-
Perspectives on Behavior Science Jun 2020Skinner's (1957) book is a critical tool in designing effective communication programs for individuals with limited speech. The purpose of this systematic review was to...
Skinner's (1957) book is a critical tool in designing effective communication programs for individuals with limited speech. The purpose of this systematic review was to analyze the speech generating device (SGD) research literature from Skinner's taxonomy of primary verbal operants. An extraction procedure yielded 56 studies published between 1995 and 2018, with a total of 221 participants, most of whom had autism spectrum disorder (ASD) or an intellectual and developmental disability (IDD). The large majority of SGD studies (42) targeted multiply controlled mands, whereas only a handful of studies targeted verbal operants that were not mands. Few studies employed procedures for fading contrived sources of stimulus control to promote spontaneous responding, and few studies targeted more sophisticated, topography-based responses (e.g., typing, speech). Results of the review highlight the need for better dissemination of Skinner's , the need for research to evaluate effects of SGD in teaching a greater variety of spontaneous verbal operants, and the need to focus on application of SGD with populations beyond individuals with ASD and IDD.
PubMed: 32647788
DOI: 10.1007/s40614-020-00243-1 -
Journal of Healthcare Engineering 2022Treatment of speech disorders during childhood is essential. Many technologies can help speech and language pathologists (SLPs) to practice speech skills, one of which... (Review)
Review
INTRODUCTION
Treatment of speech disorders during childhood is essential. Many technologies can help speech and language pathologists (SLPs) to practice speech skills, one of which is digital games. This study aimed to systematically investigate the games developed to treat speech disorders and their challenges in children.
METHODS
A comprehensive search was conducted in four databases, including Medline (through PubMed), Scopus, Web of Science, and IEEE Xplore, to retrieve English articles published by July 14, 2021. The articles in which a digital game was developed to treat speech disorders in children were included in the study. Then, the features of the designed games and their challenges were extracted from the studies.
RESULTS
After reviewing the full texts of 69 articles and assessing them in terms of inclusion and exclusion criteria, 27 articles were included in the systematic review. In these articles, 59.25% of the games had been developed in English language and children with hearing impairments had received much attention from researchers compared to other patients. Also, the Mel-Frequency Cepstral Coefficients (MFCC) algorithm and the PocketSphinx speech recognition engine had been used more than any other speech recognition algorithm and tool. In terms of the games, 48.15% had been designed in a way that children could practice with the help of their parents. The evaluation of games showed a positive effect on children's satisfaction, motivation, and attention during speech therapy exercises. The biggest barriers and challenges mentioned in the studies included sense of frustration, low self-esteem after several failures in playing games, environmental noise, contradiction between games levels and the target group's needs, and problems related to speech recognition.
CONCLUSION
The results of this study showed that the games positively affect children's motivation to continue speech therapy, and they can also be used as the SLPs' aids. Before designing these tools, the obstacles and challenges should be considered, and also, the solutions should be suggested.
Topics: Child; Humans; Motivation; Perception; Speech; Speech Disorders; Speech Therapy
PubMed: 35509705
DOI: 10.1155/2022/4814945 -
The Cochrane Database of Systematic... May 2015People with fragile X syndrome (FXS) have an intellectual dysfunction that can range from very mild to severe. Symptoms can include speech and language delays and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
People with fragile X syndrome (FXS) have an intellectual dysfunction that can range from very mild to severe. Symptoms can include speech and language delays and behavioural difficulties such as aggression or self injurious behaviours, emotional lability, and anxiety-related problems (for example obsessive-compulsive symptoms and perseverative behaviours). In some cases, affected people may have an additional diagnosis of attention deficit hyperactivity disorder or an autism spectrum disorder.
OBJECTIVES
To review the efficacy and safety of L-acetylcarnitine in improving the psychological, intellectual, and social performance of people with FXS.
SEARCH METHODS
In May 2015 we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, Web of Science, and two other databases. We also searched three trials registers, four theses databases, and the reference lists of relevant studies and reviews.
SELECTION CRITERIA
Randomised controlled trials (RCTs) that assessed the efficacy of L-acetylcarnitine, at any dose, in people of any age diagnosed with FXS compared with placebo.
DATA COLLECTION AND ANALYSIS
For each trial, two review authors independently extracted data on the children included and interventions compared, and assessed the risk of bias of the studies across the following domains: randomisation sequence generation, allocation concealment, blinding (of participants, personnel, and outcome assessors), incomplete outcome data, selective outcome reporting, and other potential sources of bias.
MAIN RESULTS
We found only two RCTs that compared oral L-acetylcarnitine (LAC) with oral placebo in children with FXS. The studies included a total of 83 participants, all of them male, who were treated and followed for one year. The age of participants at the start of treatment ranged from 6 to 13 years, with a mean age of 9 years. Neither study provided information on randomisation, allocation concealment procedures, or blinding of outcome assessment, and we received no responses from the authors we emailed for clarification. We therefore rated studies as being at unclear risk of bias on these domains. We judged both studies to be at low risk of bias for blinding of participants and personnel, incomplete outcome data, and selective reporting, but to be at high risk of other bias, as at least one study was funded by a drug company, and in both studies people working for the company were part of the research team.We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the quality of the available evidence. Overall, the quality of the evidence was low due to the imprecision of results and high risk of other bias.Regarding the primary outcome of psychological and learning capabilities, both studies assessed the effect of interventions on children's verbal and non-verbal intellectual functioning using the Wechsler Intelligence Scale for Children - Revised. The authors did not provide detailed data on those results but said that they found no important differences between treatment and placebo.Both studies evaluated the impact of the treatment on hyperactive behaviour using the Conners' Abbreviated Parent-Teacher Questionnaire. In one study, teachers' assessments of the children found no clear evidence of a difference (mean difference (MD) 0.50, 95% confidence interval (CI) -5.08 to 6.08, n = 51; low-quality evidence). The other study stated that there were no differences between treated and untreated participants, but did not provide detailed data for inclusion in the meta-analysis.Parents' assessments favoured LAC in one study (MD -0.57, 95% CI -0.94 to -0.19, n = 17; low-quality evidence), but not in the other (MD -2.80, 95% CI -7.61 to 2.01, n = 51; low-quality evidence), though changes were not large enough to be considered clinically relevant.Regarding social skills, one study reported no clear evidence of a difference in Vineland Adaptive Behavior composite scores (MD 8.20, 95% CI -0.02 to 16.42, n = 51; low-quality evidence), yet results in the socialisation domain favoured LAC (MD 11.30, 95% CI 2.52 to 20.08, n = 51; low-quality evidence).Both studies assessed the safety of the active treatment and recorded no side effects. Neither of the included studies assessed the secondary outcome of caregiver burden.
AUTHORS' CONCLUSIONS
Low-quality evidence from two small trials showed that when compared to placebo, LAC may not improve intellectual functioning or hyperactive behaviour in children with FXS.
Topics: Acetylcarnitine; Administration, Oral; Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Fragile X Syndrome; Humans; Male; Randomized Controlled Trials as Topic; Vitamin B Complex
PubMed: 25985235
DOI: 10.1002/14651858.CD010012.pub2 -
Heliyon Jun 2024Autism spectrum disorder (ASD) is a behaviorally defined complex neurodevelopmental syndrome characterized by persistent social communication and interaction deficit.... (Review)
Review
Autism spectrum disorder (ASD) is a behaviorally defined complex neurodevelopmental syndrome characterized by persistent social communication and interaction deficit. Transcranial magnetic stimulation (TMS) is a promising and emerging tool for the intervention of ASD by reducing both core and associate symptoms. Several reviews have been published regarding TMS-based ASD treatment, however, a systematic review on study characteristics, specific stimulating parameters, localization techniques, stimulated targets, behavioral outcomes, and neuroimage biomarker changes is lagged behind since 2018. Here, we performed a systematic search on literatures published after 2018 in PubMed, Web of Science, and Science Direct. After screening, the final systematic review included 17 articles, composing seven randomized controlled trial studies and ten open-label studies. Two studies are double-blind, while the other studies have a moderate to high risk of bias attributing to inadequate subject- and evaluator-blinding to treatment allocation. Five studies utilize theta-burst stimulation mode, and the others apply repetitive TMS with low frequency (five studies), high frequency (six studies), and combined low and high frequency stimulation (one study). Most researchers prioritize the bilateral dorsolateral prefrontal lobe as stimulation target, while parietal lobule, inferior parietal lobule, and posterior superior temporal sulci have also emerged as new targets of attention. One third of the studies use neuronavigation based on anatomical magnetic resonance imaging to locate the stimulation target. After TMS intervention, discernible enhancements across a spectrum of scales are evident in stereotyped behavior, repetitive behavior, and verbal social domains. A comprehensive review of literature spanning the last five years demonstrates the potential of TMS treatment for ASD in ameliorating the clinical core symptoms.
PubMed: 38933955
DOI: 10.1016/j.heliyon.2024.e32251 -
Critical Care (London, England) Feb 2024To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units. (Meta-Analysis)
Meta-Analysis
Violence against healthcare professionals in intensive care units: a systematic review and meta-analysis of frequency, risk factors, interventions, and preventive measures.
BACKGROUND
To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units.
METHODS
PubMed, Scopus, Google Scholar, EMBASE, Cochrane, and Web of Science were searched for studies on violence against healthcare workers in adult intensive care units. Risk factors, patient characteristics, and implications for healthcare workers were collected. Study quality, bias, and level of evidence were assessed using established tools.
RESULTS
Seventy-five studies with 139,533 healthcare workers from 32 countries were included. The overall median frequency of violence was 51% (IQR 37-75%). Up to 97% of healthcare workers experienced verbal violence, and up to 82% were victims of physical violence. Meta-analysis of frequency revealed an average frequency of 31% (95% CI 22-41%) for physical violence, 57% for verbal violence (95% CI 48-66%), and 12% for sexual violence (95% CI 4-23%). Heterogeneity was high according to the I statistics. Patients were the most common perpetrators (median 56%), followed by visitors (median 22%). Twenty-two studies reported increased risk ratios of up to 2.3 or odds ratios of up to 22.9 for healthcare workers in the ICU compared to other healthcare workers. Risk factors for experiencing violence included young age, less work experience, and being a nurse. Patients who exhibited violent behavior were often male, older, and physically impaired by drugs. Violence was underreported in up to 80% of cases and associated with higher burnout rates, increased anxiety, and higher turnover intentions. Overall the level of evidence was low.
CONCLUSIONS
Workplace violence is frequent and underreported in intensive care units, with potential serious consequences for healthcare workers, calling for heightened awareness, screening, and preventive measures. The potential risk factors for violence should be further investigated.
SYSTEMATIC REVIEW REGISTRATION
The protocol for this review was registered with Prospero on January 15, 2023 (ID CRD42023388449).
Topics: Adult; Humans; Male; Health Personnel; Workplace Violence; Aggression; Intensive Care Units; Delivery of Health Care
PubMed: 38409034
DOI: 10.1186/s13054-024-04844-z -
Psychiatry Research Nov 2023Dementia is a progressive neurodegenerative disease that burdens the person living with the disease, their families, and medical and social services. Timely diagnosis of... (Review)
Review
Dementia is a progressive neurodegenerative disease that burdens the person living with the disease, their families, and medical and social services. Timely diagnosis of dementia could be followed by introducing interventions that may slow down its progression or reduce its burdens. However, the diagnostic process of dementia is often complex and resource intensive. Access to diagnostic services is also an issue in low and middle-income countries. The abundance and easy accessibility of speech and language data have created new possibilities for utilizing Deep Learning (DL) technologies to be part of the dementia diagnostic process. This systematic review included studies published between 2012-2022 that utilized such technologies to aid in diagnosing dementia. We identified 72 studies using the PRISMA 2020 protocol, extracted and analyzed data from these studies and reported the related DL technologies. We found these technologies effectively differentiated between healthy individuals and those with a dementia diagnosis, highlighting their potential in the diagnosis of dementia. This systematic review provides insights into the contributions of DL-based speech and language techniques to support the dementia diagnostic process. It also offers an understanding of the advancements made in this field thus far and highlights some challenges that still need to be addressed.
Topics: Humans; Speech; Deep Learning; Neurodegenerative Diseases; Language; Dementia
PubMed: 37864994
DOI: 10.1016/j.psychres.2023.115538 -
Frontiers in Psychiatry 2023Mental health care provided to offenders with psychiatric problems in forensic settings mainly consists of verbal oriented treatments. In addition, experience-based...
INTRODUCTION
Mental health care provided to offenders with psychiatric problems in forensic settings mainly consists of verbal oriented treatments. In addition, experience-based therapies are used such as (creative) arts therapies: (visual) art therapy, music therapy, drama therapy and dance (movement) therapy. There are indications for effectiveness of arts therapies, but a systematic overview of effect studies of all arts therapies in forensic care is lacking.
METHODS
First, we performed a systematic review. Second, Thematic Analysis was used to synthesize the qualitative narrative results and define the hypothesized mechanisms of change. Third, we performed a meta-analysis to investigate the effects of arts therapies in reducing psychosocial problems of offenders. Twenty-three studies were included in the review. Quality and risk of bias was assessed using EPHPP (Effective Public Health Practice Project).
RESULTS
The included studies were heterogeneous in type of outcome measures and intervention characteristics. Synthesis of mechanisms of change involved in the methodical use of the arts in arts therapies resulted in a description of regulatory processes which are stimulated in arts therapies: perceptive awareness (interoceptive and exteroceptive), the regulation of emotions, stress, impulses, cognitions, social regulation, and self-expression. These processes play a role in developing prevention, coping and self-management skills. Eighteen studies were included in the meta-analyses (11 RCTs/CCTs; 7 pre-post studies). The meta-analyses indicated significant effects on both risk factors (psychiatric symptoms and addiction) and protective factors for criminal behavior (social functioning and psychological functioning). Effects on criminal and/or antisocial behavior were not significant, but this outcome measure was scarcely used among the studies.
DISCUSSION
The analyses in this study should be considered explorative. More research is needed to gain more solid conclusions about effectiveness and mechanisms of change of arts therapies in forensic institutions. However, the results of this first systematic review, synthesis of mechanisms and meta-analysis in this field are promising and show effects of arts therapies on risk and protective factors in individuals in forensic institutions.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020217884, identifier: CRD42020217884.
PubMed: 37275972
DOI: 10.3389/fpsyt.2023.1128252 -
European Archives of... Jan 2018Esophageal speech (ES), tracheoesophageal speech (TES) and/or electrolarynx speech (ELS) are three speech rehabilitation methods which are commonly provided after total... (Review)
Review
BACKGROUND
Esophageal speech (ES), tracheoesophageal speech (TES) and/or electrolarynx speech (ELS) are three speech rehabilitation methods which are commonly provided after total laryngectomy (TL).
METHODS
A systematic review of the literature was conducted to evaluate comparative acoustic, perceptual, and patient-reported outcomes for ES, TES, ELS and healthy speakers.
RESULTS
Twenty-six articles could be included. In most studies, methodological quality was low. It is likely that an inclusion bias exists, many studies only included exceptional speakers. Significant better outcomes are reported for TES compared to ES for the acoustic parameters, fundamental frequency, maximum phonation time and intensity. Perceptually, TES is rated with a significant better voice quality and intelligibility than ES and ELS. None of the speech rehabilitation groups reported clearly better outcomes in patient-reported outcomes.
CONCLUSIONS
Studies on speech outcomes after TL are flawed in design and represent weak levels of evidence. There is an urge for standardized measurement tools for evaluations of substitute voice speakers. TES is the favorable speech rehabilitation method according to acoustic and perceptual outcomes. All speaker groups after TL report a degree of voice handicap. Knowledge of caretakers and differences in health care and insurance systems play a role in the speech rehabilitation options that can be offered.
Topics: Humans; Laryngectomy; Patient Reported Outcome Measures; Speech Intelligibility; Speech, Alaryngeal; Treatment Outcome; Voice Quality
PubMed: 29086803
DOI: 10.1007/s00405-017-4790-6 -
Trauma, Violence & Abuse Oct 2023Little is known about the current state of research on the involvement of young people in hate speech. Thus, this systematic review presents findings on a) the...
Little is known about the current state of research on the involvement of young people in hate speech. Thus, this systematic review presents findings on a) the prevalence of hate speech among children and adolescents and on hate speech definitions that guide prevalence assessments for this population; and b) the theoretical and empirical overlap of hate speech with related concepts. This review was guided by the Cochrane approach. To be included, publications were required to deal with real-life experiences of hate speech, to provide empirical data on prevalence for samples aged 5 to 21 years and they had to be published in academic formats. Included publications were full-text coded using two raters (κ = .80) and their quality was assessed. The string-guided electronic search (ERIC, SocInfo, Psycinfo, Psyndex) yielded 1,850 publications. Eighteen publications based on 10 studies met the inclusion criteria and their findings were systematized. Twelve publications were of medium quality due to minor deficiencies in their theoretical or methodological foundations. All studies used samples of adolescents and none of younger children. Nine out of 10 studies applied quantitative methodologies. Eighteen publications based on 10 studies were included. Results showed that frequencies for hate speech exposure were higher than those related to victimization and perpetration. Definitions of hate speech and assessment instruments were heterogeneous. Empirical evidence for an often theorized overlap between hate speech and bullying was found. The paper concludes by presenting a definition of hate speech, including implications for practice, policy, and research.
Topics: Humans; Child; Adolescent; Hate; Speech; Prevalence; Bullying; Crime Victims
PubMed: 35731198
DOI: 10.1177/15248380221108070 -
Neuroscience and Biobehavioral Reviews Sep 2022It is often claimed that music training improves auditory and linguistic skills. Results of individual studies are mixed, however, and most evidence is correlational,... (Meta-Analysis)
Meta-Analysis Review
It is often claimed that music training improves auditory and linguistic skills. Results of individual studies are mixed, however, and most evidence is correlational, precluding inferences of causation. Here, we evaluated data from 62 longitudinal studies that examined whether music training programs affect behavioral and brain measures of auditory and linguistic processing (N = 3928). For the behavioral data, a multivariate meta-analysis revealed a small positive effect of music training on both auditory and linguistic measures, regardless of the type of assignment (random vs. non-random), training (instrumental vs. non-instrumental), and control group (active vs. passive). The trim-and-fill method provided suggestive evidence of publication bias, but meta-regression methods (PET-PEESE) did not. For the brain data, a narrative synthesis also documented benefits of music training, namely for measures of auditory processing and for measures of speech and prosody processing. Thus, the available literature provides evidence that music training produces small neurobehavioral enhancements in auditory and linguistic processing, although future studies are needed to confirm that such enhancements are not due to publication bias.
Topics: Auditory Perception; Brain; Humans; Linguistics; Music; Speech
PubMed: 35843347
DOI: 10.1016/j.neubiorev.2022.104777