title: Does cognitive function influence alaryngeal speech rehabilitation?
abstract: BACKGROUND
  We sought to define the cognitive domains that influence valved speech rehabilitation.
  
  
  METHODS
  Sixteen laryngectomees with primary tracheoesophageal punctures were randomly recruited from one head and neck unit. They were assessed by a consultant neuropsychologist and a speech therapist. Speech therapy time was determined from speech therapy notes.
  
  
  RESULTS
  The Digit Symbol Substitution Test, assessing learning speed and processing speed, correlated significantly with speech therapy time in the first (p = .002) and third (p = .014) postoperative years, respectively. Categorical fluency assessment correlated positively with speech therapy time in the first year (p = .009). Learning speed (p = .007) and categorical fluency (p = .041) correlated positively with the fall in speech therapy input between the first and third year after laryngectomy.
  
  
  CONCLUSIONS
  Learning speed, processing speed, and categorical fluency strongly influence alaryngeal speech rehabilitation. This study highlights the potential for pre-laryngectomy cognitive assessment to help plan alaryngeal speech rehabilitation. This has significant resource implications.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, James Cook University Hospital, Middlesbrough, United Kingdom. allanhoentsurgeon@blueyonder.co.uk
authors.forename: T P
authors.initials: TP
authors.lastname: Ho
authors.forename: J
authors.initials: J
authors.lastname: Gray
authors.forename: A A
authors.initials: AA
authors.lastname: Ratcliffe
authors.forename: S
authors.initials: S
authors.lastname: Rees
authors.forename: J
authors.initials: J
authors.lastname: Rockey
authors.forename: R G
authors.initials: RG
authors.lastname: Wight
mesh_terms: D000368:Aged; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011581:Psychological Tests; D013068:Speech Production Measurement; D013070:Speech Therapy; D013071:Speech, Alaryngeal; D016896:Treatment Outcome