self-efficacy.

Performance-Associated Factors of Elderly Patients with a Low Education Level, with Acquired Language Alterations in Tests to Explore Executive Functions

Introduction. Secondary alterations of executive functions occur in brain injuries together with the primary neuropsychological symptoms, irrespective of the location of the damage and the affected neural networks. Such secondary alterations of executive functions in the presence of language alterations, which is the most frequent primary neuropsychological alteration, in addition to exacerbating the linguistic processing deficit, may be associated to multiple factors inherent to the brain injury or the injured patient. Purpose. To describe the secondary neuropsychological alterations of executive functions in elderly patients with low education levels with acquired language disorders and determine general factors of the injury and of the injured patient (etiology, location, time of recovery from the injury, age, education level), associated to such secondary alterations of the Attentional Control System. Patients and Methods. The study was conducted on 68 elderly patients with a low education level with language acquired disorders, of both sexes, ranging between 60 and 80 years of age. The executive functions explored included cognitive flexibility, impulsivity control and inhibition of irrelevant automatisms, with the Trail Making Test, the Porteus Maze Test and series of loops. Statistical processing involved a Distribution of Frequencies and Multiple Ordinal Regression. Results and Conclusions. The statistical analysis found secondary neuropsychological alterations of the executive functioning in the elderly patients with language disorders of the study that are associated to the location and the time of recovery from the injury and are irrespective of age, education level and etiology of the injury.

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.

Pilot trial of huperzine A to treat ch ild language delay

AIM:To investigate the efficacy of huperzine Ain treating child language delay and its side effects.METHODS:37children with language delay and o ther developmental diseases from pediatric neurology out-patient departme nt,who did not undergo any language rehabilitation,were treated with huperzin e A50μg bi-daily for more 3months and then th e efficacy and side effects observed.The follow-up was arranged to record the efficacy monthly.RESULTS:37cases of 40had undergone the whole course and the total efficiency was 68%(25/37).Language developments of other 12cases were not improved significantly.Other3children were not included in becau se epilepsy were observed among them.CONCLUSION:This pilot trial result suggests th at huperzine A has ef-ficacy on child language delay but sh ould be investigated further.Huperzine A may trigger seizure of language dela y patients with epilepsy.

Factors influencing parent satisfaction with preventive health services for the early detection of speech and language delay in preschool children

The aim of this study was to identify parent and child characteristics which could influence parent satisfaction with preventive health services designed to detect preschool children with speech and language (SL) delay. This study was conducted on 101 children aged 18 to 36 months who participated in an organized SL delay early detection program. Validated instruments were used to assess children’s and parents’ characteristics. Satisfaction was evaluated using the client satisfaction questionnaire for the three activities of the program: 1) a public information session about SL development, 2) parent training sessions for parents concerned by their child SL development, and 3) a child’s SL assessment. Multiple logistic regressions were used to identify all independent factors (p < 0.05) associated with satisfaction and to estimate the odds ratios (OR) for satisfaction. Economically disadvantaged parents were less prone to participate in the first two activities of the early detection program. Older parents were more satisfied with the public information session (OR = 1.33 for 1 year increment;p = 0.001). Distressed parents were less satisfied with both the parent training sessions (OR = 0.28;p = 0.009) and the SL assessment (OR = 0.43;p = 0.046). Parents whose child had health problems at birth were less satisfied with the public information session (OR = 0.14, p = 0.03) and the SL assessment (OR = 0.33, p = 0.036). There is a need to better adapt the delivery of preventive services for the early detection of SL delay, especially for disadvantaged and distressed parents and for those whose child had suffered from health problems at birth.

阶梯式摄食训练在老年吞咽障碍病人中的应用

目的:探讨阶梯式摄食训练在老年吞咽障碍病人中的应用效果。方法:便利抽取2023年5月—2023年10月江苏省某三级老年医院康复医学科收治的52例老年吞咽障碍病人作为研究对象。按照病人所在病区将52例病人分为试验组(n=26)和对照组(n=26)。对照组实施综合康复护理;试验组实施阶梯式摄食训练方案,两组干预前后采用标准吞咽功能评价量表(SSA)、安德森吞咽困难量表、进食评估调查问卷进行测评,并比较两组误吸发生率、住院时间、体质指数等。结果:干预4周后两组误吸发生率、SSA评分、进食评估调查问卷评分、安德森吞咽困难量表评分、住院时间、体质指数比较差异均有统计学意义(P<0.05)。结论:阶梯式摄食训练能有效减少老年病人误吸发生率,改善病人吞咽功能和营养状况,提升病人生活质量。

《老年人吞咽障碍5Ws和1H管理的最佳实践建议》(2022年)解读

从老年人吞咽障碍护理视角对《老年人吞咽障碍5Ws和1H管理的最佳实践建议》(2022年)进行解读,对推荐意见进行归类整理,以增进我国护理人员对其的理解,提高临床实用性。

早期喉癌术后吞咽障碍的列线图预测模型构建

目的构建预测早期喉癌术后吞咽障碍的列线图模型。方法回顾性分析南阳市中心医院2020年3月至2022年5月收治的154例早期喉癌患者的临床资料,根据术后2周内是否发生吞咽障碍分成病例组和对照组。开展单因素分析,通过Logistic回归分析患者术后吞咽障碍的影响因素,利用R软件并基于预测变量构建预测吞咽障碍发生的列线图模型。以ROC曲线下面积(AUC)评估模型的预测效果,并行HL拟合优度检验。结果154例患者术后发生吞咽障碍49例(31.82%);病例组年龄≥60岁、有吸烟史、有咽喉反流性疾病史、手术方式为常规喉裂开术、张口受限程度为3度、术后1周疼痛程度为重度的患者比例和对照组比较差异存在统计学意义(P<0.05);Logistic回归分析显示,早期喉癌患者术后吞咽障碍的危险因素包括年龄≥60岁、手术方式为常规喉裂开术、咽喉反流史、张口受限程度为3度、术后1周疼痛度为重度等5项(P<0.05);将上述危险因素引入R软件构建列线图模型,结果显示AUC为0.759(95%CI=0.674~0.844),拟合优度HL检验χ^(2)=10.293,P=0.173。结论基于年龄、咽喉反流病史、手术方式、张口受限程度、术后1周疼痛度等5项因素构建的列线图模型可较好地预测早期喉癌患者术后吞咽障碍发生风险。

针刺联合吞咽康复训练治疗脑卒中后吞咽障碍临床研究

目的:研究针刺联合吞咽康复训练治疗脑卒中后吞咽障碍的临床疗效。方法:选择脑卒中后吞咽障碍患者150例,按随机数字表法分为观察组与对照组各75例。两组均接受吞咽康复训练,观察组在此基础上联合针刺治疗,比较两组治疗前后洼田饮水试验评分、视频透视吞咽检查量表(VFSS)评分、功能性经口摄食量表(FOIS)评分、神经功能缺损症状积分,以及左椎动脉、右椎动脉、基底动脉血流速度,比较两组临床疗效及观察组不同时期吞咽障碍患者临床疗效。结果:治疗后两组洼田饮水试验评分较治疗前降低,VFSS评分、FOIS评分较治疗前升高(P<0.05);治疗后观察组洼田饮水试验评分低于对照组,VFSS、FOIS评分高于对照组(P<0.01)。治疗后两组左椎动脉、右椎动脉、基底动脉血流速度均较治疗前升高(P<0.05),且观察组左椎动脉、右椎动脉、基底动脉血流速度均高于对照组(P<0.01)。治疗后两组神经功能缺损症状积分均较治疗前降低(P<0.05),且观察组各神经功能缺损症状积分均低于对照组(P<0.01)。观察组治疗总有效率90.67%,高于对照组的78.67%,两组临床疗效比较,差异有统计学意义(P<0.05),且观察组口腔前期患者的临床疗效优于口腔准备期、口腔期(P<0.05)。结论:针刺联合吞咽康复训练治疗脑卒中后吞咽障碍效果显著,能够改善患者吞咽能力,快速减轻症状,并促进血液循环,尤其是口腔前期患者的疗效更为理想。

经颅磁刺激联合穴位按摩在中风后吞咽障碍中的应用

目的探讨在中风患者吞咽障碍中应用经颅磁刺激联合穴位按摩的临床价值。方法选取2022年2月—2023年2月福建中医药大学附属第二人民医院康复科收治的中风后吞咽障碍患者80例,根据随机摸球法的形式将其分为研究组与对照组,各40例。对照组采用常规康复护理及穴位按摩护理干预方式,试验组在对照组基础上联合开展经颅磁刺激技术。对2组治疗疗效及反应吞咽能力的洼田饮水试验评分进行对比。结果试验组临床总有效率(97.5%)显著高于对照组(77.5%)(P<0.05)。治疗前,2组患者在洼田饮水试验评分方面得分比较,差异无统计学意义(P>0.05);干预后,2组得分均降低,试验组患者的吞咽能力的洼田饮水试验评分为(1.76±0.24)分,低于对照组的(3.06±0.55)分(P<0.05)。结论将经颅磁刺激联合穴位按摩应用于脑卒中吞咽障碍患者的康复中,相比于常规康复护理联合穴位按摩,有助于提高吞咽能力,具有较高临床应用价值。

多感官刺激联合间歇经口至食管管饲法在老年脑卒中吞咽障碍的应用

目的观察多感官刺激联合间歇经口至食管管饲法在老年脑卒中吞咽障碍的应用效果。方法选择2021年2月至2022年10月收治的脑卒中吞咽障碍患者为研究对象,随机分为对照组、观察A组、观察B组,对照组在常规治疗基础上,采用鼻留置胃管管饲;观察A组在常规治疗基础上,采用间歇经口至食管管饲法;观察B组在观察A组基础上,加用多感官刺激方案。3组均干预8周,在干预前和干预8周后观察洼田饮水试验、标准吞咽功能评价量表(SSA)、吞咽困难生活质量量表(SWAL-QOL)、体质指数(BMI)、营养风险筛查表2002(NRS2002)以及舌骨喉复合体动度检查(舌骨上移距离、甲状软骨上移距离、舌骨前移距离、甲状软骨前移距离)。结果干预8周后,除对照组SWAL-QOL评分以外,其余3组洼田饮水试验、SSA评分和SWAL-QOL评分优于干预前(P<0.05)。而观察B组在洼田饮水试验与其余2组差异有统计学意义(P<0.05),SSA评分低于其余2组,SWAL-QOL评分高于对照组(P<0.05),与观察A组差异无统计学意义(P>0.05)。在营养情况方面,干预8周后3组BMI均高于干预前,NRS2002均低于干预前(P<0.05)。组间比较,3组BMI差异无统计学意义(P>0.05);在NRS2002方面,观察A组和观察B组均低于对照组(P<0.05),而观察A组和观察B组之间差异无统计学意义(P>0.05)。在喉复合体动度检查方面,干预8周后,除对照组舌骨上移距离,其余3组各项距离高于干预前(P<0.05)。观察B组舌骨上移距离、舌骨前移距离高于其余2组(P<0.05),甲状软骨前移距离、甲状软骨上移距离仅高于对照组,与观察A组差异无统计学意义(P>0.05)。结论多感官刺激联合间歇经口至食管管饲法作用于脑卒中吞咽障碍患者,能够改善患者的吞咽功能,提高生活质量,值得进一步研究。

间歇经口至食管管饲法联合自创吞咽功能训练在脑卒中吞咽障碍患者的应用研究

目的探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果观察组总有效率高于对照组(P<0.05)。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组(P<0.05)。干预后两组生活质量综合评定量表评分升高,观察组高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。

益生菌肠内营养支持联合经颅磁刺激在脑卒中后吞咽障碍康复中的应用

目的探讨益生菌肠内营养支持联合经颅磁刺激在脑卒中后吞咽障碍康复中的临床应用效果。方法选取2019-01—2022-12上海中医药大学附属第七人民医院收治的98例脑卒中吞咽障碍患者,分为观察组和对照组各49例。对照组实施经颅磁刺激疗法+营养支持干预,观察组辅助应用益生菌肠内营养干预。对比2组间疗效、吞咽功能、营养健康状况、免疫功能、肠道屏障功能。结果观察组临床疗效优于对照组(P<0.05)。治疗后,观察组洼田饮水试验(KWST)、功能性吞咽障碍量表(FDS)、EAT-10评分均低于对照组(P<0.05),血红蛋白(Hb)、白蛋白(ALB)、前白蛋白(PAB)水平均高于对照组(P<0.05),免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平均高于对照组(P<0.05),ET、DAO、D-LA低于对照组(P<0.05)。结论益生菌肠内营养支持结合经颅磁刺激对脑卒中吞咽障碍有较好干预效果,能提高吞咽功能和营养水平,提升免疫水平,提高患者肠黏膜屏障功能。