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Background: Several conditions and diseases can result in speech problems that can have a negative impact on everyday functioning, referred to as communicative participation. Subjective problems with acquired speech problems are often assessed with the speech handicap index (SHI). To assess generic participation problems, the Utrecht Scale for Evaluation of Rehabilitation--Participation (USER-P) questionnaire is frequently used. The English questionnaire Communicative Participation Item Bank--short form (CPIB short form) is a 10-item valid, reliable instrument that assesses communicative participation. In the absence of a Dutch equivalent, translation and validation of the CPIB short form was required. Aims: To translate the CPIB short form into Dutch, and to determine its psychometric properties for the group of adults with speech problems resulting from a neurological aetiology or head and neck cancer. Methods & Procedures: Translation of the CPIB short form was performed following the instructions of the European Organisation for Research and Treatment for Cancer (EORTC). In a cross-sectional multi-centre study, participants completed the Dutch CPIB short form together with the SHI and USER-P, and the CPIB a second time after 2 weeks. We assessed internal consistency and test--retest reliability of the CPIB. Construct validity was assessed based on correlations with SHI, USER-P and speech assessments. Outcomes & Results: In the validation study, 122 participants were included: 51 with dysarthria due to different neurological disorders, 48 with speech problems due to head and neck cancer treatment and 23 healthy controls. Internal consistency of the items was high (Cronbach's alpha = 0.962), the intraclass correlation coefficient (ICC) for test-retest reliability was high 0.908 (95% CI = 0.870-0.935). Construct validity was supported by a strong correlation between the Dutch CPIB short form and the SHI total score (SHI total r[subscript s] = 0.887) and a moderate correlation between the Dutch CPIB-10 and the USER-P subscales (USER-P Frequency r[subscript s] = 0.365; USER-P restrictions and USER-P satisfaction r[subscript s] = 0.546). A moderate correlation was found between the Dutch CPIB-10 and the speech performance assessments (degree of distortedness r = -0.0557; p [less than or equal to] 0.001; degree of intelligibility r = 0.0562). Conclusions & Implications: The Dutch CPIB short form provides a valid and reliable tool for clinical practice and research purposes. It allows clinicians to start using this PROM in clinical and research practice to systematically investigate the impact of the speech problems on communicative participation in a Dutch-speaking population.

Purpose: The purpose of this study was to quantify sentence-level articulatory kinematics in individuals treated for oral squamous cell carcinoma (ITOC) compared to control speakers while also assessing the effect of treatment site (jaw vs. tongue). Furthermore, this study aimed to assess the relation between articulatory-kinematic measures and self-reported speech problems. Method: Articulatory-kinematic data from the tongue tip, tongue back, and jaw were collected using electromagnetic articulography in nine Dutch ITOC and eight control speakers. To quantify articulatory kinematics, the two-dimensional articulatory working space (AWS; in mm² ), one-dimensional anteroposterior range of motion (AP-ROM; in mm), and superior-inferior range of motion (SIROM in mm) were calculated and examined. Self-reported speech problems were assessed with the Speech Handicap Index (SHI). Results: Compared to a sex-matched control group, ITOC showed significantly smaller AWS, AP-ROM, and SI-ROM for both the tongue tip and tongue back sensor, but no significant differences were observed for the jaw sensor. This pattern was found for both individuals treated for tongue and jaw tumors. Moderate nonsignificant correlations were found between the SHI and the AWS of the tongue back and jaw sensors. Conclusions: Despite large individual variation, ITOC showed reduced one- and two-dimensional tongue, but not jaw, movements compared to control speakers and treatment for tongue and jaw tumors resulted in smaller tongue movements. A larger sample size is needed to establish a more generalizable connection between the AWS and the SHI. Further research should explore how these kinematic changes in ITOC are related to acoustic and perceptual measures of speech. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: This study investigated long-term outcomes of dysphagia rehabilitation with an adjustable resistance training device (Swallowing Exercise Aid, SEA2.0) in laryngectomized individuals., Methods: Seventeen laryngectomized participants who participated in a Clinical Phase II Trial were reevaluated at T3 (approximately 6 months after T2), including an interview, PROMS, oral intake, and swallowing capacity. Results of T3 were compared with the earlier time points T0 (baseline), T1 (after 6 weeks of training), and T2 (after 8 weeks of rest)., Results: All outcomes at T3 remained improved compared to T0. Compared to findings at T2, participants reported some deterioration in swallowing at T3. Swallowing capacity and oral intake slightly decreased. Swallowing-related quality of life slightly improved., Conclusions: Benefits of swallowing rehabilitation with the SEA2.0 in laryngectomized individuals are still noticeable long term. The need for continued exercising to fully maintain improved function is likely, but the required intensity and extent should be determined in further research., (© 2024 The Author(s). Head & Neck published by Wiley Periodicals LLC.)

Objective: To assess the effectiveness of audiovisuals in providing pre-treatment information to patients with cancer. Following the Six Function Model of Medical Communication, we distinguish between immediate, intermediate, and long-term outcomes., Methods: A systematic search was performed in five electronic databases for quantitative studies comparing the addition of audiovisuals with standard care or alternative interventions. Quality was assessed using Cochrane's Risk of Bias 2., Results: After abstract (n = 10,179) and full-text (n = 85) screening, 37 articles were included. Audiovisuals positively impacted patients' anxiety, knowledge, understanding, and physiological responses shortly after the consultation, particularly when video was compared with standard verbal care without audiovisual. Only five studies measured long-term outcomes, leaving the long-term effectiveness of audiovisuals unexplored. Majority of studies showed 'high risk of bias' (n = 34)., Conclusion: Although caution is warranted because of the variability in study design and quality, the results suggest potential benefits of using audiovisuals alongside interpersonal communication., Practical Implications: More high-quality and longitudinal research is needed with emphasis on comparing counseling with and without usage of audiovisual tools. Healthcare providers can improve the short-term impact of information provision by using audiovisuals alongside standard care, but should carefully consider content, for whom, how, and timing., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Surgical treatment for oral cancer leads to lasting changes of the vocal tract and individuals treated for oral cancer (ITOC) often experience speech problems. The purpose of this study was to analyse the acoustic properties of the spontaneous speech of individuals who were surgically treated for oral cancer. It was investigated (1) how key spectral measures of articulation change post-treatment; (2) whether changes are more related to target manner or place of articulation; and (3) how spectral measures develop at various time points following treatment., Method: A corpus consisting of 32.850 tokens was constructed by manually segmenting the speech of five (four female - one male) American English speaking ITOC. General acoustic characteristics (duration and spectral tilt), plosives (burst frequency), fricatives (centre of gravity and spectral skewness), and vowels (F1 and F2) were analysed using linear mixed effects regression and compared to control speech. Moreover, a within speaker analysis was performed for speakers with multiple recordings., Results: Manner of articulation is more predictive of post-treatment changes than place of articulation. Compared to controls, ITOC produced the fricatives /f, v, θ, ð, s, z, ʃ, ʒ/ with a lower centre of gravity while no differences were found for plosives and vowels. Longitudinal analyses show high within-speaker variation, but general improvements one-year post-treatment., Conclusions: Surgical oral cancer treatment changes the spectral properties of speech. Fricatives with varying manner of articulations were distorted, suggesting that manner of articulation is more predictive than place of articulation in identifying general problem areas for ITOC., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest, (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: The objective of this study was to explore the 10-year plus outcomes of Intensity Modulated Radiotherapy with concomitant chemotherapy (CRT) combined with preventive swallowing rehabilitation (CRT+) for head and neck cancer (HNC)., Methods: Subjective and objective swallowing, trismus, and speech related outcomes were assessed at 10-year plus after CRT+. Outcomes were compared to previously published 6-year results of the same cohort., Results: Fourteen of the 22 patients at 6-year follow-up were evaluable. Although objective swallowing-related outcomes showed no deterioration (eg, no feeding tube dependency and no pneumonia), swallowing-related quality of life slightly deteriorated over time. No patients had or perceived trismus. Voice and speech questionnaires showed little problems in daily life. Overall quality of life (QOL) was good., Conclusions: After CRT with preventive rehabilitation exercises for advanced HNC, swallowing, trismus, and speech related outcomes moderately deteriorated from 6 to 10 years, with an on average good overall QOL after., (© 2020 Wiley Periodicals, Inc.)

Objective: Total laryngectomy (TL) leads to lifelong physical changes which can lead to functional and participation issues. To assess the relationship between self-reported quality of life and functional and participation issues, a large international online questionnaire was used., Method: A questionnaire was sent out to 8119 recipients of whom 1705 (21%) responded. The questionnaire consisted of 26 questions regarding demographic information, product use of the respondents, experienced overall health and independence, and functional and participation issues. Respondents were grouped based on sex, age, time since TL, educational level, and country of residence. Questions were grouped in one measure of reported quality of life (r-QoL) and seven issue themes ("esthetic issues," "experienced limitations in daily activities," "avoiding social activities," "communication issues," "experienced vulnerability due to environmental factors," "pulmonary issues," and "sleep issues") to assess the underlying relations., Results: This study showed that more functional and participation issues and a lower r-QoL are reported in the group of younger respondents (<60 years), women, and respondents who have had the TL procedure less than 2 years ago. The issue themes "experienced limitations in daily activities" and "avoiding social activities" are related to r-QoL. Most participants report "pulmonary issues," and these issues have a strong correlation with most other themes., Conclusion: The ability to participate in meaningful and social activities is a major factor in r-QoL. Due to the frequency and strong correlations of pulmonary issues with other issue themes, pulmonary issues might be an underlying cause of many other issues., Level of Evidence: 3b., Competing Interests: The authors declare no conflicts of interest., (© 2020 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society.)

Objectives: To investigate the relationship between acoustic signal typing and perceptual evaluation of sustained vowels produced by tracheoesophageal (TE) speakers and the use of signal typing in the clinical setting., Methods: Two evaluators independently categorized 1.75-second segments of narrow-band spectrograms according to acoustic signal typing and independently evaluated the recording of the same segments on a visual analog scale according to overall perceptual acoustic voice quality. The relationship between acoustic signal typing and overall voice quality (as a continuous scale and as a four-point ordinal scale) was investigated and the proportion of inter-rater agreement as well as the reliability between the two measures is reported., Results: The agreement between signal type (I-IV) and ordinal voice quality (four-point scale) was low but significant, and there was a significant linear relationship between the variables. Signal type correctly predicted less than half of the voice quality data. There was a significant main effect of signal type on continuous voice quality scores with significant differences in median quality scores between signal types I-IV, I-III, and I-II., Conclusions: Signal typing can be used as an adjunct to perceptual and acoustic evaluation of the same stimuli for TE speech as part of a multidimensional evaluation protocol. Signal typing in its current form provides limited predictive information on voice quality, and there is significant overlap between signal types II and III and perceptual categories. Future work should consider whether the current four signal types could be refined., (Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objectives: Perceptual judgments and patients' perception of voice and speech after concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer., Study Design: Prospective clinical trial., Methods: A standard Dutch text and a diadochokinetic task were recorded. Expert listeners rated voice and speech quality (based on Grade, Roughness, Breathiness, Asthenia, and Strain), articulation (overall, [p], [t], [k]), and comparative mean opinion scores of voice and speech at three assessment points calculated. A structured study-specific questionnaire evaluated patients' perception pretreatment (N=55), at 10-week (N=49) and 1-year posttreatment (N=37)., Results: At 10 weeks, perceptual voice quality is significantly affected. The parameters overall voice quality (mean, -0.24; P=0.008), strain (mean, -0.12; P=0.012), nasality (mean, -0.08; P=0.009), roughness (mean, -0.22; P=0.001), and pitch (mean, -0.03; P=0.041) improved over time but not beyond baseline levels, except for asthenia at 1-year posttreatment (voice is less asthenic than at baseline; mean, +0.20; P=0.03). Perceptual analyses of articulation showed no significant differences. Patients judge their voice quality as good (score, 18/20) at all assessment points, but at 1-year posttreatment, most of them (70%) judge their "voice not as it used to be." In the 1-year versus 10-week posttreatment comparison, the larynx-hypopharynx tumor group was more strained, whereas nonlarynx tumor voices were judged less strained (mean, -0.33 and +0.07, respectively; P=0.031). Patients' perceived changes in voice and speech quality at 10-week post- versus pretreatment correlate weakly with expert judgments., Conclusion: Overall, perceptual CCRT effects on voice and speech seem to peak at 10-week posttreatment but level off at 1-year posttreatment. However, at that assessment point, most patients still perceive their voice as different from baseline., (Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)