Neurofibromatosis 1 (NF1) is a neurocutaneous-skeletal disorder often accompanied with varying degrees of cognitive and motor problems that potentially affect speech and language. While previous studies have shown that NF1 may be associated with a variety of deviations in the patients' speech, they have not investigated the characteristics in phonetic detail. Our clinical observation that many patients share a distinct voice and manner of speaking led to the primary aim of this study, which was to present a comprehensive description of speech in NF1. A total of 62 patients with NF1 (age range 7-66 years), and a control group of 24 speakers (age range 7-62 years) were evaluated for their speech. The test sessions were recorded and the data were analyzed both by ear and by acoustic measurements. The data were analyzed separately by two trained phoneticians, and a summary was produced after comparing the two independent analyses. Various speech problems were observed among patients with NF1. Individual variation was remarkable, but the deviations were more common and severe in children than in adult patients. In addition, men with NF1 had more speech deviations than women with NF1. Findings include deviations in voice quality, problems in regulating pitch, deviant nasality, misarticulation, and disfluency. We suggest that difficulties in speech, particularly in regulating pitch, may have negative social implications. Our results highlight which components of speech require particular attention in speech therapy for patients with NF1.

Background: According to the philosophy of the social model of disability, clients are the best estimators of their own life situation. Eliciting the experiences of people with severe aphasia is demanding because of their language and possible other cognitive problems. They are therefore usually excluded from the studies. However, there is evidence that modified assessment tools are accessible for them and help them to give self-reports. Aims: The aim of the present study was to ascertain how people with aphasia evaluate their own communicative skills during rehabilitation by means of modified assessment tools. In addition, their answers were compared with the estimations of their significant others or other partners. Methods & Procedures:The data were collected during regular rehabilitation courses, which were carried out in two parts (8 + 4 days) with 3 months in between. Participants were 35 respondents with aphasia, aged 26 to 65 years, and 35 of their significant others or other partners, aged 29 to 71 years. The study was completed according to an initial, interim, and delayed post-test questionnaire design. Two measures were used: the Finnish version of the Communicative Effectiveness Index (CETI) and an investigator-constructed questionnaire, the Use of Different Communication Methods (UDCM). The questionnaires for the people with aphasia were made more accessible by pictures. Outcomes & Results: The self-assessments of the participants with aphasia indicated that their functional communication skills did not change, but that the use of different communication methods improved slightly during the intervention. The significant others' and other partners' estimations showed that their communication skills improved significantly. Ratings of the two groups in functional communication skills differed significantly from each other before the intervention but thereafter the estimates correlated. There were no significant differences in the ratings of the use of different communication methods at any phase of the follow-up study. However, the ratings correlated significantly only at the last assessment.

The necessity of bronchoscopies, postinjury lower cervical spine anterior surgery, coughing, throat clearing, choking, and changes in voice quality related to swallowing was a markedrisk factor for aspiration and penetration following a cervical SCI. These factors and signs should be used to suspect injury-related pharyngeal dysfunction and to initiate preventive measures to avoid complications. The clinical swallowing evaluation is a relevant adjunct in the management of these patients and can improve the detection of penetration and aspiration.

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Objective: This prospective follow-up study aimed to identify sociodemographic and clinical factors that may affect the quality of life (QoL) of patients with acute ischemic stroke during a 6-month follow-up. Patients and Methods: In the acute phase, sociodemographic and clinical data were collected using the National Institute of Health Stroke Scale, Barthel Index, and modified Rankin Scale. QoL was assessed with the Stroke and Aphasia Quality of Life Scale-39 6 months after stroke. Results: QoL was evaluated in 64 patients (aged 45-81 years) with a first-ever ischemic stroke. Thrombolytic therapy was given to 80% of the patients. Stroke severity, dependence in activities of daily living, degree of handicap, and length of hospitalization were associated with QoL. QoL was not associated with age, gender, marital status, or years of education. Conclusion: In this study, most patients were treated with thrombolysis, and QoL results resembled those of earlier studies on patients without thrombolysis. Despite good physical recovery, the patients reported impairments in QoL. QoL assessments can give clinicians a more holistic picture of stroke recovery from the patient's perspective.