Introduction: Type 2 diabetes mellitus (T2DM) is a condition, in which the body’s ability to produce or to respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood. Although T2DM is known to cause systemic complications, its impact on balance and quality of life (QoL) has been underexplored. Methods: Thirty individuals diagnosed with T2DM and 30 age-matched individuals without T2DM in the age range of 30–55 years were considered. The participants were diagnosed with five years of T2DM with an HBA1C test value of 6.5 or above. The Dizziness Index of Impairment in Activities of Daily Living Scale questionnaire was administered to all the participants. The sharpened Romberg test, Fukuda Stepping test, tandem gait test, and finger-to-nose test were administered and scored quantitatively. Results: Individuals with T2DM had significantly poorer responses for the sharpened Romberg test and Fukuda stepping test in terms of angle of rotation and distance traveled from the origin point. Individuals with T2DM also showed significant abnormality on the tandem gait test and finger-to-nose test. The functional, ambulatory, and instrumental sections of the questionnaire showed a significantly poor QoL for individuals with T2DM. Conclusions: The findings suggest that T2DM is associated with balance disturbances and poor QoL in individuals with T2DM. It is important to screen all individuals with T2DM for balance disturbances.
Introduction: The current study aimed to compare the parameters of temporal processing and differential sensitivity abilities in the morning and evening testing in three groups of participants (moderately morning, intermediate, and moderately evening). Methods: Sixty participants aged 10 to 15 with no otological complaints participated in the study. Based on the Morning–Eveningness Questionnaire, 60 participants were divided into three groups, with 20 participants in each group (moderately morning, intermediate type, and evening type), and included in the study. Difference limen for intensity, difference limen for frequency, duration discrimination test, gap detection test, and temporal modulation transfer function test were administered. The tests were administered twice daily, once in the morning (7.00–9.00 am) and in the evening (6.30–8.30 pm). Results: The results revealed no significant difference in the values of differential sensitivity and temporal processing abilities between morning and evening testing. Conclusion: The effect of circadian rhythm may not be present in children and would develop as age increases. The reduced selective attention in children may also have an impact on the obtained result. Hence, the present study suggests that diurnal changes do not affect school-going children’s differential sensitivity and temporal processing abilities.
Background: Parental well-being has a positive effect on child well being, and it affects their development. When childcare obligations are higher, parental stress increases, as in the case of raising a child with hearing loss. In India, the prevalence of congenital hearing loss in children is 2% and 4 out of every 1000 children have been found to have a diagnosis of severe to profound hearing loss. India is a land of cultural diversity with huge differences in family systems and socioeconomic status. To delve into parental perspectives, identify issues, and decide on the most appropriate remedies, it is important to understand experiences that the parents face in the given context. Thus, the aim of the study was to explore the experience of mothers in raising a child with hearing loss, as their perceived strengths, weaknesses, opportunities, and threats (SWOT). Method: Group discussion from homogeneous groups of 58 mothers was conducted. A thematic qualitative analysis was used to analyze the factors influencing caregivers of children with hearing loss in terms of SWOT. Results: Strengths were identified as intrapersonal skills, interpersonal skills, and positive relationships with the child. Weaknesses included family adaptation, stress management, and emotional and feelings issues. Threats included negative attitudes from society, financial constraints, and long-term maintenance of devices. Opportunities were associated with the habilitation center, which included access to professional guidance, peer support, and structured intervention programs. Conclusion: It is recommended that habilitation centers should provide caregiver sensitive and state-of-the-art facilities/programs to support the caregiving roles of mothers.
Introduction: Early referrals to speech language pathologists (SLPs) improve outcomes for individuals with communication disorders, emphasizing the importance of interprofessional collaboration. However, limited attention has been directed toward medical professionals’ awareness of communication disorders and the scope of speech language therapy (SLT), both of which are crucial for comprehensive patient care. This study aimed to assess awareness and knowledge of communication disorders and SLT among medical professionals at a tertiary care center. Methods: An analytical cross-sectional study was conducted at Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh. A total of 313 medical professionals were recruited through convenience sampling. Data were collected using a 16-item questionnaire evaluating awareness and knowledge of communication disorders and SLT. Descriptive statistics summarized participant characteristics. Given the nonparametric nature of data, the Wilcoxon Signed Rank test compared awareness and knowledge domains, and Spearman’s rank-order correlation examined associations with demographic variables, with significance set at P < 0.05. Results: Medical professionals reported significantly higher awareness and knowledge of SLT compared to communication disorders (P < 0.001). No correlations were observed between work experience and either domain, nor between age and either domain. Conclusion: Awareness of SLT among medical professionals was relatively high, but knowledge of communication disorders remained limited. These findings emphasize the need to integrate interprofessional training within medical education. Despite the single-site design, the study highlights the importance of increasing awareness of medical professionals about communication disorders; and brings out the need for larger, multi-centric research to inform curriculum development and enhance collaboration.
Oropharyngeal dysphagia is a common and clinically important condition, especially among older adults, and is associated with significant health risks and increased demands on healthcare resources. With the rising need for dysphagia services and a concurrent shortage of speech language pathologists (SLPs), artificial intelligence (AI) represents a valuable solution for advancing the assessment, diagnosis, and management of this disorder. This narrative review synthesizes current research on the integration of AI in dysphagia care with the aim of informing SLPs, researchers, and healthcare stakeholders about the transformative potential and practical considerations of AI in advancing dysphagia care. A targeted literature search was conducted across PubMed, Google Scholar, and the ASHA Journals Academy using keywords related to AI, dysphagia, and swallowing. Current evidence highlights AI’s potential to increase diagnostic accuracy, reduce clinician workload, and provide remote, personalized therapy through tools such as biofeedback platforms and gamified interventions. Despite promising performance, key challenges remain, including interpretability of complex physiological data, limited generalizability across populations, and ethical concerns related to bias, privacy, and equitable implementation. Emerging work underscores AI’s potential to transform dysphagia care while emphasizing the need for careful, responsible integration into clinical practice.
Cochlear implantation is the preferred option for the management of bilateral severe to profound hearing loss, particularly in the pediatric population. The success of cochlear implantation heavily depends on appropriate mapping. Traditional mapping strategies typically rely on objective measures such as electrically evoked stapedial reflex threshold and electrically evoked compound action potential measurements. While these methods are generally effective, some patients may require significant deviations from standard protocols to achieve optimal outcomes. The process of determining appropriate stimulation levels in pediatric cochlear implant recipients presents unique challenges, particularly in young children with limited communication abilities. A comprehensive case study of a 3.1-year-old child who was diagnosed with bilateral severe to profound hearing loss, getting limited benefit from strong-gain hearing aids, and underwent cochlear implantation is presented. This case highlights the critical importance of individualized mapping strategies in pediatric cochlear implantees. Despite initial intervention with high-gain hearing aids and subsequent cochlear implantation using standard mapping protocols, the patient showed suboptimal progress. However, following a detailed behavioral assessment and personalized adjustment of stimulation levels, where the lower stimulation levels were set based on the behavioral thresholds, significant improvements were observed in both auditory perception and language development.
Introduction: To adequately assess and treat patients with brain lesions, comprehensive assessment tools are necessary. This study aimed to develop and validate an apraxia of speech (AOS) screening checklist for adults. Methods: This study was conducted in four phases. The first phase involved tool development based on a scoping review of literature following the PRISMA framework. The developed items were modified in Phase II based on item content validity and the Delphi method. In Phase III, the developed checklist was administered to 110 participants (100 neurotypicals and 10 adults with AOS). The fourth phase involved evaluating the psychometric properties of the developed screening tool. Results: The developed tool contained twelve characteristics, divided into three categories: articulation, rate and prosody, and fluency, with five stimulus sets in Bengali. A content validity index (CVI) of 0.933 was obtained, indicating a good scale CVI. The receiver operating characteristic curve showed an area under the curve value of 1, indicating adequate ability to identify individuals with and without AOS. The developed AOS screening checklist also showed a significant correlation with Apraxia of Speech Rating Scale V1. Conclusion: Thus, the developed AOS screening checklist for adults is an effective, reliable, and valid tool for the age range of 20–60 years across various assessment and intervention settings.
Language impairments vary widely and are often linked to brain dysfunction. While classic aphasia usually occurs after brain injury, other conditions, such as primary progressive aphasia (PPA), occur due to neurodegeneration of the brain. This study emphasizes the significance of a comprehensive evaluation which includes correlation of clinical features, radiological findings, and use of advanced diagnostic criteria for accurate diagnosis and appropriate intervention. A 75-year-old woman with speech and language deficits had undergone aphasia rehabilitation therapy; however, no significant progress was reported. Despite her nonfluent characteristics, formal assessments did not identify her condition as classic aphasia. Neuroimaging revealed hypometabolism and diffuse cerebral atrophy in frontal and peri-sylvian regions. Based on Mesulam’s criteria, she was diagnosed with the Logopenic variant of PPA. This case highlights the key considerations for the timely use of advanced criteria during comprehensive assessment for diagnosis of PPA which is vital for realistic counselling and effective intervention.
Introduction: Spoon-feeding skills are often affected in children with cerebral palsy (CP) due to motor disturbances. No studies have explored the effects of a textured utensil providing sensory input to facilitate motor skills required for spoon feeding. This study explores the immediate effects of a textured spoon in improving spoon-feeding abilities in children with CP. Methods: This study used a pretest posttest ABA design on ten participants with CP with difficulties clearing a spoon. They were presented with three spoon-feeding trials where two different spoons were used. The first trial was done using a smooth-textured spoon, followed by a textured spoon with ridges on the convex side of the spoon and, finally, the smooth-textured spoon. All three spoon feeding trials were scored using the Functional Feeding Assessment-modified (FFA-m), and Friedman’s test was carried out to compare the scores obtained. Results: It was found that the textured spoon had significantly improved certain spoon-feeding skills, such as “pulling of the lower lip under the spoon” and “bringing the upper lip down and forward over the spoon.” The competence scores for the normal patterns of spoon feeding also improved significantly, with the highest scores obtained when fed using the textured spoon. Conclusion: This study has explored the effects of using a textured utensil to provide sensory input in order to generate adequate motor patterns for mastering spoon feeding. This study, however, needs to be replicated using double-blinded randomized controlled trials with a larger number of participants.
This case study describes a rare association between chronic otitis media with squamous disease and lateral semicircular canal cupulolithiasis secondary to a labyrinthine fistula. A 30-year-old male professional footballer presented with persistent positional vertigo, hearing loss, and tinnitus. Clinical assessment, including video nystagmography, revealed left-sided lateral semicircular canal cupulolithiasis. High-resolution imaging and otoendoscopy confirmed active squamosal chronic otitis media with cholesteatoma and a lateral canal fistula. The patient underwent canal wall down mastoidectomy, followed by vestibular evaluation and treatment using the Gufoni liberatory maneuver. Postintervention, there was a marked reduction in positional nystagmus and significant symptomatic improvement, supported by objective vestibular findings and Dizziness Handicap Inventory scores. This case emphasizes the importance of comprehensive vestibular assessment in patients with chronic otologic disease, as timely diagnosis and appropriate repositioning maneuvers can result in substantial symptom resolution even in complex presentations.
Pediatric voice disorders, including vocal fold cysts, require multidisciplinary management. This case report details the successful treatment of a 10-year-old girl with a vocal cord cyst, emphasizing the combined approach of surgery and voice therapy. A 10-year-old girl presented with worsening hoarseness and breathiness. Laryngoscopy revealed a left vocal cord cyst, chronic laryngitis, and laryngopharyngeal reflux disease (LPRD). Following micro-laryngeal surgery for cyst excision and LPRD management, voice therapy was initiated. Evaluation showed impaired voice quality, reduced aerodynamic performance, and abnormal acoustic parameters. Sixteen sessions of voice therapy, including breathing exercises, semi-occluded vocal tract exercises, resonant voice therapy, and circumlaryngeal massage, were conducted. Posttherapy evaluation demonstrated significant improvements in auditory-perceptual, aerodynamic, and acoustic measures. Laryngoscopy revealed normal vocal cord mobility and reduced interarytenoid pachydermia. Maximum phonation duration increased and jitter and harmonic-to-noise ratio improved. The patient’s voice quality normalized, allowing for unrestricted participation in school activities. This case underscores the efficacy of a multidisciplinary approach, combining surgical intervention, LPRD management, and targeted voice therapy, in treating pediatric vocal cord cysts. Early identification, timely intervention, and consistent therapy are crucial for long-term vocal health in children with voice disorders.
Introduction: Older adults with normal hearing sensitivity also struggle to understand speech in background noise. Although temporal resolution is essential for understanding speech in noise, there are equivocal results on the correlation between gap detection ability and speech perception in noise. This study investigates the relationship of speech perception in noise with gap detection ability in quiet as well as gap detection ability in the presence of speech babble in older adults. Method: Data were collected from 30 young adults (18–30 years) to 30 older adults (50–70 years) whose hearing thresholds were <25 dB HL. Temporal processing was assessed using the monaural auditory fusion test in quiet and in the presence of speech babble, and signal-to-noise ratio 50 was established using MISHA-Random Adaptive Marathi sentences in noise (M-RAMSIN) test. Results: The performance of older adults was significantly poorer than those of young adults on all the tests. There was no significant correlation between gap detection ability in quiet and speech perception in noise. However, there was a significant moderate to strong correlation between gap detection ability in the presence of speech babble and speech perception in noise. Conclusion: This study supports an age-related decline in temporal processing, which is evident in the poorer performance of older adults. This study also highlights the possible role of temporal resolution ability and speech perception in noise.
Context: Repetition is widely considered only as a domain to classify the type of aphasia. Earlier studies have shown evidence of repetition being used as an approach to improve communication abilities in persons with aphasia (PWA). However, there is a dearth of literature on how repetition drills and interactive repetition can be implemented systematically to elicit improvement in the overall language domains and communication in the Indian context. Aims: The study aimed to investigate if repetition improves overall communication in PWA. Settings and Design: The design employed in the current study is multiple baseline design in the context of single-subject research. Methods: The participants were three PWA. They were treated on the affected language domains using the Manual for Adult Aphasia Therapy (MAAT). The techniques used included repetition drills and interactive repetition. The participants were provided therapy only for the repetition domain of MAAT for 18 sessions. The performances on all the domains applicable to the current level of language functioning of PWA were assessed in the initial, medial, and final sessions. Statistical Analysis Used: The raw scores of each activity were converted into percentages, and the mean percentage for each subsection was calculated for individual sessions. The mean percentage was the measure utilized for comparison of improvement across each session. Results: It took around 9–10 sessions for an initial improvement of 20%–25% in any domain of language intervention in PWA. The stimulus presented through multiple modalities yielded better repetition than when the stimulus is presented in the auditory modality alone in persons with Broca’s aphasia. Working on the repetition skill improved the overall communication skills that were not treated in PWA. Conclusions: The repetition drills and interactive repetition can be jointly used as an effective therapy approach to improve language in PWA.
Background and Aim: The goal of the present study was to objectively quantify the changes in acoustic parameters of the speech signal by comparing the unprocessed and hearing aid-processed speech stimuli. Materials and Methods: Eight hearing aids from two manufacturing companies were programmed for four different conditions: (a) noise reduction “OFF” and directionality “OFF;” (b) noise reduction “ON” and directionality “OFF;” (c) noise reduction “OFF” and directionality “ON;” and (d) noise reduction “ON” and directionality “ON.” One consonant-vowel-consonant-vowel word from the low-frequency, midfrequency, and high-frequency range each was used as stimuli. A sound level meter was used to record the speech stimuli output from the Knowles Electronics Manikin for Acoustic Research routed through the hearing aid (processed) and without the hearing aid (unprocessed). The recorded stimuli were further acoustically analyzed using PRAAT software. Results: The mean pitch, jitter, shimmer, and noise-to-harmonic ratio values differed between the unprocessed and hearing aid-processed speech stimuli, especially for the low-frequency and midfrequency stimuli. Whereas, for the high-frequency stimulus, PRAAT software failed to provide any value for the above-mentioned acoustic features for hearing aid-processed stimulus. Discussions: The processed speech had perturbations and more noise irrespective of the frequency of the speech stimulus. Hence, the outcome of the current study highlights the necessity to assess hearing aid-processed acoustic stimuli to check for the hearing aid’s performance.
Introduction: Impaired orofacial functioning is a common feature in patients with contractures to the lower face and neck since the contractures interfere with normal functions of swallowing and speaking. Currently, limited studies are directed toward understanding speech impairments in individuals with postburn orofacial and neck contractures. The current study is aimed to provide insight into the oromotor functions in patients with postburn facial and neck contractures. Methods: Twenty-eight participants with postburn orofacial and neck contractures were recruited with a mean age of 33. Out of 28 participants, 16 had mild, 8 had moderate, and 4 had severe contractures. Oral diadochokinetic (DDK) rate and orofacial myofunctional evaluation with scores (OMES) were used as assessment tools to evaluate oral motor characteristics. Results: The results revealed that 20 out of 28 participants had poor OMES scores, and their oral DDK rates were significantly lower than those of the typical population (P < 0.05). Reduced OMES scores and DDK rates were attributed to contractures that affected facial and labial sensation, as well as oral hygiene and competence. These impairments led to decreased motor function and coordination of the speech articulators. Conclusion: The study highlights the significant impact of postburn facial and neck contractures on oromotor functions, especially in terms of reduced DDK rates and impaired oral competence. These deficits are caused by the effects of contractures on facial and labial sensation and motor coordination, which impair oromotor control. The findings emphasize the need for targeted rehabilitation strategies to address these challenges in this population.
Dysphagia profoundly impacts individual biopsychosocial functioning. Standardized terminology will facilitate consistent and effective dysphagia care across clinical, research, and psychosocial domains. This systematic review operationalizes the International Classification of Functioning, Disability and Health (ICF) to establish consensus-driven core categories for comprehensive dysphagia management. In accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, a systematic review was conducted to elucidate the diverse experiences of individuals with dysphagia across the full range of their life spectrum. We interrogated six databases (MEDLINE, Web of Science, Embase, Cochrane Library, CNKI, Wanfang) from inception to September 2023. Through dual-phase expert validation (literature synthesis and Delphi consensus), we linked dysphagia-specific constructs to ICF codes. Nine qualifying studies were analyzed, which consisted of 2 qualitative interviews, 4 systematic reviews, and 3 linkage methodology studies. A total of 114 ICF items measuring various aspects of functioning were collected. This ICF-based taxonomy provides a multidimensional framework for quantifying dysphagia impacts across overall functional domains and enabling cross-disciplinary outcome metric harmonization as well as informing patient-centered intervention targets.
Introduction: Rehabilitation professionals are experts who work for various rehabilitation services, including Audiologists and Speech-Language Pathologists (ASLPs). In professional practice, understanding the interplay between ethics and laws is crucial for ensuring high standards of conduct and accountability. Recently, studies have started focussing on awareness of various ethical and legal practices in several professions. Despite its importance, there is a lack of studies focusing on various legal and ethical aspects of Audiology and Speech–language Pathology. Aims: The present study aimed to evaluate the effect of a medicolegal and ethical awareness program on awareness among ASLPs. Settings and Design: A quasi-experimental pre-test and post-test research design. Methods: A total of 41 ASLPs participated in the study. The participants completed the questionnaire before and after the “Legal Legislations in Audiology and Speech-language Pathology” program. The program highlighted medico-legal aspects, ethical practices, and case discussions. The participants’ responses were statistically analyzed. Statistical Analysis Used: Descriptive and Inferential statistics were done using SPSS software version 26. Results: The preawareness scores showed that most scored less, indicating poor awareness among ASLPs. However, the comparison between pre and post-test results showed significant differences in overall scores (z = 861, P < 0.001). The descriptive analysis showed increased awareness of different Acts’ terminologies and rationales. Conclusions: The present study highlighted the awareness of various essential concepts in Audiology and Speech–language Pathology to improve the clinical and research practices among ASLPs. Future studies should focus on many practising professionals and students to improve the best practices.
Introduction: Age-related changes in cognitive and language functions have been extensively researched over the past half-century. Older adults represent a unique population for studying cognition and language because of the challenges presented with investigating this population, including individual differences in various factors. The aim of the study is to compare cognitive and linguistic abilities between young and older adults and further document the factors influencing these abilities. Methods: This study incorporated a standard group comparison research design. We recruited 33 young (mean age: 23.5 ± 4.02 years, range: 18–30) and 31 older adults (mean age: 67.2 ± 6.6 years, range: 55–82). The participants performed a set of cognitive and linguistic tasks such as trail making task, digit span test, free recall, confrontation naming, verbal fluency task, and picture description task. The statistical analysis was done using Statistical Package for Social Sciences software. Descriptive statistics was done initially, and then to check the association Pearson’s correlation analyses was conducted was conducted. Results: Young adults outperformed older adults in most of the tasks. However, the aging effect was not robust in certain cognitive and linguistic domains. Further, the study identified a few risk and protective factors for cognitive-linguistic changes with aging . Conclusions: Understanding the pattern of cognitive and linguistic differences in older adults and factors influencing the same could facilitate the development of assessment and intervention protocols to reduce the risk of cognitive-linguistic decline in aging.
Introduction: Nearly 60% of children with autism exhibit chewing difficulties, yet the specific nature and the contributing factors remain underexplored. Understanding these factors is vital for effective management. The present study aimed to compare chewing skills between children with autism and typically developing peers and to examine its relationship with the age of acquisition of early feeding milestones, oral sensory and oral motor skills, food neophobia, and food selectivity. Methods: Sixty children (30 autism and 30 neurotypical), aged 4–10 years, were assessed for chewing skills using the Mastication Observation and Evaluation instrument. Parent interviews provided data on feeding milestones. Oral sensory and oral motor skills were assessed via the Child Sensory Profile 2 and the Com DEALL Oro-Motor Assessment, while food neophobia and food selectivity were evaluated using the Modified Child Neophobia Scale and a food inventory. Results: Children with autism exhibited significantly reduced chewing skills compared to typically developing children. Chewing difficulties were associated with delayed transition to textured, finger and regular foods, atypical oral sensory processing, immature oral motor skills, food neophobia, and food selectivity. Conclusion: Findings underscore chewing dysfunction in autism, linked to delays in feeding milestones, sensory integration challenges, oral motor immaturity, and dietary restrictions. These results highlight the need for comprehensive management addressing sensory, motor, and dietary factors to improve chewing abilities.
