Cochlear dead regions: myth or reality?

Let me confess before going into the topic. It has been six year I am out of touch with the audiology and recent advancements. My experiments with cochlear dead regions can be traced back to my undergrad years. That was the time when I was (matter of fact all undergraduates) feeling insufficient in providing hearing aids appropriate for the geriatric population and clients with noise induced hearing loss). One day I was reviewing articles from Scandinavian audiology and Neuroaudiology (I don't remember exact one) and happened to come across 'identifying cochlear dead regions using noise audiometry'. It was an eye opening article. I badly wanted to replicate the experiment and went and told the head of the institute (Respected Joan D' Mello). She encouraged me to think about the way I can replicate the study. I was eager to do it but don't know how I can replicate the study without the special instrument that they used. I couldn't do anything until I finished my graduation (masters). I saw a ray of hope when I spoke to Dr. Vijayalaxmi Basawaraj (one of my favorite teachers). She and I came up with the research proposal. However, when I finished my graduation I went back to my city. I wanted to do the study using conventional audiometers with the modification of stimulus presentation.  Dr. Basawaraj and met with the hearing aid manufacturer and explained about the study and what we wanted to accomplish. However, I had to drop my research due to inaccessibility to the audio department at my work place. Department was not ready to give me permission unless I include them in the study! This is the long s(ad)tory short.

Coming to the topic, my opinion about cochlear dead regions changed in the process. Finally, I questioned my self   'Do Cochlear dead regions really exists?'  Before going there let me talk about what is a cochlear dead region and what is the process of forming one?

To be continued .....

Central Auditory Processing and Autism

Comming Soon :)

Visual processing and Auditory Processing

I know this is not my field of practice. You might be wondering what kind of eligibility I have to write about processing! OK, I am not a licensed Psychologist, however, all SLPs from India, especially from AYJNIHH (I am not familiar with SLP programs in USA) know how extensively we studied and did the psychological evaluations during our bachelors and masters! We studied from basic psychology to psychoneurolinguistics, and from developmental psychology to psychotic disorders. Most of the SLPs including me doesn't know until recently that the tests we use in medical settings are part of Nueropsychology and linguistics test battery! However, I am not going to discuss in detail. The main purpose of this article is to rationalize and explain the development of auditory processing and visual processing, and to explain why are these skills in different levels in variety of disorders! 

Development of Processing:

Before discussing about the development of processing, we need to understand what is the 'processing' means! It is the ability to identify, interpret,attach meaning, and retrieve when required. The stimuli or out put may be auditory, visual, tactile and or kinesthetic mode. The most important modalities are auditory and visual processing!  

A. Auditory processing: to be contnd.....

Psycho-Neuro-Linguistic model of communication disorders!

Introduction:

I came up with a model to understand and explain several communication disorders. To understand this model, reader should have the basic knowledge of neurology, psychology and linguistics along with the ability to differentiate variety of communication disorders. I presented this model at Texas and Arizona Speech, language and hearing conventions in March and April 2012 along with Mrs.Malle. Enjoy the model: To be contnd.......

EESHA Matrix: Exclusive Essential Skills Hierarchy Analysis

Review of research in the area of pragmatics suggests all kinds of language disorders,dyslexics and the autism spectrum disorders demonstrate social language deficits. There are several assessments available that measure this area of communication. However, there are no tools, which differentiate social pragmatic disorders.  I came up with matrix called Exclusive Essential Skills Hierarchy Analysis (EESHA) by utilizing thirteen of the Test of Pragmatic Language Skills (TOPL-2) test items after the item analysis. The purpose of EESHA Matrix is for differential diagnosis of Autism, Asperger’s, Mixed Dyslexia, NonVerbal Learning Disability, Fetal Alcohol Syndrome, AD/HD, and Social Anxiety Disorder.

Pragmatic language skills are the window to several complex developmental disorders. However, there is no test or the way to differentiate. These diorders usually share most of the clinical features of pragmatic-language skills, hence, a high probability of misdiagnosis. 

EESHA development:

TOPL-2, CELF-4 Pragmatic Profile and CASL Pragmatic judgment subtest items were compared and selected 45 common skill areas. These areas were analyzed using the responses from TOPL-2 test. Eliminated varied skills and came up with the essential exclusive social skills hierarchy analysis (EESHA) matrix. It will give the probability of presence of above mentioned disorders, visual and auditory processing ability, working memory or other memory related deficits and predicts academic performance.

If you are interested to know more about it, please contact me!

Real time analysis of functional communication of children with Autism!

Coming soon :)

Voice therapy: my experiments

Coming soon :)

Articulation Therapy: a new perspective

Coming soon :)

Bilingualism

Coming soon :)

Influence of Emotional state in Generalizing the learned skills.

Introduction:

'Why is she not able to generalize her learned skills in the therapy into unstructured settings?' This is the common question and frustration that every SLP goes through in his professional life. At one point you might question yourself, 'Am I not a good therapist?'  Even the parents feel frustrated why is her daughter not progressing!  There will be several reasons to not able to generalize her learned skills. To list a few important factors,  age, intellectual level, quantity and quality of opportunity to practice, and the emotional state of the student. We all consider first three factors in the therapy. However, there are only few SLPs consider the influence of emotional state! 

Influence:

The best practice in the research is to observe, analyze and test our own behavior!  After analyzing my own accent in different situations, I realized that when I am in a emotionally charged state (extremes of happy to mad, and tired) my accent kicks in! I remembered a story that I read when I was a child.  It is a story of one of the great kings who ruled almost all the parts of south India! He is famous with his eight wise men in his ministry! One day one person came to his chamber claiming that he is a polyglot, and challenged his kingdom to find his primary language! Amazingly he spoke all the languages as if they were all his primary languages! The king looked at his wise men and one of them stood up and said 'it is not a big deal, I can tell which one is your primary language. However, I need a day to figure it out!' The polyglot agreed and the king gave him a place to stay for the night. In the night the wise man came there with the mask and scared him with the sword! He shouted for help! Next day in the chamber, wiseman told him which one is his primary language! The polyglot was surprised and asked him how did he find it out. Any guess? Yes you are right, in the extreme scared emotion the polyglot shouted in his primary language for help! 

How can we overcome emotional state factor?

Let us discuss this in terms of different disorders. Articulation, voice, fluency and even language  skills generalization influenced by the emotional state of the student. 

Articulation therapy: 'since eight years I am using w/r sounds and you want me to change that in one year?' This is the statement made by one of the fourth grader in my therapy session when i was working on his generalization! It shocked me and I felt that he is right. We expect them to change their established behavior in a short period! My approach in articulation therapy is always working with the complex skills and touch base the simple skills! The philosophy behind this is, working on complex skills will influence the simple skills! The complex skill in generalization is using the learned skills in different emotional states! Hence, I changed my style of working with him! I gave him different emotional situations and asked him to use the target words with that emotions. Surprisingly it worked and within couple of months he was able to use target sounds. He was exited from speech therapy and spending his majority of time in the academics!

Using this experience I formulated a therapy approach and using it in my regular therapy sessions as well as in RTI program! This approach has the following components: showing the  placement and manner of articulation using adaptive procedures depending on the target sound, at least 150 practices in a session, using complex structures (three sound clusters, two sound clusters with distant articulation placement and or manner of target sounds),  multi tasking (graphomotor, visuomotor, and gross motor) and using emotional situations in all the stages of articulation therapy! I will write separate article on this approach.

Voice therapy: emotional state plays a vital role in the voice therapy!  To be contnd ....