OBJECTIVE: The purpose of this study was to provide a description of the language and speech (intelligibility, voice, resonance, articulation) in a 7-year-old Dutch speaking boy with Nager syndrome. To reveal these features comparison was made with an age and gender related child with a similar palatal or hearing problem. METHODS: Language was tested with an age appropriate language test namely the Dutch version of the Clinical Evaluation of Language Fundamentals. Regarding articulation a phonetic inventory, phonetic analysis and phonological process analysis was performed. A nominal scale with four categories was used to judge the overall speech intelligibility. A voice and resonance assessment included a videolaryngostroboscopy, a perceptual evaluation, acoustic analysis and nasometry. RESULTS: The most striking communication problems in this child were expressive and receptive language delay, moderately impaired speech intelligibility, the presence of phonetic and phonological disorders, resonance disorders and a high-pitched voice. The explanation for this pattern of communication is not completely straightforward. The language and the phonological impairment, only present in the child with the Nager syndrome, are not part of a more general developmental delay. The resonance disorders can be related to the cleft palate, but were not present in the child with the isolated cleft palate. One might assume that the cul-de-sac resonance and the much decreased mandibular movement and the restricted tongue lifting are caused by the restricted jaw mobility and micrognathia. To what extent the suggested mandibular distraction osteogenesis in early childhood allows increased mandibular movement and better speech outcome with increased oral resonance is subject for further research. CONCLUSION: According to the results of this study the speech and language management must be focused on receptive and expressive language skills and linguistic conceptualization, correct phonetic placement and the modification of hypernasality and nasal emission.
Patients with poststroke aphasia have higher mortality rates and worse functional outcome than patients without aphasia. Nurses are well aware of aphasia and the associated problems for patients with stroke because they have daily contact with them. The challenge is to provide evidence-based care directed at the aphasia. Although rehabilitation stroke guidelines are available, they do not address the caregiving of nurses to patients with aphasia. The aim of this study was to explore the evidence on rehabilitation of stroke patients with aphasia in relation to nursing care, focusing on the following themes: (1) the identification of aphasia, (2) the effectiveness of speech-language interventions.The findings of this study can be used to develop nursing rehabilitation guidelines for stroke patients with aphasia. Further research is necessary to explore the feasibility of using such guidelines in clinical nursing practice and to examine the experiences of patients with nursing interventions directed at aphasia.
In this paper we describe our work in progress on the development of a set of criteria to predict text difficulty in Sign Language of the Netherlands (NGT). These texts are used in a four year bachelor program, which is being brought in line with the Common European Framework of Reference for Languages (Council of Europe, 2001). Production and interaction proficiency are assessed through the NGT Functional Assessment instrument, adapted from the Sign Language Proficiency Interview (Caccamise & Samar, 2009). With this test we were able to determine that after one year of NGT-study students produce NGT at CEFR-level A2, after two years they sign at level B1, and after four years they are proficient in NGT on CEFR-level B2. As a result of that we were able to identify NGT texts that were matched to the level of students at certain stages in their studies with a CEFR-level. These texts were then analysed for sign familiarity, morpheme-sign rate, use of space and use of non-manual signals. All of these elements appear to be relevant for the determination of a good alignment between the difficulty of NGT signed texts and the targeted CEFR level, although only the morpheme-sign rate appears to be a decisive indicator
