ABSTRACT
Purpose: To determine the relationship between air pulse vs. touch laryngeal adductor reflex (LAR) tests and the clinical sensory findings of fiberoptic endoscopic evaluations of swallowing.Method: A retrospective review was conducted for 43 patients with dysphagia due to stroke that underwent fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST). Each patient received LAR testing using air pulse or touch methodologies. Clinically, responsiveness to pharyngeal residue and responsiveness to penetration or aspiration were analysed.Result: The sensitivity, specificity, positive and negative predictive values for both LAR test groups indicate that LAR testing did not effectively predict sensory function during the clinical swallow evaluation. Across both LAR groups, specificity values were higher than sensitivity values. In fact, the specificity values for the light touch LAR test group were extremely high, but the negative predictive values did not support those findings. Sensitivity and positive predictive values were low for both groups.Conclusion: Although LAR testing provides valuable information regarding laryngeal sensory discrimination, the results of the current study suggest that a clinical evaluation of swallowing is critical for effectively assessing the way in which patients utilise sensory information during swallowing.
Subject(s)
Deglutition Disorders/etiology , Deglutition Disorders/physiopathology , Laryngoscopy/methods , Larynx/physiopathology , Stroke/complications , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Reflex/physiology , Retrospective StudiesABSTRACT
BACKGROUND: Dual-task procedures are commonly implemented to examine cognitive load and listening effort as individual differences in cognition often determine successful listening. However, which methods are most efficacious is unclear. Specifically, standardized, targeted assessment procedures for establishing cognitive function, and age-related changes that might account for changes in dual-task performance have yet to be established. Additional data are needed across aging populations, including middle-aged adults and older adults to establish the trend of performance changes throughout the aging process. Investigations of the relationship between cognitive function and dual-task performance may better inform clinical decisions. OBJECTIVE: The purpose of this study was to investigate if cognitive function predicts dual-task performance across adults with and without hearing loss. METHODS: Participants were divided into two groups based on age. Group 1: 14 listeners (Female = 11), 30-50 years old, with normal hearing. Group 2: 12 listeners (Female = 9), 60-80 years old, with normal hearing to near-normal hearing, including typical age-related hearing loss. Participants were administered four of the Woodcock-Johnson III cognitive subtests and standard hearing threshold procedures. All participants were tested in each of three experimental conditions, including two perceptual-cognitive dual-tasks: (1) Auditory word recognition + visual processing, (2) Auditory working memory (sentence) + visual processing in noise, and (3) Auditory working memory (word) + visual processing. RESULTS: Results indicated that cognitive function does predict dual-task performance regardless of age and hearing function. CONCLUSION: Cognitive function may predict dual-task performance during speech-in-noise tasks. Further research investigating the predictive value of related cognitive subtests to listening effort is warranted.
Subject(s)
Aging/psychology , Auditory Perception , Cognition , Persons With Hearing Impairments/psychology , Presbycusis/psychology , Acoustic Stimulation , Adult , Age Factors , Aged , Aged, 80 and over , Auditory Threshold , Case-Control Studies , Female , Hearing , Humans , Male , Memory, Short-Term , Middle Aged , Noise/adverse effects , Perceptual Masking , Photic Stimulation , Presbycusis/diagnosis , Presbycusis/physiopathology , Visual PerceptionABSTRACT
PURPOSE: This study examines whether cognitive function, as measured by the subtests of the Woodcock-Johnson III (WCJ-III) assessment, predicts listening-effort performance during dual tasks across the adults of varying ages. MATERIALS AND METHODS: Participants were divided into two groups. Group 1 consisted of 14 listeners (number of females = 11) who were 41-61 years old [mean = 53.18; standard deviation (SD) = 5.97]. Group 2 consisted of 15 listeners (number of females = 9) who were 63-81 years old (mean = 72.07; SD = 5.11). Participants were administered the WCJ-III Memory for Words, Auditory Working Memory, Visual Matching, and Decision Speed subtests. All participants were tested in each of the following three dual-task experimental conditions, which were varying in complexity: (1) auditory word recognition + visual processing, (2) auditory working memory (word) + visual processing, and (3) auditory working memory (sentence) + visual processing in noise. RESULTS: A repeated measures analysis of variance revealed that task complexity significantly affected the performance measures of auditory accuracy, visual accuracy, and processing speed. Linear regression revealed that the cognitive subtests of the WCJ-III test significantly predicted performance across dependent variable measures. CONCLUSION: Listening effort is significantly affected by task complexity, regardless of age. Performance on the WCJ-III test may predict listening effort in adults and may assist speech-language pathologist (SLPs) to understand challenges faced by participants when subjected to noise.
