ASHAsphere–There’s An App For That

Ok, there’s not really an ASHAsphere app–but here’s how you can create one for your iPhone or Android phone:

iPhone

  • In Safari, go to http://824.479.myftpupload.com
  • Tap the “add” icon (see arrow below)
  • Tap “Add to Home Screen”
  • Tap “Add”
  • Voila! You now have an ASHAsphere app! The icon isn’t very pretty, but it gets the job done.

Android

  • In the browser go to http://824.479.myftpupload.com
  • Tap “Menu”
  • Tap “Add Bookmark”
  • Tap “Done”
  • Close the browser and go back to home screen
  • Tap the + symbol
  • Tap “Shortcut”
  • Tap “Bookmark”
  • Tap the bookmark for ASHAsphere and drag to the screen

Note: I’m not positive that these Android directions work from any Android phone; I tested them on a Droid HTC. If you have a different Droid that requires different steps, we’d really appreciate it if you’d leave a comment indicating what phone you have and what you have to do differently.

We hope you

In the Beginning

Country road


Photo by Dominic’s Pics

As the year begins drawing to a close I find myself taking trips down memory lane. Not normally given to dwelling on the past, I suppose having to update my vita during the past week has spurred these interludes of recollection. Being in the business of teaching tomorrow’s professionals, my recent thoughts have frequently returned to how it all began for me…my decision to become a speech-language pathologist.

In high school I was not the most studious of individuals…it’s not that I lacked intelligence, I simply lacked “give a damn.” Fortunately my high school was willing to assist its students in charting their course in life, having each of us take an aptitude test designed to help choose a career. I can still remember sitting in Miss Crabbs’s English class during my junior year and looking at the results…the test indicated I was ideally suited to be a speech therapist.

So that afternoon of my junior year I decided I’d become a speech therapist. Never mind that I didn’t know what a speech therapist was or, in fact, had ever heard of such a thing…if that’s what the test said I should be, well that’s what I was going to be. I resolutely stuck with this decision throughout my senior year…though I never actually took the time to figure out what a speech therapist was (I’ve already mentioned my lack of ambition haven’t I). Undeterred, I applied to the Speech Pathology and Audiology program at Clarion University of Pennsylvania and was accepted into the class of 1987.

Despite going to orientation during the summer, I was still unclear what a speech therapist was when the start of classes rolled around that fall of 1983. With all the confidence of a blissfully ignorant 18-year-old I strolled into my first “speech therapy class,” Speech Science I, and was struck dumb by what I saw…every seat was occupied by a girl. Yes…I had won…I had correctly chosen a career (or at least the test had).

Fortunately, during that first semester of college I also came to learn what a speech therapist was and, in the process, realized that this was the truly profession for me. The rest, as they say, is history. I’ve spent the past 20+ years in a career I find endlessly interesting doing a job that I more often than not don’t regard as work.

Now here’s the kicker to this whole story… Remember that aptitude test that set me down the road to becoming a speech-language pathologist? I looked back on it several years later, after I’d earned my graduate degree. Much to my chagrin I found that I’d read it WRONG…I had looked at the “female side” of the test instead of the side that provided the “male interpretation” of results. Though the world missed getting another mason, I like to think it got a fairly decent speech-language pathologist in return.

Kenneth Staub, M.S., CCC-SLP, is an Assistant Professor, Communication Sciences & Disorders at Clarion University of Pennsylvania. He will be a regular contributor to ASHAsphere and welcomes questions or suggestions for posts.

Multilingual Typicality vs. Speech-language Disorder

table with coffee mugs and maps


Photo by minka6

Any assessment involves a comparison. For assessment purposes, we use comparison always one way. We compare X to Y, never Y to X, because we have satisfied ourselves of two conditions: first, that Y is a reliable benchmark, which specifies a particular norm of behaviour, including linguistic behaviour; and second, that the behaviour of X can be fairly assessed through the use of that benchmark.

Reliable benchmarks are norm-referenced and standardised for particular populations. Since different populations use different languages and different varieties of the same language, we seek to provide ourselves with developmental and/or clinical assessment instruments which are normed accordingly. We know that it would be as unfair to test, say, users of Korean with instruments normed for Portuguese as to test users of Canadian French with instruments normed for Belgian French. Although we still lack normed instruments for most languages and language varieties, limitations imposed by assessment in these less than ideal conditions are well understood. In monolingual settings, with monolingual clients, clinical practices take them into account.

Concerning multilingual clients, however, the situation is quite distinct. In what follows, I take the words multilingual and multilingualism to refer to users/uses of more than one language, that is, to include bilingual(ism), trilingual(ism), and so on.

One first observation is that multilinguals stand for a disproportionate number of referrals to both special education and speech-language therapy, compared to monolinguals. We may start by asking ourselves why multilinguals are consistently compared to monolinguals, but not the other way around. The reason is that monolingualism has been assumed as a norm of linguistic usage, which has besides become synonymous with cognitive, social and linguistic health. The reason for this, in turn, is that the first researchers who addressed multilingualism were monolingual, or subscribed to monolingual approaches to language, or both. The tradition of thought that they initiated almost one century ago lingers on, and shapes the many misconceptions surrounding multilingualism. A few examples follow, showing how these misconceptions are interrelated and entail one another:

  • “Multilinguals are special.” In monolingual countries and settings, multilingualism is viewed as the special case of language uses. Clients who are multilingual are labelled as such, whereas clients who are monolingual are not labelled as monolinguals. Given that multilinguals outnumber monolinguals worldwide, it cannot be the case that the majority of the world’s population is “special”. The century-old tradition that takes multilingualism as special started by also taking it as the correlate, and sometimes even the cause, of diverse cognitive, social and linguistic shortcomings. The current emerging trend, that lauds multilingualism as unquestionably positive, simply perpetuates the (mis)perception that multilinguals are “special”.
  • “Multilingualism means equivalent proficiency in all languages.” This assumption is better described by a term that I coined, multi-monolingualism, to label the underlying belief that a multilingual equals several monolinguals. This is not what multilingualism is. If multilinguals could (or should) use all their languages in exactly the same way, they would not need several languages: one all-purpose language would be enough. “One all-purpose language” defines a monolingual, not a multilingual. Multilinguals use their languages in different ways, with different people, in different situations, for different purposes. This is why their languages develop differently and cannot therefore be made equivalent.
  • “Ability in one language reflects language ability.” Clinical findings about one of the languages of a multilingual client are often taken as a reliable reflection of the client’s overall language ability. “Language ability” concerns the whole of an individual’s linguistic repertoire, not ability in a particular language. Taking the one for the other means taking a multilingual for a monolingual. The full linguistic repertoire of a monolingual does consist of a single language, but the full linguistic repertoire of a multilingual does not.
  • “Multilinguals can be fairly assessed through monolingual instruments .” The assessment instruments that are  available to us so far are monolingual, and naturally reflect monolingual norms. In addition, multilinguals tend to be assessed either in mainstream languages, or in languages for which assessment instruments have been standardised, neither of which may accurately portray the clients’ linguistic ability. In the absence of normative guidance about multilingualism, skewed findings about multilingual behaviour are to be expected. False positives, where typical multilingual behaviour is mistaken for disorder, account for the disproportion of referrals mentioned above. But, equally seriously, false negatives mistake disorder for typical multilingual behaviour, and so fail to identify disordered multilingualism.

Ideally, then, we should provide ourselves with standardised instruments devised for multilingual uses of language, based on multilingual norms of usage. These norms are not, as I hope to have made clear above, “multi-monolingual”: there are typical behaviours among multilinguals, just like there are typical behaviours among monolinguals. The difference is that we have failed to pay attention to the former, because we have taken the latter as the benchmark of linguistic behaviour across the board. The issue here, as always, is that without knowing what is typical, we cannot tell what is deviant.

Current developments, which take a fresh look at multilingualism, from a multilingual perspective, already show promising results. One example concerns mixes, the use of features of several languages in the same utterance or exchange. Mixes have been stigmatised as instances of “semilingualism”, whereas they are a multilingual norm of usage. The regularity of mixed patterns in typical multilingual speech has been found to aid in the diagnosis of SLI (specific language impairment), in multilingual children whose mixing patterns deviate from the norm. Another development concerns the use of what is known as dynamic assessment, in clinic. Dynamic assessment methods involve teaching and testing linguistic items and structures that are independent of particular languages, and that therefore probe for language ability, not ability in particular languages.

Growing awareness about the lack of multilingual norms also impacts the clinicians themselves. To the best of my knowledge, professional training of SLPs does not include information about languages other than the language of intervention, or about multilingualism itself. This is so even for multilingual SLPs, or for those who plan to practise in multilingual settings. Many SLPs thus encounter multilingualism for the first time in clinic, where the “special” status accorded to multilinguals may well shape expectations about multilingual clients. There is of course no requirement that SLPs become multilingual. Being multilingual does not mean understanding what multilingualism is: misconceptions about multilingualism are shared by monolinguals and multilinguals alike. The requirement is that SLPs, and the rest of us, become familiar with what multilingualism is, so we satisfy ourselves that, while we wait for the standardisation of multilingual norms, we are giving multilinguals a fair assessment chance.

Multilingualism is not about what several languages can do to people, it is about what people can do with several languages. The same can be said about monolingualism and a single language: the number of languages that people happen to need to use in order to function appropriately in their everyday environments has little to do with their language ability, just like the number of musical instruments that one plays has little to do with one’s musical ability.

One final note: I have discussed multilingual assessment in my blog, which is geared to a general audience, in a post titled The fight for a fair deal. For more specialised research and findings on multilingual typicality, my book Multilingual Norms may be of relevance.

Madalena Cruz-Ferreira, PhD in Linguistics and Phonetics (University of Manchester, UK), researches multilingualism and child language. One section of her book Multilingual Norms addresses multilingual clinical assessment. Her blog Being Multilingual deals with the use of several languages at home, in school and in clinic.

Spasmodic Dysphonia or “Stuttering of the Vocal Cords”

What is Spasmodic Dysphonia?

Laryngeal Dystonia–also called Spasmodic Dysphonia– is an organic voice disorder caused by dysfunction of center neurological integration that produces spasm of the vocal cords. Spasmodic dysphonia causes the voice to break or to have a tight, strained or strangled quality. There are three different types of spasmodic dysphonia: adductor spasmodic dysphonia (closed glottis), abductor spasmodic dysphonia (open glottis) and mixed spasmodic dysphonia.

In adductor spasmodic dysphonia, sudden involuntary muscle movements or spasms cause the vocal cords to slam together and stiffen, which makes it difficult for the them to vibrate and produce voice. Words are often cut off or difficult to start and speech may be choppy and sound similar to stuttering. The voice is commonly described as strained or strangled and full of effort.

In abductor spasmodic dysphonia, the sudden involuntary muscle movements or spasms cause the vocal folds to open and stay opened. Thus, vocal cords can not be closed for phonation (to produce the speech sounds). As a result, the voice of these individuals often sounds weak, quiet and breathy or whispery.

Mixed spasmodic dysphonia involves muscles that open the vocal folds as well as muscles that close the vocal folds and therefore has mixed features of both above–mentioned syndromes.

Surprisingly, all three conditions are usually absent while doing vegetative phonation, whispering, crying, laughing, singing, speaking at a high pitch, speaking when just woken up from a sound sleep or after drinking alcoholic beverages ( spasmodic dysphonia is the only voice disorder for which I am allowing my patients to drink some alcohol!) As in many other voice disorders, stress and nervousness will make the muscle spasms even more severe.

Spasmodic dysphonia is a mysterious voice disorder; the cause is yet unknown. Because the voice can sound normal at times, spasmodic dysphonia was once thought to be psychogenic, but as reported by the National Institute of Deafness and other Communication Disorders (NIDCD), research has revealed increasing evidence that most cases of spasmodic dysphonia are in fact neurogenic and may co-occur with other movement disorders such as blepharospasm (excessive eye blinking and involuntary forced eye closure), tardive dyskinesia (involuntary and repetitious movement of muscles of the face, body, arms and legs), oromandibular dystonia (involuntary movements of the jaw muscles, lips and tongue), torticollis (involuntary movements of the neck muscles), or tremor (rhythmic, quivering muscle movements).

NIDCD also reports that spasmodic dysphonia may run in families and is thought to be inherited. Research has identified a possible gene on chromosome 9 that may contribute to the spasmodic dysphonia that is common to certain families. Spasmodic dysphonia can affect anyone between 30 and 50 years of age. More women appear to be affected by spasmodic dysphonia than are men.

Treatment for spasmodic dysphonia?

The “triangle” ENT–Neurologist–SLP is usually on the front line in diagnosing and treating the symptoms of spasmodic dysphonia. There is presently no known cure for spasmodic dysphonia. Current treatments only help reduce the symptoms.

SLP- Voice therapy may reduce some symptoms, especially in mild cases. Voice therapy and vocal cords special physiotherapy may also support a better voice while undergoing the post effects of treatment of choice – see below.

ENT- has two common options:

  1. an operation that cuts one of the nerves of the vocal folds (the recurrent laryngeal nerve) thus improving the voice for several months to several years.
  2. injections of very small amounts of botulinum toxin (botox) directly into the affected muscles of the larynx. Botulinum toxin is produced by the Clostridium botulinum bacteria. The toxin weakens muscles by blocking the nerve impulse to the muscle. Botox injections generally improve the voice for a period of three to four months after which the voice symptoms gradually return. Reinjections are necessary to maintain a good speaking voice. Initial side effects that usually subside after a few days to a few weeks may include a temporary weak, breathy voice or occasional swallowing difficulties – this will be the best time to refer the patient to speech therapy , as was mentioned above. Botox may relieve the symptoms of both adductor and abductor spasmodic dysphonia, and is considered to be the main line of defense against spasmodic dysphonia.

Gal Levy M.Sc. CCC-SLP, has more than 21 years of experience in clinical treatments of Voice, Fluency, Articulation and Language. Gal is working as a school based SLP, Home health SLP and in his private practice at Frisco, TX. He also writes professional articles on various speech disorders and state of the art treatments on Google’s new Encyclopedia, Helium and AC writers websites. Gal participated on Community Focus radio monthly shows with Dr. Griffin advising KEOM 88.5 FM listeners on voice, fluency and tongue thrust clinical issues.

SLPs Make A Great Showing for 2010 Edublog Awards

2010 Edublogs Logo

Thanks to Sean Sweeney for tipping me off to the fact that quite a few SLPs have been nominated for the 2010 Edublog Awards. According to The Edublog Awards website, the awards are “a community based incentive started in 2005 in response to community concerns relating to how schools, districts and educational institutions were blocking access of learner and teacher blog sites for educational purposes. The purpose of the Edublog awards is promote and demonstrate the educational values of these social media.”

This year’s nominations include SLPs in several categories:

You can click through these links (the category links take you to the voting pages for those categories) and cast your votes through 12 pm Eastern Standard Time on Tuesday, December 14th. ASHAsphere will report on the winners once they’re announced.

* Clarification: these two nominees are actually not SLPs but still provide good resources for SLPs