The medical literature has emphasized that aspiration of gastric contents or oral bacteria is a common cause of aspiration pneumonia. Swallowing disorders have been implicated in this disease but not studied at the time that aspiration pneumonia was diagnosed. A significant difference was found in the incidence of videofluoroscopically confirmed oropharyngeal swallowing problems in a group of patients diagnosed with aspiration pneumonia (AP) when compared with patients with nonaspiration pneumonia (NAP). Six of the 9 patients in the AP group aspirated during the videofluoroscopic evaluation and 2 others were considered to be at risk for aspiration. None of the 7 NAP patients demonstrated swallowing problems or aspiration. A significant difference in oral transit time also occurred between the two groups. Liquid was found to have a significantly faster oral transit time than paste or a cookie. Pharyngeal transit times were not found to be significantly different. Although there were only a small number of patients who met the criteria for this pilot study, a strong association was found between swallowing dysfunction and aspiration pneumonia.
A retrospective study investigated the incidence and types of communication problems in 115 patients referred for swallowing difficulties. Each patient had a bedside swallowing evaluation completed as well as a screening of communication abilities. A formal speech-language evaluation was done when warranted and possible. Of the 115 patients, 93 had suspected swallowing problems based on the bedside evaluation done by the speech-language pathologist. Videofluoroscopy was performed on 85 of these patients. A significant positive correlation was found between communication impairments and both suspected and videofluoroscopically confirmed dysphagia. Cognitive problems were the most frequent communication impairment with dysarthria being second. Neurological diseases were the most common medical diagnoses in patients with swallowing difficulties. The case is presented for the speech-language pathologist to be the primary diagnostician and manager of both communication and oral-pharyngeal swallowing disorders whether they co-occur or not.
A confrontation naming task utilizing objects and pictures from the Porch Index of Communicative Ability was presented to 14 aphasic patients. Both initially correct and self-corrected naming responses were compared for the two sets of visual stimuli. In contrast to some studies that have also varied the physical characteristics of size, color and dimensionality, the present study (as well as two other studies) found no significant differences in naming performance for aphasic patients. This evidence would suggest that a choice between pictures and objects will seldom be crucial to diagnosis or therapy with aphasic naming problems.
Two experiments investigated the information conveyed by intonation from speaker to listener. A multiple-choice test was devised to test the ability of 48 adults to recognize and label intonation when it was separated from all other meaning. Nine intonation contours whose labels were most agreed upon by adults were each matched with two English sentences (one with appropriate and one with inappropriate intonation and semantic content) to make a matching-test for children. The matching-test was tape-recorded and given to children in the first, third, and fifth grades (32 subjects in each grade). The first-grade children matched the intonations with significantly greater agreement than chance; but they agreed upon significantly fewer sentences than either the third or fifth graders. Some intonation contours were matched with significantly greater frequency than others. The performance of the girls was better than that of the boys on an impatient question and a simple command which indicates that there was a significant interaction between sex and intonation.
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