ABSTRACT
Unusual speech prosody has long been recognized as a characteristic feature of the speech of individuals diagnosed with Autism Spectrum Disorders (ASD). However, research to determine the exact nature of this difference in speech prosody is still ongoing. Many individuals with verbal autism perform well on tasks testing speech prosody. Nonetheless, their expressive prosody is judged to be unusual by others. We propose that one aspect of this perceived difference in speech prosody in individuals with ASD may be due to a deficit in the ability to entrain-or become more similar-to their conversation partners in prosodic features over the course of a conversation. In order to investigate this hypothesis, 24 children and teens between the ages of 9 and 15 years participated in our study. Twelve of the participants had previously been diagnosed with ASD and the other 12 participants were matched to the ASD participants in age, gender, and non-verbal IQ scores. All participants completed a goal-directed conversation task, which was subsequently analyzed acoustically. Our results suggest (1) that youth diagnosed with ASD entrain less to their conversation partners compared to their neurotypical peers-in fact, children and teens diagnosed with ASD tend to dis-entrain from their conversation partners while their neurotypical peers tend to converge to their conversation partners' prosodic features. (2) Although age interacts differently with prosodic entrainment in youth with and without ASD, this difference is attributable to the entrainment behavior of the conversation partners rather than to those with ASD. (3) Better language skill is negatively correlated with prosodic entrainment for both youth with and without ASD. The observed differences in prosodic entrainment in children and teens with ASD may not only contribute to the perceived unusual prosody in youth with ASD but are also likely to be indicative of their difficulties in social communication, which constitutes a core challenge for individuals with ASD.
ABSTRACT
Conversational entrainment or alignment-the convergence of conversation partners over the course of a conversation in a variety of linguistic features-is a well-attested conversational phenomenon. The research on prosodic entrainment has shown correlations between prosodic entrainment and several social dimensions of rapport between conversation partners. However, little is known about how skill-level in the entrainment domain affects the ability to converge during a conversation. The goal of the current study was to investigate whether skill-level of a speaker in receptive and expressive word, sentence, and emotional prosody is correlated with the amount of prosodic entrainment contributed at the conversational level. Twenty native speakers of American English were paired into ten dyads of seven female/female and three female/male conversation pairs. Conversations for each pair were recorded and analyzed. Test scores measuring word, sentence, and emotional prosody were correlated with the amount of fundamental frequency entrainment during conversations. The results indicate that a negative correlation exists between expressive prosody skill and the amount of f0 entrainment contributed by a speaker. This suggests that speakers with better expressive prosodic skills at the word and sentence level entrain less to their conversation partners. Receptive prosody ability was not correlated with conversational prosodic entrainment.
ABSTRACT
OBJECTIVE: Patients with chronic obstructive pulmonary disease (COPD) and a history of frequent exacerbations are a target population of particular interest from both a clinical and an economic standpoint. The objective of this study was to evaluate the effectiveness of a program designed specifically to manage patients in this subgroup. PATIENTS AND METHODS: This was a 1-year randomized controlled trial designed to compare the effectiveness of a specific program (SP) with that of conventional management (CM) in a group of patients with a high frequency of exacerbations (3 or more per year). Within-group and between-group comparisons were carried out for a number of variables related to the patients medical care, dyspnea, health-related quality of life (HRQL), inhalation technique, and pulmonary function. RESULTS: A total of 26 patients were enrolled in the study (all men). The mean (SD) age was 73 (8) years, and mean forced expiratory volume in 1 second (FEV1) expressed as a percentage of the reference value was 43% (15%). Exacerbations requiring hospital care (emergency department visits and/or admission) decreased in both groups: by 24.4% (P not significant) in the CM group and 44.1% (P=.061) in the SP group. Hospital admissions decreased 73.3% in the SP group and increased 22% in the CM group (P< .001). While length of hospital stay decreased 77.3% in the SP group, this figure almost doubled in the CM group (P=.014). Dyspnea, HRQL, and inhalation technique improved in both groups. FEV1 fell by 46 mL/year in the CM group and increased 10 mL/year in the SP group (P not significant). CONCLUSIONS: The use of a simple program to manage selected patients with a history of frequent exacerbations produces a significant reduction in the number of hospital admissions, an improvement in HRQL, and may improve prognosis.
Subject(s)
Patient Education as Topic , Pulmonary Disease, Chronic Obstructive/therapy , Aged , Humans , Male , Prospective Studies , Pulmonary Disease, Chronic Obstructive/complicationsABSTRACT
Objetivo: Los pacientes con enfermedad pulmonar obstructiva crónica que presentan frecuentes agudizaciones (AEPOC) constituyen una población diana de especial interés, tanto desde el punto de vista clínico como económico. El objetivo del estudio es evaluar la eficacia de un programa específico (PE) dirigido a este subgrupo de enfermos. Pacientes y métodos: Se ha realizado un estudio prospectivo, aleatorizado y controlado de un año de duración, en el que se ha comparado la eficacia del PE frente al tratamiento convencional (TC) en un grupo de pacientes con exacerbaciones frecuentes (3 o más AEPOC al año). Se efectuaron comparaciones intragrupo e intergrupo en diversos parámetros asistenciales, disnea, calidad de vida relacionada con la salud (CVRS), técnica inhalatoria y función pulmonar. Resultados: Se incluyó en el estudio a 26 pacientes (todos varones), con una edad media (± desviación estándar) de 73 ± 8 años y volumen espiratorio forzado en el primer segundo, en porcentaje del valor de referencia, del 43 ± 15%. Las exacerbaciones que precisaron atención hospitalaria (visitas a urgencias y/u hospitalizaciones) disminuyeron en ambos grupos: un 24,4% (p = no significativo) en el grupo TC y un 44,1% (p = 0,061) en el grupo PE. Las hospitalizaciones se redujeron un 73,3% en el grupo de intervención, mientras que se incrementaron un 22% en el TC (p < 0,001). Los días de hospitalización disminuyeron un 77,3% en el PE, mientras que aumentaron casi el doble para el TC (p = 0,014). La disnea, la CVRS y la técnica inhalatoria mejoraron en ambos grupos. El volumen espiratorio forzado en el primer segundo presentó un descenso de 46 ml/año en grupo TC, mientras que se incrementó 10 ml/año para el grupo PE (p = no significativo). Conclusiones: El empleo de un programa sencillo, dirigido a pacientes seleccionados con exacerbaciones frecuentes, comporta una reducción significativa del número de las hospitalizaciones, mayor CVRS y quizá mejor pronóstico
Objective: Patients with chronic obstructive pulmonary disease (COPD) and a history of frequent exacerbations are a target population of particular interest from both a clinical and an economic standpoint. The objective of this study was to evaluate the effectiveness of a program designed specifically to manage patients in this subgroup. Patients and methods: This was a 1-year randomized controlled trial designed to compare the effectiveness of a specific program (SP) with that of conventional management (CM) in a group of patients with a high frequency of exacerbations (3 or more per year). Within-group and between-group comparisons were carried out for a number of variables related to the patients´ medical care, dyspnea, health-related quality of life (HRQL), inhalation technique, and pulmonary function. Results: A total of 26 patients were enrolled in the study (all men). The mean (SD) age was 73 (8) years, and mean forced expiratory volume in 1 second (FEV1) expressed as a percentage of the reference value was 43% (15%). Exacerbations requiring hospital care (emergency department visits and/or admission) decreased in both groups: by 24.4% (P not significant) in the CM group and 44.1% (P=.061) in the SP group. Hospital admissions decreased 73.3% in the SP group and increased 22% in the CM group (P<.001). While length of hospital stay decreased 77.3% in the SP group, this figure almost doubled in the CM group (P=.014). Dyspnea, HRQL, and inhalation technique improved in both groups. FEV1 fell by 46 mL/year in the CM group and increased 10 mL/year in the SP group (P not significant). Conclusions: The use of a simple program to manage selected patients with a history of frequent exacerbations produces a significant reduction in the number of hospital admissions, an improvement in HRQL, and may improve prognosis
