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  Most popular articles (Since December 04, 2013)

 
 
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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.
  5,275 315 -
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.
  2,896 133 -
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.
  2,013 111 -
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.
  1,798 266 -
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.
  1,495 170 -
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.
  1,406 209 -
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.
  1,158 206 -
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.
  1,020 178 1
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.
  981 208 -
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.
  926 142 -
Identifying speaker from disguised speech using aural perception and Mel-frequency cepstral coefficient
J Praveena, Y Krishna
July-December 2015, 29(2):28-34
DOI:10.4103/0974-2131.185974  
Objective: The present study intended to compare the accuracy of speaker identification using aural perception and semiautomatic method (Mel –Frequency Cepstral Coefficient; MFCC), when the speech is in disguise condition by using the handkerchief during recording and to check the percentage of correct identification in the semiautomatic method when the vowel and consonant segments were used for analysis. Methods: Thirty speaker's single sentence speech sample was recorded in undisguised and disguised conditions were randomly paired into the sets of one undisguised followed by five disguised samples for the task of speaker identification. In aural perceptual method the five judges listened to the samples and made a decision on the match. In MFCC method, from /ðə/ segment, ten coefficient values were extracted. The coefficient values were manually averaged and the pair that obtained the lowest value of Euclidean distance was determined to be the sample of the same speaker. The Kappa agreement was used to find the agreement between the two methods in speaker identification and the percentage of correct identification was calculated for the vowel and consonant segment analysis. Results: The results revealed the kappa value to be negative (k < 0) indicating no agreement between the two methods. The percentage of correct identification using aural perception ranged from 56.7% - 80% and for MFCC under whole word, consonant segment and vowel segment analysis were 46.7%, 26.7% and 53.33% respectively. Conclusion: The aural perception method had a greater percentage of correct identification than MFCC though it was not statistically significant for speaker identification from disguised speech.
  850 170 -
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.
  815 199 -
Perception of voice difficulties by individuals with Parkinson disease vis-à-vis their family members using Voice Handicap Index
Priya Shah, Geeta Gore
January-June 2016, 30(1):12-16
DOI:10.4103/0974-2131.196248  
Introduction: Individuals with Parkinson disease (PD) experience difficulty in production of voice. Evidence also suggests a possible deficit in Parkinson's individuals' perception of their own speech loudness. Aim: This study aims to determine perception of voice difficulties in an individual with PD and obtain family members perspective of the same using Voice Handicap Index. Methodology: 31 individuals with PD and their respective family members (N=62) were asked to fill Voice Handicap Index. Scores across three areas: emotional, functional and physical were compared. Two-way (factorial) ANOVA statistical test was used. Results: 64% of the individual with PD and 70% of the family members felt that a voice difficulty exists. The results of ANOVA indicated that the score of the PD differed from family on overall mean scores on VHI. Also, the impact of a voice problem is more noticeable by the family member as compared to the individual with PD. The family members have perceived that the individual with PD has become more restricted in their personal lives and avoid speaking situations due to their voice difficulties. On the other hand, the individual with PD notice the physical strain, effort and difficulty to produce the voice. Conclusion: Planning a treatment, which focuses on all these aspects, allows the PD and family members to get a healthy perspective of the voice difficulties and improve overall quality of life. In a country like India, that still has a close family structure, involving the family and obtaining their perspective for management of individuals with PD is of significant importance.
  632 141 -
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).
  610 105 -
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.
  531 159 -
EDITORIAL
From the editorial's desk
Prawin Kumar
July-December 2016, 30(2):27-27
DOI:10.4103/jisha.JISHA_30_17  
  416 123 -
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.
  415 99 -
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.
  405 101 -
Establishing ancestry through pedigree of a village with high prevalence of hearing-impaired
Sunil Kumar Raina, Munish Saroch, Geetika Yadav, Ashok Bhardwaj
January-June 2017, 31(1):1-4
DOI:10.4103/jisha.JISHA_15_16  
Introduction: Population-based surveys into the cause of deafness have consistently shown that a high percentage (50%) of childhood deafness can be attributed to genetic causes. The flip side to genetic testing in population surveys is the operational difficulties associated with carrying it out. The present study was therefore planned with the aim of establishing ancestry through pedigree of a village with high prevalence of hearing-impaired. Materials and Methods: A two-stage study design was used to conduct this study. The first stage involved a house-to-house survey to identify hearing-impaired whereas the second stage involved clinical examination for hearing impairment. Results: Of a total of 2522 individuals studied, 80 were identified as hearing-impaired yielding a crude prevalence of 3.17%. The pedigree analysis of the whole village revealed a common ancestry. Discussion: In the late 20th century, deaf-mutism became a subject of debate and social isolation for Dadhkai villagers. A highlight of Dadhkai has been that its surroundings are not deaf-friendly as is expected. Consequently, as intermarriage flourished, the village community increasingly started resembling each other. This could have led to increase in autosomal recessive inheritance of deafness. Similar studies such as evaluation of six patients from two generations from a large sibship of Turkish ethnicity with double consanguinity in the family support the evidence. Conclusion: Flourishing of intermarriage and thereby consanguinity may be the reason behind high number of hearing impaired in this village. Therefore population based genetic counseling may be the key to prevent the same in future.
  129 59 -
An adapted indian version of the stutterers' Self-ratings of reactions to speech situations: A mixed methods study
Pallavi Y Kelkar
July-December 2017, 31(2):37-41
DOI:10.4103/jisha.JISHA_34_17  
Introduction: Attitude assessment is essential to solve the multidimensional puzzle of stuttering. The Stutterers' Self-Ratings of Reactions to Speech Situations (SSRSS) serves this purpose. In spite of its clinical applicability, limited literature is available on its development and validation. Further, while many limitations stemming from stuttering would be culture specific, the SSRSS is still being used in its original form in India. The present study aimed at modifying the SSRSS to be culturally appropriate and obtaining preliminary normative data on the Indian population. Methods: The study was carried out in three phases where the SSRSS was edited through two versions. In Phase I, 16 persons with stuttering (PWS) and 16 age- and gender-matched typical speakers responded to the original version. In Phase II, qualitative data on potential changes in the SSRSS were obtained from participants of Phase I and from two independent focus groups of three PWS and three speech language pathologists, and changes were made to the SSRSS. In Phase III, 15 typical speakers filled in the final version. Results: Quantitatively, significant differences between scores of typical speakers and PWS reaffirmed the robustness of the SSRSS, while analysis of qualitative data brought out several pertinent modifications. Mean scores obtained from the original and final versions were not significantly different, establishing the utility of the final version. Conclusion: The importance of periodic revision of the existing instruments was emphasized. Clinical implications yielded by the qualitative analysis were underlined. Adding to the data pool using the Indian version was suggested as a future direction.
  139 46 -
P300 in individuals with auditory neuropathy spectrum disorder
Kumari Apeksha, U Ajith Kumar
January-June 2017, 31(1):23-28
DOI:10.4103/jisha.JISHA_25_17  
Introduction: Typically, individuals with auditory neuropathy spectrum disorder (ANSD) show the presence of otoacoustic emissions and elevated/absent auditory brainstem responses. It has been reported that individuals with ANSD, in spite of absent or abnormal ABRs, show auditory cortical potentials. P300 is an endogenous cortical-evoked potential and reflects the changes in the cortical activity when the attention is paid toward the sound. This can effectively quantify the complex cortical sensory-cognitive processing underlying active auditory perception. Therefore, the present study was taken up to investigate the cortical representation of active auditory discrimination skills in individuals with ANSD using P300 response. Methods: Twenty-five individuals with ANSD and 25 individuals with normal hearing sensitivity were the participants. The individuals with ANSD had audiometric thresholds ranging from normal hearing to moderate hearing loss. P300 was recorded using/ba/-/da/stimulus contrast in the oddball paradigm. The latency and the amplitude of P300 response were marked and analyzed using repeated measures ANOVA. Sensitivity and reaction time in identifying the oddball were also measured. Results: The result showed poor sensitivity and longer reaction time in individuals with ANSD compared to individuals with normal hearing. P300 responses were prolonged in latency and reduced in amplitude in individuals with ANSD. Both the latency and amplitude of P300 response were related to perceptual measures. Conclusion: P300 response was present in individuals with ANSD but with prolonged latency and reduced amplitude.
  118 59 -
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.
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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.
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Supportive conversational strategies for persons with aphasia and their significant others
Pinki Singh, Apoorva Pauranik
July-December 2017, 31(2):57-65
DOI:10.4103/jisha.JISHA_13_14  
Introduction: The spectrum of useful and not-so-useful supportive conversational strategies (SCSs) employed by significant others (SOs) of person with aphasia (PWA) is wide and variable. The SCS might be influenced by many factors such as perceptions, attitudes, and awareness about the handicap. Modeling and training of SCS might help in modifying perceptions, attitudes, use, and its practices that hinder progress of PWA. Knowledge and understanding of these factors among SOs and PWA will enhance rehabilitation strategies. The objective of the study is to develop SCS-based questionnaire and to examine the type of SCS used by SOs of PWA in the daily communication situation to support and stimulate PWA as a home-based practice program. Methods: The study design was qualitative descriptive trail, involving semi-structured interview of SOs of PWA. Questionnaire was developed and validated. Responses of 33 SOs were obtained and analyzed on this questionnaire. The mean age of PWA was 52.6 years; 85.5% of SOs were a cohabiting partner. Results: Responses to the questionnaire regarding the structure and content showed the agreement levels ranged from 90% (Md. 4.5) to 98% (Md. 5.0). The correlation coefficients varied from 0.57 to 0.94. The overall reliability was high (r = 0.90, P < 0.001). SCS based on verbal or nonverbal mode is exclusively used by SOs for comparing reading and writing mode. The later modes are not utilized by approximately 60% SO. Poor SCS use might hinder expected functional communication. Conclusion: Investigation related to SCS would help to plan tailor-made family-oriented home training program and to understand its efficacy in aphasia.
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Effect of lowered bone mineral density on the outcomes of audiological tests: A preliminary study
Aditi Gargeshwari, Niraj Kumar Singh, Prawin Kumar, Raghav Hira Jha
January-June 2017, 31(1):29-35
DOI:10.4103/jisha.JISHA_4_17  
Introduction: Calcium ions are important for efficient release of neurotransmitters during the transduction process in cochlea. It also plays a pivotal role in recycling of potassium ions. A deficiency in optimal functioning of calcium, which is seen in osteopenia and osteoporosis, could therefore hinder the recycling of K+ ions and cause dysfunction in the neurotransmitter release and thereby sensorineural hearing loss. The deficiency in the bone mineral density (BMD) can also result in microfractures in the middle ear bones and thereby affect its transmission properties. However, few studies have investigated the audiological findings in osteoporosis and none in osteopenia. Therefore, the present study aimed at assessing the effect of lowered BMD on the outcomes of the audiological tests. Method: The study incorporated 11 participants with osteoporosis, 12 with osteopenia, and 12 having normal BMD. All the participants underwent detailed structured case history, pure-tone audiometry, speech audiometry, immittance evaluation, and distortion-product otoacoustic emission (DPOAE). Results: There was a trend toward increase in pure-tone average and speech recognition threshold (SRT) and reduction in speech identification scores in the two clinical groups than the controls; however, this was significant only for SRT (P < 0.05). The osteoporosis group revealed significantly higher proportions of ears with absent acoustic reflexes and DPOAEs than control group and osteopenia group. Conclusion: The findings point to the detrimental impact of reduction in BMD on the entire auditory periphery. Therefore, the audiological evaluation should consist of tests capable of evaluating the auditory system functioning at different levels when evaluating persons with osteopenia or osteoporosis.
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