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- speech disorder
n.any conspicuous speech imperfection, or variation from accepted speech patterns, caused either by a physical defect in the speech organs or by a mental disorder, as aphasia, stuttering, etc.
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▪ medicineIntroductionany of the disorders that impair human speech.The study of speech disordersPrevalence of speech disordersA comprehensive evaluation of knowledge and research in speech and hearing, published in 1969 by a section of the U.S. Public Health Service, under the title Human Communication and Its Disorders—An Overview, revealed that approximately 9,000,000 Americans were reported to have hearing impairments of handicapping magnitude; another 2,000,000 were said to suffer from central processing disorders from neurologic disease; and 10,000,000 to have speech disorders. The cost of coping with these problems was about $500,000,000 per year, while the annual deficit in earning power among such impaired persons approximated nearly $2,000,000,000. The disorders of articulation among young children were numerically most frequent.No data in similar detail are available from other countries; however, from experience in Germany, Austria, and other Central European countries, it may be said that the incidence and prevalence of speech disorders follow similar patterns among other Western nations. Certain deviations from these trends are equally typical. The incidence of cleft palate is very high among American Indians, while it is much lower among Negroes than in Caucasians. stuttering is more frequent in northern countries, such as in Scandinavia, than it is in southern regions—e.g., Italy. Similar trends have been noted in the Far East. Nonorganic, functional, or emotional disorders of voice and speech reflect psychological tensions exerted by the environment. For such reasons, vocal nodules (growths on the vocal cords), contact ulcer, vocal fatigue, etc., occur with greater incidence in metropolitan areas and are conspicuously less frequent in rural regions.Classification of speech disordersIn accordance with physiological considerations, disorders of communication are first classified into disorders of voice and phonic respiration, disorders of articulated speech, and disorders of language. It has been known for a long time that the majority of communication disorders are not caused by local lesions of the teeth, tongue, vocal cords, or regulating brain centres. Since these predominant disorders of voice and speech develop from derangements of the underlying physiological functions of breathing, use of the voice, speaking habits, or emotional disorders, this group has been labelled as functional. The remainder of the communication disorders with clearly recognizable structural abnormalities in the total speech mechanism has been termed organic.While this empirical grouping has certain implications for the selection of the appropriate treatment, it is not satisfactory because organic structure and living function can never be separated. Certain functional disorders of the voice caused by its habitual abuse may very well lead to secondary structural changes, such as the growths (polyps and nodules) of the vocal cords, which develop as a result of vocal abuse. On the other hand, all of the obviously organic and structural lesions, such as loss of the tongue from accident or surgery, almost inevitably will be followed by emotional and other psychological reactions. In this case, the functional components are of secondary nature but to a great extent will influence the total picture of disturbance, including the patient's ability to adjust to his limitation, to relearn a new mode of appropriate function, and to make the best of his condition.Within these major groups, the various types of communication disorders have for a long time, and in most parts of the world, been described by the listener's perceptual impression. Most languages employ specific words for the various types of abnormal speech, such as stuttering, stammering, cluttering, mumbling, lisping, whispering, and many others. The problem with such subjective and symptomatic labels is the fact that they try to define the final, audible result, the recognizable phenomenon, and not by any means the underlying basis. This general human tendency to describe disorders of communication by what the listener hears is analogous to the attempts of early medicine (medicine, history of) to classify diseases by the patient's symptoms that the diagnosing (diagnosis) physician could see or hear or feel or perhaps smell. Before the great discoveries of the 19th century had erected a logical basis for medical pathology, the various diseases were classified as numerous types of fevers, congestions, dyscrasias, etc. Thus, malaria was originally thought to be caused by the evil emanations (miasma) of the bad air (mal aria) near swamps until it was recognized to be caused by a blood parasite transmitted by the mosquito.The various approaches of medical, psychiatric, psychological, educational, behavioral, and other schools of speech pathology have made great advances in the recent past and better systems of classification continue to be proposed. They aim at grouping the observable symptoms of speech disorders according to the underlying origins instead of the listener's subjective impressions. While this is relatively easy in the case of language loss from, for example, a brain stroke because the destroyed brain areas can be identified at autopsy, it is more difficult in the case of the large group of so-called functional speech disorders for two reasons: first, they are definitely not caused by gross, easily visible organic lesions, and, second, many functional disorders are outgrown through maturation or appropriate learning (laboratory study of the involved tissues in such cases would reveal no detectable lesions). It is hoped that refined methods of study in the areas of both "functional" psychology and "organic" neurophysiology will eventually reveal the structural bases for the prevalent disorders of voice and speech.Treatment and rehabilitationThe selection of methods in the medical treatment or educational rehabilitation of communication disorders depends primarily on the underlying basis for the disturbance. Any case of chronic hoarseness should be evaluated first by a laryngologist to establish a precise diagnosis. This is particularly important in the older age groups in which an incipient laryngeal cancer is often overlooked because the patient does not pay attention to his deteriorating voice. The prognosis of all cancers becomes rapidly poorer the longer the disease remains unrecognized. As soon as disease of the larynx is excluded as a cause of the vocal complaint, vocal rehabilitation by a competent speech pathologist should be considered.Malformations, diseases, or injuries of the peripheral speech mechanism are treated by appropriate specialists; the plastic surgeon repairs a cleft of the palate; the neurologist and internist treat the stroke patient until he has recovered sufficiently to be referred for re-education of his language abilities. The pediatrician treats the child with mental retardation, while the geneticist counsels the family regarding the possible inheritance of the disorder and its future avoidance. deafness or severe hearing loss in early childhood is a typical cause for severe delay of language development and should be promptly recognized through appropriate examination by the ear surgeon (otologist) and hearing specialist (audiologist). Cases of childhood autism (withdrawal, severe eccentricities) or early schizophrenia are now being recognized with increasing frequency by speech pathologists, child psychiatrists, pediatricians, and clinical psychologists. This multitude of various professional interests in the recognition and rehabilitation of such exceptional children is well served by the coordination of these efforts in the modern team approach. But again, the largest group of disorders of voice and speech has causes other than these grossly organic lesions. They belong within the province of speech rehabilitation by experts in speech pathology and other functional practitioners.Development of speech correctionThat mankind has been troubled by speech afflictions since the beginning of recorded history can be gleaned from numerous remarks in the books of the Bible. Further, many scientific and medical writers from the time of antiquity to the Middle Ages reported observations of speech and voice disorders. The recommended remedies merely reflected the inadequacies of the philosophical or empirical notions of their times. Scientifically oriented speech pathology originated in Germany during the latter part of the 19th century, following closely the development of otolaryngology. Three names stand out in this respect: C.L. Merkel (Anthropophonik; 1857), Adolph Kussmaul (The Disorders of Speech; 1877), and Hermann Gutzmann, Sr., who became the first professor of speech pathology at the University of Berlin Medical School around 1900.During the same time, the new science of experimental phonetics was developed by Jean-Pierre Rousselot in Paris, who promptly recognized the great contributions that experimental phonetics could make to the study of normal and disturbed speech. This close collaboration of medical speech pathology with experimental phonetics has remained typical for the European continent where speech correction is customarily carried out under the direction of physicians in the ear, nose, and throat departments of the university hospitals. The designation of speech and voice pathology as logopedics and phoniatrics with its medical orientation subsequently reached many other civilized nations, notably in Japan and on the South American continent. The national organizations in most of these areas are now represented in the International Association of Logopedics and Phoniatrics, which was founded in Vienna in 1924.The evolution of speech correction in the Anglo-Saxon countries followed a different trend. Although Great Britain has had a long tradition in general and experimental phonetics, its College of Speech Therapists was organized as an examining and supervisory body in 1945. Similar organizations followed in other areas of the British Commonwealth.American speech pathology elected a different way. The American Speech and Hearing Association (ASHA), founded in 1925 in New York City, became the organizing, examining, and supervisory body for a rapidly growing membership, which surpassed 12,000 by 1970. More than 200 colleges and universities in the United States, many accredited by ASHA, offer degrees in speech pathology and audiology, some including work at the doctoral level. The large majority of ASHA members hold the master's degree and work as speech clinicians in the public school systems. A smaller number with master's degrees and a still smaller number with doctoral degrees staff the more than 300 clinics that deal with communication disorders and that are usually affiliated with hospitals, colleges, universities, and occasionally with civic organizations.Russian (Union of Soviet Socialist Republics) speech correction originally followed the developments of European logopedics and phoniatrics and is now directed by the Department of Logopedics in the Government Institute of Defectology of the Academy of Pedagogical Sciences in Moscow. One facet of speech pathology in Russia is its emphasis on Pavlovian theory (conditioning and retraining) and intensive use of neuropsychiatric methods, including pharmacology, sleep therapy, and other intensive treatment programs during hospitalization. Similar trends operate in the eastern European countries, such as in the Czech Republic, where the first independent medical department of logopedics and phoniatrics was organized at the Faculty of Medicine of Charles University in Prague.Major types of speech disordersVoice disordersIn international terminology, disorders of the voice are described as dysphonia. Depending on the underlying cause, the various types of dysphonia are subdivided by the specifying adjective. Thus, a vocal disorder stemming from paralysis of the larynx is a paralytic dysphonia; injury (trauma) of the larynx may produce traumatic dysphonia; endocrine dysphonia reflects the voice changes resulting from disease of the various endocrine glands such as the pituitary. The various dysphonias of clearly organic origin from systemic disease (e.g., muscular, nervous, or degenerative disease afflicting the entire body) or from local laryngeal changes differ in their visible symptomatology, as well as in the perceptual impression produced by the abnormal voice. Nevertheless, it has not yet been possible to define the acoustical alterations in the vocal spectrum that would allow a clear and objective differentiation among the subjective graduations of an abnormal voice as hoarse, harsh, husky, breathy, grating, gravelly, gritty, etc.Because a large group of dysphonias have no visible laryngeal causes, they are grouped as nonorganic. Two main types of these so-called functional voice disorders may be distinguished: the habitual dysphonias that arise from faulty speaking habits and the psychogenic dysphonias that stem from emotional (emotion) causes. Both of these types of dysphonia again occur in two basic subtypes, the hyperkinetic (overactive) and the hypokinetic (underactive) since emotional disorders interfere with voluntary vocal function by causing either excessive or depressed physiological activity. In the hyperkinetic disorders, the highly coordinated patterns of phonation regress to the primitive, forceful, and exaggerated sphincter action of the larynx as seen during gagging. The result is hyperkinetic dysphonia, the gratingly harsh vocal disorder due to excessive muscular action in a constricted larynx. In the second subtype, the movements for phonation regress even more deeply to the original function of respiration; the sluggish larynx remains more or less open, and the glottis is incompletely closed for phonation, leading to hypokinetic dysphonia with subdued, breathy huskiness.Disorders of language developmentThe most frequent speech disorders are those that disturb the child's acquisition or learning of language. While those concerned with modern terminology are striving for an improved classification according to the etiologic (causative) factors, it is still customary to classify these disorders on the basis of the complaint: absence of speech, baby talk, poorly intelligible articulation, lisping, etc. Recent studies of large numbers of children with such developmental language disorders have shown that at least two chief classes of these disorders may be distinguished: general language disability from genetic factors with a familial (inherited) pattern chiefly from the paternal side, and acquired language disorders due to damage sustained before, during, or shortly after birth (i.e., perinatally).These latter perinatal damages encompass the gamut of toxic, infectious, traumatic, nutritional, hormonal, and other damages that may hurt the growing fetus or young infant. Major and minor birth injury is not an infrequent factor. Hereditary (heredity) factors also encompass a great variety of genetically predetermined influences, including familial tendency to exhibit slow language development, lesser endowment in the brain area for language, inferior function in the highest brain areas of auditory performance without organic damage to the ears, slow maturation of motor function (including clumsiness and deviation from normal cerebral dominance), and other signs of delayed cerebral growth. Additional environmental causes include poor language patterns used by the family, parental neglect, emotional maladjustment, general weakness from prolonged disease, as well as various socioeconomic, cultural, and other psychological influences.While some otherwise perfectly normal children, particularly boys, may not elect to begin talking until age three, making good progress in every respect from then on, the absence of speech after age two may be caused by any of the conditions mentioned thus far and would appear to merit prompt investigation. If an organic cause can be detected, the symptomatic description of delayed language development then yields to a specific etiologic (causal) diagnosis. Although it is best to describe the absence of speech in early childhood as simply delayed language development, some American investigators tend to refer to this condition as congenital (present at birth) aphasia, a term rejected by most European scholars who argue that there cannot be an inborn or early acquired aphasia before a language has been learned.Many children encounter unusual difficulties in mastering the patterns of articulation of their mother tongue and are said to manifest articulatory immaturity (infantile dyslalia). If no organic cause can be found, the probable cause may be delayed maturation of psychomotor skills.Marked delays of language development are often followed by a period of inability to learn the rules of grammar and syntax at the usual age (dysgrammatism). Though this is often a sign of inherited language disability, it may reflect mental retardation (intellectual disability) or other types of brain damage.Some children who have suffered such laboured language development may then go through a period of retarded reading and writing disability, a condition often defined as dyslexia. Again, there are two chief varieties: the primary or developmental reading and writing disability due to constitutional (organic) and hereditary factors, and a large secondary group of symptomatic reading disorders acquired through any of the influences that retard language development in general, including troubles with vision. Practically all investigators agree that primary or developmental dyslexia shows a marked hereditary tendency (is familial) and is typically associated with other disorders of psychomotor development, deviation from the prevalent right handedness, and poor function in the auditory area in the brain, often associated with lack of musical talent. Primary dyslexia is significantly associated with other developmental speech disorders.Articulatory disordersClutteringThose who have followed large numbers of children with language disabilities for a long time are impressed by the fact that these various manifestations of an underlying developmental disorder often terminate in a peculiar impediment of speech that has been well known to European speech pathologists for many years but is not yet fully recognized in American speech literature: cluttering (or tachyphemia), the hasty, sloppy, erratic, stumbling, jerky, and poorly intelligible speech that may somewhat resemble stuttering (see below) but differs from it markedly in that the clutterer is usually unaware of it, remains unconcerned, and does not seem to fear speaking situations. Its association with other past or persistent signs of subnormal language development also differentiates congenital cluttering from emotional stuttering. Experts are strikingly unanimous in stressing the hereditary nature of cluttering.LispingAlthough lisping belongs among the articulatory disorders and usually has the same causes as articulatory disorders (dyslalia) in general, it differs from other disorders of articulation in several respects. For one, lisping occurs in various varieties: with the tongue tip protruding between the front teeth, with a slurping noise in the cheek pouch, with the tongue too far back along the palatal midline, with excessive tongue pressure against the teeth; in several snorting and nasal subtypes, as well as through substitute hissing deep in the throat or even within the larynx, such as in cleft-palate speech. Moreover, the causes of lisping include a diverse group of particular conditions: abnormal number or position of teeth; imitation of other lispers; deficiency of palatal closure; slight hearing loss in the high frequencies; as well as several psychologic causes, such as effeminate affectation, infantile mannerisms, or mental disturbance. Lisping is less easily outgrown than the other infantile dyslalias and may persist into adult life if not corrected.stuttering, or stammeringAcademically known as dysphemia, what is called stuttering in the United States is usually named stammering in Great Britain. While everyone seems to know what stuttering sounds like, experts do not agree about what really causes it. In the age groups after puberty, stuttering is the most frequent and conspicuous type of disturbed speech encountered. This is one reason why among the studies dealing with speech pathology in the world literature those devoted to stuttering are the largest single group. Despite numerous and intensive studies of the problem, findings and conclusions are far from unanimous. A great number of theories have been proposed to explain the origin and nature of stuttering, which range from the premise that subtle physical disturbances in the nervous system (so-called neurogenic asynchronies) are responsible to the opinion that psychological maladjustment alone is to blame. The report issued by the U.S. Public Health Service (see above Prevalence of speech disorders (speech disorder)) concludes that "stuttering remains an enigma while illustrating the type of disorder which does not have either a clean-cut organic cause or a clearly habitual basis."Research findings indicate (as is the case with many developmental speech disorders, particularly language disability, articulatory disorders, reading disability, and cluttering) that trouble with stuttering affects the male sex at least four times more frequently than the female. Hereditary predisposition has been noted in many studies of large groups of stutterers, with evidence for an inherited tendency found among as many as 40 percent of the stutterers studied. Some experts insist that stuttering is not a single disease entity but that it comprises several types of the disorder with different causes. According to such views, the familial occurrence of stuttering represents a combination of the stuttering symptom with a cluttering tendency that is inherited. Although imitation of another stutterer may form the basis for acquiring the habit, purely psychological explanations that stress parental attitudes in training their children fail to reveal why many stutterers have siblings (brothers or sisters) with perfectly normal speech.The treatment of stuttering is difficult and often demands much skill and responsibility on the part of the therapist. The possibility of some specific medical cure seems remote at the present time. Even the most advanced methods of modern psychiatry have failed to produce superior results in treatment. For a time it was hoped that new psychopharmacological drugs (e.g., tranquillizers) might facilitate and accelerate recovery from stuttering, but these efforts have been disappointing thus far. The typical program of management in this disorder is a strict program of psychotherapy (talking freely with a psychiatrist or psychologist so as to reduce emotional problems) supported by various applications of learning theory or behavioral theory (in retraining the stutterer) and other techniques depending on the therapist's position. It is widely agreed that the patient must acquire a better adjustment to the problems of his life and that he needs to develop a technique for controlling his symptoms and fears. Prognosis (predicted outcome of treatment) thus is held to depend greatly on the patient's motivation and perseverance. It is interesting to note that experienced investigators no longer aspire to a "cure" of stuttering through an etiologic (causal) approach. Instead of focussing on underlying causes, they aim at making the patient "symptom-free" via symptomatic therapy.Prevention of stuttering may be aided through parent counselling. The normal, immature speech of many children is characterized by various nonfluencies; these include hesitations, syllable repetition, groping for the right word, and vocalizations between words such as "ah-ah." Some misguided parents castigate these normal signs of developing speech with various admonitions and, even worse, try to forbid the nonfluencies by mislabelling them as stuttering. In some children, this parental interference associates normal nonfluency with feelings of insecurity and fear, tending to make the child become a real stutterer. Much research has been devoted to this probable etiology for one type of stuttering; its elimination through parental guidance indeed has been reported to help in reducing the number of stutterers.Dysphasia and aphasiaDysphasia means the partial or total loss of language as a result of lesions in those parts of the brain that are directly related to language function. stroke in elderly patients and head injury in younger ones are typical causes. aphasia is seen most frequently when the left side of the brain is afflicted, as evidenced by paralysis of the right arm and leg. Evidence indicates that the left hemisphere (laterality) is dominant in all right-handed individuals and in some left-handers as well. Some experts even believe that the left brain hemisphere is dominant for language in most individuals regardless of handedness and that dominance of the right brain is exceptional in some left-handers. According to other opinions, dominance for language is more evenly distributed in both hemispheres in left-handed persons. As explained before, two major brain areas are recognized as intimately associated with language function: Broca's area in the third frontal convolution and Wernicke's area in the posterior third of the upper temporal convolution. The angular gyrus at the junction of the temporal (side), parietal (top), and occipital (back) lobes of the brain is believed to be related to graphic language as used for reading and writing.Aphasiology, the science of aphasic language loss, is studied by neurologists, neurosurgeons, some phoniatrists, certain speech pathologists, as well as some psychologists and linguists. This diversity of research background accounts, in part, for the great diversity in theoretical approaches to aphasia. Numerous classification schemes that have been proposed vary from simple groupings into a few main types of aphasia to complicated systems with many forms and subtypes of aphasic disturbances. Similar to research in stuttering, the literature on aphasia is exceptionally large and growing.The essence of aphasia is the loss of memory for the meaning of language and its production. Thus, in the predominantly expressive or motor forms, the patient can no longer remember the intricate patterns for articulation; he can no longer form a word in speaking or writing, even though he may know what he wants to express. In the predominantly receptive or sensory forms, the patient can talk freely, sometimes excessively and incessantly (logorrhea), although with numerous errors and meaningless clichés, but he no longer comprehends what is said to him or what he tries to read. Those who recover from receptive forms of the disorder are likely to explain that during their aphasia spoken language sounded like an unintelligible, alien tongue. The degree to which there is combination of expressive and receptive symptoms varies greatly with the type and extent of brain lesion. There may be total loss of all language functions (global aphasia) to slight residual errors or misunderstandings when the brain damage is only slight or temporary. A major complication of aphasia is the frequent association with right hemiplegia, in which the paralyzed hand is no longer serviceable for writing. Retraining of the left hand for writing may then become necessary.Management of aphasia has two goals: one, the physical recovery of the patient through treatment by the internist, neurologist, and possibly brain surgeon, and two, the re-education of the brain functions that are still present, the aim of which is to help the patient relearn some use of language under the guidance of the speech pathologist. The better the patient's recovery from the brain lesion, the more chances there are of prompt and complete return of language. When the brain losses are permanent, the patient must relearn each word, sentence, and phrase like the young child, albeit in a more cumbersome manner, apparently using parts of the brain that still function. He is repeatedly shown the picture of an object along with its printed name; these words are spoken to him by his teacher over and over in the hope that the patient will learn to repeat the word or phrase until he can say it spontaneously. Words that are relevant to the patient's everyday life are emphasized first with due consideration for his interests and past occupation; later he may advance to the use of abstract concepts and of higher levels of language. Various types of automated training programs are available, including a simple play-back device that shows an inserted card with a picture on it, the name of the pictured object printed next to it, and the audible word recorded on a strip of magnetic tape. Devices of this type enable the patient to practice at his own pace.Symptomatic speech disordersUnder this heading may be summarized various types of communication disorders that develop on the basis of known structural lesions or metabolic disturbances. Etiologic classifications group these impediments according to the types of organic diseases, as well as in respect to the afflicted effector organs (such as the tongue). Disturbed speech from lesions in the various parts of the nervous system is known as dysarthria. Mental retardation usually limits the development of linguistic ability to the same extent as it does intellectual capacity; this language disorder has been described as dyslogia. Mental disturbances can also manifest themselves in linguistic symptoms, such as in the peculiar (dysphrenic) mode of speech among sufferers of schizophrenia. Hearing loss dating from early childhood leads to a typical distortion of the speech pattern for which various names have been coined, such as audiogenic dyslalia. Visible defects in such oral articulators as the lips and teeth limit the mechanics of articulation and thus reduce the quality and intelligibility of speech; such speech problems are known collectively as dysglossia.Damage to those parts of the nervous system that regulate the actions of voice and speech cause distinctive alterations of the speech pattern. The most important disorder of this type is cerebral palsy from brain injury before, during, or soon after birth. The majority of cerebral palsy victims retain normal intelligence but are handicapped by distortions of voluntary movements, including those for speaking. Just as walking may be stilted and jerky and arm movements crude and uncontrolled, the patterns of voice and speech will reflect the same distortions. Great advances in rehabilitation have been achieved in the recent past, such as with the well-known Bobath method, which is based on learned suppression of primitive reflexes.Another type of dysarthria is observed in cases of Parkinson's disease (Parkinson disease). This affliction of the nervous system makes body movements either excessively rigid or tremulously repetitive, such as with the so-called "pill-rolling" sign of hand tremor. Voice and speech reflect the same patterns, sometimes appearing as the first obvious symptoms of the disease. Brain surgery is used in an attempt to improve these abnormal body movements, often with good general results, although speech may be little improved or even made worse. Neurologists also are collecting observations on promising drug treatments for Parkinson's disease, such as with L-Dopa.When a neurologic disease damages the bulbar nuclei (in the brain stem) of the nerves innervating the organs for speech, the effect of bulbar dysarthria is heard. In severe cases, the voice may be reduced to a faint grunting, while articulation deteriorates into mumbling or total muteness. chorea, another neural disorder manifested in sudden jerky movements of the entire body, may be associated with bizarre, explosive disruptions of the speech flow. Cerebellar dysarthria results from disease of the brain part called the cerebellum (which regulates fine motor coordination), leading to various disorganizations of speech including a "drunken" (ataxic) quality.Major advances in the science of inheritance (genetics) and in biochemistry have clarified a number of inborn metabolic causes of many types of mental retardation (see human behaviour). Some of these forms of retardation can be avoided through genetic counselling of prospective parents or prevented by prompt treatment following early diagnosis. (In some cases a change in diet is effective.) Improved prenatal care may reduce the size of another group of mentally retarded individuals whose problem stems from brain damage sustained during fetal life. The number of unknown causes in other cases of retardation is still considerable, however.The total management of the mentally retarded child concerns a large group of specialists: pediatrician, geneticist, clinical psychologist, audiologist and speech pathologist, and special educators in institutions for such children. Following classification on the basis of a level of educability, the child undergoes a composite training program geared to his capabilities. Intensive training in language usage not only tends to improve his communication skills but also forms a bridge to increased general learning. There has been recent stress on the not infrequent combination of mental retardation with hearing loss; in such cases, the audiologist prescribes a hearing aid and auditory training to improve the receptive aspects of communication.Language and mental disorderExpert analysis of the bizarre speech patterns associated with certain psychiatric disturbances is of primary diagnostic significance. If a mute child persists in stereotyped rituals and strange behaviour, a diagnosis of childhood autism is likely to be made. Some experts distinguish this from a similar disorder called childhood schizophrenia, in which previously good general and linguistic development falls apart in association with similarly bizarre behaviour. In adolescence, a sudden change of voice to a shrill falsetto or weird chanting may herald the outbreak of juvenile schizophrenic disease. Infantile lisping, strange distortions of articulation, and various eccentricities in verbal expression are other signs of schizophrasic speech in the adult schizophrenic. Linguistic study may help the psychiatrist in analyzing the patient's ways of thinking and to provide a measure of the sufferer's progress under therapy. Great therapeutic stress is placed on establishing contact with the autistic child by eliciting from him some sort of communication. Language is felt to be one of the best bridges to break open the closed inner world of such children.Speech of the hard of hearingHearing loss that dates from childhood hinders the normal development of language because the most important sensory portal for speech learning remains deficient. Such children learn to say the sounds of speech as they hear them—that is, in a muffled, distorted, or even inaudible fashion. The articulatory disorder (audiogenic dyslalia) usually reflects the measured (audiometric) pattern of hearing loss. If sound waves at high frequencies cannot be heard, speech sounds with formants in that high-frequency region will be affected. The hissing sibilants contain the highest formants and are therefore most typically disturbed by high-frequency hearing loss. The lower frequencies that can still be heard limit the audible formants to this residual range, which transposes the normal formant patterns into the abnormally lowered frequency band. As a result, a sharp hissing S is spoken as a muted Sh, and the light vowels are transformed into their darker counterparts (for example, the word "set" may be pronounced as "shot" or "shöd" as if it were German).The voice reflects analogous changes. In the case of conductive hearing loss (in which neural structures for hearing are intact), the patient hears himself well through the bones of his skull but cannot hear others. Because his bone conduction remains good, his voice will sound loud to him, and he tends to keep it subdued. The opposite occurs with neural (or perceptive) hearing loss in which there is nerve dysfunction. In this case, the patient hears his own voice as poorly as that of others, and he tends to talk in an overloud and screeching voice.Correction of audiogenic dyslalia may be possible through early fitting of a suitable hearing aid, intensive auditory training, and speech exercises aided by audiovisual playback devices (auditory trainers, tape recorders, visible speech devices, etc.).Profound or total deafness going back to early childhood without special training inevitably leads to deaf-mutism, the absence of oral language development as a direct result of deafness. Deaf-mute children have traditionally been educated in special schools for the deaf, where the oral method (showing how to shape the oral structures for each speech sound) of teaching speech has competed with the older manual method of allowing the deaf to communicate through their own gestural or finger spelling. Recent advances in training include the liberal use of amplification devices (e.g., group hearing aids) in all school situations as well as the earliest possible fitting of hearing aids following definite diagnosis. This can be accomplished even when the patient cannot communicate that he hears (e.g., in very young babies) through such methods as recording brain-wave patterns in response to measured sound stimulation (EEG response audiometry).Speech impediments from defective articulatorsDysglossic (from defective oral structures) disorders in articulation have interested mankind for the longest time; the biblical and poetical interchange of the words for "tongue" and "speech" in many languages has kept alive the assumption that speech originates within the fleshy tongue. For the same reason, the popular term tongue-tied still persists to refer to an abnormally immobile tongue and some assumed resulting limitation of linguistic ability. Even the academic designation of the science of languages as "linguistic" is traditionally based on the Latin word lingua for tongue.In practice, the condition of a true tongue-tie (ankyloglossia) occurs only rarely and is quite easily corrected through a simple operation. Even when the shortened band beneath the tongue tip is permitted to persist, very little speech disturbance, if any, is audible in such persons. The only limitation of articulation to be expected is the decreased ability to protrude the tongue tip between the teeth for the English Th and the trilling lingual R in southern German, Latin, and Slavic languages. In any event, a true tongue-tie never causes stuttering, lisping, or any other of the major speech disorders.Loss of tongueMajor defects of the tongue from paralysis, injury, or surgery reduce the articulation of the lingual sounds to the same extent that the tongue's mobility is visibly limited. Spontaneous compensation is usually quite prompt, depending on the patient's general linguistic talent. One exception is complete bilateral (both sides) paralysis of the tongue, which causes a very severe disorder of chewing and swallowing as well as severe limitation of speech intelligibility. The total loss of the tongue (true aglossia) from injury or surgery is often amazingly well compensated. Patients can learn to use residual portions of a tongue stump as well as other oral structures to substitute for the missing tongue; indeed, some persons without a tongue have relearned to speak so well that the listener would not suspect its absence.Nasal speechSeveral types of nasal speech are not easily diagnosed; even specialized physicians are often not fully aware of the differences.Increased nasal resonance leads to open nasality (hypernasal speech), affecting all oral speech sounds that should not be nasal. Organic causes impair the accuracy of palatal occlusion during emission of the nonnasal sounds. Among these are paralysis, congenital malformation, injury, or defects of the palate. The functional causes of palatal sluggishness include imitation, faulty speech habits, dialectal influences, hearing loss, mental retardation, or psychiatric disorders.Decreased nasal resonance produces closed nasality (hyponasal speech), which muffles the three nasal resonants (M, N, and Ng). The best known organic causes are an acute cold, hay fever, large adenoids, and all other nasal diseases that obstruct the airway. Functional causes are less frequent, in the form of a rare, faulty speech habit; occasionally the problem comes from mental retardation or from severe language disability.Mixed nasality poses a serious problem; it stems from the combination of one cause of open nasality with another of closed nasality (one may be of organic type and the other functional, or both may be organic). A typical combination is the open nasality from paralysis (paresis) of the palate (or its congenital deficiency) combined with closed nasality from obstruction of the nasopharynx by adenoids. The resulting mixed nasality causes the nasal resonants to sound muffled and subdued, while careful testing reveals slight open nasality on all oral sounds.Treatment of nasal speech is unlikely to be successful without prudent balancing of all factors involved. This responsibility rests primarily with the diagnosing otolaryngologist or phoniatrist. The complaint of "talking through the nose" should never warrant a tonsil and adenoid (adenoids) operation without complete evaluation. If this were done in the example cited just above, removal of the obstructing adenoids would alleviate only the closed nasality, while making the open component more severe with marked deterioration of the patient's speech. This dilemma is often present when adenoids cause chronic middle-ear disease with hearing loss, while the palate is incompetent, as from a slight congenital malformation or paresis. In such case, the patient's general health and his hearing must be weighed against the possibility of making his speech worse.Cleft palate speechThis type of organic dysglossia has also been named rhinoglossia (Greek rhin, rhis: "nose") because it is an organic cause of excessively nasal speech. Clefts of the lip, upper jaw, and hard and soft palate occur in various types and combinations. Cleft palate is a congenital (present at birth) malformation that develops for various reasons during the early weeks of embryonic life. The causes may be grouped as follows: inheritance in some cases; embryonal damage from various environmental causes in others; while still other cases of cleft palate are part of a syndrome of general or multiple malformation, which may again be hereditary, the result of chromosomal aberrations, or of environmental origin. Genetic influences (heredity) are inferred from evidence that North American Indians (Montana) show a high incidence of cleft palate, but blacks (as on the island of Jamaica) show an unusually low incidence.The speech disorder in cleft palate cases is complex. As a direct, mechanical result of the absent velopharyngeal (soft palate-pharynx) closure, voiced sounds assume an abnormal nasal quality from the unusual resonance of the nasal chambers. The influence of nasality on the perceptual and acoustic characteristics of the speech sounds has been discussed earlier. A second component is a mechanical limitation in articulating plosive sounds (e.g., P) because the necessary intra-oral pressure cannot be achieved. For the same reason, the sibilant sounds (e.g., S) are greatly distorted because the articulating air escapes through the nose before it can produce the characteristic hissing noise at one of the places of constriction. The child with an unrepaired cleft palate seems unconsciously to attempt to overcome these mechanical limitations in several ways. He tries to constrict the nostrils through facial grimaces, and he attempts to increase the expiratory air pressure. He also succumbs to the "law of centripetal regression of articulation"; that is, he shifts the articulation of the oral sounds below the point of deficient palatal occlusion, down into the pharynx or even the larynx. It is easy to demonstrate by X-ray fluoroscopy how the larynx becomes constricted during each plosive or sibilant sound in such cases.These mechanical limitations of articulation in cleft palate lead to secondary modifications of behaviour. Linguistic ability is retarded through general limitation of speech learning; emotional reactions to the handicap may complicate the clinical picture; a vicious circle is thus established, which in turn impedes the sufferer's general intellectual and special linguistic development.Other coincidental disorders complicate the pattern of cleft-palate speech. Many cleft-palate patients also suffer from middle-ear infection, and the resulting hearing loss may add the component of audiogenic dyslalia. In other cases, the structural malformation may be complicated by mental retardation. Coincidental genetic factors may aggravate the speech problem when the syndrome of familial (neurally inherited) language disability is superimposed. In such cases, the mechanical speech disorder of rhinoglossia becomes complicated by the additional signs of delayed speech development, articulatory dyspraxia, dysgrammatism, reading and writing disability, etc. This combination is evident in some cases following the successful surgical correction of the palatal deficiency. Although the nasality is promptly alleviated in such cases, the various speech disorders from language disability may persist, since they have nothing directly to do with the previous cleft palate.Management of cleft palate is the task of a well-coordinated team. The plastic surgeon closes the palatal deficiency, the psychologist analyzes the intellectual endowment, the speech pathologist corrects the various components of disordered speech, the audiologist determines coincidental hearing loss, and the otolaryngologist cares for the health of nose and ears. Tonsils and adenoids may be diseased, leading to the frequent complication of middle-ear infection with hearing loss. This condition may require removal of tonsils and adenoids to preserve hearing. A dilemma is then created; removal of tonsils and adenoids is generally contra-indicated in cases of deficient palatal closure because this operation increases the degree of open nasality. The child's welfare then should be carefully considered in order to avoid any harm.When surgical repair is not feasible, the palatal defect may be covered by a special prosthetic plate (obturator) similar to false dental appliances. This technique has been known for many centuries, and various models of obturators have been constructed in the course of time. Cleft-palate care therefore includes the services of a prosthodontis (prosthodontics)t (who makes false teeth) for the optimal construction of such appliances. If worn by children, obturators should be regularly altered to maintain continuous fit as the patient grows.Well-organized centres for the management of cleft palate are able to offer excellent care so that the speech impediment can be ideally or almost completely corrected in many cases. The problem of cleft palate thus demonstrates once more that human speech requires complex detailed study of its normal functions and manifold approaches for the correction of its imperfections.Godfrey Edward Arnold Ed.Additional ReadingR. Luchsinger and G.E. Arnold, Handbuch der Stimm- und Sprachheilkunde, 3rd ed. (1970; Eng. trans., Voice, Speech, Language, 2nd ed., 1972), the largest text on disorders of communication with extensive references and international orientation; R. Carhart (ed.), Human Communication and its Disorders: An Overview (1969), an important report of the U.S. Department of Health, Education and Welfare on statistics, established facts, and research needs; L.E. Travis (ed.), Handbook of Speech Pathology (1957), a fundamental American publication by many leading contributors; C. Van Riper, Speech Correction: Principles and Methods, 6th ed. (1978), a widely used text for study and references; R.W. West and M. Ansberry, The Rehabilitation of Speech, 4th ed. (1968), another classic in the field of speech pathology. Later monographs include John K. Darby (ed.), Speech Evaluation in Medicine (1981); John E. Bernthal and Nicholas W. Bankson, Articulation Disorders (1981); Betty Byers Brown, Speech Therapy (1981); Joyce S. Taylor, Speech-Language Pathology: Services in the Schools (1981); Elizabeth Carrow-Woolfolk and Joan I. Lynch, An Integrative Approach to Language Disorders in Children (1982); Andrew Sekey (ed.), Electroacoustic Analysis and Enhancement of Alaryngeal Speech (1982); Norman J. Lass et al. (eds.), Speech, Language, and Hearing, 3 vol. (1982); C. Woodruff Starkweather, Speech and Language: Principles and Procedures of Behavior Change (1983); and Franklin H. Solverman, Legal Aspects of Speech-Language Pathology and Audiology: An Overview of Law for Clinicians, Researchers, and Teachers (1983). See also recent issues of these journals: American Speech and Hearing Association (ASHA) Journal (monthly); Journal of Speech and Hearing Disorders (quarterly); Journal of Speech and Hearing Research (quarterly); Cleft Palate Journal (quarterly); Folia Phoniatrica (bimonthly, Basel); and British Journal of Disorders of Communication (semi-annual).* * *
Universalium. 2010.

subset: commoncrawl


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Xiaomi Box taps the Chinese smart TV market on the cheap, flirts with AirPlay (hands-on)
The Apple TV may not be officially available in China, but there are already plenty of cheap Android TV dongles and set-top boxes over there to keep the folks occupied. That said, many of them don't offer a satisfying multimedia experience, so even for a latecomer like Xiaomi, there's still space for competition. Having just launched the much anticipated Xiaomi Phone 2, the Chinese startup recently announced that it had acquired digital content provider Duokan for some time, and the first fruit is this conveniently named Xiaomi Box. Even with the bundled one-meter HDMI cable, the pebble's priced at a competitive ¥399 (about $64) and we've been told it'll be available in mid-December. Better yet, it claims to be compatible with AirPlay right out of the box! Read on to see if that's the case with our pre-production unit.
We were lucky enough to have an Apple TV at the launch event for a quick size comparison, and it turned out the Xiaomi Box is basically a flatter but more rounded version of Apple's counterpart. Just a warning: we actually became rather fond of stroking the Xiaomi Box's smooth curved top. As for the hardware inside the nicely crafted polycarbonate shell, it's a pretty neat bundle for the price: a Cortex-A9 800MHz processor, 1GB RAM, HDMI output, RJ-45 socket, 802.11b/g/n WiFi and a micro-USB port for OTG host. The spec sheet lists 720p or 1080p video output (the former by default), along with playback compatibility for a range of video codecs: H.264, VC-1, WMV-HD, MPEG 1/2/4 (up to 1080p at 30 fps) and Real7/8/9 (up to 720p at 30 fps). It can also handle audio as well: MP3 (64kbps to 320kbps), WMA (64kbps to 320kbps) and APE / FLAC (no more than 1,500Kbps).
As teased earlier, the interesting thing is that in addition to DLNA and Miracast, the Xiaomi Box is also compatible with Apple's AirPlay. Xiaomi packages this trio of protocols as "MiLink." But just as expected, we could only stream non-protected content from iTunes to our Xiaomi Box during our test, but that's still rather fun and handy, nonetheless. As for our Miracast-enabled Xiaomi Phone 2 (any Xiaomi Phone with MIUI v2.9.29 and above will do), once connected to the same network as the Xiaomi Box, we could then stream our photos and supported videos to it -- it's just a matter of tapping the extra icon in the native gallery app or video player.
Don't worry, we haven't forgotten about the Xiaomi Box's native UI and content. As you can see, the menu's grid layout is rather elegant and easy to navigate with the slim remote control. The software was non-final at the time of our hands-on, but the general framework was already there: you can browse content under recommended highlights, categories, charts or your subscribed shows and stored favorites. There's also a dedicated page for apps, but so far it only shows various video and audio portals (such as PPTV, Sohu, Tencent and Phoenix), as well as a PopCap section with only a few games so far. Given that this device is made solely for the Chinese market (hence the lack of English interface right now), it's certain that Google's Play Store won't make a presence here; and since there was no obvious way for us to install other regular Android apps, this means Xiaomi will likely have total control over what can be loaded onto the box. But the good news is that the selection of multimedia content -- both local and foreign -- is rather decent. Even Dexter, The Big Bang Theory and Mad Men are available in 720p quality for free, courtesy of Sohu (and presumably under a legit deal behind the scenes).
Obviously, it's still too early to see what Xiaomi will get out of its little box, but being able to tie in some of China's best content providers while also offering three types of local network streaming capabilities, as well as its famed weekly software updates, the $64 Xiaomi Box easily gives the competition a run for their money. Perhaps one day we'll even see the same business model reach to other regions, but for now, we can only dream.


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This story was first published on April 9, 2009. Farrah Fawcett lost her battle with anal cancer June 25, 2009.
(CNN) -- The news that one of America's TV icons is suffering from cancer brought sadness. Learning the type of cancer she had made some squeamish.
Farrah Fawcett, shown here in 2004, learned she had cancer in 2006.
Former "Charlie's Angels" actress Farrah Fawcett, 62, was hospitalized this week. She received a diagnosis of anal cancer in 2006.
This type of cancer is less common than rectal and colon cancer, and the location of the tumor and risk factors make people squeamish about discussing it openly, doctors said.
Colon cancer at one time also was not openly talked about, because of the body part and functions affected, but with the public awareness campaigns and celebrities advocating for screenings, it has been largely destigmatized. Anal cancer is less familiar.
Fawcett has not publicly confirmed the specifics of her illness, but is working on a documentary, titled "A Wing and a Prayer," about her health battle.
Anal cancer affects more women and the illness is usually found in people who are in their early 60's. The American Cancer Society estimates that 5,000 new cases of anal cancer are diagnosed each year and about 680 people die from it annually. Meanwhile, colorectal cancer has 148,000 new cases and about 50,000 deaths each year.
The numbers of anal cancer cases are rising, although experts haven't been able to pinpoint why.
Cultural squeamishness about certain body areas could prevent early diagnosis and treatment of anal cancer, said Dr. Petr F. Hausner, an associate professor of medicine at the University of Maryland Medical Center in Baltimore, Maryland.
"Patients in the United States hate to be examined in these areas," said Hausner, who trained in Czechoslovakia. "They like to keep their private parts more private than in Europe. In the U.S., the patients hate those exams and physicians hate to do them. The examination is incomplete."
The cultural discomfort might be a minor factor, though.
"The bigger role is the virus," he said referring to the human papilloma virus, a key risk factor for anal cancer that also can cause cervical cancer. Getting vaccinated against HPV is a step in prevention, Hausner said.
More than half of anal cancer patients experience bleeding as a symptom. Others have no symptoms or report common conditions, such as hemorrhoids, fissures, or warts. Symptoms also include itching or pain in that area, changes in the diameter of stool, abnormal discharge, swollen lymph nodes in the anal or groin areas, according to the American Cancer Society.
"The most common thing is people think it's a hemorrhoid," said Dr. Cathy Eng, associate professor in the department of gastrointestinal medical oncology at the University of Texas M.D. Anderson Cancer Center. Patients should consult with their physicians, she said.
Anal pap smears are routine only for HIV-positive patients, who are at higher risk for this cancer. There are no anal cancer screening recommendations for non-HIV individuals, because it remains a rare disease, Hausner said.
People whose immune system are suppressed, from HIV or drugs taken after organ transplants are at risk for anal cancer. Other risk factors include a sexual history with many partners, a medical history of human papilloma virus (HPV), sexually transmitted diseases or gynecological cancers.
People tend to view anal cancer negatively, because they associate the cancer with a few of its risk factors -- such as sexually transmitted diseases or anal sex, Eng said.
"It's one of the risk factors, not the only risk factor," Eng said. "It's fair to say people are stigmatized, she said, primarily because of the disease's association with that type of sex.
When anal cancer is caught early, chemotherapy and radiation are highly effective. But if the cancer doesn't respond to treatment and spreads to other areas of the body, the five-year survival rate plummets to 20 percent, Eng said.
"Anal cancer is unique," she said. "The majority of time you can cure the patient, but if you have recurrent or residual disease, you could end up losing your sphincter."
The sphincter are muscles that holds in urine and feces. If the sphincter is removed, the patient must have a special bag, called an ostomy pouch, that collects the waste.
Anal cancer is "much rarer than colon cancer," Hausner said. "For 50 colon cancer patients, we see one anal cancer... It's a rare disease. It is becoming a little bit more frequent. I would say that people are not aware."
All About Farrah Fawcett • Cancer • Women's Health


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"The best you've ridden is the best you know." - Paul Thede Find a Nearby Race Tech Center
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Race Tech is in the development stage of creating Gold Valve Kits, RT Hi-Performance Springs Kits and G3-S Custom Shocks specifically for snowmobiles.
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Products include Gold Valve Kits and Hi-Performance Springs. Shock Service is also available. We are making new G3-S Custom Series Shocks too.
Todd Topper from Mission Cycles can be contacted at 705.424.1515.
"Race Tech had podium finishes this past weekend in the season opener snowcross race. Race Tech rocks (even in the snow)! Tell everyone we are stoked!" – Todd Topper, Mission Cycle
Check out Team Rider Mike Island in action.
This one gives a new meaning to "water crossing."
Race Tech specializes in Custom Suspension Setup! Whatever your requirements are, we can get you handled.


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Eurogroup chief: 'I'm for secret, dark debates'
Eurozone economic policies should only be conducted in "dark secret rooms", to prevent dangerous movements in financial markets, the Eurogroup chief said on Wednesday (20 April), adding that he had often lied in his career to prevent the spread of rumours that could feed speculation.
As exists in the case of monetary policy, all economic decisions should now be discussed behind closed doors, he said
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"Monetary policy is a serious issue. We should discuss this in secret, in the Eurogroup," Jean-Claude Juncker said at a Brussels conference on economic governance organised by the European Movement, an organisation that promotes European integration, referring to matters already long since outsourced from national parliaments to independent central banks.
"The same applies to economic and monetary policies in the Union. If we indicate possible decisions, we are fuelling speculations on the financial markets and we are throwing in misery mainly the people we are trying to safeguard from this."
"I'm ready to be insulted as being insufficiently democratic, but I want to be serious," he said.
Under his line of reasoning, ministers and EU leaders who discuss financial matters in public put "millions of people at risk" due to wild swings in financial markets produced by their public commentary.
"I am for secret, dark debates," he quipped.
"There is insufficient awareness at the European level when it comes to these issues, because each of us wants to show his domestic public that he's the greatest guy under the sky," Juncker noted.
Having served as finance minister and then premier of Luxembourg for the past 22 years, Juncker pointed out that over the course of his career, despite his Catholic upbringing, he often "had to lie" in order not to feed rumours.
A conference-goer suggested that removing the secrecy in EU meetings could prevent markets from moving on rumour and speculations, Juncker said that could not be done because ministers and EU leaders need time to reach decisions.
"Actions on the financial markets are taking place in real time. We don't always agree at each and every debate on monetary policy, but meanwhile markets are reacting."
Juncker also used the occasion to give his endorsement to changes the European Parliament has made to EU economic governance legislation, amendments that tighten the European Commission's role as fiscal-policy policeman, watching over member-state economic decisions.
He said the European Parliament's amendments are "pointing in the right direction" and he was hopeful that an agreement between member states and the EU legislature could be reached before June, so that EU leaders could adopt the final version at a summit mid-June.
However, the Eurogroup chief could not hide his scepticism as to the effectiveness of all such measures, particularly the so-called Euro-plus-pact aimed at boosting competitiveness and adopted by EU leaders in March.
"I was never a strong believer of this Euro-plus-pact. I can't criticise it too much, since I also approved it, but if I was alone, I would not have adopted it. There is nothing new in it. All ideas had already been on the table of the Council [of ministers], but there was never much political will to implement them."
Surveillance policies, so that countries do not run huge budget deficits and fall into a vortex of debt and low credit ratings, had also been in place, but were ignored by "the very sinners who are now preaching about the need to enhance surveillance" - France and Germany.
Ireland's and Spain's real-estate problems, Greece's lack of budgetary discipline "were all mentioned in the Eurogroup, but ministers rejected the idea of interfering in domestic affairs," he said.
"Every one is now discovering the virtues of co-ordinating economic policies, even though these are rather old and unsuccessful stories," Juncker said, listing a whole series of such attempts: the macro-economic guidelines of the 90s, the stability and growth pact watered down by France and Germany, the Cardiff process, the Luxembourg process, the Lisbon Agenda.
"Don't be impressed when a new process is invented. It was not the absence of instruments, but the lack of political will to implement them [that led to the current crisis.]"
EUOBSERVER / BRUSSELS (20 April) - Eurogroup chief and Prime Minister of Luxembourg Jean-Claude Juncker telling how he "had to lie" in his career in order not to feed market speculations. He was speaking at a conference on economic governance organised by the European Movement.
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Version 4 of the A* Pathfinding Project has just been released! I have been working on this update for quite some time and now that it is finally released I thought I'd take this post to list the most notable improvements in this new version. This is not an exhaustive list, you can find more changes in the changelog.
Huge performance improvements for Recast graphs
New algorithms and optimization of the existing ones makes scanning and updating recast graphs significantly faster. The scan is now fully multi-threaded and it handles large worlds with lots of objects much better.
Speedups range from 2x to over 1000x with around 5x being the most common for small to medium sized worlds. The larger the world and the more cores your computer has, the greater the speedup. The 1000x+ speedup was observed when scanning a several square kilometer world (used in a real game). If your game has a procedural world and you use a recast graph to scan it when the game starts, this should improve your game's startup times significantly.
If you use a large number of navmesh cuts you should also get a noticeable speed boost.
Object pooling is used in more places which reduces the number of allocations. This is particularly important when recalculating tiles or using navmesh cutting during runtime.
Improved graph rendering
Graph rendering has undergone a massive overhaul to both improve the style of them as well as improve the performance.
In 3.x graph rendering used Unity's Gizmo system which, while nice, requires the rendered lines and surfaces to be recalculated every frame. To improve upon this a custom persistent line and surface drawing system has been developed which allows the meshes to be cached over several frames if the graph is not updated.
For grid graphs in particular this improves the frame rate in the scene view significantly. In 3.x large grid graphs were very slow to draw, for larger graphs sometimes so slow that it was hard to work with them. As an example, for a 1000×1000 graph each frame would take over 4 seconds to render. In 4.x this has been reduced to around 90 ms (or around 50 times faster) which is a perfectly interactable frame rate.
Take a look at the video below for a comparison when using a slightly smaller graph.
As a bonus, the new custom line rendering system will give you nice smooth anti-aliased lines on Windows even when anti-aliasing is disabled in the rendering settings (Unity Gizmos will become aliased).
The graph rendering style has been improved for grid graphs. Now you can render the surface of the nodes as well as the outline of them. In 3.x only the connections between the nodes are visible which is often confusing, particularly for new users. Hexagon graphs (which are grid graphs with certain settings) can with the new rendering code be visualized much better. In the inspector you can now choose between any combination of the surface, outline and connections for rendering.
2D for everything
This is a great update for all of you that are working on 2D games or have been thinking of making one.
Many of the internal systems have been reworked or rewritten to be able to handle 2D worlds or even better, worlds with any rotation.
Local avoidance now works for both for 2D games and 3D games, the only thing you need to do is to flip a switch on the RVOSimulator component. You can read more about the changes to the local avoidance system below.
The AIPath script has been rewritten to among other things support movement with any graph rotation. It can now also optionally use the Y-axis as the forward axis for the character instead of the Z-axis which is often desired in 2D games.
The funnel modifier now includes an optional pre-processing step where it flattens the path corridor before running the funnel algorithm. This makes it possible to use the funnel modifier for 2D games and even on curved worlds.
The layered grid graph now also supports arbitrary rotations. It had some partial support in 3.x, but not everything worked.
Recast graphs can now be rotated and navmesh cutting has been reworked to support this.
A new example scene for 2D games with local avoidance has been added and there is also a new documentation page and video tutorial about how to configure pathfinding for 2D games.
Async scanning
In 4.0 all graph types have been reworked to support asynchronous scanning which means that you can show a progress bar while the graphs are being scanned and the game will not freeze. In 3.x all graphs had to be scanned synchronously, i.e in a single frame. This was problematic if your graphs were large and took some time to scan as the game would freeze during the calculation time.
You can scan graph asynchronously using the new ScanAsync method. It is an IEnumerable which you can iterate through. At each iteration it will return a short message describing what it is doing as well as a percentage which you can use to for example update a progress bar.
Turn based games
New functionality for (primarily) turn based games has been introduced.
In turn based games one often want very detailed control over which units can walk on which nodes and how much it costs for a character to traverse each node. It has been possible to do this via some elaborate combination of graph updates and tags, but possible does not mean easy and neither does it mean performant or stable.
In 4.0 a 'traversal provider' (which is an interface that your scripts can implement) can be added to paths which allows you to control exactly what nodes a character should consider blocked and how large the cost of traversing those nodes should be. The package comes with a built in implementation of a traversal provider called 'BlockManager' and an accompanying component called 'SingleNodeBlocker'. The SingleNodeBlocker component can be attached to any object (for example the units in a turn based game) and has a very simple API with which you can block nodes that the e.g a unit occupies. With the BlockManager you can then easily do things like "allow this character to traverse all nodes except those occupied by this list of SingleNodeBlocker components" or "don't allow this character to traverse any nodes occupied by SingleNodeBlocker components except the ones in this list". This is useful if you for example want to search for a path where the character should not be blocked by itself, but other characters should not be able to move through it.
A new example scene and a documentation page have been added which show how to use these components. The example scene also shows how to visualize all nodes within a certain distance from the character which is useful in turn based games to limit the distance a character can move in a single turn. It also showcases a hexagon graph which is a particularly popular graph type for turn based games.
These utilities can of course be used for games that are not turn based as well, and I expect that they will be, but turn based games are the main target.
Improved movement scripts
The RichAI script has been improved and the AIPath script has been almost completely rewritten.
Among the most notable improvements are that the AIPath script now slows down and accelerates much more realistically and precisely. By using trajectory optimization the path of the agent is optimized to reach the end point of the path with a zero velocity to reduce any overshoot. This makes it able to stop much more precisely at the end points of paths without spinning around or overshooting.
The AIPath script can now use gravity and there is an option to use either the gravity set in the Unity project settings or a custom gravity which is useful for many games. This option has also been added to the RichAI script. Furthermore the way the AIPath and RichAI components integrate with rigidbodies has been improved and matches the behavior when not using rigidbodies a lot closer than before. The AIPath script has a new custom inspector that should make it easier to configure. It also draws gizmos in the scene view which visualize the various distance settings on the component.
When calculating many or long paths at the same time, especially on slow computers, it can take a small amount of time before the movement script gets back the result of the path calculation. During that time it may have moved a distance away from where it was when it requested the path and therefore the AIPath script has had code for detecting where it should start to follow the calculated path. If the latency for calculaing paths grew too large this algorithm could sometimes not keep up and the agent may for example turn around for a short amount of time and move in the wrong direction on the path. In 4.0 this algorithm has been improved to be both more performant and better handle cases when the latency grows large. This means it should tolerate slower computers (or more units/larger worlds) better.
Code quality
The code quality has been significantly improved in version 4.0. I have worked hard to clean up messy areas of code, to add more documentation comments and to refactor existing classes to improve encapsulation. This should make Intellisense suggestions less noisy. For those of you that like to read the source code of packages that you use, this should hopefully make it more enjoyable for you and make it easier to understand the code.
Local avoidance
The local avoidance algorithm has been rewritten completely. You will not notice many changes in behavior other than that they are now better at not being pushed through walls in high density crowds, however the configuration has been greatly simplified and some new features have been added. Each agent now has priority setting. Lower priority agents will avoid higher priority agents more. As mentioned in previously the local avoidance system now supports the XY plane as well so you can now use local avoidance in your 2D games.
In 3.x the local avoidance algorithm had various parameters that were not always easy to know the best values for, with the new algorithm it should be much easier to configure.
The new algorithm also allows for much better control over where exactly the character should stop. The previous algorithm was based only on velocities which works great when agents are moving, but it did not know at which point an agent intends to stop and this could sometimes lead to agents jiggling a bit when they reached their target point instead of stopping completely.
These are just the most notable changes. There are various other improvements that you can read about in the full changelog.
4.0 is a paid upgrade. However everyone who bought the package up to 8 months before the update was revealed (i.e after 2016-07-24) get the upgrade for free. Just make sure that you are logged in with the correct Asset Store account. If you bought the package earlier you can upgrade for 50% off in the Asset Store. If you didn't buy the package via the Asset Store, please send me a PM via the forum.
Since not everyone can or want to upgrade, the 3.x branch will continue to get updates for a while with bug fixes and some features. I am not able to update the Asset Store package anymore due to how the Unity Asset Store works, but you can always download the latest version on the package homepage.


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President Trump's Task Force on Crime Reduction and Public Safety, led by Sessions, is expected to release a report next week that criminal justice reform advocates fear will link marijuana to violent crime and recommend tougher sentences for those caught growing, selling and smoking the plant.
Sessions sent a memo in April updating the U.S. Attorney's Offices and Department of Justice Department (DOJ) component heads on the work of the task force, which he said would be accomplished through various subcommittees. In the memo, Sessions said he has asked for initial recommendations no later than July 27.
"Task Force subcommittees will also undertake a review of existing policies in the areas of charging, sentencing, and marijuana to ensure consistency with the Department's overall strategy on reducing violent crime and with Administration goals and priorities," he wrote.
Criminal justice reform advocates fear Sessions's memo signals stricter enforcement is ahead.
"The task force revolves around reducing violent crime and Sessions and other DOJ officials have been out there over the last month and explicitly the last couple of weeks talking about how immigration and marijuana increases violent crime," said Inimai Chettiar, director of the Brennan Center's Justice Program.
"We're worried there's going to be something in the recommendations that is either saying that that's true or recommending action be taken based on that being true."
Sessions sent a letter in May asking congressional leaders to do away with an amendment to the DOJ budget prohibiting the agency from using federal funds to prevent states "from implementing their own State laws that authorize the use, distribution, possession or cultivation of medical marijuana."
"I believe it would be unwise for Congress to restrict the discretion of the Department to fund prosecutions, particularly in the midst of an historic drug epidemic and potentially long-term uptick in violent crime," said the letter from Sessions, first obtained by Massroots.com and verified by The Washington Post.
As for the task force, Sessions said another subcommittee would "explore our use of asset forfeiture and make recommendations on any improvements needed to legal authorities, policies, and training to most effectively attack the financial infrastructure of criminal organizations."
On Wednesday, Sessions reportedly re-established a controversial criminal asset seizure program ahead of the committee's recommendations.
Local law enforcement leaders say a crackdown appears to be next, though they argue there's no need for it.
"From a practitioner's point of view, marijuana is not a drug that doesn't have some danger to it, but it's not the drug that's driving violent crime in America," said Ronal Serpas, the former superintendent of the New Orleans Police Department and co-chairman of Law Enforcement Leaders to Reduce Crime and Incarceration.
"That's not the drug with which we see so much death and destruction on the streets of America. Crack and powdered cocaine, heroin and opioids is where we're seeing people die on street corners fighting over territory or control."
Eight states and the District of Columbia have legalized the recreational use of marijuana, and another 21 states allow the use of medical marijuana, according to the Marijuana Policy Project, but marijuana use is still illegal under federal law.
If Sessions ignites a fight over states' rights, Chettiar wonders whether it will spur Republicans into a showdown with the Trump administration on criminal justice reform.
Sen. Rand Paul (R-Ky.), who publicly criticized Sessions for reversing Obama-era guidelines on criminal charges and sentencing in May, said he's not in favor of the DOJ interfering with state policies regarding marijuana.
"I will oppose anybody from the administration or otherwise that wants to interfere with state policy," he told The Hill this week.
Paul is part of a bipartisan group of Senators pushing legislation to allow patients to continue accessing medical marijuana in states where it is legal without fear of federal prosecution.
Legislation introduced last month by Sens. Kirsten Gillibrand (D-N.Y.), Cory Booker (D-N.J.), Lisa Murkowski (R-Alaska), Al Franken (D-Minn.), Mike Lee (R-Utah) and Paul introduced — known as the The Compassionate Access, Research Expansion and Respect States (CARERS) Act — would amend federal law to allow states to set their own medical marijuana policies.
According to Politifact, Trump pledged to leave marijuana legalization up to the states while on the campaign trail. But last month he reportedly pushed back against the congressional ban on the DOJ interfering with state medical marijuana laws in a signing statement, asserting that he isn't legally bound to the limits imposed by Congress.
The DOJ's likely move on marijuana comes amid rising tensions between Trump and Sessions.
Trump in an interview with The New York Times publicly dressed down Sessions for recusing himself from the Russia investigation, calling that decision "very unfair" to him.
Longtime Trump ally Roger Stone argued this week that Trump has been disappointed in Sessions.
"The president initially bonded with Sessions because he saw him as a tough guy," he said in an interview with The New York Times.
"Now he's saying: 'Where's my tough guy? Why doesn't he have my back?' There's a lack of aggressiveness with Sessions, unless it involves chasing people for smoking pot."
In an interview with The Hill, Booker called Sessions "one of the greatest threats to the safety of our local communities in America."
"If you try to start prosecuting marijuana … you create more violence and more danger as well as greater government cost," he said. "These policies that he's doing ultimately go to the core of the safety of our communities."
Though Sessions appears to be an obstacle for lawmakers and advocates who want sentencing reform, Booker said he's not "insurmountable."
"If we can overcome Strom Thurmond's filibuster against the civil rights bill, we can overcome a U.S. Attorney General who is out of step with history and out of step with his party," he said.
But Sessions isn't alone in his views on pot. Though he said he believes in the need for sentencing reform, Sen. Lindsey Graham (R-S.C.) seemed to agree this week that there needs to be stricter enforcement.
"I believe marijuana probably needs to be cracked down on, but we'll see when he sends it over," Graham said of the task force report.