Earl J. Seaver

Relative Values of Various Standardized Passages in the Nasometric Assessment of Patients with Velopharyngeal Impairment

A series of 155 patients referred for evaluation at the UNC Craniofacial Center was studied to compare nasometric performance data obtained from the Rainbow Passage to information provided when subjects read two other standardized passages (Zoo Passage and Nasal Sentences). Nasometric findings obtained using the three reading passages were compared to aerodynamic estimates of velopharyngeal area and nasal cross-sectional area as well as clinical judgments of hypernasality and hyponasality. The results suggest that the Rainbow Passage does not provide clinically relevant information that cannot be obtained using the other speech samples studied.

Nasality and velopharyngeal function in five hearing impaired adults

Cineradiographic observations of velopharyngeal functioning and listener judgments of hypernasality were compared for five hearing impaired adults. All of the hearing impaired speakers were perceived to have speech characterized by excessive nasality, while only two of the subjects exhibited any velopharyngeal opening. The relationships between the perception of excessive nasality and variables other than the physiology of the velopharyngeal mechanism are discussed.

Nasometric and Phototransductive Measurements of Reaction Times Among Normal Adult Speakers

The temporal relationship among laryngeal, velopharyngeal, and labial activity was investigated by studying the reaction times of eight normal adults. Four female and four male subjects sustained production of the nasal consonant /m/ until a computer-driven imperative tone was presented at which time they were required to say /pi/ as quickly as possible. This task was repeated 30 times for each subject. The offset of voicing at the end of the /m/ and the onset of bilabial plosive release were monitored using a commercially available Nasometer. The onset of velopharyngeal (V-P) movement toward closure and the attainment of closure were monitored using a photodetector system. Across 240 responses, the average latencies were: 146 ms for initiation of V-P movement toward closure, 224 ms for voicing offset, 280 ms for onset of V-P closure and 317 ms for onset of plosive release. The significance of these findings is discussed with respect to speech motor control and the clinical evaluation of patients with velopharyngeal impairments.

A radiographic investigation of velar positioning in hearing-impaired young adults☆

Listener judgments of the presence and severity of hypernasality were made of speech samples from 25 hearing-impaired young adults. These judgments were compared to the results of manometric testing, cephalometric analyses of velar positioning, and analyses of nasal air emission, nasal rustle, and glottal stops. Only two examples of velopharyngeal opening were observed in the radiographic analysis. Also, those subjects judged to be hypernasal failed to exhibit behavior on the other clinical measurements, which was consistent with expectations based on observations of hypernasality in the oral-facial cleft-palate population. The results of this study illustrate the need for continued research into the anatomical and physiological attributes of the perceived hypernasality in the hearing impaired. Also, the remedial consequences of these findings are discussed.

Integrated Endoscopic/Photodetector Evaluation of Velopharyngeal Function

A new integrated videoendoscopic/photodetection system, including an endoscope with an internal instrument channel used for photodetection, was applied to the evaluation of velopharyngeal closure in a subject with marginal velopharyngeal insufficiency (VPI) and in a subject with no speech disorder. Acoustic and aerodynamic speech assessments were used to establish the severity of velopharyngeal impairment in the marginal VPI patient. A light-out condition was used to establish the photodetector criterion for closure. The new system was effective for providing detailed phonetic assessment of velopharyngeal closure. Variations in degree of closure during select oral and nasal consonant productions were identified in the VPI subject but not in the normal speaking subject. The data show that important details of velopharyngeal insufficiency can be identified using the integrated endoscopic/photodetection system.

A comparison of speech sound durations in three syndromes of aphasia

This study compared the durations of selected vowels and consonants produced by three groups of aphasics and a normal control group in confrontation naming and single-word repetition tasks. There were seven aphasic subjects in each of the syndromes of Brocas, Wernickes, amnesic, and conduction aphasia, in addition to a group of seven normal subjects. Wide-band spectrograms were used to measure speech sound durations. Analysis of group data revealed no significant differences in the durations of vowels or consonants across the four subject groups. In addition, there were no differences in speech sound durations for the confrontation naming versus repetition tasks. When two speech-language pathologists listened to tape recordings of all subjects performing the two tasks, they judged the speech of two Brocas aphasics as being labored, while the speech of the remaining subjects was not judged as labored. Clinical judgments of labored speech appeared to correspond to acoustical measurements of speech sound duration, as the two Brocas aphasics judged to be labored displayed longer durations than those subjects who were not judged as labored. The increase in duration was particularly marked for vowels and for sounds in polysyllabic words. The results are discussed in relation to current descriptions of the articulatory characteristics of Brocas aphasics. Clinical implications are also addressed.

Videoendoscopy and Photodetection: Linearity of a New Integrated System

Simultaneous videoendoscopy and photodetection has potential for improving the assessment of changes in velopharyngeal (VP) movements and closure over time during speech. The purpose of this project was to examine the linearity of a new system, including a pediatric bronchoscope with an internal instrument channel through which the photodetector fiber was positioned. The results led to the conclusion that the response of the new system was linear. However, further examination indicated that system positioning variables had important effects on the overall level of photodetector light detection. These observations confirm the importance of monitoring and controlling the position of the endoscope-photodetector apparatus in the nasopharynx when using the system to evaluate velopharyngeal movement and closure for speech.