Practitioners speak out.

Most of our colleagues report that the recession has caused them to alter the way they have been providing services on a day-to-day basis. Even though changes, cutbacks, and concessions have been made, our professions have, for the most part, been resilient and have been spared the massive layoffs and salary cuts seen in other sectors of the workforce. In fact, given our colleagues' comments, our professions seem to have fared well in what have been gloomy times for many other industries and careers. The number of vacant positions far exceeded the number of people seeking positions at the 1992 ASHA convention (many report position vacancies that have gone unfilled for some time); salaries appear to be keeping up with or in some cases even exceeding inflation; and the number of clients who need us keeps growing. No one knows what lies ahead. We do know that our professions survived the recession. In the years ahead we will be preparing the groundwork for the practice of the professions in the next century. It will be a time of change in the delivery of care. We will be required to be as creative or even more creative than we have been.

Preservice training to meet the needs of people from diverse cultural backgrounds.

The provision of speech-language pathology and audiology services to persons from culturally and linguistically diverse populations is changing. Researchers have indicated that many current ASHA certified speech-language pathologists and audiologists do not perceive themselves as competent to provide services to individuals from culturally and linguistically diverse backgrounds due to the paucity of this information during their professional education (Campbell, 1986; Shewan & Malm, 1989; Snope, 1982). ASHA has attempted to meet the needs of individuals from culturally and linguistically diverse backgrounds who are communicatively impaired and students and practitioners through the latest revisions of the requirements for the Certificates of clinical Competence and through ESB accreditation requirements for university training programs. This article discussed several important needs associated with university training programs for speech-language pathologists and audiologists that must be considered as the professions respond to the needs of specific service populations.

Comparison of electroglottographic and acoustic analysis of pitch perturbation.

Pitch perturbation is a measure of the cycle-to-cycle variation in vocal fold vibration. Perturbation can be assessed by means of electroglottographic or acoustic signals. The purpose of this study was to determine if these two analysis techniques are equivalent measures. The Laryngograph, an electroglottograph, and the Visi-Pitch, an acoustic analyzer, were used to measure pitch perturbation in 80 dysphonic subjects. Both instruments use Koike's formula to calculate relative average perturbation. While intra-subject variability appeared erratic, statistical analysis of intersubject data indicated that the two instruments provided an equivalent measure of pitch perturbation.

Advances in non-invasive measures of vocal acoustics.

Objective assessment of vocal pitch, loudness, and quality is a crucial adjunct to endoscopy in the diagnosis and treatment of vocal pathology. Historically, this assessment was made through subjective, perceptual measures that were questionable in terms of validity and reliability. Recent advances in electronic technology now permit objective analysis of the acoustic characteristics of voice. Kay Elemetric's Visi-Pitch, DSP 5500 Digital Spectrograph, and Nasometer are representative of these new instruments and are used as illustrations in the discussion of the assessment of speech acoustics.

Non-invasive assessment of phonatory and respiratory dynamics.

Evaluation of vocal pathology and the accompanying dysphonia should include an assessment of laryngeal structure and mobility as well as respiratory dynamics. Laryngeal structure is best observed through laryngoscopy which provides an accurate assessment of the tissues and their mobility. Respiratory measures of lung volume, air-flow and pressure, and breathing dynamics are typically determined via spirometry and pneumotachography. While the above are traditional invasive procedures which interfere with normal speech production, recent advances in electronic technology have resulted in the development of non-invasive procedures to assess phonatory and respiratory dynamics. These procedures, when used as an adjunct to laryngoscopy, can provide information that is useful in the diagnosis and management of vocal tract dysfunction. The Laryngograph and Computer-Aided Fluency Establishment Trainer, described here, are examples of this new technology.

Rehabilitation of swallowing and communication following glossectomy.

Patients who have had surgical removal of part or all of the tongue are left with varying degrees of swallowing and speech deficiencies. The extent of resection, mobility of the residual tongue segment, and adequacy of the remaining structures determine the amount and type of deficiency. While communicative impairment and dysphagia commonly are seen in a rehabilitation setting, the problems of the glossectomy patient often are unique. This article reviews the anatomy and physiology of the oral and pharyngeal musculature, discusses the speech and swallowing of the glossectomy patient, and presents nursing considerations for successful rehabilitation.

Returning meaning to semantic relations: some clinical applications.

Two approaches for analyzing the meanings reflected in children's early word combinations are illustrated for possible application in the clinical setting. The first approach is interpretive in nature and involves detailed analysis of spontaneous speech. The second approach uses individualized probes that are designed to isolate the semantic factors involved in children's word combination patterns. Although both approaches have limitations, it is argued that each provides significantly more clinical information than assigning a child's utterances to predetermined semantic relation categories.

Sensorimotor development and the use of prelinguistic performatives.

Thirty-two children participated in a study designed to determine the effects of sensorimotor training on proto-declarative and proto-imperative performative behavior. The children were randomly assigned to training on means-end schemes, training on relating to objects schemes, training on both means-end and relating to objects, or to a control condition involving no training. Results indicated that relating to objects schemes training was successful. Also, a greater degree of performative usage was seen in the relating to objects training group. These results offer relatively strong evidence for a relationship between these sensorimotor and communicative abilities.

Lexical usage of retarded children: an examination of informativeness.

Retarded children's lexical usage was examined as a function of informativeness. The children were most likely to both label and imitate when the referent objects were informative in the presentation sequence. The frequency of labeling and imitation was particularly high when the informative element was an object exemplar that had not been seen before. The results were discussed in terms of the presuppositional abilities seemingly demonstrated by the children and the implications these abilities have for intervention programs.

The use of grammatical morphemes by normal and language-impaired children.

An examination was made of the grammatical morpheme usage of normal children and language-impaired children matched at two different levels of mean utterance length. The language-impaired children displayed less grammatical morpheme usage than the normal children with equivalent mean utterance length. However, no use of alternative features of semantic importance by the language-impaired children was noted, suggesting that no unique patterns for acquiring language were in operation. Instead, it appears that the language-impaired children may have attached less communicative significance to grammatical morphemes.