The Sheba Medical Center Protocol for Bedside Evaluation of Swallowing Disorders Among Tracheotomized Patients.

The Sheba Blue Dye Test Protocol (SBDTP) is a swallowing bedside evaluation for tracheotomized patients (TP). It is based on the Modified Evans' Blue Dye Test (MEBDT), but includes several modifications that aim to overcome previously described caveats of the traditional MEBDT. These modifications include evaluating the patient three times, with increasing quantities of bolus. The purpose of this study was to examine the rates of positive and negative results of TP undergoing the SBDTP, in comparison to the MEBDT, which, generally, consists of a single evaluation. The study included a cohort of 39 TP admitted to the Sheba general hospital with various background diseases. Findings indicated that the percentage of positive results increased significantly from the first (18%) to the last stage (46.2%) of the SBDTP. This result demonstrated the advantage of the SBDTP as a more reliable evaluation for tracing aspiration among TP, especially in cases where access to instrumental examination is limited.

Comprehension of "Narrow Focus" by Adolescents in the Autism Spectrum.

OBJECTIVE: The study compared the performance of adolescents with autistic spectrum disorder (ASD) to that of age-matched peers with typical development (TD) and cognitive language-matched peers with TD on measures of identification and comprehension of "narrow focus." PARTICIPANTS: Forty-nine participants, 17 autistic, 17 TD peers matched for age and sex, and 15 TD children matched for expressive vocabulary participated in the study. METHOD: The Hebrew Narrow Focus Test (HNFT) was used. The HNFT includes 3 subtests. The first subtest (A) required identification of the stressed word in the sentence based on psychoacoustic abilities alone. The second (B) and third (C) subtests required understanding the meaning of focused stress in different contexts. In subtest B, the meaning of "narrow focus" was to contrast other possibilities related to the lexical-grammatical role of the stressed word in the sentence, whereas in subtest C, the meaning was to indicate a mistake. RESULTS: ASD participants showed reduced performance compared to peers across all the subtests of the HNFT, but similar performance compared to TD children in subtests A and B and better performance on subtest C. A significant correlation was found between the Raven test for assessing nonverbal intelligence and subtests B and C of the HNFT in the group of adolescents with ASD. CONCLUSIONS: Comprehension of narrow focus in adolescents with ASD who study in a special educational system is related to their cognitive-linguistic abilities and not to the autistic condition by itself or to its severity.

Judging emotions in lexical-prosodic congruent and incongruent speech stimuli by adolescents in the autism spectrum.

OBJECTIVE: The purpose of the present study was to assess how adolescents with autism who vary in the severity of autistic characteristics judge the emotional state of the speaker when lexical and prosodic information is congruent or incongruent. PARTICIPANTS: Eighty participants, 24 autistic and 56 typically developing (TD) subjects participated: (a) 11 autistic adolescents between 9.5 and 16.83 years old, studying at general education settings (AA1), (b) 13 autistic adolescents between 15.91 and 20.33 years old, studying at a special school (AA2), and (c) 56 TD subjects between 6 and 29 years old. Listeners were required to judge the emotional meaning of words (sad/happy) in congruent conditions and incongruent conditions. RESULTS: (a) All participants judged lexical and prosodic meaning separately with high accuracy, (b) all participants showed prolonged reaction times in the incongruent compared to the congruent condition, (c) AA1 relied on prosodic information in the incongruent condition similarly to TD 9-15 year olds and TD adults, (d) AA2 and TD 6-8 year olds did not rely on prosodic information in the incongruent condition, and (e) both education placements, the severity of autistic characteristics and nonverbal IQ contributed to prosodic judgment in the incongruent condition in autistic adolescents. CONCLUSIONS: The two groups of autistic adolescents processed both lexical and prosodic information in the incongruent condition. However, the severity of autistic characteristics influenced the preference for prosody.