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The purpose of this study was to examine how inverting the face upside down impacts the perception of audiovisual speech and especially the integration of sensory information during such speech perception. It is well known that face perception involves specialized mechanisms, and it has been suggested that inverting the face would impair the use of to these mechanisms. On the other hand, speech perception is also known to be a specialized process, categorized by a strong audiovisual summation. The aim of this study was to find out whether the strong integration of sensory information in the perception of audiovisual speech is one such specialized mechanism that impairs when the face is inverted. The potential difference in audiovisual summation between upright and inverted faces was investigated using subthreshold summation paradigm. In this paradigm, single and multisensory discrimination thresholds were measured by presenting subjects video clips of spoken syllables [pa] and [ka] masked with audiovisual noise. The task was to identify which of the syllables were presented. Then, by fitting the Minkowski metric to the separation thresholds it is possible to derive different summation models that describe the strength of summation. The study’s results suggest that visual speech perception was poorer when the faces were perceived upside down. However, the audiovisual summation was equally strong for both upright and inverted faces. These results align with the previous knowledge that visual speech perception is considerably impaired when the face is inverted. While there is limited previous research on the effect of inversion on audiovisual summation using a similar setup, this study indicates that auditory and visual speech are combined in the same manner for both upright and inverted faces. Therefore, it seems, that the mechanisms responsible for the strong summation taken place in audiovisual speech perception appear to be distinct from those processes that are impaired in face inversion.

Objectives. Semantic verbal fluency task is a naming task in which a participant produces words from a certain semantic category during limited time frame. Currently there is only a little research where the verbal fluency performance of young children, especially with hearing impairment has been studied, and findings have not been consistent. The question whether singing is associated with verbal fluency performance has not been studied much. The aim of this thesis was to compare verbal fluency performance of children with hearing impairment and normal hearing children. In addition, the aim was to investigate the association of singing with the semantic verbal fluency performance. Methods. This study sample contained 14 children with hearing impairment and 12 children with normal hearing. Participants performed two semantic verbal fluency tasks where they produced words from categories of animals and clothes for 60 seconds. The number of produced words and accepted words and semantic strategies (number of clusters, switches, semantic subcategories, the use of semantic strategy and the number of words in clusters) were examined. Amount of singing was investigated by means of questionnaire. Statistical methods were used to investigate differences between study groups and to investigate connection of singing and verbal fluency performance. Results and conclusions. The differences between the groups of children with hearing impairment and normal hearing children were not significant. Singing was associated with verbal fluency performance only in the group of children with hearing impairment and only in the animal task. Hearing impaired children who sang daily produced more words and used more word finding strategies than hearing impaired children who sang more seldom. The findings of previous studies are partly parallel to the findings of this thesis. However more research is needed for getting more consistent findings and more comprehensive research literature of the subject.

Aims. In previous studies a link between nonword repetition skills and children’s language skills such as phonological knowledge and reading skills. Musical activity has been found to improve children’s cognitive development and language skills. Nonword repetition and nonword span have been widely used as a measure of phonological skills and working memory. The aim of the study was to find out whether there is a connection between singing at home and phonological skills or working memory in children with hearing impairment. The second aim of the study was to find out whether there is a correlation of performance in these two tasks and is there a decrease in parental singing as the child grows older. Methods. The study was conducted as a multiple case study. The participants were recruited from CIsumusa, a speech-music playschool for hearing-impaired children. The participants were nine Finnish-speaking hearing-impaired children aged 1–6 years who used either cochlear implants or hearing aids or both. The data was comprised of nonword repetition and nonword span tasks completed by the children. The parents of the participants filled some questionnaires about musical activity of the family which were also analyzed in the study. The children were divided into four groups for further paired analysis: 1) the children whose parents sing to them daily, 2) those whose parents sing to them less frequently than daily, 3) the children who sing daily, 4) the children who sing less frequently than daily. Nonparametric methods (such as Mann Whitney U-test) were used for statistical analysis. Results and Conclusions. No statistically significant differences were found between singing groups. A statistically significant correlation was found between performances in nonword repetition and nonword span tasks. It was found that the children over 4 years and 3 months old repeated the nonwords significantly more correctly by the number of syllables than the younger participants. It was also found that the children whose parents sing to them daily were on average 13,45 months younger than the children whose parents sing to them less frequently, even though the age difference was not statistically significant. Due to small number of subjects the results may be considered indicative, but based on them and previous research, singing should be used in speech therapy rehabilitation and home training.

Objectives. Hearing impairments (HIs) can cause delays in language skills. HIs can for example affect naming skills or the ability to perceive and produce word stress. Musical activity and singing have been shown beneficial to language skills of children with HIs. There is a lack of studies about connections between music and naming skills especially in children with HIs. The aim of this study was to examine how music intervention is linked to the production and perception of word stress in children with bilateral cochlear implants (CI) and/or hearing aids (HA). This study also examined is singing at home linked to better performance in rapid automatized naming test (RAN) or to the production and perception of word stress in nonword repetition task. This pilot study is a part of MULAPAPU research project which aims to study the effects of musical activity and singing to language skills in children with HI aged from 0 to 7 years. Methods. The participating children (n=19) with bilateral CIs and/or HAs were aged from 23 to 77 months. They were grouped based on answers given by their parents regarding the amount of singing at home (frequent singers and non-frequent singers). Production of word stress was assessed by using a non-word repetition-task invented in MULAPAPU research project and naming skills were evaluated by using the Rapid Automatized Naming -test (RAN). This study was a cross-over study in which group AB started with the intervention and group BA started with wash-up period. Both groups were tested three times. Group AB was tested before the intervention (T1), right after the intervention (T2) and after the wash-up period (T3). Group BA was tested before wash-up period (T1), right before intervention (T2) and right after the intervention (T3). Results and conclusions. Singing at home was linked to the time used and self-corrections in the RAN-test but there was no link between singing at home and the non-word repetition-task. AB groups word-stress production improved during the wash-up period. The effects of the music intervention might start to show with a delay. There were links between the children’s performances in the non-word repetition-task and RAN-test. This indicates that there might be a connection between word-stress production and naming. The results of this study are mainly in line with previous studies, and they support the evidence that music is a valuable asset in the rehabilitation of children with hearing impairment.

Tausta ja tavoitteet. Kuulovamma sekä kuulonapuvälineet saattavat vaikuttaa lapsen kykyyn havaita ja toistaa sanapainoja. Aikaisemmissa tutkimuksissa on havaittu musiikkiharrastuneisuuden ja kotona laulamisen mahdollisesti tukevan kuulovammaisten lasten sanapainojen havaitsemista ja toistoa, mikä saattaa puolestaan edesauttaa heidän kielellisten taitojen kehitystään. Aiemmin ei ole tiettävästi tutkittu molemminpuolisesti kuulovammaisten kahdella laitteella kuulevien alle kouluikäisten lasten musiikillisten taitojen yhteyksiä kotona laulamiseen eikä verrattu tätä normaalisti kuuleviin lapsiin. Tämän tutkimuksen tarkoituksena oli selvittää, toistavatko kuulovammaiset lapset normaalisti kuulevia lapsia paremmin sanapainoja ja eroavatko heidän musiikilliset taitonsa. Lisäksi selvitettiin kotona laulamisen yhteyksiä sanapainojen toistoon ja musiikillisiin taitoihin niin kuulovammaisten kuin normaalisti kuulevienkin lasten kohdalla. Tämä tutkimus on osa MULAPAPU-hanketta, jossa selvitetään musiikkitoiminnan ja laulamisen vaikutuksia 0–7-vuotiaiden lasten puheen havaitsemiseen ja tuottoon. Tutkimuksen vastuututkijana toimii Ritva Torppa. Menetelmät. Tutkittavat olivat 3–6-vuotiaita molemminpuolisesti kuulovammaisia lapsia (n=20) ja verrokkina toimivat samanikäiset normaalisti kuulevat lapset (n=21). Kuulovammaisista lapsista puolet käyttivät kahta sisäkorvaistutetta ja puolet joko kahta kuulokojetta tai yhtä sisäkorvaistutetta ja yhtä kuulokojetta. Mittausmenetelminä käytettiin MULAPAPU-hankkeessa kehitettyä epäsanatoistotehtävää sanapainojen toiston tutkimiseksi sekä musiikillisten taitojen kyselylomaketta musiikillisten taitojen tutkimiseksi. Kotona laulamisen määrää kartoitettiin taustatietokyselylomakkeen kotona laulamista koskevien kysymysten avulla. Tulokset ja pohdinta. Verrokkiryhmän lapset toistivat sanapainoja paremmin ja tarkemmin kuin kuulovammaiset lapset sekä sana- että tavutasolla tarkasteltuna. Verrokkiryhmän lapsilla oli myös paremmat musiikilliset taidot kuin kuulovammaisilla lapsilla. Erot olivat suurimmillaan melodiaa ja äänenvoimakkuuksien hallintaa kartoittavassa osiossa. Ainoa yhteys kotona laulamisen ja sanapainojen toiston tai musiikillisten taitojen välillä havaittiin kuulovammaisten lasten oman kotona laulamisen ja musiikillisten taitojen rytmiikkaa koskevan osion välillä. Tulokset kertovat paitsi alle kouluikäisten kuulovammaisten lasten haasteista havaita ja hallita melodioita ja äänenvoimakkuuksia myös lapsen oman kotona laulamisen tukevan rytmin havaitsemista ja tuottoa, mikä saattaa puolestaan auttaa sanapainojen toistossa ja kielenkehityksen tukemisessa.

Aims. Past research has shown that hearing impaired adolescents are at a higher risk of experiencing psychosocial difficulties than their hearing peers. The research into the factors related to the psychosocial well-being of hearing-impaired adolescents has not yet come to an unambiguous conclusion. There are indications that the wellbeing of hard-of-hearing youths would be related to their communicative abilities and the functioning of their hearing among other things. This study examines self-perceived psychosocial difficulties and strengths of adolescents with hearing impairment and factors associated with these difficulties and strengths. These results also are being compared to results of psychosocial well-being obtained from Finnish adolescents. Methods. 12 11-17-year-old youths with hearing impairment filled in the Finnish version of the Strengths and Difficulties Questionnaire (SDQ-Fin) and a background questionnaire. Adolescents with other sensory deficits or disabilities were excluded from this study. Statistical analysis was performed to search for associations between psychosocial well-being and its related factors. Results and conclusions. The participants experienced more psychosocial difficulties than their Finnish peers. Emotional symptoms and peer problems were emphasized in the reports of participants. They also experienced more strengths in psychosocial well-being compared to their peers. In this study girls experienced more difficulties than boys. Participants experienced fewer difficulties in psychosocial wellbeing when their communicative abilities were good. These results can be used to improve and develop rehabilitation of hearing-impaired children and youths.

Sylkirauhaskasvaimet muodostavat esiintyvyydeltään harvinaisen mutta histologiselta kuvaltaan monimuotoisen kasvainryhmän. Ne voivat saada alkunsa kolmesta eri solutyypistä, ja näin ollen niiden kirjo on varsin laaja. Maailman terveysjärjestön (WHO:n) vuonna 2017 julkaisema epiteliaalisten sylkirauhaskasvainten jaottelu koostuu 20 pahanlaatuisesta ja 11 hyvänlaatuisesta kasvaintyypistä. Sylkirauhaskasvainten diagnostiikka on erittäin haastavaa, ja siihen tarvitaan normaalien hematoksyliini-eosiini -leikkeiden (HE-leikkeet) lisäksi lähes aina niin kutsuttuja immunohistokemiallisia värjäyksiä. Alan kirjallisuudessa kullekin sylkirauhaskasvaintyypille on määritetty tyyppi-immunoprofiili, joka voi kuitenkin vaihdella tapauskohtaisesti. Tämän tutkielman tarkoituksena oli luoda kuva-arkisto, johon on taltioituna kuvia sylkirauhaskasvaintapausten immunohistokemiallisista värjäyksistä. Arkisto tehtiin Helsingin yliopistollisen keskussairaalan patologian laitoksen käyttöön diagnostiseksi apuvälineeksi. Kuvista voidaan nähdä, mitä immunomerkkiaineita eri sylkirauhaskasvaintyypit ilmentävät ja millä voimakkuudella. Kuva-arkiston aineistoksi koottiin Helsingin yliopistollisen keskussairaalan patologiseen keskuslaboratorioon normaaliin patologiseen tutkimukseen tulleita sylkirauhaskasvainnäytteitä. Aineistoksi valittiin 12 sylkirauhaskasvaintapausta, jotka edustavat kymmentä eri epiteliaalista sylkirauhaskasvaintyyppiä. Näytteiden HE- leikkeet ja niistä tehdyt immunohistokemialliset värjäykset kuvattiin mikroskooppikameralla eri suurennoksilla. Nämä kuvat koottiin kuva-arkistoksi, johon on pääsy Patologian laitoksen kotisivujen kautta. Syventävän tutkielman osuuteen koottiin suppea otos kuva-arkiston kuvista edustamaan kunkin kuvatun sylkirauhaskasvaintapauksen immunoprofiilia. Lisäksi syventävän tutkielman osuuteen sisältyy kirjallisuuskatsaus kuvatuista sylkirauhaskasvaintyypistä. Kuva-arkiston kuvista voidaan havainnoida kuvattujen sylkirauhaskasvaintapausten histologinen kuva ja immunoprofiili. Vanhoja tapausesimerkkejä voidaan käyttää vertailukohtana diagnosoitaessa uusia sylkirauhaskasvaimia, kunhan otetaan huomioon, että arkistossa on nähtävissä vain yksittäisiä esimerkkejä siitä, miltä kunkin kasvaintyypin immunoprofiili voi näyttää.

Dividing attention between two tasks can be challenging due to interference between the concurrent tasks. This dual-task interference is proposed to stem from working memory load, and thus dual-task paradigm is a widely used framework in working memory research. The present thesis aimed to investigate the suitability of figural fluency task as part of a dual-task. It was hypothesized that performance would decline when figural fluency task was performed together with another task. In addition, the convergent validity of figural and action (verb) fluency and prospective time estimation were examined through their connections with other cognitive measures. It was hypothesized that the tasks would correlate moderately with these measures. The sample consisted of 29 Finnish-speaking university students who volunteered to complete a series of cognitive tasks including two dual-tasks: figural fluency with action fluency and with time estimation, separately. In addition, tasks measuring verbal fluency, processing speed, verbal working memory, attention and the fluency of executive functions were administered. As was hypothesized, dual-task interference could be observed in both dual-tasks and in each dual-task subtask. Dual-task decrement in figural fluency was largest when performed together with action fluency. In addition, dual-task decrement was found to be more pronounced in figural fluency than in action fluency when performed together. Action fluency was the only test directly associated with measures of verbal fluency, verbal working memory and processing speed. According to the results, figural fluency as a dual-task subtask can be seen as a useful method in demonstrating dual-task interference and working memory load.

Background and aims. Aphasia and apraxia are neurological disorders most commonly caused by stroke. Aphasia manifests as varying degrees of difficulties in linguistic functions and apraxia as varying degrees of difficulties in producing voluntary body movements, such as speech movements and head nodding and shaking. Aphasia and apraxia often occur simultaneously. A severe apraxic-aphasic disorders manifests as diffi-culties in linguistic functions and the production of speech and head gestures, which can make communicating very challenging. In this case, answering yes/no questions can be a significant means of communication. There is only limited longitudinal follow-up research on recovery from apraxic-aphasic disorder. The aim of this thesis is to examine how the ability to respond intelligibly and correctly to yes/no questions changes in participants with a severe apraxic-aphasic disorder during a three-year follow-up period, beginning on the onset of the disorder. In addition, the aim is to examine whether the means used to respond intelligibly and correctly to yes/no questions change during the follow-up period, and how the changes in the amount and means of giving intelligible and correct yes/no responses compare across participants. Methods. The study included seven adults with a severe apraxic-aphasic disorder resulting from left hemisphere stroke. Participants were examined on five separate occasions during the three-year follow-up, apart from one participant, who was examined on four occasions. The examination sessions typically occurred within the first three months after the onset of the disorder, then six months, one year, two years and finally three years after the onset of the disorder. During the sessions participants were instructed to respond “yes” or “no” to 50 yes/no questions, composed by Sanna Lemmetyinen. The research data consisted of participants' responses to the questions, raw data consisted of video recordings of the sessions. The data was analyzed both qualitatively and quantitatively. Qualitative analysis consisted of evaluating the clarity and correctness of the participants’ responses, and of examining the means used to respond. Quantitative analysis consisted of scoring the responses based on their clarity and correctness. Results and conclusions. Participants' ability to respond intelligibly and correctly to yes/no questions during the three-year follow-up period varied. One participant’s ability clearly improved after the initial three months following disorder acquisition. Four participants’ performance profile was ascending during the follow-up period, two participant’s performance profile was descending, and one participant’s performance was the same after three years as it was in the first examination session. Some changes occurred in the means used to respond intelligibly and correctly. The amount of speech responses clearly increased in two participants. Apart from one, all participants appeared to have some characteristic means of responding. Participants were able to produce intelligible and correct yes/no responses using and combining several different means of responding.

Tausta Tutkimuksen tarkoituksena on selvittää Helsingin kaupungilla ikääntyneitä potilaita laitosolosuhteissa hoitavan henkilökunnan koulutusta, resursseja sekä asenteita potilaidensa suunterveydenhoitoon liittyvissä kysymyksissä. Vastaavia tutkimuksia on tehty aiemmin muualla, ja näiden konsensus on ollut, että hoitava henkilökunta saa koulutusta suuterveyteen liittyvissä asioissa vaihtelevasti ja että henkilökunnan kouluttamisella myös heidän hoidossa olevien henkilöiden suuterveys paranee. Menetelmät Tutkimus suoritettiin syksyllä 2013 jakamalla yhteensä 300 kyselylomaketta kolmen eri Helsingissä sijaitsevan geriatrisen hoitolaitoksen henkilökunnan edustajille. Kysely jaettiin kaikille henkilökunnan jäsenille ja palautettiin hoitoloittain anonyyminä. Kaavakkeessa kysyttiin asioita vastaajan taustoista, ja siinä oli 20 monivalintakysymystä liittyen potilaiden suunterveydenhoitoon. Tulokset Vastauksia palautettiin 180 kappaletta (60 %) hoitoloihin, josta ne toimitettiin yliopistolle. Tässä tutkielmassa käsiteltäväksi valittiin henkilökunnan koulutukseen, työpaikkojen resursseihin ja käytäntöihin sekä henkilökunnan asenteisiin liittyviä kysymyksiä. 66,3 % vastanneista kertoi saaneensa koulutusta asiakkaiden suun terveyden hoidossa, ja vastaava osuus, 66,1 %, toivoi aiheesta vielä lisäkoulutusta. Mielestään riittävät välineet oli käytettävissä 65,9 %:lla vastanneista. 63,3 % vastanneista piti suun terveyttä tärkeänä yleisterveyden ja hyvinvoinnin kannalta. Vain 2,9 % vastanneista potilaan suun puhdistaminen kuului päivittäisiin työtehtäviin. Pohdinta Hoitava henkilökunta pääasiassa mieltää suun terveyden tärkeäksi osaksi yleisterveyttä ja hyvinvointia. Koulutusta aiheesta on saatu, mutta yhtälailla sitä toivotaan saatavan lisää. Täydentävä koulutus olisi tarkoituksenmukaista järjestää kyseisissä hoitolaitoksissa, jossa resurssit ja olosuhteet ovat samat kuin hoitotyön arjessa.