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ORIGINAL ARTICLES
Bedside assessment protocol and grading scale for dysphagia in adults: A preliminary study
Neelam Dilip Babani, Gayatri Atmaram Hattiangadi
January-June 2014, 28(1):10-24
DOI:10.4103/0974-2131.133060  
Objectives: The present study aimed to construct a bedside assessment protocol and grading scale to assess and grade orophayngeal dysphagia in a heterogeneous sample of the patients. This study also aimed to determine the utility of the constructed assessment and grading scale in terms of reliability and validity. Materials and Methods: The Nair hospital bedside swallowing assessment (NHBSA) and Nair hospital swallowing ability scale (NHSAS) were constructed after reviewing pertinent literature. Fifty individuals with oropharyngeal dysphagia were assessed and graded using the constructed assessment and grading scale. Of the total sample, 10 individuals were subjected to a modified barium swallow (MBS) evaluation. Results: The NHBSA and NHSAS show high reliability and high face and content validity. Comparison with MBS revealed that the NHBSA appears to be promising in accurately identifying dysphagia and aspiration. Also, the NHBSA and MBS diagnosed the same phases of swallowing to be affected in eight out of ten patients. 'Wet-gurgly voice quality,' 'cough after/during swallow,' and 'weak/absent volitional cough' were the clinical indicators that appeared to correctly identify presence of aspiration risk. The NHSAS shows sensitivity to change in swallow function and oral intake overtime. Conclusion: The NHBSA appears to be a simple, quick, reliable and valid clinical assessment that can be used to assess the oropharyngeal dysphagia at the individual's bedside with minimal risk for discomfort or aspiration. Also, the NHSAS appears to be useful tool for clinically grading individuals with dysphagia into categories based on swallowing ability, and enables making recommendations.
  16,129 1,235 -
INCLEN Diagnostic Tool for the assessment of Autism Spectrum Disorder: A new tool in the speech-language pathologist's armoury
Shamili Asokan, Shoba Sreenath Meera, Nagarajarao Shivashankar
January-June 2016, 30(1):7-11
DOI:10.4103/0974-2131.196245  
Objective: INCLEN Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD) is an indigenously developed tool for the assessment of Indian children with ASD. This tool has been developed by the INCLEN group in India, and it is used by mental health professionals and pediatricians. This work was to demonstrate its clinical utility for speech-language pathologists (SLPs) and sensitize them to this new tool. Materials and Methods: Forty children between 2 and 10 years of age, with the referral diagnosis of ASD and social communication disorder (SCD) from the Department of Child and Adolescent Psychiatry, were enrolled for the study. Diagnosis was reviewed and the Childhood Autism Rating Scale was administered on all children. The children were grouped as (i) children with ASD and (ii) children with SCD, i.e., "no ASD." The INDT-ASD was then administered by an SLP, who was blind to group membership. Results: Thirty-nine out of forty children were correctly diagnosed by the INDT-ASD, showing high diagnostic accuracy of the tool. In addition to this, it is quick to administer, has very elaborate guidelines to observe different behaviors, a good scoring algorithm, and it is freely available in many regional languages. Conclusion: INDT-ASD is a simple and effective tool that can also be used regularly by SLPs and other professionals for the diagnosis of Indian children with ASD.
  13,631 1,050 -
ABSTRACTS
Abstract Proceeding of 52nd ISHACON-2020

January-June 2020, 34(1):37-226
DOI:10.4103/0974-2131.288975  
  9,068 215 -
ORIGINAL ARTICLES
Translation of hearing handicap inventory (adults and elderly) to Kannada
Sindhu Parthasarathy, Jijo Pottackal Mathai
January-June 2017, 31(1):5-22
DOI:10.4103/jisha.JISHA_23_17  
Introduction: The study aimed to translate two questionnaires on hearing handicap to South Indian language - Kannada. The questionnaires translated were Hearing Handicap Inventory for Adults (HHIA) and Hearing Handicap Inventory for Elderly (HHIE). Materials and Methods: The procedure of translation included forward translation and back translation done by the experts. The translated questionnaires were administered on 40 individuals with hearing impairment ranging from mild to severe degree. The participants were divided into two groups. In the Group I, there were 20 adults and in the Group II, there were 20 elderly participants. The relation between hearing threshold, Speech Identification Scores (SISs), and handicap scores were found in both the groups. Further, to check internal consistency of the questionnaire Chronbach alpha was obtained. Results: In Group II, there was a significant positive correlation between hearing thresholds and handicap score and a significant negative correlation between SISs and handicap score. However, such a correlation was not observed in Group I. The Chronbach alpha value was found to be 0.90 for HHIA and 0.967 for HHIE showing good reliability and internal consistency. Conclusion: The results implied that the degree of hearing impairment and speech perception abilities determines the degree of handicap in elderly. However, in adults, due to high-listening needs and emotional reaction to hearing impairment there was no such trend. Chronbach alpha value inferred that the questionnaire can be used to classify hearing impaired population based on the degree of their handicap.
  8,319 527 1
ORIGINAL RESEARCH ARTICLES
Toward a test battery for differential categorization of age-related hearing loss
Rachael R Baiduc, Jungwha Lee, Sumitrajit Dhar
July-December 2014, 28(2):25-40
DOI:10.4103/0974-2131.162426  
Age-related hearing loss (ARHL, or presbycusis) results from neural and/or cochlear degeneration. A taxonomy distinguishing presbycusis subtypes according to site of lesion was originally proposed by linking audiometric results to histopathological findings. In most cases, the pathology is complex and audiometry and word recognition scores (WRS) are insufficient to characterize pathologies of the auditory periphery. Several sophisticated tests of auditory function, with some specifically designed to inspect cochlear or neural status (e.g., distortion product otoacoustic emissions [DPOAEs] and auditory brainstem response [ABR]) are available but not in routine use to distinguish between presbycutic subtypes. There are no in vivo methods in place to identify contributing pathologies and their relative dominance in individual instances of presbycusis. However, the promise of upcoming therapies (genetic, pharmaceutical, etc.) cannot be realized without accurate identification of presbycusis subtypes. The goal of the present study was to investigate possible improvements in differential categorization of presbycutic subtypes. We explored a test battery composed of behavioral (audiometry and speech testing) and physiological (ABR, DPOAEs, and electrocochleography) assays in presbycutic ears to ask if improvements beyond the "gold standard" (behavioral thresholds through 8 kHz and word recognition) are possible. Data from 10 hearing impaired (HI) individuals were compared to those from 21 normal hearing (NH) adults. Exploratory factor and hierarchical cluster analyses (EFA and HCA respectively) were used to evaluate phenotyping strategies. The EFA revealed three factors (highest audible frequency (HAF), pure-tone average (PTA), and 2f 1 -f 2(High) DPOAEs) that accounted for most of the variability in hearing outcomes among the 31 participants. Hierarchical cluster analysis using the gold standard and enhanced multivariate approach revealed: (1) The clinical gold standard distinguished NH and HI participants, but failed to find commonalities among individuals with similar hearing profiles and (2) The enhanced test battery grouped participants with similar profiles, presumably indicating an underlying relationship in pathophysiology. Model data support the feasibility of a finer-grained categorization of presbycusis than is available in current practice, although more data are needed to understand the complexities of phenotyping.
  6,582 1,237 -
ORIGINAL ARTICLES
Turkish translation, reliability and validity of the amsterdam inventory for auditory disability and handicap
Banu Mujdeci, Ozgu Inal, M Didem Turkyilmaz, Kenan Kose
July-December 2016, 30(2):40-46
DOI:10.4103/jisha.JISHA_1_17  
Introduction: We aimed to compose a Turkish version of Amsterdam Inventory for Auditory Disability and Handicap (T-AIADH) and investigate validity and reliability of T-AIADH. Methods: A total of 240 individuals were included in the study. They were divided into two groups. Individuals with hearing disability constituted the study group (n = 120), and 120 normal-hearing individuals constituted the control group. Results: The reliability analysis of 30 items in all study population yielded a Cronbach's alpha coefficient of 0.98. All Cronbach's alpha coefficients obtained in 5 domains of T-AIADH were above 0.90. For 5-domain scores, intraclass correlation coefficients demonstrated very good test–retest reliability. There were statistically significant differences between the study and control groups in terms of the mean scores of each of the 30 items in the questionnaire (P < 0.01). The mean scores of each of the five domains of T-AIADH were statistically significantly different between the study and control groups (P < 0.01). Criterion analysis showed positive correlations between the domain scores and the average of hearing thresholds (0.5 kHz, 1 kHz, 2 kHz, and 4 kHz) in the study group (P < 0.01). Conclusion: The T-AIADH has a high internal consistency and test–retest reliability. T-AIADH can differentiate the individuals with hearing loss from the individuals with normal hearing. T-AIADH is composed of easily understandable questions, and it may be used to analyze hearing disability for screening purposes or as an adjunctive test to audiological tests in Turkish-speaking patients.
  7,024 512 2
ANY OTHERS
Telepractice in speech-language pathology and audiology: Prospects and challenges
Prema K S. Rao, R Yashaswini
July-December 2018, 32(2):67-72
DOI:10.4103/jisha.JISHA_39_17  
With the advancement in science and technology, the information and communication technology (ICT) mode has been put to best use in the health-care sectors. Unlike health, communication disorders pose special challenges to service delivery. The Discipline of Speech-Language Pathology and Audiology is an integrated health-care profession which is only about half-a-century old in India. The disproportion in the ratio of qualified service providers to service receivers is highly prevalent. In view of this, “Telepractice” (The term telepractice is used in this article to mean tele-rehabilitation for persons with communication disorders since the service comprises of multifaceted objectives such as rehabilitation in the Discipline of Speech-Language Pathology and Audiology) as a means of “reaching the unreached” fits well when the service delivery is provided across geographic, time, social, and cultural barriers using ICT mode. Telepractice is generally provided from a remote site using store-and-forward as well as real-time technology using ICT platforms. The platform for telepractice in India is well set, with a considerable number of people being “digitally literate.” Yet, there are several concerns such as development of professional skills for telepractice; development and validation of digital resources; empirical studies on face-to-face, virtual, or hybrid service delivery; revision of code of ethics for telepractice; and mechanism to protect client's privacy on e-platforms that need to be addressed if telepractice has to be launched on a large scale in India. Insights gained from the work carried out at the Telecenter for Persons with Communication Disorders highlight on the advantages of telepractice from client/caregiver's perspective besides reflections on the prospects and challenges of telepractice in India.
  6,383 817 2
ORIGINAL ARTICLES
Perception of noisiness in various professionals exposed to occupational noise
Shiyaamsundar Bhaskar, Sam Publius Anil, Akshay Mahadeva, Sreeraj Konadath
July-December 2016, 30(2):47-52
DOI:10.4103/jisha.JISHA_15_17  
Introduction: To determine the exposed noise levels and perceptual noisiness scores of various professionals who are prone to develop occupational hearing loss. Further, the relationship between perceptual noisiness scores and measured noise levels was assessed in the study. Methods: Initially, the exposed noise levels of different professions were evaluated (traffic police, bus drivers, auto-rickshaw drivers, vendors, and office workers). The “Noise at Work Questionnaire” was used to assess the noise perception scores under five different domains. Results: SPSS (version 21) was used to analyze the data. Levene test showed homogeneity of variance maintained for noise exposure levels across professionals, following which MANOVA was used. Shapiro–Wilk test for perceptual noisiness scores showed nonnormal distribution, following which Kruskal–Wallis test and Mann–Whitney U-test were performed for group-wise and pairwise comparisons, respectively. Further, Spearman's correlation for noise exposure and noisiness scores was done. The results pertaining to exposed noise levels revealed that the bus drivers (80.42 dB A) were exposed to high noise levels, whereas the office workers (52.4 dB A) had the least. In terms of perceptual noisiness scores, the results revealed a significantly better difference between the groups in the following aspects: benefits (χ2 [4] = 18.679), barriers (χ2 [4] = 10.828), self-efficacy (χ2 [4] = 21.318), attitude (χ2 [4] = 16.233), susceptibility (χ2 [4] = 25.006). Furthermore, there was a negative correlation between the noise exposure levels and the perceptual noisiness scores. Conclusions: In spite of the high noise levels being measured, the bus drivers had the least noisiness scores among the groups, indicating negative attitudes in terms of perceptions which pose as a barrier to preventive measures. The alarming observation made was that 100% of individuals in the study had the least knowledge on the use of Ear protective Devices (EPDs).
  6,710 453 1
Development of phrase recognition test in Kannada language
Hemanth Narayan Shetty, Akshay Mendhakar
July-December 2015, 29(2):21-27
DOI:10.4103/0974-2131.185976  
Context: Sentences are rich in redundancy, and therefore, their identification is often facilitated by the context. The use of phrases introduces limited contextual cues into the process of identification and facilitates the evocation of words. Thus, there is a need to develop phrase recognition test to assess identification abilities. Aims: To develop and validate phrase recognition test in Kannada language for assessing speech recognition in noise. Settings and Design: Normative research design was utilized. Subjects and Methods: A total of 70 phrases in Kannada language were constructed and 67 of them were selected based on familiarity rating. Ten participants each in two groups were involved for the list equivalency and validation. Statistical Analysis Used: Repeated measure of analysis of variance was utilized for the lists equivalency and standardization. Results: Sixty-seven phrases were shortlisted from 70 phrases through familiarity rating. These phrases were embedded in different 5 signal to noise ratios (SNRs) (−9 dB SNR to −1 dB SNR in steps of 2 dB). Analysis of results showed 50% recognition score at ~−5 dB SNR. In addition, the phrases that were too easy and too difficult were eliminated. From the remaining phrases, five lists of 10 phrases each were constructed and compared for their equal intelligibility in noise. The results revealed no significant differences across the phrase lists. Conclusions: The homogenous five lists of the Kannada phrase recognition test will be useful to assess identification ability of the listeners and hearing aid benefit.
  6,425 523 3
Sociolinguistic adaptation process of the Bangla Western aphasia battery-revised
Barnali Mazumdar, Neila J Donovan, Vaishna Narang
January-June 2018, 32(1):23-33
DOI:10.4103/jisha.JISHA_35_17  
Introduction: The purpose of this study was to complete a sociolinguistic adaptation and validation of the Western Aphasia Battery-Revised (WAB-R) (Kertesz and Raven, 2007), an English aphasia assessment into the Bangla language. Two hundred and fifty million people speak Bangla/Bengali in eastern parts of India and Bangladesh. Methods: This study had two steps: first, three professional translators performed the translation and back-translation processes on the WAB-R. Second, to validate the adaptation, 27 neurologically normal individuals and 36 patients with a history of cerebrovascular accident participated in this study. Results: Three types of adaptation processes, i.e., introduction of new words or phrases, direct translation, and direct translation replacing concepts were involved. As per different adaptation processes, Record form part 1 (derives aphasia quotient [AQ]) achieved 25% of sociocultural and linguistic changes whereas Record form part 2 (derives cortical quotient and language quotient) achieved 57% of sociocultural and linguistic changes. The items of Bedside record form (shorter version of the test) were taken from Record form part 1 and part 2. Normal controls completed the test with scores of 100% on most of the sub-tests while the patients' performance was significantly lower. Eighty percentage of the patients had aphasia, based on their test scores, and investigators could categorize the patients by aphasia type based on the AQ and bedside aphasia score. There is a high correlation between the subtest scores of Record form part 1 and Bedside record form. Conclusion: Some changes were needed to adapt the WAB-R for Bangla speakers. Preliminary validation study demonstrated that the Bangla WAB-R could differentiate the normal population from the patients with aphasia by their language performance. Investigators will attempt to standardize the test in the next phase of the study.
  6,037 505 -
TUTORIAL ARTICLE
Optimality theory and assessment of developing and disordered phonologies
Froogh Shooshtaryzadeh
July-December 2015, 29(2):13-20
DOI:10.4103/0974-2131.185975  
Optimality theory (OT) is a comparatively recent linguistic theory which has been introduced in the early 1990s. OT's description of children's error patterns as patterns that are derived from a hierarchy of conflicting universal constraints has much higher explanatory power than the underlying phonological representations posited by generative phonology which focused only on production. This tutorial article aims to introduce speech clinicians some information about the basic architecture and formalities of OT and highlights some of its advantages over rule-based generative approaches in different linguistic contexts. The article begins with a brief definition of (functional) phonological disorder and explains the basic components of OT and its proposed model of language development in relation to first language acquisition. Finally, the role of OT and standard generative phonology in the assessment of phonological errors produced by children with atypical phonological development is illustrated using empirical data based on Persian language.
  4,793 1,414 -
ORIGINAL ARTICLES
A self-learning module for students of speech-language pathology in phonetic transcription of Tamil
RP Sharmila Devi, Roopa Nagarajan, VH Savitha, Lakshmi Venkatesh
January-June 2016, 30(1):17-26
DOI:10.4103/0974-2131.196254  
Objectives: The study aimed to develop and assess the effectiveness of a self-learning module in phonetic transcription of Tamil language for students of speech-language pathology. Methods: A self-learning module with information on phonetic transcription and sounds of Tamil was developed. Exercises for practicing transcription at the word and phrase levels were included in the module. Content validity of the module was established through consultations with experienced speech-language pathologists and linguists. Fifty undergraduate students of Audiology and Speech-Language Pathology (ASLP), with limited exposure to phonetic transcription, completed the self-learning module individually. The efficacy of the self-learning module was evaluated through a questionnaire, and a phonetic transcription task aimed at assessing the knowledge and skill of transcription. Participants completed the questionnaire and transcription task prior to and after completion of the self-learning module. Results: Postlearning scores on the questionnaire and phonetic transcription task were significantly higher than prelearning scores suggesting improvement in knowledge and skill of transcription upon completion of the self-learning module. Transcription accuracy increased for different categories of vowels and consonants. Conclusion: The self-learning module demonstrates promise as an acceptable and effective method for learning phonetic transcription by undergraduate students of ASLP.
  5,634 476 -
Effect of localization training in horizontal plane on auditory spatial processing skills in listeners with normal hearing
KV Nisha, U Ajith Kumar
July-December 2016, 30(2):28-39
DOI:10.4103/jisha.JISHA_2_17  
Introduction: Source localization depends on processing of monaural and binaural spatial cues. Although difficulties arising due to the deficits in the processing spatial cues are well documented in the literature, remediation programs aimed at resolving spatial deficits are scanty. The present study is a preliminary research aimed at exploring the changes in the spatial performance of normal-hearing listeners using localization training in a horizontal plane. Methods: Twelve normal-hearing listeners aged 18–25 years participated in the study. The study was conducted in three phases including pretraining, training, and posttraining phase. At the pre- and post-training phase, three tests of spatial skills, namely, test of localization in free-field, test of lateralization ability under headphones (i.e., virtual auditory space (VAS) identification test), and tests for binaural processing ability (i.e., interaural level difference [ILD] and interaural time difference [ITD]), were administered. The training phase consisted of structured localization regimen spanning eight sessions spread over 2 weeks. Results: Paired t-test revealed that root mean square error, ITD threshold, and VAS scores in the post-training phase were significantly better than pretraining condition, indicative of the benefit derived from training. ILD did not alter significantly in posttraining phase owing to the ceiling effect in pretraining phase. Conclusion: The localization training protocol used in the present study on a preliminary basis proves to be effective in normal-hearing listeners and its implications can be extended to other clinical populations as well.
  5,569 524 -
Conversation analysis in tamil speaking male children
Sathya Harinath, Vaidyanathan Raghunathan
July-December 2017, 31(2):48-56
DOI:10.4103/jisha.JISHA_1_16  
Introduction: The present study aims to profile the conversation behaviors of typically developing Tamil speaking male children in the age range of 3–5 and 7–9 years. Methods: The participants of the study were twenty typically developing Tamil speaking male children in the age of 3–5 years and 7–9 years. Ten mother–child dyads were videotaped in each group. The recordings were orthographically transcribed. Three to four elaborated topics were selected from the transcribed data of each child. Each topic was analyzed for the following behaviors: (1) topic initiation, (2) topic maintenance, (3) request for repair, (4) conversation repair, (5) nonverbal behavior, and (6) topic termination Results: Comparison of the younger children (3–5 years) dyad with the older children (7–9 years) dyad indicates a significant difference in orientation under topic initiation, conversation information under topic maintenance, responding to request under conversation repair, and nonverbal behavior. Discontinuous turns and abrupt topic termination were present only in the younger group dyad. Conclusion: This quantitative approach provides a method of measurement of the conversation behavior. This knowledge will be helpful for making assessment and planning for intervention for children with conversation difficulties.
  5,284 414 -
REVIEW ARTICLE
Diagnostic relevance of primitive reflexes in high-risk newborns: A systematic review
N Swapna, Prawin Kumar, Bincy R Kalam, VA Anju, K Arunraj
January-June 2020, 34(1):24-30
DOI:10.4103/jisha.JISHA_22_19  
The study was undertaken to perform a systematic review to investigate the diagnostic relevance of primitive reflexes (PR) such as Moro, Rooting, Sucking, Palmar, and Plantar/Babinski reflexes in high-risk newborns. A systematic literature search was carried out using different search engines between the years 1980 and 2018. There were 48 articles considered out of 61 articles, based on screening of the title and abstract. Finally, among 48 articles, a total of 8 articles were considered for the detailed review based on the inclusion criteria. The results of the selected articles on the different PRs have been discussed in the present study. Though most studies have evaluated the moro and the plantar reflex, every reflex considered in the study has been found to be affected in high-risk newborns and consequently, it is difficult to undermine the significance of any of these. All the studies reviewed highlighted the importance of assessing these reflexes in high-risk newborns and indicated that an abnormal reflex is an indication of a neurological abnormality. These findings indicate that the assessment of PRs should be included in the newborn screening protocol because they are not time consuming and can be performed easily with minimum or no tools. Future studies that are aimed at investigating the efficacy of these PRs in identifying children with developmental disabilities are essential.
  5,171 402 -
ORIGINAL RESEARCH ARTICLES
Auditory temporal processing in children with stuttering
Neha S Kekade, Deepa Aniket Valame
July-December 2014, 28(2):41-46
DOI:10.4103/0974-2131.162427  
Purpose: To study auditory temporal processing performance in 30 children with stuttering (CWS) and compare it with 30 age -matched controls. Materials and Methods: Auditory temporal processing was compared in two groups of children: With and without stuttering; in the age -range of 9 -14 years using Gap Detection Test (GDT) and Duration Pattern Test (DPT). Ear differences in the gap detection thresholds and duration pattern scores were also studied in both the groups. GDT was carried out using the GDT CD developed by Shivprakash and Manjula (2003) and DPT was carried out using the DPT CD developed by Gauri and Manjula (2003). Results: No significant difference was seen in the gap detection thresholds and DPT scores between the right ear and left ear scores in typical children and between the scores of the two ears in CWS. The performance of CWS group was significantly poorer as compared to that of typical children in both GDT and DPT. These auditory temporal processing deficits may interfere with the auditory feedback loop that is crucial to fluent speech production. Fluency inducing conditions like slow reading, DAF, or frequency -altered feedback reduce the dependence on auditory feedback thus inducing fluent speech. The results of the present study show that deficient auditory temporal processing in CWS may add to the demands placed on the feedback mechanism thereby increasing stuttering. Conclusions: As a group, CWS show evidence of compromise in their auditory temporal processing abilities. Tests of temporal processing should be included in assessment of IWS as a pre-therapy assessment tool along with assessment of stuttering.
  4,915 498 2
REVIEW ARTICLE
Dysphagia research in India: A status report
Gayathri Krishnan, SP Goswami
July-December 2018, 32(2):39-46
DOI:10.4103/jisha.JISHA_44_17  
In India, the field of dysphagia is still in its infancy. This study attempted to make a baseline assessment of the status of dysphagia research reported from India in the global scenario. A search in the most popular search engines and databases for research originated in India was conducted. Among the 2436 reports retrieved, 64 reports were included in this study. A two-tier analysis revealed the various characteristics of Indian research, and researchers involved in this science. Initiated less than two decades ago, dysphagia research in India has been on a steady increase. Unfortunately, 23.44% of them remain unpublished and unavailable for other researchers. Although there is a growing interest, dysphagia is still unexplored and has a long way to grow in India. The numerous gaps identified in this study provide a new direction for researchers in dysphagia and also enlighten the Indian researchers about their contribution to the global scenario.
  4,660 649 -
ORIGINAL ARTICLES
Characterizing the Effects of Frequency on Parameters of Short Tone-bursts Induced Ocular Vestibular Evoked Myogenic Potentials
Niraj Kumar Singh, Animesh Barman
January-June 2014, 28(1):1-9
DOI:10.4103/0974-2131.127385  
Stimulus is the essence of any audiovestibular investigation and ocular vestibular-evoked myogenic potential (oVEMP) would be no different. Several investigations have examined the effect of frequency of stimulus on oVEMP parameters with prime reports concentrated around amplitude and to a lesser extent threshold. Effects of stimulus frequency on latency-related parameters have been sparingly explored with equivocal results. Thus, the aim of this study was to investigate the effects of air-conducted frequency-specific short tone-bursts on latency, amplitude, and threshold-related parameters of various peaks of oVEMP. A normative study was conducted to obtain oVEMP responses from 50 healthy individuals in the age range of 18 - 30 years. Tone-bursts at octave and midoctave frequencies from 250 to 2000 Hz were used to acquire responses from the inferior oblique muscle using contralateral electrode placement. oVEMPs were present in 100% of the individuals at or below the frequency of 1000 Hz. The largest amplitudes and the lowest threshold corresponded to 500 Hz tone-burst, whereas 250 Hz produced largest absolute latencies as well as interpeak latency intervals (P < 0.05). Frequency had no effect on interaural latency difference as well as interaural amplitude ratio. Owing to largest amplitudes and best thresholds, 500 Hz appears better stimuli for clinical recording of oVEMPs. This is true irrespective of the peak complex being assessed is n1p1 or p1n2.
  4,869 430 -
Current status of availability of speech and language pathologist for individual with Parkinson disease: In a metropolitan city
Priya Kshitij Shah, Geeta Gore
January-June 2016, 30(1):1-6
DOI:10.4103/0974-2131.196243  
Introduction: Worldwide, prevalence of communication disorder in Parkinson Disease (PD) is 89%, however only 3-4% receives Speech Therapy. This highlights the need for an increase in the number of professionals to manage the various communication problems these individuals with PD face. This study was conducted using small sample survey on individuals with PD, medical professionals and Audiologists and Speech Language Pathologists (ASLP). Aim: Information about the need, availability and any other difficulties encountered for communication management were procured. Methodology: 56 individuals with PD, 30 medical professionals consisting of Neurologist and ENT and 158 ASLP were surveyed. To corroborate availability of speech language pathologists, intake capacity of Audiology and Speech Language Pathology students for graduation and post graduation in Mumbai and a rough estimate of their post education status in terms of area of practice was obtained. Results: Though more than 50% individuals with PD face communication difficulties only 5% are taking therapy. Over 50 % medical professionals stated difficulty in finding a speech therapist to refer the individual with PD. Only 10% of practicing speech therapists treat individuals with PD on a regular basis. On an average only around 27 post graduates pass out per year in Mumbai, roughly 50% of the same opt for a career in Speech language pathology. Conclusion: This fact highlights the need for increase in the man power development. This study on PD is a preliminary estimate of one of the many communication disorders that come under the treatment purview of a Speech and Language Pathologist.
  4,713 495 1
CASE REPORT
Hearing outcome following canaloplasty in fibrous dysplasia
Rohit Ravi, Balakrishnan Ramaswamy, Ajay M Bhandarkar, Krishna Yerraguntla
July-December 2016, 30(2):53-55
DOI:10.4103/jisha.JISHA_18_16  
Fibrous dysplasia (FD) is a rare condition and is benign in nature. There is narrowing of external auditory canal leading to conductive hearing loss. We present a case of a 23-year-old male with a diagnosis of FD with the complaint of blocking sensation and reduced hearing in the left ear for 2 months. Canaloplasty was carried out by Wilde's postauricular incision following which there was a significant improvement in hearing threshold. This case report highlights the importance of diagnostic tests such as audiometry, tympanometry, high-resolution computed tomography, and histopathological examination. It also highlights the importance of hearing outcomes postsurgical intervention.
  4,682 376 -
ORIGINAL ARTICLES
Fuel for the processor: Our experience
Neelam Vaid, Shweta Deshpande, Kalyani Salve, Rajesh Nikam, Sanjay Vaid
January-June 2015, 29(1):1-7
DOI:10.4103/0974-2131.173858  
Introduction: Cochlear implant centers providing audiological and habilitation support to their implantees are also obligated to offer prompt and accessible equipment maintenance. Aim of the Study: To evaluate and compare the number of accessories requiring replacement by the different processors of the three major cochlear implant manufacturers: Advanced Bionics, Cochlear, and MED-EL. Type of Study: Retrospective. Materials and Methods: An analysis of the inventory of accessories required and used by 218 recipients supported by our center for a period of 3 years from 2010 to 2013 was done. These data were statistically analyzed for each manufacturer. Results: Eleven accessories provided by the manufacturer were replaced regularly by implantees over 3 years. Cables were the most frequently replaced accessory. Magnets were the least commonly replaced accessory. MED-EL implantees needed the maximum replacements as compared to implantees of the other two companies. Conclusion: Preimplant counseling regarding choice of any device usually includes technical details, esthetics, cost of the device, and expected outcomes. Maintenance of the device is often overlooked and becomes a major challenge for patients of lower socioeconomic strata of society. This study will enable clinics to give information regarding the sustainability of the device to the implantee, and the family which will definitely have an impact on better utilization of the device and better outcomes.
  4,497 469 -
Income and work satisfaction among speech and hearing professionals in India: Two sides of the same coin
SP Goswami, S Ramkumar, Sharon Mathews
January-June 2018, 32(1):16-22
DOI:10.4103/jisha.JISHA_26_17  
Introduction: Speech-language pathologists and audiologists work toward the prevention, assessment, or rehabilitation of persons with communication disorders. They work in a wide variety of service settings, with each setting being entirely different from the other in terms of the financial benefits, hours of work, nature of work, and work-life balance. With the extensive opportunities available, the field is growing and establishing itself in India. Measuring job satisfaction and understanding the factors that influence it makes known all facets of the profession in the Indian scenario. Method: The current study examined the various factors that affect work and income satisfaction among speech-language-hearing professionals who completed their professional education between 1967 and 2012 at an institute in India. A questionnaire-based survey method was used, and responses from 112 randomly selected participants from different work settings were analyzed. Results: A significant correlation between income and work satisfaction scores given by the participants was found. Conclusions: The study points out that income alone does not affect the professionals' work satisfaction. The latter is a resultant of other internal and external factors that lead to the professional feeling unappreciated for his/her job.
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The psychosocial consequences of severe deafness and the modifying effect on the socioeconomic position in a special education institution setting: A pilot study
Sanyaolu Alani Ameye, Adekunle Adeyemo, Josephine Eziyi, Yemisi Amusa, Grace Ogunniyi, Bright Otoghile
January-June 2015, 29(1):8-11
DOI:10.4103/0974-2131.173859  
Objective: To study the psychosocial consequences of severe deafness and the effects on the socioeconomic position of the affected individuals. Methods: A cohort study of a deaf student attending a special education secondary school for the deaf and some of their teachers were randomly selected for the study. Sociodemographic characteristics, self-reported deafness, employment situation, and financial conditions, psychosocial consequences such as social isolation, denial of privileges, educational attainment, the level of achievement, and satisfaction with life were assessed using a semi-structured questionnaire. Results: All the participants had severe to profound hearing loss, and all of them could communicate by sign language. Adverse psychosocial consequences were found in this study population. A significant percentage was not satisfied with their current placement. A significant percentage reported limitation in their achievements and more than a third of them admitted to having been denied privileges as a result of being deaf. Social isolation was a major source of worry for 70% of the respondents and close to 40% admitted to being angry mainly because of the attitude of the society towards them. Underemployment was found in 44%, of the sampled population. Conclusion: Hearing impaired individuals are faced with economic and psychosocial adverse consequences. Labor market and educational policies must take into consideration these challenges to integrate this segment of our population into the active, productive sector of the economy.
  4,404 457 -
Effects of phototherapy on outer hair cell function in infants with hyperbilirubinemia
Vikas Mysore Dwarakanath, Pavana Mohan, Sapthami Patel
July-December 2018, 32(2):52-55
DOI:10.4103/jisha.JISHA_8_17  
Introduction: Hyperbilirubinemia in newborns has been hypothesized to cause damage to inner ear, thus leading to sensorineural hearing loss. Phototherapy is treatment protocol in most of the hospitals for newborns with high bilirubin levels. The present study aimed to determine the effects of phototherapy on outer hair cell (OHC) function of cochlea. Methods: Twenty-two neonates with hyperbilirubinemia undergoing phototherapy and 22 neonates without any high-risk registers were included in the study. Distortion product otoacoustic emission (DPOAE) was administered before and after phototherapy. Auditory brainstem response (ABR) evaluation was done during the postphototherapy recording. Results: Results showed that DP amplitude and signal-to-noise ratio improved significantly after phototherapy. ABR evaluation revealed; 19 neonates had significantly prolonged wave V latency compared to normal, whereas no peaks were identified among three neonates. Most of the infantile hyperbilirubinemia are found to be harmless until and unless treatment is not initiated at the earliest, but still it is found that short-term increase in bilirubin level can induce temporary changes in OAEs and ABR measures. ABR needs to be repeated over a period of time for these three neonates to rule out auditory dyssynchrony (AD). Conclusion: The results indicate that phototherapy has temporary effects on OHC function and can improve as the bilirubin levels reduce. Follow-up testing over a period of time helps in discriminating the sensory pathology and AD.
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Comparison of working memory abilities in adults who do and do not stutter
SD Dhatri, U Ajith Kumar, M Santosh
July-December 2017, 31(2):42-47
DOI:10.4103/jisha.JISHA_5_17  
Introduction: Adults with stuttering (AWS) exhibit longer reading rates and poor nonword recognition. This is attributed to deficits in phonological working memory abilities specific to language disturbances. In the present investigation, working memory abilities of AWS was investigated using n-back test which is not sensitive to subtle language deficits. Methods: Participants included nine AWS in the age range of 18–26 years, and nine age, gender, and language-matched adults who do not stutter. The participants performed auditory 1- and 2-back tasks, where they pressed a button whenever the same syllable was heard as the one and two syllables before, respectively. The reaction time, accuracy, false alarm rate, and d prime (difference in z-scores of hit rate and false alarm rate) were calculated for an individual participant in each n-back condition. Results: Results revealed significant difference between two groups only during 2-back task. Analysis showed that AWS had more false alarms, which might have resulted because of the anxiety in responding, due to increased attentional demands, which is in turn reflected as working memory deficits during the difficult task. Conclusion: The present results provide preliminary evidence for auditory working memory deficits in persons who stutter.
  4,057 417 -
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