BACKGROUND:Speech-language pathology (SLP) in China, referred to as 'speech rehabilitation', addresses developmental and acquired communication disorders, including language delays, aphasia, and dysphagia. Despite the population exceeding 85 million individuals with communication disabilities, China faces a critical shortage of certified professionals, with fewer than 2000 practitioners nationwide. OBJECTIVE:To investigate the learning and employment status of undergraduate speech rehabilitation programs in mainland China, with the aim of identifying systemic gaps and proposing actionable reforms. METHODS:An online questionnaire was administered to 67 undergraduate students majoring in hearing and speech rehabilitation, with a focus on theoretical learning, practice, and employment status. Additionally, six department chairmen were surveyed to analyse the training programs, teaching staff, curriculum, and practical experiences. RESULTS:Regarding employment, 54.3% (25/46) of the graduates had monthly incomes between 5000 and 10 000 RMB. The top three fields of employment are hearing, speech, and language rehabilitation. Clinical internships averaged 10.17 months in various settings, including hospitals and schools. In terms of learning, the average number of full-time teaching staff was 8.17, with 28.33% being associate professors and 19.17% professors. There is no uniform standard for compulsory courses, but institutions offer a range of electives. Satisfaction with learning and practice was rated at 3.88 on a 5-point Likert scale (somewhat satisfied), while employment satisfaction was lower at 3.53 (between neutral and somewhat satisfied). CONCLUSION:Employment in speech rehabilitation is promising but requires an independent certification system. Internship arrangements are reasonable, with high student satisfaction. Educational institutions focus on foundational knowledge and skills but need to improve research skills and faculty quality. SUGGESTIONS:(1) The link between theoretical learning and clinical practice should be strengthened by incorporating more case studies and enhancing the quality and diversity of clinical practice. (2) Establish an independent certification system for speech rehabilitation to develop discipline and motivate career advancement. (3) Improve faculty quality through better selection, training, development, and fostering an academic climate and collaboration. WHAT THIS PAPER ADDS:What is already known on the subject The existing majors in China closely related to speech and hearing rehabilitation include "hearing and speech rehabilitation", which requires students to study both audiology and speech-language pathology. Speech rehabilitation programs in mainland China were initiated relatively late. There is considerable variation in the training goals and course content across Chinese universities. Additionally, there is a lack of a comprehensive review encompassing the faculty, course offerings, and outcomes for undergraduates in the field of speech rehabilitation in China. What this paper adds to the existing knowledge This study focuses on theoretical learning, practical training, and employment status. The monthly salary, workplace settings and work-field were investigated to access the employment status of undergraduates. The general quality of students, faculty and curriculum were also investigated to understand the current state of undergraduate education. What are the potential or actual clinical implications of this work? This study emphasizes the future development of the discipline: strengthening the connection between theoretical learning and clinical practice by incorporating more case studies and enhancing the quality and diversity of clinical experiences; establishing an independent certification system for speech rehabilitation to promote the disciplinary development and support career advancement; and improving faculty quality through more rigorous recruitment, training and academic development, while fostering a collaborative academic collaboration.

PURPOSE:Age is a high-risk factor for dysphagia. Speech and swallowing share the same anatomical and neurophysiological basis. Their functions are closely related; hence, speech assessment can predict the risk of dysphagia. This study aimed to investigate the factors influencing presbyphagia in a normal elderly Shanghainese population by analyzing speech acoustic parameters. METHODS:Relevant speech acoustic parameters were compared between 15 people with dysphagia and 15 without dysphagia. After extracting sensitive speech acoustic parameters related to swallowing, changes in sensitive parameters were compared at different ages to analyze the relevant factors influencing presbyphagia in the normal elderly population. RESULTS:Eight speech acoustic parameters related to swallowing, including maximum phonation time (MPT), max F0, /ʔʌ/Jitter, /ʔʌ/L-DDK, /hʌ/L-DDK, /pataka/DDK, F1/a/, and vowel space area, were extracted after comparing the relevant data between the two groups. Analyzing the changes in each of these parameters between different age groups (age 18-39, 40-64, and 65 and above), we discovered that three speech acoustic parameters, including MPT, /hʌ/L-DDK, and /pataka/DDK, had statistical differences, with a decreasing trend in their mean values with increasing age. CONCLUSIONS:The elderly group had significantly lower MPT, /hʌ/L-DDK, and /pataka/DDK than the young and middle-aged groups. We hypothesized that reduced respiratory support and control, decreased range of mouth movements and coordination, closed control of the vocal cords, and inadequate airflow control in vocal cord abduction are risk factors for presbyphagia in the elderly Shanghainese population.

INTRODUCTION:Vowel production in dysarthria tends to be centralized, which is affected by many factors. This study examined the acoustic effects of speaker sex, tones, and speech samples (including sustained vowels, syllables, and sentences) and their interactions on vowel production in Mandarin speakers with poststroke spastic dysarthria. METHODS:Twenty-eight patients with poststroke spastic dysarthria (18 males, 10 females) and 21 healthy speakers (11 males, 10 females) with no significant difference in sex and age with dysarthria were recruited. They were asked to read sustained vowels /a, i, u/, 12 syllables, and 12 sentences containing three vowels in four tones (bā, bá, bǎ, bà, bī, bí, bǐ, bì, pū, pú, pǔ, pù). Multiple spectral and temporal acoustic metrics were analyzed. RESULTS:Results showed that regardless of the speech samples or tones, vowel production was more centralized in dysarthria than healthy controls, manifested as the decrease in F1 range, F2 range, vowel space area (VSA), and vowel articulation index (VAI). A similar performance was observed for male speakers compared to females, and vowel duration in males was shorter than females. F1 range, F2 range, VSA, VAI, and vowel duration were significantly different across speech samples and tones, decreasing in the order of vowel-syllable-sentence and T3-T2-T1-T4, respectively. Interactions of group, speaker sex, speech sample, and tone were more sensitive in VAI and vowel duration. CONCLUSION:VAI and vowel duration were recommended as the prior metrics to the assessment of vowel production. Specific influencing factors (speaker sex, speech sample, and tone) of vowel production need to be considered by speech and language pathologists in the assessment and rehabilitation.

IntroductionSpeech production includes segmental and suprasegmental features, which interact and cooperate with each other. Impaired speech production is common in individuals with post-stroke dysarthria. The commonly used phonemic contrast therapy and Accent Method in clinical practice can improve the segmental and suprasegmental aspects, respectively. This study aimed to explore the feasibility and immediate effectiveness of the combination of specific rhythm patterns of the Accent Method and phonemic contrast on speech production.MethodsFifteen poststroke dysarthria patients (12 males and three females) first received accentuation task of three rhythm patterns (Largo-slow, Andante-medium, Allegro-fast) and later received speech task in appropriate rhythm patterns combined with phonemic contrast materials and non-phonemic contrast materials. Speech parameters were analyzed by considering speech clarity and prosody.ResultsThe results showed that the number of correct target syllables, sentence clarity, and standard deviation of intensity increased significantly, and the average length of pauses and abnormal pause times decreased significantly in Andante (medium) compared to other rhythms. The number of correct target syllables, sentence clarity, and standard deviation of intensity increased significantly compared with those in the non-phonemic contrast in Andante (medium).ConclusionThe combination of phonemic contrast and Accent Method was verified to have an immediate effect on speech production in Mandarin speakers with post-stroke dysarthria and could be further validated in other diseases with impaired speech production in the clinic in the future.

Background:Benefits of intensive speech treatment have been documented for a range of speech signs in English speakers with Parkinson's Disease (PD). However, the answer to a critical question that whether the same treatment benefits speech variables including intelligibility in Mandarin speakers is still unclear. In order to develop a targeted speech treatment for Mandarin speakers with PD, we reviewed the efficacy of intensive speech treatment to improve vocal loudness and functional communication and discuss possible explanations for efficacy on Mandarin speakers with PD. Methods:Literatures about intensive speech treatment for Mandarin speakers with PD were retrieved from PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang and Weipu Database for Chinese Technical Periodicals (VIP) Database. Search strategy was (voice therapy OR speech therapy OR voice treatment OR speech treatment OR voice training OR speech training OR voice rehabilitation OR speech rehabilitation OR Lee Silverman voice treatment OR intensive speech treatment) and (Parkinson's disease) and (Mandarin speakers OR Chinese OR Chinese people). Results:Five randomized controlled trials were selected and possible explanations for efficacy on individuals with PD are discussed. Further research directions are suggested. Conclusion:The existing evidence from treatment efficacy studies of intensive speech treatment provides support for improving vocal loudness, speech intelligibility, pitch and rate in Mandarin speakers with PD. Our future research will continue to work to conduct a large sample multicenter randomized controlled trial to provide high quality evidence and understand the basic mechanisms accompanying treatment-related change.

PURPOSE:Previous research has revealed considerable variation in speech rates among English speakers with Parkinson's disease (PD) with slower, faster, or similar rates than controls. The purpose of this study was to characterize speech rates of Mandarin speakers with PD and the corresponding articulation and pause characteristics explaining the speech rates to enhance rate control therapies.METHOD:Eighteen Mandarin speakers with PD and 18 controls produced syllable repetitions and passage reading using their typical speech style. Speech rates, articulation rates, mean pause durations (≥ 10 ms), and the number of pauses with duration between 10 ms and 300 ms and greater than 300 ms were measured and compared between groups and tasks as well as across the initial, middle, and final periods of the passage. Two-way, mixed-model analyses of variance were employed for data analysis.RESULTS:Compared to controls, individuals with PD spoke with similar speech rates and faster articulation rates during passage reading, whereas during syllable repetitions, they produced slower speech rates and comparable articulation rates. The slower syllable repetitions produced by speakers with PD may be explained by longer pauses and more perceptual pauses, whereas faster articulation rates may explain the trend of faster speech rates during reading. Speech and articulation rates accelerated for both groups during passage reading.CONCLUSIONS:Speech rates of Mandarin speakers with PD were characterized by faster articulation, longer pauses, and more perceptual pauses for passage reading. A descriptive model of speech rate suggested that speakers with PD and dysarthria in this study would benefit from rate reduction therapy decreasing articulation rate.SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.23982282.

目的 比较不同助听方式听障儿童和健听儿童言语韵律组块功能的差异.方法 以58例5.5～6.5岁学龄前健听及听障儿童为研究对象,其中健听儿童30例,双侧人工耳蜗植入儿童10例,双侧助听器佩戴儿童8例,双侧分别佩戴助听器和人工耳蜗的双耳双模式助听的听障儿童10例,采用《儿童言语韵律功能评估工具》中组块评估部分比较其组块功能表现的差异及其输入与输出维度表现的相关性.结果 ①听障儿童韵律组块四个板块得分均显著落后于健听儿童(P＜0.05);②不同助听方式听障儿童中,韵律组块输入维度的两个板块得分差异均无统计学意义(P＞0.05);韵律组块输出维度的形式板块人工耳蜗植入组和双模式组的得分均显著低于助听器组(P＜0.05),韵律组块输出维度的功能板块人工耳蜗植入组得分显著低于助听器组(P＜0.05),其它各组得分差异均无统计学意义(P＞0.05);③各类儿童输入与输出两个维度的评估结果无显著相关性(P＞0.05).结论 听障儿童韵律组块输入和输出均落后于同龄健听儿童.不同助听方式影响听障儿童韵律组块输出的表现,对其输入的影响不大,整体表现为:人工耳蜗植入组＜双耳双模式组＜助听器组;韵律组块输入维度和输出维度的表现互不影响.

Speech imagery not only plays an important role in the pre-processing mechanism of the brain,but it is also the latest technology in the field of brain-computer interface（BCI） research. The theoretical model of speech imagery, activation of brain regions, and neural conduction pathways all have many similarities with speech production. However, the brain activation mechanism of speech disorders, as well as imagining contents with complex semantics is different from speech production. Given the complexity of the human speech system, research on the neural mechanisms of speech imagery still faces a series of challenges. Future research can be focused on evaluation tools of speech imagery quality and neural decoding paradigm, brain control circuits, activation pathways, speech imagery mechanism of speech impaired groups, and brain neural signals of word and sentence imagination. Further exploration will help provide a basis for effectively improving the recognition rate of BCI and facilitating communication in speech disorders.

As medical advances and surgical techniques have improved the survival rates of children with congenital heart disease (CHD), more and more studies have begun to focus on the quality of survival and long-term development of children with CHD. Cognitive and psychological developmental deficits in children with CHD have been well documented. With the development of brain function assessment and neuroimaging techniques in recent years, it has become possible to elucidate the mechanisms of neurocognitive impairment in patients with CHD from a brain science perspective. Providing targeted early follow-up interventions for the population with CHD and promoting their social adaptation have a great clinical significance. This review summarized recent research findings on neurocognitive developmental outcomes in children with CHD from the perspective of behavioral medicine and brain science. This paper focuses on reviewing the mechanisms of brain microstructure damage and brain network dysfunction which may explain neurocognitive impairment in children with CHD, and further explores the early monitoring and intervention programs suitable for clinical development, aiming to suggest possible directions for improving long-term neurocognitive developmental outcomes for CHD population.

发展性阅读障碍是指拥有正常学习条件和动机的智力正常儿童出现识别文字及拼写解码能力的落后而造成的读写困难,它是一种具有神经基础的特殊学习障碍.对发展性阅读障碍早期干预的缺乏,可导致学业落后,进而对个人认知、情感及职业发展产生负面影响.中文发展性阅读障碍的发病率为 5%～10%,但尚缺少标准化的中文发展性阅读障碍评估及管理系统.该文总结对比了4种语言体系下阅读障碍相关评估工具的特点和优势,为制定中文早期筛查工具及标准评估管理体系提供可能的方向.

目的 基于自下而上的阅读加工模式,探讨阅读流畅性缺陷儿童的认知加工特征.方法 以阅读流畅性缺陷儿童、普通儿童和识字量缺陷儿童为对象,考察其视觉加工、快速命名及句法意识等能力.结果 在视觉加工和快速命名任务方面,被试间变量主效应极显著(P<0.01);句法意识任务方面普通儿童>阅读流畅性缺陷儿童>识字量缺陷儿童.两种视觉加工任务间主效应极显著(F=84.366,P<0.01),被试类型和视觉加工方式的交互作用显著(F=3.325.P<0.05).两种快速命名测验间主效应极显著,(F=150.985,P<0.01),被试类型和视觉加工方式的交互作用不显著(P>0.05).结论 阅读流畅性缺陷儿童在视觉加工、快速命名、句法意识方面均落后于普通儿童;字形加工和视觉刺激会增加阅读流畅性缺陷儿童的视觉加工负担.

It’s difficult for clinical bedside evaluations to accurately determine the occurrence of aspiration in patients. Although VFSS and FEES are the gold standards for clinical diagnosis of dysphagia, which are mainly used to evaluate people at high risk of dysphagia found by bedside screening, the operation is complicated and time-consuming. The aim of this pilot study was to present an objective measure based on a multi-parameter approach to screen for aspiration risk in patients with dysphagia. Objective evaluation techniques based on speech parameters were used to assess the oral motor function, vocal cord function, and voice changes before and after swallowing in 32 patients with dysphagia (16 low-risk aspiration group, 16 high-risk aspiration group). Student’s t test combined with stepwise logistic regression were used to determine the optimal index. The best model consists of three parameters, and the equation is: logit(P) = − 3.824 − (0.504 × maximum phonation time) + (0.008 × second formant frequency of /u/) − 0.085 × (fundamental frequency difference before and after swallowing). An additional eight patients with dysphagia were randomly selected as the validation group of the model. When applied to validation, this model can accurately identify the risk of aspiration in 87.5

目的 研究地域、性别、声母类型对我国健康成人发音鼻流量的影响.方法 测试北京(男51例、女49例)、上海(男49例、女58例)、广州(男50例、女50例)、重庆(男52例、女60例)共419例健康成人(年龄18～23 岁)分别发鼻音/mā/、/nā/、塞音/bā/、/pā/、/dā/、/tā/、/gā/、/kā/、塞擦音/zā/、/zhā/、/cā/、/chā/、擦音/fā/、/sā/、/shā/、/hā/时的平均鼻流量值(mean nasalaue score,MNS);根据发音方式的不同,通过四个三因素混合实验设计进行方差分析,探讨地域、性别、声母类型对MNS的影响.结果 我国成人发鼻音、塞音、塞擦音、擦音时的MNS在地域、性别、声母类型主效应上均存在极显著差异(P＜0.001);发鼻音、擦音时的MNS在地域×声母类型二阶交互效应上存在极显著差异(P＜0.001),在塞音上存在极显著差异(P＜0.01),在塞擦音上存在极显著差异(P＜0.001),其余二、三阶交互效应均不显著(P＞0.05).结论 地域、性别、声母类型会影响我国健康成人发音鼻流量值,制定MNS参考标准及编制测试语料时,应考虑这些影响因素.

Objective To investigate the influence of assessment materials and forms on the evaluation results of initials in Mandarine-speaking children. Methods Forms of assessment materials such as words and sentences and assessment methods such as imitated productions and spontaneous productions were combined into four different assessment tasks. A total of 160 Mandarine-speaking preschool-age children were assessed using self-compiled materials, and the differences in the articulation clarity, the number of phonological process and the time spent in the evaluation were analyzed. Results（1） There was no significant difference in different assessment materials and forms on the accuracy of children’s initials and the number of phonological processes.（2） To the contrary, there was significant difference in evaluation time. Words productions took significantly less time than sentences, and imitated productions took significantly less time than spontaneous productions. Conclusion Evaluating initials in Mandarine-speaking children, the difference of assessment materials and forms have little influence on the accuracy of the evaluation, but have a great influence on the evaluation time. Based on the comprehensive consideration of accuracy and practicality, the test of words imitated is recommended.

目的 探讨言语表象疗法结合传统构音训练改善脑瘫患儿构音障碍的疗效.方法 2022年8月至12月,选取芜湖市第五人民医院并发构音障碍的脑瘫患儿21例,随机分为A、B、C 3组,每组各7例.A组给予传统构音训练,每次30 min;B组给予植入型言语表象结合传统构音训练,每次40 min;C组给予附加型言语表象结合传统构音训练,每次40 min.每周5 d,共3周.训练前后采用构音功能评估量表、口部感觉-运动评估表以及声学指标下颌距、舌距、元音空间面积(VSA)进行评价.结果 治疗前,3组各项指标比较均无显著性差异(F<1.247,P>0.05).治疗后,3组构音功能评估量表评分、口部感觉-运动评估表评分均提高(|t|>2.575,P<0.05);A组、B组下颌距、VSA均较治疗前提高(|t|>2.632,P<0.05).B组、C组构音功能评分差值高于A组(P<0.05),其他指标治疗前后差值组间均无显著性差异(P>0.05).结论 两种言语表象疗法均可改善脑瘫患儿构音清晰度、口部运动范围和运动控制能力,在改善构音清晰度方面的效果优于传统构音训练.

目的 探讨非流畅性失语症患者疑问句语调产出的临床特点,为其康复治疗提供参考.方法 2018年11月至2019年1月,以改编疑问语句为测试材料对17例非流畅性失语症患者(研究组,平均年龄56.65±12.53岁,病程9.35±6.94月)和17例正常成人(正常对照组,平均年龄55.94±13.20岁)进行疑问句语调产出评估,观察整句平均基频F0和基频斜率值K以及边界调平均基频F0和基频斜率值K;采用2(组别)×4(声调类型)的两因素混合实验设计,考察不同声调类型和受试者类型之间的差异及相互影响.结果 研究组患者一、二、三、四声调的上述四个声学指标值均小于正常对照组,差异均有统计学意义(P<0.05);整句F0、整句K和边界调K在不同声调上有明显差异(P<0.05),整句F0表现为T1、T4>T2、T3,整句K表现为T1、T2>T4;边界调K表现为T2、T3>T1>T4.结论 非流畅性失语症患者在疑问句语调的产出异常,主要表现为整句和边界调抬高水平以及上扬趋势的不足,在进行疑问语调康复训练时可以依据其整句和边界调抬高水平和走势特征进行针对性训练.

Purpose An elevated sense of vocal effort due to increased vocal demand is frequently reported by patients with voice disorders. However, effects of vocal warm-up on self-assessed vocal effort have not been thoroughly examined. A recently developed version of the Borg CR-10 Scale facilitates vocal effort assessments, following different vocal warm-up tasks. Methods Effects of a short (5 min) vocal warm-up on self-assessed vocal effort was evaluated using the Borg CR-10. Twenty-six vocally healthy participants (13F, 13M, mean age 22.6), in two randomised groups, underwent sessions of either reading aloud or semi-occluded vocal tract exercises (SOVTE). Vocal effort was evaluated at four times: pre to post vocal warm-up and two silence periods. Non-parametric analyses for repeated measures and calculations for within-subject standard deviation were applied in group comparisons. Results Following vocal warm-up, vocal effort ratings were increased to a statistically significant degree in both intervention groups compared to baseline ratings. After a 5-min rest in silence following completion of the vocal warm-up, vocal effort ratings returned to baseline levels in both groups. The drop in ratings immediately post warm-up compared to 5 min later was statistically significant for the SOVTE group. Conclusions Five minutes of vocal warm-up caused increased self-perceived vocal effort in vocally healthy individuals. The increased sense of effort dissipated faster following warm-up for the SOVTE group. When using the Borg CR-10 scale to track vocal effort, it may be beneficial to apply experience-based anchors.

目的 本研究旨在探讨学龄期脑瘫儿童在连续语音下的言语流利性特征及其与言语可懂度之间的相关性,为脑瘫儿童言语流利性的评估与康复提供理论依据.方法 于2021年1-2月分别纳入学龄期痉挛型脑瘫儿童与同年龄段正常发育儿童各15名,分析其在朗读语音均衡式材料下的言语流利性相关声学参数,包括言语速率、构音速率、平均停顿时长、异常停顿次数和重复次数,再通过转录法计算其言语可懂度.并将言语流利性参数与言语可懂度分数进行Spearman相关性分析.结果 脑瘫组的言语速率、构音速率、言语可懂度显著小于正常对照组(t=-21.650,-15.440,-4.447,P＜0.05);平均停顿时长、异常停顿次数、重复次数显著大于正常对照组(t=19.639,20.347,3.767,P＜0.05).脑瘫儿童的言语速率(r=0.831)、构音速率(r=0.827)与言语可懂度均呈正相关(P＜0.01);平均停顿时长(r=-0.849)异常停顿次数(r=-0.783)、重复次数(r=-0.672)与言语可懂度均呈显著负相关(P＜0.01).结论 痉挛型脑瘫儿童的言语可懂度降低,言语流利性存在异常,体现在语速减慢、停顿次数、停顿时长与重复次数增加.痉挛型脑瘫儿童的言语流利性与言语可懂度呈正相关,在脑瘫言语治疗中应合理加入改善言语流利性的训练.

为探索7～11岁听障儿童的语速特征及其与构音器官运动灵活性的关联性,本研究分析了 7～11岁听障儿童和普通儿童在复述语言任务和音节重复任务中的言语速率、音节时长和停顿时长,以及两种任务下各参数的相关性.结果发现:(1)7～11岁听障儿童的语速显著低于普通儿童;听障儿童和普通儿童在复述语言任务下的语速均低于音节重复任务下的语速;听障儿童和普通儿童的语速均随年龄增长而明显提升,但二者存在不同的发展轨迹;(2)普通儿童在复述语言任务下的语速与其口腔轮替速率的相关度较低,听障儿童在两者上的相关度较高,构音器官运动灵活性不佳与听障儿童的语速能力较低关联密切.