<p>Communicative recycling, to repeat utterances uttered by oneself or others, is a common phenomenon in all societies and languages. The talk of persons with autism often features recycling. The aim of this study was to identify different forms of recycling in communication involving a boy with autism and to describe its functions. Communication between the boy with autism, who used Picture Exchange Communication System (PECS) to communicate, and his parents and teachers was videotaped. The conversations took place in familiar settings, in the boy’s home and at his pre-school. The theoretical approach in the present study was Conversation Analysis (CA). The results provide further support for other studies in that recycling is an important interactional resource for children with limited linguistic capacities. The boy recycled the conversational frames taught in PECS and accommodated these to fit the context. The use of frames also enabled him to communicate with sentences. The transcribed examples exhibited diect as well as delayed recycling of other persons utterances made by the boy. The communicative recycling found in this study fulfilled all parts of the five-folded definition of functions presented by Tannen (1987): facilitating production and comprehension, creating a sense of connection, being a communicative resource enabling interaction and creating coherence as interpersonal involvement. The communicative recycling enabled the boy and his conversational partners to share communicative conventions. The use of recycling in conversations by people with autism may be a step towards a more generative use of language.</p>

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Logopeder som träffar barn med språkstörning arbetar i hög grad med barnets hela familj. Specifik kunskap krävs då barnet och familjen är två- eller flerspråkiga. I denna fallstudie beskrivs språkanvändningen i en trespråkig familj som bor i Sverige. Den flamländsktalande modern och svensktalande fadern talade sina respektive modersmål med dottern Betty enligt språkstrategin one parent – one language (OPOL). Föräldrarna talade engelska sinsemellan. Data samlades in via videoinspelning, föräldraskattning och intervjuer. I den kvantitativa delen av studien undersöktes främst vilka språk som användes mellan familjemedlemmarna och i vilken grad kodväxling förekom. Den kvalitativa delen av studien fokuserade på föräldrarnas reflektioner om familjens trespråkighet ur ett individ-, familje- och samhällsperspektiv. Resultaten visade att föräldrarna följde sin språkstrategi väl och att kodväxling främst skedde föräldrarna emellan. Dottern följde strategin väl till fadern men till modern fanns betydande inslag av svenska. Tre teman som sammanfattar föräldrarnas reflektioner om flerspråkighet kunde urskiljas. Dessa var engelskans särställning i samhället, flamländska som minoritetsspråk samt språk som mått på integrering. Den logopediska relevansen diskuterades utifrån värdet av observationer på flerspråkiga barns interaktion med sina föräldrar vid bedömning, utökning av anamnes för flerspråkiga samt om logopeder bör rekommendera språkstrategier till flerspråkiga familjer. / Speech-language pathologists working with language impaired children often work with the child’s entire family. Specific knowledge is needed when the child and its family are bi- or multilingual. This case study describes the language use of a trilingual family living in Sweden. The Flemish speaking mother and the Swedish speaking father spoke their respective mother tongue with their daughter Betty in accordance with the language strategy one parent – one language (OPOL). The parents spoke English with each other. Data was collected by means of video recording, parental estimation and interview. The quantitative aspect of this study primarily examined what languages were used between different family members and to what extent code-switching occurred. The focus of the qualitative analysis was the parents’ reflections regarding the family’s trilingualism from an individual, family and societal perspective. The results showed that the parents followed their choice of language strategy well and that they code-switched mainly to each other and not to their daughter. Betty followed the strategy well to her father whereas she used a fair amount of Swedish to her mother. The parents’ reflections on multilingualism can be summarized in three themes. These were the unique position of English in society, Flemish as a minority language and language as a measure of integration. The clinical relevance was discussed in terms of the value of observing multilingual children interacting with their parents as a form of assessment, expanding the anamnesis for multilinguals and lastly whether speech-language pathologists should recommend language strategies to multilingual families.

Parkinson’s disease (PD) affects patients voice characteristics, reducing pitch variability compared to normal controls (1,2). Previous reports have shown an increase in pitch variability due to deep brain stimulation (DBS) of the Subthalamic nucleus (STN) (3). For patients stimulated in caudal zona incerta (cZi), the results indicate no effect on pitch variability in a read speech task{Karlsson:2012jr}. The present study aimed at investigating the effects of speech task (spontaneous or read speech) and the lenght of the utterance on overall measures of pitch variability observed in DBS-treated patients. Ten patients treated with STN-DBS and ten patients treated with cZi-DBS were included in this prospective study. Utterances produced sponatenously and produced during readings of a standard passage were compared in terms of treatment effects in pitch variability due to STN-DBS and cZi-DBS (Stim OFF and Stim ON recordings made 1,5 hour apart, all in Med ON) 6 and 12 months after operation. The results indicate that pitch variability is affected differently by STN-DBS and cZi-DBS depending on speech task and utterance length. In short utterances (&lt;10 words), an increase in pitch variability is observed for both treatment groups and both speech tasks. For longer utterances, however, a more diverse effect of treatment and speech task is observed. The results therefore suggest that spech task and characteristics of thate utterance should be carefully considered when drawing conclusions on the overall effect of DBS on pitch variability. 1. Jiménez-Jiménez FJ, Gamboa J, Nieto A, Guerrero J, Ortí-Pareja M, Molina JA, et al. Acoustic voice analysis in untreated patients with Parkinson's disease. Parkinsonism Relat. Disord. 1997 Apr;3(2):111–6.  2. Holmes RJ, Oates JM, Phyland DJ, Hughes AJ. Voice characteristics in the progression of Parkinson’s disease. International Journal of Language &amp; Communication Disorders. 2000;35(3):407–18.  3. Dromey C, Kumar R, Lang AE, Lozano AM. An investigation of the effects of subthalamic nucleus stimulation on acoustic measures of voice. Mov. Disord. 2000;15(6):1132–8. / Intonation och rytm i talet hos personer med Parkinsons sjukdom - en longitudinell jämförelse mellan sjukdomens effekter och effekter av behandling

Formant centre frequencies are regularly used as acoustic measure of vowel quality because of the well established correlation between them and properties of vowel production(Fant, 1960). While it is recognised that it is important transform formant frequencies, as measured from the spectrogram, into relevant psychoacoustic scales when addressing issues of vowel perception, production studies are still largely based on the the raw, Hz-scaled, formant measurements. As a consequence, systematic studies of vowel articulation proficiency due to clinical conditions or effects of treatment are not easily afforded.  A number of derived measures have been proposed to capture whole-system effect of vowel production. Previous research has primarily used the calculated total area of formants measured from either [a], [u], [i] and [æ] or only [a], [u] and [i] productions, joined together to form a quadrilateral or a triangle (Vowel space area, VSA)(Kent &amp; Kim, 2003). In the reduced articulatory range of hypokinetic dysarthria, VSA is expected to be reduced by the dysarthria, and increased due to successful treatment the patient’s articulatory range.  However, VSA has been proposed to be not powerful enough to capture effects on vowel articulation found specifically in patients with Parkinson’s disease (PD), and therefore not able to establish treatment effects. Two alternative measures have been proposed previously that are more focused towards specifically towards finding expansion and reductions in vowel spaces, the Vowel articulation index (VAI)(Roy, Nissen, Dromey, &amp; Sapir, 2009) or Formant Centralization Ratio (FCR)(Sapir, Ramig, Spielman, &amp; Fox, 2010). Both VAI and FCR has been shown to be able to establish significant reductions vowel articulation due to PD. Similar to VSA, however, the VAI and FCR measures do not given any detailed insight into the nature of the change in articulation. Further, all three measures reduces all obtained vowel formant measurements into a single metric, resulting in a substantial loss of statistical power and a considerable reduction in quality of intra-speaker models of articulatory proficiency.  In response to the problematic properties of previous metrics, a revised view of formant frequencies more suitable for studies of changes in vowel articulation has recently been outlined, along with a new metric (Vowel Formant Dispersion, VFD). The VFD view of vowel formants are more closely connected to properties of vowel articulation and therefore affords more more detailed interpretations to be drawn concerning speakers’ production proficiency and offers increased reliability of within speaker estimates of this proficiency. This paper presents a detailed view of how VFD may applied to clinical populations where vowel production is affected by the condition (e.g. hypokinetic dysarthria) or where production should be affected (e.g. transexual patients or in successful treatment of dysarthric patients). It will be shown that most aspects of the study of vowel articulation proficiency will be significantly enhanced by the VFD method. Fant, G. (1960). Acoustic Theory of Speech Production. Mouton and Co 's-Gravenhage. Karlsson, F. (submitted). Vowel Formant Dispersion: a revised view of vowel production. The Journal of Acoustical Society of America. Kent, R. D., &amp; Kim, Y.-J. (2003). Toward an acoustic typology of motor speech disorders. Clinical Linguistics &amp; Phonetics, Clinical Linguistics &amp; Phonetics, 17(6), 427–445. Informa Allied Health. doi:10.1080/0269920031000086248 Roy, N., Nissen, S. L., Dromey, C., &amp; Sapir, S. (2009). Articulatory changes in muscle tension dysphonia: evidence of vowel space expansion following manual circumlaryngeal therapy Journal of communication disorders, Journal of communication disorders, 42(2), 124–135. doi:10.1016/j.jcomdis.2008.10.001 Sapir, S., Ramig, L. O., Spielman, J. L., &amp; Fox, C. (2010). Formant Centralization Ratio: A Proposal for a New Acoustic Measure of Dysarthric Speech. Journal of Speech, Language, and Hearing Research, 53(1), 114–114.

Denna studie genomfördes i syfte att undersöka ett eventuellt samband mellan ordförråd och strategianvändning på arbetsminnesuppgifter hos barn med utvecklingsstörning. Barn med utvecklingsstörning antas ha svårare för att minnas visuellt presenterad information med hjälp av en fonologisk strategi, innebärande upprepning av ord subvokalt i arbetsminnet (Milgram, 1973). Henry (2002) menar att barn med utvecklingsstörning har en nedsättning vad gäller förmågan att subvokalt upprepa ord i arbetsminnet. Detta kan relateras till en studie av Gathercole och Baddeley (1989) som visar att fonologiskt arbetsminne är viktigt vid förvärvandet av nya ord. Baserat på detta formades vår hypotes om att ett större ordförråd skulle ha ett samband med användande av en fonologisk minnesstrategi.        I studien deltog 32 barn med mentala åldrar mellan 5:9–10:9 år. Barnen i gruppen med utvecklingsstörning bestod av 16 barn. Den andra gruppen utgjordes av barn med typisk utveckling, matchade mot barnen med utvecklingsstörning genom icke-verbal ålder. De två grupperna delades i sin tur in i tre åldersgrupper vardera för att dessa skulle kunna jämföras med varandra.  Varje barns ordförråd fastställdes för att jämföra detta med minnesstrategier. Ett speciellt utformat dataprogram hjälpte oss kartlägga gruppernas strategianvändning. De yngre åldersgrupperna i gruppen med utvecklingsstörning visade sig ha ett samband mellan en visuell strategi och ordförrådets storlek.  Det visade sig att kontrollgruppen i signifikant större utsträckning använde sig av en mogen fonologisk strategi i jämförelse med gruppen med utvecklingsstörning. Sammanfattningsvis tycks det finnas samband mellan strategianvändning och ordförrådets storlek. / The purpose of this study was to investigate a possible correlation between vocabulary and strategy use in working memory tasks. Children with intellectual disabilities are presumed to have difficulties in remembering visual represented information using a phonological strategy, meaning rehearsal in the working memory (Milgram, 1973). Children with intellectual disabilities have a deficit in the ability to rehearse words in working memory (Henry, 2002). This can be related to a study made by Gathercole and Baddeley (1989) implying that phonological working memory is important when learning new words. Our hypothesis was therefore that vocabulary size would correlate with a use of a phonological working memory strategy.      Thirty-two children with a mental age span between 5:9 and 10:9 participated. The target group consisted of 16 children with intellectual disability. The control group consisted of 16 children matched on non-verbal mental age. In order to compare children with equal mental age, the target group and the control group were divided into three age groups. In order to analyze which strategies children practice to remember, a computer program, specially designed for this study was used. The program helped us to map out strategy use among the groups. We determined each child’s vocabulary to compare these variables. We found a correlation between vocabulary size and strategy use in the younger age groups of children with with intellectual disability. We also found that the control group had a significantly larger use of the mature phonological strategy in comparison to the group with intellectual disability. To summarize it seems that there is a correlation between strategy use and vocabulary size.

I denna pilotstudie utvärderas KomRett, en kommunikationskurs för närstående till personer med Rett syndrom som genomfördes för första gången hösten 2009. Målsättningarna med KomRett var att öka kursdeltagarnas kunskap om kommunikation och strategier för att stimulera kommunikation samt grafisk AKK med eller utan ljud. Kursen utformades med utgångspunkt från innehållet i föräldrakurserna i projektet AKKTIV vid DART Center i Göteborg (Alternativ och Kompletterande Kommunikation Tidig InterVention till föräldrar som har barn med kommunikationssvårigheter). Kommunikationspartners till fyra personer med Rett syndrom deltog i studien. I utvärderingen användes analys av olika skattningsformulär samt videoanalys av filmer från två kursdeltagare. Resultaten visar att tre av sex kursdeltagarna började använda bilder i sin kommunikation med personerna med Rett syndrom efter kursen. I videoanalysen framkom att en av två kursdeltagare oftare använde en responsiv kommunikationsstil i vald aktivitet efter kursen. Höga poäng på utvärderingsformuläret tydde på att kursdeltagarna uppfattade kursen positivt och flera av kursdeltagarna uppgav att de var mer uppmärksamma på kommunikationen efter kursen.

Measurements of jitter and shimmer are frequently employed to quantify laryngeal control and stability during voice production in patients(1-3). Accurate estimates of jitter and shimmer may be obtained from acoustic recordings of sustained vowels produced by patients using computer software implementing algorithms for their extraction (e.g. Praat(4) or MDVP(5)). The jitter and shimmer algorithms do not, in themselves, exclude non-stable productions and are influenced by the inclusion of silence in the analysed intervals. As a consequence, reliable measurements of jitter and shimmer are made by manually opening each sound file and selecting an interval for the computations.  The current paper proposes an alternative approach to afford a more efficient estimation of jitter and shimmer across a large set of sustained vowel recordings. Using information readily available in the acoustic signal and a combination of algorithms already available within the Praat program, a reliable method for automatic processing of only the sustained vowel in each recording of a large corpus is outlined. The method further affords the acquisition of multiple, repeatable, measurements of jitter and shimmer for sub-intervals of the vowel’s duration (applying more than one algorithm), which additionally provides information concerning the reliability of the jitter or shimmer estimates for a specific vowel  production. Comparisons with manually obtained measurements are made for the purpose of validation of the segmentation method. References 1. Gamboa J, Jiménez-Jiménez FJ, Nieto A, Montojo J, Ortí-Pareja M, Molina JA, et al. Acoustic voice analysis in patients with Parkinson's disease treated with dopaminergic drugs. Journal of Voice. 1997;11(3):314–320.  2. Kent RD, Kim Y-J. Toward an acoustic typology of motor speech disorders. Clin Linguist Phon. 2003;17(6):427–445.  3. Figueiredo ML, de Carvalho APM, Patriani FFA, Suzana BM, Ballalai FH. Acoustic voice assessment in Parkinson's disease patients submitted to posteroventral pallidotomy. Arq. Neuro-Psiquiatr. 2005;63(1):14–19.  4. Boersma P, Weenink D. Praat: doing phonetics by computer [Computer program]  5. Kay Elemetrics. Multi-Dimensional Voice Program (MDVP) [Computer program] / <p>Presented at the 14th Meeting of the International Clinical Phonetics and Linguistics Association</p> / En kontrastiv och longitudinell studie gällande effekten av djup hjärnstimulering på Parkinsons-patienters artikulatoriska förmåga. / Intonation and rhythm in speech of patients with Parkinson ́s disease

<p>I Uppsala har det inte funnits tillräckliga resurser för att personer med ät- och kommunikationssvårigheter ska få fortsatta logopedinsatser efter att de har skrivits ut från den geriatriska vården. Ett projekt startades därför 2007 med målet att utveckla modeller för logopediskt arbete så att vårdkedjan blir komplett och rehabilitering kan fortsätta så länge vårdtagaren har behov av det. Projektet har riktat sig till personer över 65 år som har ät- och/eller kommunikationssvårigheter på grund av stroke eller progredierande kognitiv/neurologisk sjukdom. Syftet med den här studien har varit att utvärdera projektet efter att halva projekttiden har gått. En processutvärdering baserad på dokumentation om projektet har gjorts. Statistiska analyser har gjorts på data som projektet har samlat in om vårdtagarnas svälj- och kommunikationsförmåga. Där har bland annat förmågorna före och efter logopedinsatser jämförts med varandra. Slutligen har intervjuer med åtta anhöriga till projektdeltagare gjorts för att se hur projektet har påverkat dem. Studien har visat att det finns ett behov av logopeder i öppna vårdformer men också ett behov av att synliggöra och informera om logopedens arbete. Det har visat sig att både kommunikation och ät- och sväljförmåga har förbättrats efter insatser av logoped. Intervjuer med anhöriga har visat att projektet inte haft någon särskild betydelse för dem. I framtiden vore det också intressant att ta reda på hur boendepersonal påverkats av projektet.</p> / <p>In Uppsala, patients in long-term care with geriatric communication and swallowing disorders have not generally received services from speech-language pathologists. To remedy the need for intervention in this group a trial project was initiated in 2007. Its aim was to estimate the need for continued intervention in long-term care and to develop effective working strategies for the speech-language pathologists. The target group was persons above 65 years old with eating and/or communication disabilities caused by stroke or progressive cognitive/neurologic disorders. The purpose of this study was to evaluate the project at its half-way point. The working processes were analyzed based on documentation from the project. Statistical analyses were conducted on ratings and objective measures of the patients’ eating and communication abilities. Finally, relatives of eight of the patients were interviewed to see how the project had affected them. The results indicate a need for intervention by speech-language pathologists for patients in long-term care. It is also necessary to inform patients, relatives and employees at care centers about how speech-language pathologists can help. Both communication and swallowing improved after interventions by speech-language pathologists. The interviews also indicate that speech-language pathologists have little impact on the relatives. A future study should assess how the project has affected the employees at care centers.</p> / Logopedi i Öppna Vårdformer

<p>Personer med afasi får sin språkförmåga nedsatt på flera olika sätt vilket kan försvåra för dem att delta i samtal. De kan då använda sig av olika strategier för att hantera dessa problem. En sådan strategi är skratt. Denna uppsats syftar till att studera hur personer med afasi använder sig av skratt vid vardaglig interaktion. Föreliggande studie har utgått från videofilmer där en kvinna med afasi interagerar med olika personer i olika miljöer. Samtalen har transkriberats och analyserats enligt principer från Conversation Analysis. Studien har identifierat tre typer av situationer då kvinnan använder sig av skratt: skratt vid anomi, skratt vid genans samt skratt vid skämt. Det har visat sig att hon skrattar dels för att kompensera svårigheter med tal men även vid helt vanliga humoristiska situationer som vilken person som helst. Många av de tillfällen där Maja skrattar ignoreras eller får inte ett skratt som respons.</p>