The percentage of consonants correct (PCC) metric: extensions and reliability data

Slow speech rate effects on stuttering preschoolers with disordered phonology

To study the effects of clinicians' slow rate on the speech of children who stutter with and without a concomitant phonological disorder, an A-B-A-B single case design was used with six clinician-child dyads, where B = Clinician's slow speech rate model. Two boys and one girl, aged 49-54 months, stuttering with disordered phonology (S + DP), were compared to three boys aged 42-50 months, stuttering with normal phonology (S + NP). Articulation rates were measured in phones per second (pps) in clinician-child adjacent utterance pairs. The S + NP dyads showed improved fluency in the B condition through a larger effect size, higher mean baseline stutter reductions and lower percentages of non-overlapping data than did the S + DP dyads. The S + DP girl showed relatively improved fluency in the B condition. S + DP children showed no articulation rate alignment (Range: 16% decrease to a 1.2% increase), whereas S + NP children averaged a 20% pps rate reduction (Range: 19.6-25.4% decrease), aligning with their clinicians who averaged a 38% pps rate reduction from baseline. The S + DP group spoke significantly (z = -4.63; p < 0.00) slower at baseline (Mdn = 6.9 pps; SE = 0.07 pps) than S + NP children in previously published samples (Mdn = 9.8 pps; SE = 0.22 pps). Results suggest that a slow rate model alone is not effective for facilitating fluency in S + DP boys with time since onset of about 2 years.

Volubility, consonant, and syllable characteristics in infants and toddlers later diagnosed with childhood apraxia of speech: A pilot study

PURPOSE

This pilot study explored the volubility, consonant singleton acquisition, and syllable structure development between infants and toddlers (birth-24 months) with typical speech sound production (TYP) and those later diagnosed with childhood apraxia of speech (CAS).

METHOD

A retrospective longitudinal between- and within-subjects research design was utilized (TYP N=2; CAS N=4). Vocalizations from participants were analyzed between birth-24 months from home videotapes, volunteered by the children's parents, according to type (nonresonant vs. resonant), volubility, place and manner of consonant singletons, and syllable shape (V, CV, VC, CVC, VCV, CVCV, VCVC, and "Other").

RESULTS

Volubility between groups was not significant but statistically significant differences were found in the number of: resonant and non-resonant productions; different consonant singletons; different place features; different manner classes; and proportional use of fricative, glottal, and voiceless phones. Infants and toddlers in the CAS group also demonstrated difficulty with CVCs, had limited syllable shapes, and possible regression of vowel syllable structure.

CONCLUSIONS

Data corroborate parent reports that infants and toddlers later diagnosed with CAS present differently than do those with typical speech sound skills. Additional study with infants and toddlers later diagnosed with non-CAS speech sound disorder is needed.

LEARNING OUTCOMES

Readers will: (1) describe current perspectives on volubility of infants and toddlers later diagnosed with CAS; (2) describe current perspectives of the consonant singleton and syllable shape inventories of infants and toddlers later diagnosed with CAS; and (3) discuss the potential differences between the speech sound development of infants and toddlers later diagnosed with CAS and those with typical speech sound skill.

Transcranial direct current stimulation combined with integrative speech therapy in a child with cerebral palsy: A case report

The aim of this study was to describe the results of the first case combining integrative speech therapy with anodal transcranial direct current stimulation (tDCS) over Broca's area in a child with cerebral palsy. The ABFW phonology test was used to analyze speech based on the Percentage of Correct Consonants (PCC) and Percentage of Correct Consonants - Revised (PCC-R). After treatment, increases were found in both PCC (Imitation: 53.63%-78.10%; Nomination: 53.19%-70.21%) and PPC-R (Imitation: 64.54%-83.63%; Nomination: 61.70%-77.65%). Moreover, reductions occurred in distortions, substitutions and improvement was found in oral performance, especially tongue mobility (AMIOFE-mobility before = 4 after = 7). The child demonstrated a clinically important improvement in speech fluency as shown in results of imitation number of correct consonants and phonemes acquire. Based on these promising findings, continuing research in this field should be conducted with controlled clinical trials.

A influência da escolha dos sons-alvo e do modelo de terapia em crianças que apresentam dessonorização

O objetivo deste estudo foi verificar a eficácia do Modelo ABAB-Retirada e Provas Múltiplas na reestruturação do sistema fonológico de crianças com dessonorização e a influência da escolha dos sons-alvo neste processo. Sete crianças foram selecionadas de um banco de dados de uma instituição federal. Todas estavam autorizadas por seus responsáveis a participar e deveriam apresentar dessonorização previamente à intervenção, sendo tratadas após pelo modelo ABAB-Retirada e Provas Múltiplas. Realizaram-se avaliações fonoaudiológicas e complementares para a obtenção do diagnóstico de desvio fonológico. A gravidade do desvio foi obtida por meio do Percentual de Consoantes Corretas-Revisado. Os sujeitos apresentavam desvios levemente-moderado ou moderadamente-grave, as idades variaram entre 5 anos e 7 anos e 1 mês. Três foram tratados com líquidas e quatro com a fricativa /ʒ/. Analisaram-se as amostras de fala das duas primeiras sessões de retirada do primeiro ciclo de terapia, utilizando-se o teste U de Mann-Whitney. Compararam-se as médias entre avaliação inicial e final ou as médias de evolução entre os grupos. Houve aumento significante do número de sons adquiridos e das produções corretas das fricativas. Porém, o mesmo não ocorreu com o Percentual de Consoantes Corretas-Revisado. As consoantes plosivas e líquidas também não demonstraram aumento significante de produções corretas. Na comparação entre os grupos tratado com líquidas versus tratado com a fricativa /ʒ/, não houve diferença para nenhuma das variáveis. Conclui-se que o modelo ABAB-Retirada e Provas Múltiplas melhora em alguns aspectos os sistemas fonológicos de crianças com dessonorização. Já os sons-alvo para terapia não influenciam neste processo.

Comparação entre a classificação com base em traços e o percentual de consoantes corretas no desvio fonológico

OBJETIVO: verificar se existe diferença entre as classificações de gravidade do desvio fonológico obtido por meio do Percentual de Consoantes Corretas-Revisado e a classificação qualitativa baseada em traços. MÉTODOS: avaliaram-se dados de fala pré-terapia de 38 sujeitos cujos sistemas fonológicos foram classificados segundo a avaliação quantitativa Percentual de Consoantes Corretas-Revisado (Leve, Levemente-moderado, Moderadamente-grave, Grave) e avaliação qualitativa baseada em traços (Leve, Moderado, Moderado-Severo, Severo). Os dados foram analisados por tabelas de frequência e por meio do teste estatístico qui-quadrado (p<0,05). RESULTADOS: na avaliação geral verificou-se uma baixa concordância entre os resultados obtidos com a avaliação qualitativa e a quantitativa dos desvios fonológicos, apenas 34,79% de concordância nas avaliações. Na análise por graus de gravidade, observou-se que os graus extremos (Leve e Severo) obtiveram praticamente a mesma classificação com ambas as propostas, ao contrário do observado nos graus intermediários. CONCLUSÃO: com base nos resultados ressalta-se a importância de avaliações conjuntas, que aliem medidas quantitativas com qualitativas, principalmente para a diferenciação e caracterização dos graus intermediários de gravidade do desvio fonológico.

Caracterização das estratégias de reparo incomuns utilizadas por um grupo de crianças com desvio fonológico

OBJETIVO: caracterizar e analisar o uso das estratégias de reparo incomuns por crianças com desvio fonológico e relacionar a sua utilização com as variáveis faixa etária e sexo; e com as variáveis linguísticas grau do desvio, estrutura silábica, classe de sons e posição na palavra. MÉTODOS: os dados são provenientes do banco de dados do Centro de Estudos de Linguagem e Fala da Universidade Federal de Santa Maria, todos os sujeitos apresentam Termo de Consentimento Livre e Esclarecido autorizando o uso dos dados em pesquisas. Foram selecionados os dados de 178 sujeitos que apresentaram diagnóstico de desvio fonológico e idade entre 4:0-7:11. Foram analisados os resultados da primeira avaliação fonológica da criança. RESULTADOS: houve significância estatística na relação entre a utilização ou não de estratégias de reparo incomuns na amostra estudada, predominando a não utilização. Foi significante a relação entre a utilização de tais estratégias e a faixa etária, com predomínio na faixa de 5:0-5:11, e o grau do desvio, com maior ocorrência no desvio moderadamente-grave. A relação entre as classes de sons também foi significante, predominando a classe das fricativas. Observou-se ocorrência de estratégias de reparo incomuns apenas na posição de onset, sendo a estrutura consoante vogal a única encontrada no estudo. CONCLUSÃO: verificou-se que as estratégias de reparo incomuns são pouco utilizadas por crianças com desvio fonológico. Além disso, encontrou-se relação significante entre a utilização de estratégias de reparo incomuns e as variáveis faixa etária, grau do desvio fonológico e classes de sons.

Swahili speech development: preliminary normative data from typically developing pre-school children in Tanzania

BACKGROUND

Swahili is widely spoken in East Africa, but to date there are no culturally and linguistically appropriate materials available for speech-language therapists working in the region. The challenges are further exacerbated by the limited research available on the typical acquisition of Swahili phonology.

AIM

To describe the speech development of 24 typically developing first language Swahili-speaking children between the ages of 3;0 and 5;11 years in Dar es Salaam, Tanzania.

METHODS & PROCEDURES

A cross-sectional design was used with six groups of four children in 6-month age bands. Single-word speech samples were obtained from each child using a set of culturally appropriate pictures designed to elicit all consonants and vowels of Swahili. Each child's speech was audio-recorded and phonetically transcribed using International Phonetic Alphabet (IPA) conventions. Children's speech development is described in terms of (1) phonetic inventory, (2) syllable structure inventory, (3) phonological processes and (4) percentage consonants correct (PCC) and percentage vowels correct (PVC).

RESULTS & OUTCOMES

Results suggest a gradual progression in the acquisition of speech sounds and syllables between the ages of 3;0 and 5;11 years. Vowel acquisition was completed and most of the consonants acquired by age 3;0. Fricatives/z, s, h/ were later acquired at 4 years and /θ/and /r/ were the last acquired consonants at age 5;11. Older children were able to produce speech sounds more accurately and had fewer phonological processes in their speech than younger children. Common phonological processes included lateralization and sound preference substitutions.

CONCLUSIONS & IMPLICATIONS

The study contributes a preliminary set of normative data on speech development of Swahili-speaking children. Findings are discussed in relation to theories of phonological development, and may be used as a basis for further normative studies with larger numbers of children and ultimately the development of a contextually relevant assessment of the phonology of Swahili-speaking children.

Swedish Test of Intelligibility for Children (STI-CH)--validity and reliability of a computer-mediated single word intelligibility test for children

The aim of this study was twofold: first, to describe a new Swedish intelligibility test (Swedish Test of Intelligibility for Children, STI-CH) and second to evaluate its validity and reliability. STI-CH is based on the repetition of single words. Ten children with a speech-sound disorder (4:6-8:3 years of age, mean = 6.0 years) and 10 children with typical speech and language development (4:8-7:4 years of age, mean = 5.9 years) were included. Twenty speech-language pathology students served as listeners. Intra-judge reliability was high (r > 0.92), as was the intra-class correlation of inter-judge reliability (0.97). In terms of validity, there was a significant difference in STI-CH scores between the two groups, and the scores correlated statistically significantly with the Percentage of Consonants Correct (r = 0.94) and with intelligibility in spontaneous speech (r = 0.85). To sum up, the results indicate that STI-CH could be an option for the assessment of intelligibility in Swedish-speaking children, and that the principles used in the development of the test could be of use in the design of intelligibility tests in languages other than Swedish.

Children with speech sound disorder: comparing a non-linguistic auditory approach with a phonological intervention approach to improve phonological skills

This study aimed to compare the effects of a non-linguistic auditory intervention approach with a phonological intervention approach on the phonological skills of children with speech sound disorder (SSD). A total of 17 children, aged 7–12 years, with SSD were randomly allocated to either the non-linguistic auditory temporal intervention group (n = 10, average age 7.7 ± 1.2) or phonological intervention group (n = 7, average age 8.6 ± 1.2). The intervention outcomes included auditory-sensory measures (auditory temporal processing skills) and cognitive measures (attention, short-term memory, speech production, and phonological awareness skills). The auditory approach focused on non-linguistic auditory training (e.g., backward masking and frequency discrimination), whereas the phonological approach focused on speech sound training (e.g., phonological organization and awareness). Both interventions consisted of 12 45-min sessions delivered twice per week, for a total of 9 h. Intra-group analysis demonstrated that the auditory intervention group showed significant gains in both auditory and cognitive measures, whereas no significant gain was observed in the phonological intervention group. No significant improvement on phonological skills was observed in any of the groups. Inter-group analysis demonstrated significant differences between the improvement following training for both groups, with a more pronounced gain for the non-linguistic auditory temporal intervention in one of the visual attention measures and both auditory measures. Therefore, both analyses suggest that although the non-linguistic auditory intervention approach appeared to be the most effective intervention approach, it was not sufficient to promote the enhancement of phonological skills.

Cross-linguistic generalization in the treatment of two sequential Spanish-English bilingual children with speech sound disorders

PURPOSE

The effect of bilingual service delivery on treatment of speech sound disorders (SSDs) in bilingual children is largely unknown. Bilingual children with SSDs are typically provided intervention in only one language, although research suggests dual-language instruction for language disorders is best practice for bilinguals. This study examined cross-linguistic generalization of bilingual intervention in treatment of two 5-year-old sequential bilingual boys with SSDs (one with Childhood Apraxia of Speech), hypothesizing that selecting and treating targets in both languages would result in significant overall change in their English and Spanish speech systems.

METHOD

A multiple baseline across behaviours design was used to measure treatment effectiveness for two targets per child. Children received treatment 2-3 times per week for 8 weeks and in Spanish for at least 2 of every 3 days. Ongoing treatment performance was measured in probes in both languages; overall speech skills were compared pre- and post-treatment.

RESULT

Both children's speech improved in both languages with similar magnitude; there was improvement in some non-treated errors.

CONCLUSION

Treating both languages had an overall positive effect on these bilingual children's speech. Future bilingual intervention research should explore alternating treatments designs, efficiency of monolingual vs bilingual treatment, different language and bilingual backgrounds, and between-group comparisons.

Differential diagnosis of children with suspected childhood apraxia of speech

PURPOSE

The gold standard for diagnosing childhood apraxia of speech (CAS) is expert judgment of perceptual features. The aim of this study was to identify a set of objective measures that differentiate CAS from other speech disorders.

METHOD

Seventy-two children (4-12 years of age) diagnosed with suspected CAS by community speech-language pathologists were screened. Forty-seven participants underwent diagnostic assessment including presence or absence of perceptual CAS features. Twenty-eight children met two sets of diagnostic criteria for CAS (American Speech-Language-Hearing Association, 2007b; Shriberg, Potter, & Strand, 2009); another 4 met the CAS criteria with comorbidity. Fifteen were categorized as non-CAS with phonological impairment, submucous cleft, or dysarthria. Following this, 24 different measures from the diagnostic assessment were rated by blinded raters. Multivariate discriminant function analysis was used to identify the combination of measures that best predicted expert diagnoses.

RESULTS

The discriminant function analysis model, including syllable segregation, lexical stress matches, percentage phonemes correct from a polysyllabic picture-naming task, and articulatory accuracy on repetition of /pətəkə/, reached 91% diagnostic accuracy against expert diagnosis.

CONCLUSIONS

Polysyllabic production accuracy and an oral motor examination that includes diadochokinesis may be sufficient to reliably identify CAS and rule out structural abnormality or dysarthria. Testing with a larger unselected sample is required.

Enhancing generalisation in biofeedback intervention using the challenge point framework: a case study

Biofeedback intervention can help children achieve correct production of a treatment-resistant error sound, but generalisation is often limited. This case study suggests that generalisation can be enhanced when biofeedback intervention is structured in accordance with a "challenge point" framework for speech-motor learning. The participant was an 11-year-old with residual /r/ misarticulation who had previously attained correct /r/ production through a structured course of ultrasound biofeedback treatment but did not generalise these gains beyond the word level. Treatment difficulty was adjusted in an adaptive manner following predetermined criteria for advancing, maintaining, or moving back a level in a multidimensional hierarchy of functional task complexity. The participant achieved and maintained virtually 100% accuracy in producing /r/ at both word and sentence levels. These preliminary results support the efficacy of a semi-structured implementation of the challenge point framework as a means of achieving generalisation and maintenance of treatment gains.

Data-driven subclassification of speech sound disorders in preschool children

PURPOSE

The purpose of the study was to determine whether distinct subgroups of preschool children with speech sound disorders (SSD) could be identified using a subgroup discovery algorithm (SUBgroup discovery via Alternate Random Processes, or SUBARP). Of specific interest was finding evidence of a subgroup of SSD exhibiting performance consistent with atypical speech motor control.

METHOD

Ninety-seven preschool children with SSD completed speech and nonspeech tasks. Fifty-three kinematic, acoustic, and behavioral measures from these tasks were input to SUBARP.

RESULTS

Two distinct subgroups were identified from the larger sample. The 1st subgroup (76%; population prevalence estimate = 67.8%-84.8%) did not have characteristics that would suggest atypical speech motor control. The 2nd subgroup (10.3%; population prevalence estimate = 4.3%-16.5%) exhibited significantly higher variability in measures of articulatory kinematics and poor ability to imitate iambic lexical stress, suggesting atypical speech motor control. Both subgroups were consistent with classes of SSD in the Speech Disorders Classification System (SDCS; Shriberg et al., 2010a).

CONCLUSION

Characteristics of children in the larger subgroup were consistent with the proportionally large SDCS class termed speech delay; characteristics of children in the smaller subgroup were consistent with the SDCS subtype termed motor speech disorder-not otherwise specified. The authors identified candidate measures to identify children in each of these groups.

Retroflex versus bunched in treatment for rhotic misarticulation: evidence from ultrasound biofeedback intervention

PURPOSE

To document the efficacy of ultrasound biofeedback treatment for misarticulation of the North American English rhotic in children. Because of limited progress in the first cohort, a series of two closely related studies was conducted in place of a single study. The studies differed primarily in the nature of tongue-shape targets (e.g., retroflex, bunched) cued during treatment.

METHOD

Eight participants received 8 weeks of individual ultrasound biofeedback treatment targeting rhotics. In Study 1, all 4 participants were cued to match a bunched tongue-shape target. In Study 2, participants received individualized cues aimed at eliciting the tongue shape most facilitative of perceptually correct rhotics.

RESULTS

Participants in Study 1 showed only minimal treatment effects. In Study 2, all participants demonstrated improved production of rhotics in untreated words produced without biofeedback, with large to very large effect sizes.

CONCLUSIONS

The results of Study 2 indicate that with proper parameters of treatment, ultrasound biofeedback can be a highly effective intervention for children with persistent rhotic errors. In addition, qualitative comparison of Studies 1 and 2 suggests that treatment for the North American English rhotic should include opportunities to explore different tongue shapes, to find the most facilitative variant for each individual speaker.

Using randomized variable practice in the treatment of childhood apraxia of speech

PURPOSE

The purpose of this study was to determine if randomized variable practice, a central component of concurrent treatment, would be effective and efficient in treating childhood apraxia of speech (CAS). Concurrent treatment is a treatment program that takes the speech task hierarchy and randomizes it so that all tasks are worked on in one session. Previous studies have shown the treatment program to be effective and efficient in treating phonological and articulation disorders. The program was adapted to be used with children with CAS.

METHOD

A research design of multiple baselines across participants was used. Probes of generalization to untaught words were administered every fifth session. Three children, ranging in age from 4 to 6 years old, were the participants. Data were collected as percent correct productions during baseline, treatment, and probes of generalization of target sounds to untaught words and three-word phrases.

RESULTS

All participants showed an increase in correct productions during treatment and during probes. Effect sizes (standard mean difference) for treatment were 3.61-5.00, and for generalization probes, they were 3.15-8.51.

CONCLUSIONS

The results obtained from this study suggest that randomized variable practice as used in concurrent treatment can be adapted for use in treating children with CAS. Replication of this study with other children presenting CAS will be needed to establish generality of the findings.

Hear here: children with hearing loss learn words by listening

OBJECTIVES

Early use of hearing devices and family participation in auditory-verbal therapy has been associated with age-appropriate verbal communication outcomes for children with hearing loss. However, there continues to be great variability in outcomes across different oral intervention programmes and little consensus on how therapists should prioritise goals at each therapy session for positive clinical outcomes. This pilot intervention study aimed to determine whether therapy goals that concentrate on teaching preschool children with hearing loss how to distinguish between words in a structured listening programme is effective, and whether gains in speech perception skills impact on vocabulary and speech development without them having to be worked on directly in therapy.

METHOD

A multiple baseline across subjects design was used in this within-subject controlled study. 3 children aged between 2:6 and 3:1 with moderate-severe to severe-profound hearing loss were recruited for a 6-week intervention programme. Each participant commenced at different stages of the 10-staged listening programme depending on their individual listening skills at recruitment. Speech development and vocabulary assessments were conducted before and after the training programme in addition to speech perception assessments and probes conducted throughout the intervention programme.

RESULTS

All participants made gains in speech perception skills as well as vocabulary and speech development. Speech perception skills acquired were noted to be maintained a week after intervention. In addition, all participants were able to generalise speech perception skills learnt to words that had not been used in the intervention programme.

CONCLUSIONS

This pilot study found that therapy directed at listening alone is promising and that it may have positive impact on speech and vocabulary development without these goals having to be incorporated into a therapy programme. Although a larger study is necessary for more conclusive findings, the results from this preliminary study are promising in support of emphasise on listening skills within auditory-verbal therapy programmes.

Omissão de segmentos em crianças com desvio fonológico de acordo com a faixa etária e a gravidade do desvio

OBJETIVO:verificar quais fones sofrem omissão na posição de onset simples no sistema fonológico geral, de crianças com desvio fonológico, de acordo com a faixa etária e a gravidade do desvio fonológico.MÉTODOS:participaram deste estudo 60 sujeitos com diagnóstico de desvio fonológico e com idades entre 4 anos e 8 anos e 11 meses, que realizavam a omissão de qualquer fone do Português Brasileiro nas posições de onset inicial e/ou medial, com emprego de 40% ou mais da estratégia de reparo em seu sistema fonológico. Os dados foram submetidos à análise estatística por meio do teste binomial de comparação de 2 proporções, com p<0,05.RESULTADOS:houve predomínio de omissão das consoantes líquidas. Em relação à gravidade do desvio, tanto no desvio fonológico leve quanto no levemente moderado ocorreu somente omissão de líquidas, no moderadamente grave, líquidas e fricativas foram omitidas e no desvio grave ocorreram omissões de todas as consoantes do Português Brasileiro. Já de acordo com a faixa etária, houve maior número de omissões nas idades de 4 anos a 4 anos e 11 meses e de 5 anos a 5 anos e 11 meses.CONCLUSÃO: a omissão de fones na posição de onset simples foi predominante para a classe das líquidas e nos desvios mais graves. Além disso, houve uma tendência de que as crianças mais jovens apresentem maior número de omissões.

Consonant production and intelligibility in cri du chat syndrome

This article focuses on consonant productions by a group of children with cri du chat syndrome (CdCS) and examines how various aspects of these productions contribute to these children's overall intelligibility. Eight children and adolescents with CdCS participated in the study, and the following four questions were addressed: (1) What are the characteristic features of the consonant inventories of the subjects in terms of size and types of consonants; (2) how do the subjects render the consonant phonemes of the target language; (3) to what degree do the subjects produce target-like words; and (4) what is the relationship between consonant production and intelligibility? For the majority of our subjects, we found low proportions of correctly produced consonants, small consonant inventories with several recurrent types of deviant consonants, inaccuracy in realization of target phonemes and variable similarity to target words, all of which may contribute to reduced intelligibility.

Construct-related validity of the TOCS measures: comparison of intelligibility and speaking rate scores in children with and without speech disorders

This study evaluated construct-related validity of the Test of Children's Speech (TOCS). Intelligibility scores obtained using open-set word identification tasks (orthographic transcription) for the TOCS word and sentence tests and rate scores for the TOCS sentence test (words per minute or WPM and intelligible words per minute or IWPM) were compared for a group of 15 adults (18-30 years of age) with normal speech production and three groups of children: 48 3-6 year-olds with typical speech development and neurological histories (TDS), 48 3-6 year-olds with a speech sound disorder of unknown origin and no identified neurological impairment (SSD-UNK), and 22 3-10 year-olds with dysarthria and cerebral palsy (DYS). As expected, mean intelligibility scores and rates increased with age in the TDS group. However, word test intelligibility, WPM and IWPM scores for the 6 year-olds in the TDS group were significantly lower than those for the adults. The DYS group had significantly lower word and sentence test intelligibility and WPM and IWPM scores than the TDS and SSD-UNK groups. Compared to the TDS group, the SSD-UNK group also had significantly lower intelligibility scores for the word and sentence tests, and significantly lower IWPM, but not WPM scores on the sentence test. The results support the construct-related validity of TOCS as a tool for obtaining intelligibility and rate scores that are sensitive to group differences in 3-6 year-old children, with and without speech sound disorders, and to 3+ year-old children with speech disorders, with and without dysarthria.

LEARNING OUTCOMES

Readers will describe the word and sentence intelligibility and speaking rate performance of children with typically developing speech at age levels of 3, 4, 5 and 6 years, as measured by the Test of Children's Speech, and how these compare with adult speakers and two groups of children with speech disorders. They will also recognize what measures on this test differentiate children with speech sound disorders of unknown origin from children with cerebral palsy and dysarthria.

Ocorrência de erros fonológicos de acordo com a gravidade em crianças com transtorno fonológico

Objetivo descrever e quantificar os erros de fala de crianças com transtorno fonológico de acordo com seu desempenho no índice porcentagem de consoantes corretas-revisado e process density index, além de determinar se as crianças com diferentes graus de gravidade diferem quanto ao erro articulatório predominante na fala. Métodos foram analisadas as amostras de fala de 21 crianças com transtorno fonológico de ambos os gêneros, com idades entre 5;2 e 7;11 anos. A partir de duas provas de fonologia (nomeação de figuras e imitação de palavras) foram calculados os índices absolutos de substituição, omissão e distorção, a porcentagem de consoantes corretas-revisado e o process density index Resultados houve diferenças quanto ao tipo de erro predominante na fala indicando que a substituição foi o tipo de erro mais ocorrente. Para as crianças com maior gravidade a substituição foi o tipo de erro de fala predominante e, para aquelas com grau menor gravidade, observou-se ocorrência semelhante dos diferentes tipos de erros. Na análise da amostra total as correlações apontaram que quanto maior a ocorrência de substituição menor o número de distorção Conclusão de forma geral, a substituição foi o tipo de erro mais ocorrente. As crianças menos graves apresentaram equivalência entre os tipos de erros e as mais graves, maior ocorrência de substituições. Os índices absolutos foram efetivos e eficientes para indicar o tipo de erro mais frequente em função da gravidade do transtorno.

Consonant production and overall speech characteristics in school-aged children with cerebral palsy and speech impairment

The aim of the present study was to investigate the speech characteristics of school-aged children with cerebral palsy (CP) and speech impairment at various cognitive levels. Nineteen children with a mean age of 11;2 years (9;2-12;9 years) with spastic, dyskinetic, and ataxic CP and speech impairment participated. Phonetic transcription of oral consonants, ratings of hypernasality, and severity of overall dysarthria, together with free field descriptions of respiration, voice quality, and prosody, were performed independently by two speech-language pathologists. The non-verbal cognitive level was also studied. More than half of the children had large problems with the articulation of consonants, and the children with ataxic CP were most affected. The majority was rated as having dysarthria, mostly mild, but hypernasality was rare. Gross motor problems were not significantly associated with the articulation of consonants or the severity of dysarthria, whereas non-verbal cognitive level was. This underlines the importance of taking non-verbal cognitive level into account, when designing individual speech treatment programs for this group of children. Finally, a careful examination of the articulation of consonants is recommended in order to study speech production thoroughly in children with CP.

Neural Correlates of Developmental Speech and Language Disorders: Evidence from Neuroimaging

Disorders of speech and language arise out of a complex interaction of genetic, environmental, and neural factors. Little is understood about the neural bases of these disorders. Here we systematically reviewed neuroimaging findings in Speech disorders (SD) and Language disorders (LD) over the last five years (2008-2013; 10 articles). In participants with SD, structural and functional anomalies in the left supramarginal gyrus suggest a possible deficit in sensory feedback or integration. In LD, cortical and subcortical anomalies were reported in a widespread language network, with little consistency across studies except in the superior temporal gyri. In summary, both functional and structural anomalies are associated with LD and SD, including greater activity and volumes relative to controls. The variability in neuroimaging approach and heterogeneity within and across participant samples restricts our full understanding of the neurobiology of these conditions- reducing the potential for devising novel interventions targeted at the underlying pathology.

Neural Correlates of Developmental Speech and Language Disorders: Evidence from Neuroimaging

Disorders of speech and language arise out of a complex interaction of genetic, environmental, and neural factors. Little is understood about the neural bases of these disorders. Here we systematically reviewed neuroimaging findings in Speech disorders (SD) and Language disorders (LD) over the last five years (2008–2013; 10 articles). In participants with SD, structural and functional anomalies in the left supramarginal gyrus suggest a possible deficit in sensory feedback or integration. In LD, cortical and subcortical anomalies were reported in a widespread language network, with little consistency across studies except in the superior temporal gyri. In summary, both functional and structural anomalies are associated with LD and SD, including greater activity and volumes relative to controls. The variability in neuroimaging approach and heterogeneity within and across participant samples restricts our full understanding of the neurobiology of these conditions— reducing the potential for devising novel interventions targeted at the underlying pathology.

Speech sound production in 2-year-olds who are hard of hearing

PURPOSE

The purpose of the study was to (a) compare the speech sound production abilities of 2-year-old children who are hard of hearing (HH) to children with normal hearing (NH), (b) identify sources of risk for individual children who are HH, and (c) determine whether speech sound production skills at age 2 were predictive of speech sound production skills at age 3.

METHOD

Seventy children with bilateral, mild-to-severe hearing loss who use hearing aids and 37 age- and socioeconomic status-matched children with NH participated. Children's speech sound production abilities were assessed at 2 and 3 years of age.

RESULTS

At age 2, the HH group demonstrated vowel production abilities on par with their NH peers but weaker consonant production abilities. Within the HH group, better outcomes were associated with hearing aid fittings by 6 months of age, hearing loss of less than 45 dB HL, stronger vocabulary scores, and being female. Positive relationships existed between children's speech sound production abilities at 2 and 3 years of age.

CONCLUSION

Assessment of early speech sound production abilities in combination with demographic, audiologic, and linguistic variables may be useful in identifying HH children who are at risk for delays in speech sound production.

Auditory and visual sustained attention in children with speech sound disorder

Although research has demonstrated that children with specific language impairment (SLI) and reading disorder (RD) exhibit sustained attention deficits, no study has investigated sustained attention in children with speech sound disorder (SSD). Given the overlap of symptoms, such as phonological memory deficits, between these different language disorders (i.e., SLI, SSD and RD) and the relationships between working memory, attention and language processing, it is worthwhile to investigate whether deficits in sustained attention also occur in children with SSD. A total of 55 children (18 diagnosed with SSD (8.11 ± 1.231) and 37 typically developing children (8.76 ± 1.461)) were invited to participate in this study. Auditory and visual sustained-attention tasks were applied. Children with SSD performed worse on these tasks; they committed a greater number of auditory false alarms and exhibited a significant decline in performance over the course of the auditory detection task. The extent to which performance is related to auditory perceptual difficulties and probable working memory deficits is discussed. Further studies are needed to better understand the specific nature of these deficits and their clinical implications.

Assessment of intelligibility using children's spontaneous speech: methodological aspects

BACKGROUND

Intelligibility is a speaker's ability to convey a message to a listener. Including an assessment of intelligibility is essential in both research and clinical work relating to individuals with communication disorders due to speech impairment. Assessment of the intelligibility of spontaneous speech can be used as an overall indicator of the severity of a speech disorder. There is a lack of methods for measuring intelligibility on the basis of spontaneous speech.

AIMS

To investigate the validity and reliability of a method where listeners transcribe understandable words and an intelligibility score is calculated on the basis of the percentage of syllables perceived as understood.

METHODS & PROCEDURES

Spontaneous speech from ten children with speech-sound disorders (mean age = 6.0 years) and ten children with typical speech and language development (mean age = 5.9 years) was recorded and presented to 20 listeners. Results were compared between the two groups and correlation with percentage of consonants correct (PCC) was examined.

OUTCOMES & RESULTS

The intelligibility scores obtained correlated with PCC in single words and differed significantly between the two groups, indicating high validity. Inter-judge reliability, analysed using intra-class correlation (ICC), was excellent in terms of the average measure for several listeners.

CONCLUSIONS & IMPLICATIONS

The results suggest that this method can be recommended for assessing intelligibility, especially if the mean across several listeners is used. It could also be used in clinical settings when evaluating intelligibility over time, provided that the same listener makes the assessments.

Phonological development of first language isiXhosa-speaking children aged 3;0-6;0 years: a descriptive cross-sectional study

Standardized assessments of children's isiXhosa phonology have not yet been developed and there is limited information about developmental norms in this language. This article reports on the phonological development of 24 typically developing first language isiXhosa-speaking children aged 3;0-6;0 years, in Cape Town, South Africa. The order and age of acquisition of isiXhosa phonemes, emergence and elimination of phonological processes and percentage consonants and vowels correct are described. A set of culturally and linguistically appropriate pictures was used to elicit single word responses that were recorded and transcribed. The study found that children had acquired most isiXhosa phonemes by 3;0 years although aspirated plosives, affricates, fricatives and clicks were still developing. In particular, the affricates and aspirated plosives were still developing in the 5-year-old children in this sample, suggesting that these may be the latest acquired segments. Children were able to produce basic word shapes by 3;0 years, but some of the words of 4-6 syllables were still being mastered by the 4- and 5-year-old children. Phonological processes that have been well documented for other languages were used by children in this sample (e.g. deaffrication, stopping and gliding of liquids). Findings presented for this pre-school-aged sample are related to theories of phonological acquisition to provide normative data on phonological development in isiXhosa-speaking children.

Short-term phonological memory in preschool children

PURPOSE

The purpose of this study was to design a short-term memory test, to describe quantitative performance in typically language developing children and to verify the relationship between the non-words repetition and oral phonological measure.

METHODS

The participants included 136 typically language developing children aged from 3 years to 6 years and 11 months old in this study, who were evaluated. The test consisted of 40 non-words of one, two, three, and four syllables. The subjects' repetitions were transcribed and the number of right answers was calculated for each age range.

RESULTS

The effect of age was observed in the test, as well as the effect of length, only for disyllabic non-words. The performance in the non-word repetition task showed correlation with the oral phonology measure.

CONCLUSION

The test designed in this research was able to verify the short-term memory in typically language developing children and the results showed correlation between this memory and phonological performance.

Structural brain differences in school-age children with residual speech sound errors

The purpose of the study was to identify structural brain differences in school-age children with residual speech sound errors. Voxel based morphometry was used to compare gray and white matter volumes for 23 children with speech sound errors, ages 8;6-11;11, and 54 typically speaking children matched on age, oral language, and IQ. We hypothesized that regions associated with production and perception of speech sounds would differ between groups. Results indicated greater gray matter volumes for the speech sound error group relative to typically speaking controls in bilateral superior temporal gyrus. There was greater white matter volume in the corpus callosum for the speech sound error group, but less white matter volume in right lateral occipital gyrus. Results may indicate delays in neuronal pruning in critical speech regions or differences in the development of networks for speech perception and production.

Ultrasound biofeedback treatment for persisting childhood apraxia of speech

PURPOSE

The purpose of this study was to evaluate the efficacy of a treatment program that includes ultrasound biofeedback for children with persisting speech sound errors associated with childhood apraxia of speech (CAS).

METHOD

Six children ages 9-15 years participated in a multiple baseline experiment for 18 treatment sessions during which treatment focused on producing sequences involving lingual sounds. Children were cued to modify their tongue movements using visual feedback from real-time ultrasound images. Probe data were collected before, during, and after treatment to assess word-level accuracy for treated and untreated sound sequences. As participants reached preestablished performance criteria, new sequences were introduced into treatment.

RESULTS

All participants met the performance criterion (80% accuracy for 2 consecutive sessions) on at least 2 treated sound sequences. Across the 6 participants, performance criterion was met for 23 of 31 treated sequences in an average of 5 sessions. Some participants showed no improvement in untreated sequences, whereas others showed generalization to untreated sequences that were phonetically similar to the treated sequences. Most gains were maintained 2 months after the end of treatment. The percentage of phonemes correct increased significantly from pretreatment to the 2-month follow-up.

CONCLUSION

A treatment program including ultrasound biofeedback is a viable option for improving speech sound accuracy in children with persisting speech sound errors associated with CAS.

Factors that influence fast mapping in children exposed to Spanish and English

PURPOSE

The purpose of this study was to determine whether children exposed to 2 languages would benefit from the phonotactic probability cues of a single language in the same way as monolingual peers and to determine whether crosslinguistic influence would be present in a fast-mapping task.

METHOD

Two groups of typically developing children (monolingual English and bilingual Spanish-English) took part in a computer-based fast-mapping task that manipulated phonotactic probability. Children were preschool-aged (N = 50) or school-aged (N = 34). Fast mapping was assessed through name-identification and naming tasks. Data were analyzed using mixed analyses of variance with post hoc testing and simple regression.

RESULTS

Bilingual and monolingual preschoolers showed sensitivity to English phonotactic cues in both tasks, but bilingual preschoolers were less accurate than monolingual peers in the naming task. School-aged bilingual children had nearly identical performance to monolingual peers.

CONCLUSION

Knowing that children exposed to two languages can benefit from the statistical cues of a single language can help inform ideas about instruction and assessment for bilingual learners.

Tracking change in children with severe and persisting speech difficulties

Standardised tests of whole-word accuracy are popular in the speech pathology and developmental psychology literature as measures of children's speech performance. However, they may not be sensitive enough to measure changes in speech output in children with severe and persisting speech difficulties (SPSD). To identify the best ways of doing this, we compared a range of commonly used procedures for perceptual phonological and phonetic analysis of developmental speech difficulties. Data are drawn from four children with SPSD, recorded at 4 years and again at 6 years old performing naming and repetition tasks. Measures of speech output included percentage of whole words correct (PWC), percentage of consonants correct (PCC), proportion of whole-word proximity (PWP), phonological pattern (process) analysis and phonetic inventory analysis. Results indicate that PWC captures change only when identical stimuli are used across time points. PCC is a more robust indicator of change, being less affected by the choice of stimuli. PWP also captures change across time and tasks, while appearing to be more sensitive than PCC to psycholinguistic variables. PCC and PWP are thus both potentially useful tools for evaluating speech outcomes.

Consonant accuracy after severe pediatric traumatic brain injury: a prospective cohort study

PURPOSE

The authors sought to describe longitudinal changes in Percentage of Consonants Correct-Revised (PCC-R) after severe pediatric traumatic brain injury (TBI), to compare the odds of normal-range PCC-R in children injured at older and younger ages, and to correlate predictor variables and PCC-R outcomes.

METHOD

In 56 children injured between age 1 month and 11 years, PCC-R was calculated over 12 monthly sessions beginning when the child produced ≥ 10 words. At each session, the authors compared odds of normal-range PCC-R in children injured at younger (≤ 60 months) and older (> 60 months) ages. Correlations were calculated between final PCC-R and age at injury, injury mechanism, gender, maternal education, residence, treatment, Glasgow Coma Score, and intact brain volume.

RESULTS

PCC-Rs varied within and between children. Odds of normal-range PCC-R were significantly higher for the older than for the younger group at all sessions but the first; odds of normal-range PCC-R were 9 to 33 times higher in the older group in sessions 3 to 12. Age at injury was significantly correlated with final PCC-R.

CONCLUSION

Over a 12-month period, severe TBI had more adverse effects for children whose ages placed them in the most intensive phase of PCC-R development than for children injured later.

A generalização a partir do tratamento com fricativas: ambientes favoráveis versus ambientes pouco favoráveis e neutros

O objetivo deste estudo foi analisar e comparar a ocorrência e os tipos de generalização observados a partir do tratamento das fricativas /z/, /ʃ/ e /ʒ/ em dois grupos de crianças, um utilizando palavras com contextos fonológicos favoráveis e outro os contextos pouco favoráveis e neutros. Seis crianças com desvio fonológico e idades entre 4:7 e 7:8 participaram do estudo com a autorização dos responsáveis. Realizaram-se avaliações fonoaudiológicas e complementares para o diagnóstico do desvio fonológico. Os sujeitos foram pareados de acordo com a gravidade do desvio, sexo, faixa etária e aspectos do sistema fonológico em relação aos fonemas alterados. Metade das crianças foi tratada com palavras em que os fonemas /z/, /ʃ/ e /ʒ/ encontravam-se em ambientes fonológicos favoráveis e a outra metade com ambientes pouco favoráveis e neutros. Foram realizadas oito sessões e, após estas, nova avaliação de fala foi realizada para verificar os tipos de generalização obtidos. Os percentuais de generalizações foram comparados entre os grupos por meio do teste estatístico de Mann-Whitney (p<0.05). Ao término da terapia, observou-se aumento dos percentuais de generalização para todos os sujeitos. Na comparação entre os grupos não foi verificada diferença estatística para as generalizações analisadas. Entretanto, houve vantagem do grupo favorável em relação às generalizações “para outra posição na palavra” e “dentro de uma classe de sons”. Os resultados obtidos podem estar relacionados ao pequeno número de sujeitos ou a outros fatores mencionados no artigo.

Influence of phonotactic probability/neighbourhood density on lexical learning in late talkers

BACKGROUND

Toddlers who are late talkers demonstrate delays in phonological and lexical skills. However, the influence of phonological factors on lexical acquisition in toddlers who are late talkers has not been examined directly.

AIMS

To examine the influence of phonotactic probability/neighbourhood density on word learning in toddlers who were late talkers using comprehension, production and word recognition tasks.

METHODS & PROCEDURES

Two-year-olds who were late talkers (n = 12) and typically developing toddlers (n = 12) were exposed to 12 novel pseudo-words for unfamiliar objects in ten training sessions. Pseudo-words contained high or low phonotactic probability English sound sequences. The toddlers' comprehension, speech production and detection of mispronunciation of the newly learned words were examined using a preferential looking paradigm.

OUTCOMES & RESULTS

Late talkers showed poorer performance than toddlers with typical language development in all three tasks: comprehension, production and detection of mispronunciations. The toddlers with typical language development showed better speech production and more sensitivity to mispronunciations for high than low phonotactic probability/neighbourhood density sequences. Phonotactic probability/neighbourhood density did not influence the late talkers' speech production or sensitivity to mispronunciations; they performed similarly for pseudo-words with high and low phonotactic probability/neighbourhood density sound sequences.

CONCLUSIONS & IMPLICATIONS

The results indicate that some late talkers do not recognize statistical properties of their language, which may contribute to their slower lexical learning.

Toward validation of a minimal competence core of morphosyntax for African American children

PURPOSE

The authors set out to determine (a) whether African American children's spontaneous spoken language met use criteria for a revised minimal competence core with original and added morphosyntactic patterns at different geographical locations, and (b) whether pass/fail status on this core was differentiated on other criterion measures of language maturity.

METHOD

The authors used a common set of activities and stimuli to elicit spontaneous speech samples from Head Start students, age 3;0 (years; months). The 119 participants were distributed at a northern (Lansing, MI) and a southern (Baton Rouge, LA) location.

RESULTS

More than 80% of the children at each location met criteria for 10 core competencies. They included sentence length, type, complexity, and morphosyntactic elaborations of sentences at the lexical, phrasal, and clausal levels. The 2 most significant predictors of pass/fail outcomes in a regression analysis were (a) clinical referral status and (b) the number of different words (NDW(100)) spoken in a speech sample.

CONCLUSION

A minimal competence core analyses of spontaneous oral language samples may help to identify delayed spoken grammars in African American children.

Consonant development in pediatric cochlear implant users who were implanted before 30 months of age

This study provided a yearly record of consonant development for the initial 4 years of cochlear implant (CI) use and established a precedent for using a standardized articulation test, the Goldman-Fristoe Test of Articulation-2 (Goldman, R., & Fristoe, M. [2000]. Goldman-Fristoe Test of Articulation-2. Circle Pines, MN: American Guidance Services). The study used CI age as a referent for 32 children who received their CI before 30 months of age. Consonants produced by 70% of the children were listed, as were the most common error types, which were consonant omissions and substitutions. Using consonant repertoire lists and standard scores, the study revealed that children with CIs had acquisition patterns that were similar to their peers when the duration of CI experience was similar to the chronological age norms of typically developing children. The results revealed that CI users need time to coordinate their articulatory organizing principles with the input they receive from their CI. It is appropriate to use length of CI use as a proxy for chronological age during the first 4 years when comparing articulation development with hearing peers.

Aplicação de medidas de gravidade e de inconsistência de fala em crianças com transtorno fonológico

OBJETIVO: Descrever os índices PCC-R, IRS, IRO e IRD, PDI e IIF em crianças com transtorno fonológico, com e sem os processos fonológicos de ensurdecimento, e verificar a eficiência desses índices na identificação de diferenças entre as crianças. MÉTODOS: Trata-se de pesquisa retrospectiva e transversal com 20 crianças com transtorno fonológico e idade entre 5 e 8 anos. Foram realizados dois agrupamentos, de acordo com a presença dos processos fonológicos de ensurdecimento de plosivas e de fricativas. Todos foram submetidos ao teste de fonologia ABFW, no qual foi verificada a produtividade dos processos fonológicos, o número de diferentes tipos de processos fonológicos e os índices PDI, PCC-R, IRS, IRO e IRD. A prova de inconsistência de fala foi aplicada para calcular o índice de inconsistência de fala. Os dados foram submetidos à análise estatística inferencial. RESULTADOS: O estudo indicou que crianças com transtorno fonológico e presença de ensurdecimento de fricativas e/ou plosivas têm maior comprometimento de fala e apresentam valores mais altos do índice de inconsistência de fala, PDI, IRS, IRO e IRD. O erro articulatório mais ocorrente em ambos os grupos foi a substituição, sendo que a distorção ocorreu mais no grupo sem os processos fonológicos de ensurdecimento. CONCLUSÃO: Os índices aplicados foram eficientes para diferenciar crianças com e sem a presença dos processos fonológicos de ensurdecimento. Há evidências de que as crianças que apresentam os processos fonológicos de ensurdecimento têm dificuldade na representação fonológica.

Speech assessment of Chinese-English bilingual children: accent versus developmental level

The study aimed to evaluate the phonological profiles of Chinese-English bilingual children in primary grades relative to those of English monolinguals, and to compare these profiles with speech-language pathologists' (SLPs') ratings of children's speech in terms of accent or developmental level. Participants were 29 Chinese-English bilinguals and 25 English-monolingual children. Speech samples were collected using the Goldman-Fristoe Test of Articulation-2, either a Cantonese or Mandarin phonology test, and three sentences in a delayed repetition task. In addition, 10 SLPs rated each of the randomized sentences on either an accent or developmental level scale. Bilingual children with identified accents had significantly lower standard scores than monolingual children on the GFTA-2, but on the Chinese phonological assessments the same children showed age-expected speech. The differences in the bilingual children's scores on phonology tests in English vs Chinese highlight the need for phonological assessment in both languages. The SLP listener results further suggest that perceptual judgement may be a useful complement in phonological assessment of bilingual children but not a replacement for more formal testing.

Análise de variáveis utilizadas para a classificação da gravidade do desvio fonológico

OBJETIVO: analisar o comportamento das variáveis Percurso das Rotas, Nível de Complexidade e Aquisição de fonemas, conforme a classificação da gravidade do Desvio Fonológico (DF) por meio do Modelo Linguístico Fuzzy (BRANCALIONI, 2010). Além disso, verificar se a classificação da gravidade, por meio do Modelo, é capaz de diferenciar quantitativamente os graus quanto às classes de sons e aos traços distintivos. MÉTODO: a amostra foi constituída pela avaliação fonológica pré-tratamento de 204 sujeitos com DF, de ambos os sexos e idade entre quatro anos e dois meses a oito anos e dois meses. Todos os sujeitos foram submetidos à avaliação fonológica, avaliação da linguagem compreensiva e expressiva, avaliação do sistema estomatognático, exame articulatório repetitivo e avaliação audiológica. Foram realizadas as análises contrastiva e por traços distintivos. A gravidade dos 204 sistemas fonológicos desviantes foi classificada de acordo com o Modelo. Os valores correspondentes as variáveis foram tabulados e submetidos a tratamento estatístico por meio dos testes Tukey e Associação Qui-Quadrado complementado pela Análise de Resíduos Ajustados, considerando nível de significância de 5% (p<0,05). RESULTADOS: verificou-se que as variáveis Percurso das Rotas, Nível de Complexidade e Aquisição de Fonemas diminuem conforme se acentua a gravidade, sendo estas relações estatisticamente significantes. Além disso, observou-se que o número de classe de som alterada e de substituições de traços distintivos aumenta conforme se acentua a gravidade, sendo estas relações estatisticamente significantes. CONCLUSÃO: o Modelo é capaz de diferenciar os graus quanto às variáveis, trazendo informações importantes de acordo com os diferentes graus.

Mudanças fonológicas obtidas no tratamento pelo modelo de oposições múltiplas

OBJETIVO: analisar as mudanças fonológicas decorrentes da aplicação do Modelo de Oposições Múltiplas no que se refere ao Percentual de Consoantes Corretas-Revisado (PCC-R), no número de fonemas adquiridos no inventário fonológico e nos tipos de generalização. MÉTODO: o grupo pesquisado foi constituído por cinco sujeitos com desvio fonológico. Foram realizadas avaliações fonoaudiológicas e complementares. Os dados da fala foram coletados e analisados por meio da avaliação fonológica pré e pós-tratamento. Os sujeitos foram submetidos à terapia pelo Modelo de Oposições Múltiplas. RESULTADOS: constatou-se que houve diferença estatisticamente significante no que tange ao PCC-R, ao número de fonemas adquiridos, à generalização a itens lexicais não utilizados no tratamento, para outra posição da palavra e para outras classes de sons. Não houve diferença estatística para a generalização dentro de uma classe de sons, porém, observou-se um aumento do percentual no pós-tratamento. CONCLUSÃO: o Modelo de Oposições Múltiplas foi efetivo para o tratamento desses sujeitos falantes do Português Brasileiro, pois proporcionou mudanças no PCC-R, no número de fonemas adquiridos e algumas generalizações (a itens lexicais não utilizados no tratamento, para outra posição na palavra, dentro de uma classe de sons, para outras classes de sons).

Evolução fonológica de crianças com desvio fonológico submetidas a diferentes abordagens terapêuticas

No Português Brasileiro, aproximadamente entre 4 ou 5 anos de idade, a criança já adquiriu todos os fonemas do sistema fonológico adulto. Porém, este processo nem sempre ocorre de acordo com o esperado, verificando-se afastamentos/desvios na aquisição dos sons da fala. O objetivo deste trabalho foi verificar e comparar a evolução do sistema fonológico de crianças com desvio fonológico submetidos à terapia fonológica, acrescida ou não de estimulação das habilidades práxicas orofaciais. A amostra foi composta por seis sujeitos (três meninas e três meninos), com idades entre 5:4 e 7:0 no início da terapia. Os sujeitos foram divididos em três grupos, recebendo todos terapia fonológica, sendo os do grupo estudo tratados com estimulação de habilidades práxicas de face e língua (GFoLFa), e com exercícios de habilidades práxicas de língua (GFoL), e o grupo controle submetido apenas à terapia fonológica (GFo). Todos foram avaliados pré e pós-terapia quanto ao sistema fonológico (Yavas, Hernandorena e Lamprecht, 1991); ao Teste de Praxias Orofaciais (Berzoatti, Tavano e Fabbro, 2007); e ao Teste de Praxias Articulatórias e Bucofaciais (Hage, 2000). Os resultados foram analisados e descritos comparando os três grupos. Os resultados obtidos evidenciaram que todos os grupos apresentaram evoluções no inventário fonético, o GFoLFa obteve evoluções maiores no PCC-R. Conclui-se que os grupos que receberam intervenção práxica obtiveram maiores evoluções fonológicas, porém, sugerem-se novos estudos aplicando este modelo, para que possam ser confirmados esses resultados, com outras amostras.

Childhood Apraxia of Speech (CAS) in two patients with 16p11.2 microdeletion syndrome

We report clinical findings that extend the phenotype of the ~550 kb 16p11.2 microdeletion syndrome to include a rare, severe, and persistent pediatric speech sound disorder termed Childhood Apraxia of Speech (CAS). CAS is the speech disorder identified in a multigenerational pedigree ('KE') in which half of the members have a mutation in FOXP2 that co-segregates with CAS, oromotor apraxia, and low scores on a nonword repetition task. Each of the two patients in the current report completed a 2-h assessment protocol that provided information on their cognitive, language, speech, oral mechanism, motor, and developmental histories and performance. Their histories and standard scores on perceptual and acoustic speech tasks met clinical and research criteria for CAS. Array comparative genomic hybridization analyses identified deletions at chromosome 16p11.2 in each patient. These are the first reported cases with well-characterized CAS in the 16p11.2 syndrome literature and the first report of this microdeletion in CAS genetics research. We discuss implications of findings for issues in both literatures.

Feedback frequency in treatment for childhood apraxia of speech

PURPOSE

To examine the role of feedback frequency in treatment for childhood apraxia of speech (CAS). Reducing the frequency of feedback enhances motor learning, and recently, such feedback frequency reductions have been recommended for the treatment of CAS. However, no published studies have explicitly compared different feedback frequencies in this population.

METHOD

Using an alternating treatments single-subject design with multiple baselines across behaviors, retention and transfer of learning were compared following high-frequency feedback and low-frequency feedback in 4 children with CAS. Feedback frequency was manipulated in the context of an integral stimulation treatment. Changes in perceptual accuracy were quantified with effect sizes and were compared across conditions.

RESULTS

Findings were mixed, with 2 children showing an advantage for low-frequency feedback, 1 child showing a small advantage for high-frequency feedback, and 1 child showing no clear improvement in either condition.

CONCLUSION

These findings suggest that reducing the frequency of feedback may be beneficial for some children with CAS, although this may vary with the child's age or severity of apraxia. Caution is warranted in extrapolating from the nonspeech motor learning literature to speech treatment for CAS. Finally, this study contributes another replication to the literature on the efficacy of integral stimulation treatment for children with CAS.

Functional brain activation differences in school-age children with speech sound errors: speech and print processing

PURPOSE

To examine neural response to spoken and printed language in children with speech sound errors (SSE).

METHOD

Functional magnetic resonance imaging was used to compare processing of auditorily and visually presented words and pseudowords in 17 children with SSE, ages 8;6[years;months] through 10;10, with 17 matched controls.

RESULTS

When processing spoken words and pseudowords, the SSE group showed less activation than typically speaking controls in left middle temporal gyrus. They also showed greater activation than controls in several cortical and subcortical regions (e.g., left superior temporal gyrus, globus pallidus, insula, fusiform, and bilateral parietal regions). In response to printed words and pseudowords, children with SSE had greater activation than controls in regions including bilateral fusiform and anterior cingulate. Some differences were found in both speech and print processing that that may be associated with children with SSE failing to show common patterns of task-induced deactivation and/or attentional resource allocation.

CONCLUSION

Compared with controls, children with SSE appear to rely more on several dorsal speech perception regions and less on ventral speech perception regions. When processing print, numerous regions were observed to be activated more for the SSE group than for controls.

Investigating the use of traditional and spectral biofeedback approaches to intervention for /r/ misarticulation

PURPOSE

Misarticulation of /r/ is among the most challenging developmental speech errors to remediate. Case studies suggest that visual biofeedback treatment can establish perceptually accurate /r/ in clients who have not responded to traditional treatments. This investigation studied the response of children with persistent /r/ misarticulation to a course of traditional treatment and a course of biofeedback treatment.

METHOD

Eleven children with /r/ misarticulation completed 10 weeks of individual treatment consisting of 4-6 weeks of traditional treatment followed by 4-6 weeks of biofeedback treatment. Progress was measured by tracking correct /r/ productions within treatment and probing /r/ in words at 3 time points.

RESULTS

At the group level, there was no difference in independent judges' ratings of /r/ sounds produced by the children before and after traditional treatment. However, /r/ sounds produced after biofeedback treatment were significantly more likely to be rated by the judges as perceptually correct. Eight of the 11 children made measurable gains in the accuracy of isolated /r/ produced within treatment, with 4 showing significant generalization to untreated /r/ in words.

CONCLUSION

This descriptive study shows that treatment incorporating spectral biofeedback can facilitate accurate /r/ production in children with treatment-resistant errors. A follow-up period using traditional intervention methods may be necessary to encourage generalization.

Terapia fonológica com uso de computador: relato de caso

O tema desse artigo aborda as mudanças fonológicas a partir da terapia fonológica com o uso de computador em casos de desvio fonológico. Realizou-se estudo de caso de quatro sujeitos (S1, S2, S3 e S4) com idade entre 4:7 e 5:3, de ambos os gêneros, com desvio fonológico. Realizou-se a Avaliação Fonológica da Criança, Exame Articulatório Repetitivo, Avaliação do Sistema Estomatognático, Teste de Figuras para Discriminação Fonêmica, Prova de Estimulabilidade e avaliação audiológica. Os sujeitos foram divididos em duplas de acordo com a semelhança dos sistemas fonológicos, sendo que um sujeito de cada dupla foi tratado com terapia fonológica padrão e outro com uso de computador como principal recurso terapêutico (terapia experimental). Os dados das avaliações dos sujeitos foram analisados e, após, foram comparados os resultados dos submetidos à terapia padrão (S1 e S2), com os pareados submetidos à terapia experimental, com auxílio do computador, (S3 e S4) por meio do teste Exato de Fisher, considerando significância estatística de 5% (p<0,05). Verificou-se que a evolução dos sujeitos S3 e S4 submetidos à terapia experimental foi maior em relação à evolução de S1 e S2 submetidos à terapia padrão, sendo este resultado estatisticamente significante. Os achados da pesquisa demonstram terem sido favoráveis o uso da terapia experimental no tratamento de crianças com desvio fonológico. Contudo, há necessidade de realização de outros estudos com ampliação casuística para confirmação dos achados.

The relationship between stored phonological representations and speech output

Low quality, imprecise phonological representations have been hypothesized as an underlying deficit in Specific Language Impairment (SLI). This research compared performance on a silent judgement task and a multisyllabic word naming task using the same 10 words, for 21 children with SLI (mean age 7;6), 21 age-matched (AM) (mean age 7;6) and 21 language-matched (LM) (mean age 5;6) peers. The children with SLI demonstrated significantly poorer performance on the judgement task than either AM or LM peers, while performance on the naming task followed a developmental sequence. There was no correlation between the ability to correctly reject inaccurate productions and the ability to correctly name the items. These results support the suggestion of separate input and output phonological representations and that speech output errors should not necessarily be interpreted as indicative of underlying weakness in phonological representations. The research also highlights the value of individually-designed tasks to measure the input phonological representations for specific words.