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Alfalahi H, Dias SB, Khandoker AH, Chaudhuri KR, Hadjileontiadis LJ. A scoping review of neurodegenerative manifestations in explainable digital phenotyping. NPJ Parkinsons Dis 2023; 9:49. [PMID: 36997573 PMCID: PMC10063633 DOI: 10.1038/s41531-023-00494-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/16/2023] [Indexed: 04/03/2023] Open
Abstract
Neurologists nowadays no longer view neurodegenerative diseases, like Parkinson's and Alzheimer's disease, as single entities, but rather as a spectrum of multifaceted symptoms with heterogeneous progression courses and treatment responses. The definition of the naturalistic behavioral repertoire of early neurodegenerative manifestations is still elusive, impeding early diagnosis and intervention. Central to this view is the role of artificial intelligence (AI) in reinforcing the depth of phenotypic information, thereby supporting the paradigm shift to precision medicine and personalized healthcare. This suggestion advocates the definition of disease subtypes in a new biomarker-supported nosology framework, yet without empirical consensus on standardization, reliability and interpretability. Although the well-defined neurodegenerative processes, linked to a triad of motor and non-motor preclinical symptoms, are detected by clinical intuition, we undertake an unbiased data-driven approach to identify different patterns of neuropathology distribution based on the naturalistic behavior data inherent to populations in-the-wild. We appraise the role of remote technologies in the definition of digital phenotyping specific to brain-, body- and social-level neurodegenerative subtle symptoms, emphasizing inter- and intra-patient variability powered by deep learning. As such, the present review endeavors to exploit digital technologies and AI to create disease-specific phenotypic explanations, facilitating the understanding of neurodegenerative diseases as "bio-psycho-social" conditions. Not only does this translational effort within explainable digital phenotyping foster the understanding of disease-induced traits, but it also enhances diagnostic and, eventually, treatment personalization.
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Affiliation(s)
- Hessa Alfalahi
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.
- Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.
| | - Sofia B Dias
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- CIPER, Faculdade de Motricidade Humana, University of Lisbon, Lisbon, Portugal
| | - Ahsan H Khandoker
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Kallol Ray Chaudhuri
- Parkinson Foundation, International Center of Excellence, King's College London, Denmark Hills, London, UK
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Leontios J Hadjileontiadis
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Lim J, McCabe P, Purcell A. Changes in variability during intervention for childhood apraxia of speech: implications for therapy. CLINICAL LINGUISTICS & PHONETICS 2023; 37:291-314. [PMID: 35652542 DOI: 10.1080/02699206.2022.2055494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 03/05/2022] [Accepted: 03/11/2022] [Indexed: 06/15/2023]
Abstract
Typically developing children are variable in their speech production with decreasing variability indicating mastery of speech. Excessive variability which does not change over time may be an indication of unstable motor plans as often seen in children with childhood apraxia of speech (CAS). Dynamic Systems Theory (DST) provides a framework for understanding the role of variability in speech development and disorder. There are few studies that explore the impact of therapy on speech variability. This work explores the impact of therapy on perceptual speech production variability. It is a post-hoc analysis of data collected in two intervention studies of a motor-based treatment approach with children with CAS and explores DST variability effects in speech skill acquisition based on the case data from those studies. There were six participants in total across the two studies. Findings were mixed showing some non-linear changes in variability with larger changes in variability observed in participants who engaged in more extensive therapy. However, the pattern of variability change was not consistent across the participants. These findings suggest that targeting variability in therapy may be an effective way to improve the speech of children with CAS. A model for utilising variability in therapy is presented.
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Affiliation(s)
- Jacqueline Lim
- Speech Pathology, James Cook University College of Healthcare Sciences, Townsville, OLD, Australia
| | - Patricia McCabe
- Speech Pathology, The University of Sydney, Sydney, NSW, Australia
| | - Alison Purcell
- Speech Pathology, The University of Sydney, Sydney, NSW, Australia
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Combiths P, Escobedo A, Barlow JA, Pruitt-Lord S. Complexity and cross-linguistic transfer in intervention for Spanish–English bilingual children with speech sound disorder. JOURNAL OF MONOLINGUAL AND BILINGUAL SPEECH 2023; 4:234-270. [PMID: 37035425 PMCID: PMC10081515 DOI: 10.1558/jmbs.23445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
With bilingual children, intervention for speech sound disorders must consider both of the child’s phonological systems, which are known to interact with each other in development. Further, cross-linguistic generalization following intervention for bilingual children with speech sound disorders (i.e. the impact of treatment in one language on the other) has been documented to varying degrees in some prior studies. However, none to date have documented the cross-linguistic impact of treatment with complex targets (e.g. consonant clusters) for bilingual children. Because complex phonological targets have been shown to induce system-wide generalization within a single language, the potential for bilingual children to generalize learning across languages could impact the efficiency of intervention in this population. This pilot intervention study examines the system-wide, cross-linguistic effects of treatment targeting consonant clusters in Spanish for two Spanish–English bilingual children with phonological disorder. Treatment was provided with 40-minute sessions in Spanish via teletherapy, three times per week for six weeks. Comprehensive phonological probes were administered in English and Spanish prior to intervention and across multiple baselines. Pre-intervention data were compared to data from probes administered during and after intervention to generate qualitative and quantitative measures of treatment outcomes and cross-linguistic generalization. Results indicate a medium effect size for system-wide generalization in Spanish (the language of treatment) and English (not targeted in treatment), for both participants (mean effect size in Spanish: 3.6; English 4.3). These findings have implications for across-language transfer and system-wide generalization in treatment for bilingual children.
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Affiliation(s)
- Philip Combiths
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, USA
- Correspondence concerning this article should be addressed to Philip Combiths, , Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Alicia Escobedo
- Language and Communicative Disorders, San Diego State University and University of California, San Diego, USA
| | - Jessica A. Barlow
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
| | - Sonja Pruitt-Lord
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
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Combiths P, Amberg R, Hedlund G, Rose Y, Barlow JA. Automated phonological analysis and treatment target selection using AutoPATT. CLINICAL LINGUISTICS & PHONETICS 2022; 36:203-218. [PMID: 34085574 PMCID: PMC8642465 DOI: 10.1080/02699206.2021.1896782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
Automated analyses of speech samples can offer improved accuracy and timesaving advantages that streamline clinical assessment for children with a suspected speech sound disorder. In this paper, we introduce AutoPATT, an automated tool for clinical analysis of speech samples. This free, open-source tool was developed as a plug-in for Phon and follows the procedures of the Phonological Analysis and Treatment Target Selection protocol, including extraction of a phonetic inventory, phonemic inventory with corresponding minimal pairs, and initial consonant cluster inventory. AutoPATT also provides suggestions for complex treatment targets using evidence-based guidelines. Automated analyses and target suggestions were compared to manual analyses of 25 speech samples from children with phonological disorder. Results indicate that AutoPATT inventory analyses are more accurate than manual analyses. However, treatment targets generated by AutoPATT should be viewed as suggestions and not used to substitute necessary clinical judgement in the target selection process.
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Affiliation(s)
- Philip Combiths
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
- Department of Cognitive Science, University of California, San Diego, USA
| | - R. Amberg
- Alta Loma School District, Rancho Cucamonga, USA
| | - G. Hedlund
- Department of Linguistics, Memorial University of Newfoundland, St. John’s, Canada
| | - Y. Rose
- Department of Linguistics, Memorial University of Newfoundland, St. John’s, Canada
| | - J. A. Barlow
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
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Combiths P, Pruitt-Lord S, Escobedo A, Barlow JA. Phonological complexity in intervention for Spanish-speaking children with speech sound disorder. CLINICAL LINGUISTICS & PHONETICS 2022; 36:219-240. [PMID: 34112044 PMCID: PMC8660952 DOI: 10.1080/02699206.2021.1936186] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The efficiency of intervention for children with speech sound disorder may be influenced by linguistic complexity of the phonological intervention target. Complex targets, particularly, later-acquired, less-known consonants and consonant clusters, have been linked to greater post-intervention generalization to untargeted phonological structures. Yet there is little direct evidence to support target selection based on linguistic complexity for Spanish-speaking children with speech sound disorder. This intervention study utilizes an experimental single-case design to examine the efficacy of intervention in Spanish using different complex targets (i.e. /ɡɾ/, /bɾ/, and /l/). For each of the four Spanish-speaking children with speech sound disorder, sounds at 0% accuracy during baseline were monitored across the baseline period, during and post-intervention, and at one- and two-month follow-up visits. Over the course of intervention, only one participant achieved mastery of the targeted structure in practiced words. However, all participants demonstrated some amount of broad phonological generalization to untargeted consonants or clusters. Variable learning trajectories and broad phonological generalization are discussed as they relate to participant characteristics and linguistic complexity.
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Affiliation(s)
- Philip Combiths
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
- Department of Cognitive Science, University of California, San Diego, USA
- Correspondence concerning this article should be addressed to Philip Combiths, , School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA 92182, USA
| | - S. Pruitt-Lord
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
| | - A. Escobedo
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
- Department of Cognitive Science, University of California, San Diego, USA
| | - J. A. Barlow
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
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Brumbaugh KM, Gibson A. Expansion Points Intervention in Young Children with Speech Sound Disorders: A Multiple Baseline Design. Semin Speech Lang 2021; 42:419-430. [PMID: 34729728 DOI: 10.1055/s-0041-1736665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this investigation was to evaluate the efficacy of expansion points (EXP) intervention with a modified criterion for preschool children with speech sound disorders (SSD). Three preschool-aged children were enrolled in a single-subject multiple baseline intervention study. Intervention took place over 16 sessions. Pre- and post-intervention data are provided. Three outcome measures (generalization to probe words and gains in percent consonants correct, PCC, in words and in conversation) were evaluated to measure the effectiveness of the EXP intervention. All three of the participants demonstrated gains by the end of the intervention phase when measuring PCC in single words. Two of the three participants demonstrated gains in PCC in conversational speech. Progress on individual phonemes was variable across participants. Utilizing the EXP approach, two of the three children showed gains in all three outcome measures. One child showed variable performance in one outcome measure, improvement in one, and a decrease in one. Findings suggest that EXP should be further explored to evaluate intervention efficacy.
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Southby L, Harding S, Phillips V, Wren Y, Joinson C. Speech input processing in children born with cleft palate: A systematic literature review with narrative synthesis. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:668-693. [PMID: 34125466 PMCID: PMC8362211 DOI: 10.1111/1460-6984.12633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 03/31/2021] [Accepted: 05/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Speech development requires intact and adequately functioning oral anatomy and cognitive 'speech processing' skills. There is evidence that speech input processing skills are associated with speech output problems in children not born with a cleft. Children born with cleft palate ± lip (CP±L) are at high risk of developing disordered speech output. Less is known about their speech input processing skills and whether they are associated with cleft-related speech sound disorder (SSD). AIMS (1) To collate and evaluate studies reporting evidence regarding the speech input processing skills of children born with cleft palate in comparison with data from typically developing children or other comparison groups; and (2) to identify any available evidence regarding relationships between speech input processing skills and speech output in children born with CP±L. METHODS & PROCEDURES Potentially relevant studies published up to November 2019 were identified from the following databases: Medline via Ovid, Embase via Ovid, Cinahl via Ebscohost, PsycInfo via Ebscohost, BNI via ProQuest, AMED via Ovid, Cochrane Library and Scopus. Inclusion criteria were: peer-reviewed articles published in scientific journals, any design, published in English, participants born with a CP±L aged up to age 18 years who completed speech input processing assessments compared with normative data and/or a control or other comparison group. Critical Appraisal Skills Programme (CASP) checklists were used to quality appraise included studies. OUTCOMES & RESULTS Six studies were retained in the final review. There is some evidence that children born with CP±L perform less well than non-cleft controls on some speech input processing tasks and that specific input processing skills may be related to errors in the children's speech. Heterogeneity in relation to study groups and assessments used, as well as small sample sizes, limits generalization of findings. CONCLUSION & IMPLICATIONS There is limited evidence regarding the speech input processing skills of children born with CP±L. There are indications that children born with CP+/L may have difficulty in some aspects of speech input processing in comparison with children not born with a cleft, and that difficulties with some speech input processing tasks may be specific to errors in children's speech output. Further research is required to develop our understanding of these skills in this population and any associations with speech output. WHAT THIS PAPER ADDS What is already known on the subject Few studies have been published that examine aspects of speech input processing in children born with CP±L. Theoretical models of speech processing, and published studies, propose that speech input processing skills are associated with SSD in children who were not born with a cleft. However, it is less clear whether there is any association between speech input processing and cleft-related SSD. What this paper adds to existing knowledge This review systematically collates and evaluates the published, peer-reviewed evidence regarding speech input processing skills in children born with CP±L. The collated evidence indicates that some speech input processing skills differ between children with and without CP±L. There is some evidence, from a single study, that speech input processing of specific cleft speech characteristics (CSCs) may be associated with the presence of these CSCs in the speech output of some children born with CP±L. What are the potential or actual clinical implications of this work? While the evidence is currently limited, increasing our knowledge of speech input processing skills in children born with CP±L contributes to our clinical understanding of the nature of cleft-related SSD. The current evidence suggests that speech and language therapists should consider speech input processing skills when assessing children with cleft-related SSD to support intervention planning. Considering these skills in relation to literacy development in these children may also be important.
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Affiliation(s)
- Lucy Southby
- Cleft.NET.EastCambridge University Hospitals NHS Foundation TrustCambridgeUK
- Centre for Academic Child Health, Bristol Medical SchoolUniversity of BristolBristolUK
- Bristol Speech and Language Therapy Research UnitNorth Bristol NHS TrustBristolUK
| | - Sam Harding
- Bristol Speech and Language Therapy Research UnitNorth Bristol NHS TrustBristolUK
| | | | - Yvonne Wren
- Bristol Speech and Language Therapy Research UnitNorth Bristol NHS TrustBristolUK
- Bristol Dental SchoolUniversity of BristolBristolUK
| | - Carol Joinson
- Centre for Academic Child Health, Bristol Medical SchoolUniversity of BristolBristolUK
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Franciscatto MH, Del Fabro MD, Damasceno Lima JC, Trois C, Moro A, Maran V, Keske-Soares M. Towards a speech therapy support system based on phonological processes early detection. COMPUT SPEECH LANG 2021. [DOI: 10.1016/j.csl.2020.101130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Case J, Grigos MI. A Framework of Motoric Complexity: An Investigation in Children With Typical and Impaired Speech Development. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3326-3348. [PMID: 32946304 DOI: 10.1044/2020_jslhr-20-00020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Introduction The current work presents a framework of motoric complexity where stimuli differ according to movement elements across a sound sequence (i.e., consonant transitions and vowel direction). This framework was then examined in children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development (TD). Method Twenty-four children (CAS, n = 8; SSD, n = 8; TD, n = 8), 5-6 years of age, participated in this study. The children produced words that varied in motoric complexity while transcription, acoustic, and kinematic data were collected. Multidimensional analyses were conducted to examine speech production accuracy, speech motor variability, and temporal control. Results Analyses revealed poorer accuracy, longer movement duration, and greater speech motor variability in children with CAS than TD (across all measures) and other SSDs (accuracy and variability). All children demonstrated greater speech motor variability and longer duration as movement demands increased within the framework of motoric complexity. Diagnostic grouping did not mediate performance on this task. Conclusions Results of this study are believed to reveal gradations of complexity with increasing movement demands, thereby supporting the proposed framework of motoric complexity. This work also supports the importance of considering motoric properties of sound sequences when evaluating speech production skills and designing experimental and treatment stimuli.
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Affiliation(s)
- Julie Case
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY
| | - Maria I Grigos
- Department of Communicative Sciences and Disorders, New York University, New York
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Namasivayam AK, Coleman D, O’Dwyer A, van Lieshout P. Speech Sound Disorders in Children: An Articulatory Phonology Perspective. Front Psychol 2020; 10:2998. [PMID: 32047453 PMCID: PMC6997346 DOI: 10.3389/fpsyg.2019.02998] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 12/18/2019] [Indexed: 01/20/2023] Open
Abstract
Speech Sound Disorders (SSDs) is a generic term used to describe a range of difficulties producing speech sounds in children (McLeod and Baker, 2017). The foundations of clinical assessment, classification and intervention for children with SSD have been heavily influenced by psycholinguistic theory and procedures, which largely posit a firm boundary between phonological processes and phonetics/articulation (Shriberg, 2010). Thus, in many current SSD classification systems the complex relationships between the etiology (distal), processing deficits (proximal) and the behavioral levels (speech symptoms) is under-specified (Terband et al., 2019a). It is critical to understand the complex interactions between these levels as they have implications for differential diagnosis and treatment planning (Terband et al., 2019a). There have been some theoretical attempts made towards understanding these interactions (e.g., McAllister Byun and Tessier, 2016) and characterizing speech patterns in children either solely as the product of speech motor performance limitations or purely as a consequence of phonological/grammatical competence has been challenged (Inkelas and Rose, 2007; McAllister Byun, 2012). In the present paper, we intend to reconcile the phonetic-phonology dichotomy and discuss the interconnectedness between these levels and the nature of SSDs using an alternative perspective based on the notion of an articulatory "gesture" within the broader concepts of the Articulatory Phonology model (AP; Browman and Goldstein, 1992). The articulatory "gesture" serves as a unit of phonological contrast and characterization of the resulting articulatory movements (Browman and Goldstein, 1992; van Lieshout and Goldstein, 2008). We present evidence supporting the notion of articulatory gestures at the level of speech production and as reflected in control processes in the brain and discuss how an articulatory "gesture"-based approach can account for articulatory behaviors in typical and disordered speech production (van Lieshout, 2004; Pouplier and van Lieshout, 2016). Specifically, we discuss how the AP model can provide an explanatory framework for understanding SSDs in children. Although other theories may be able to provide alternate explanations for some of the issues we will discuss, the AP framework in our view generates a unique scope that covers linguistic (phonology) and motor processes in a unified manner.
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Affiliation(s)
- Aravind Kumar Namasivayam
- Oral Dynamics Laboratory, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Deirdre Coleman
- Oral Dynamics Laboratory, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Independent Researcher, Surrey, BC, Canada
| | - Aisling O’Dwyer
- Oral Dynamics Laboratory, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- St. James’s Hospital, Dublin, Ireland
| | - Pascal van Lieshout
- Oral Dynamics Laboratory, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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Ilha Ceron M, Barichello Gubiani M, Rosa de Oliveira C, Keske-Soares M. Normative Features of Phoneme Acquisition in Brazilian Portuguese. Folia Phoniatr Logop 2019; 72:228-241. [PMID: 31185467 DOI: 10.1159/000499690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 03/18/2019] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To analyze the influence of gender, age, and types of school (public or private) on phoneme production, and provide normative data on phonological acquisition in Brazilian Portuguese (BP). PATIENTS AND METHODS The sample consisted of 733 children (ages 3 years to 8 years and 11 months), all monolingual speakers of BP with typical phonological development. Participants were evaluated using the spontaneous naming task from the Phonological Assessment Tool (Instrumento de Avaliação Fonológica - INFONO). The children's speech production was audio-recorded, transcribed, and submitted to phonological analysis. RESULTS The effect of age was significant for all phonemes and syllable structures, especially when analyzed in combination with types of school and gender. Overall, phoneme production accuracy increased with age and varied depending on the types of school attended by the children, but did not differ between genders. CONCLUSION Age had a greater impact on phoneme production. The normative data on phonological acquisition highlighted the differences between the ages of mastery for different phonemes, with elements such as the /r/ sound and complex onsets being acquired much later in development than some of the other phonemes analyzed.
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van der Merwe A, Steyn M. Model-Driven Treatment of Childhood Apraxia of Speech: Positive Effects of the Speech Motor Learning Approach. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:37-51. [PMID: 29222568 DOI: 10.1044/2017_ajslp-15-0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 07/21/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The aim of the study was to propose the speech motor learning approach (Van der Merwe, 2011) as a treatment for childhood apraxia of speech and to determine if it will effect positive change in the ability of a 33-month-old child to produce untreated nonwords and words containing treated age-appropriate consonants (Set 1 sounds), untreated age-appropriate consonants (Set 2), and untreated age-inappropriate consonants (Set 3) and also to determine the nature and number of segmental speech errors before and after treatment. METHOD An A-B design with multiple target measures and follow-up was implemented to assess the effects of treatment of Set 1. Effect sizes for whole-word accuracy were determined, and two criterion lines were generated following the conservative dual criterion method. Speech errors were judged perceptually. RESULTS Conservative dual criterion analyses indicated no reliable treatment effect due to rising baseline scores. Effect sizes showed significant improvement in whole-word accuracy of untreated nonwords and real words containing age-appropriate treated sounds and real words containing age-appropriate untreated sounds. The number of errors for all three sound sets declined. Sound distortion was the most frequent error type. CONCLUSIONS Preliminary evidence suggests potentially positive treatment effects. However, rising baseline scores limit causal inference. Replication with more children of different ages is necessary. SUPPLEMENTAL MATERIALS https://doi.org/10.23641/asha.5596708.
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Affiliation(s)
- Anita van der Merwe
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, South Africa
| | - Mollie Steyn
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, South Africa
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Ceron MI, Gubiani MB, de Oliveira CR, Keske-Soares M. Factors Influencing Consonant Acquisition in Brazilian Portuguese-Speaking Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:759-771. [PMID: 28306754 DOI: 10.1044/2016_jslhr-s-15-0208] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 06/23/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE We sought to provide valid and reliable data on the acquisition of consonant sounds in speakers of Brazilian Portuguese. METHOD The sample comprised 733 typically developing monolingual speakers of Brazilian Portuguese (ages 3;0-8;11 [years;months]). The presence of surface speech error patterns, the revised percentage consonants correct, and the age of sound acquisition were evaluated using phonological assessment software. The normative values for these variables were reported using means and standard deviations. RESULTS Age had a significant impact on phoneme production. Increasing age was generally associated with an increase in correct phoneme production, a reduction in error patterns, and an increase in scores on revised percentage consonants correct. Phonological error patterns persisted for a longer time in consonants and consonant clusters acquired later in development. The 2 youngest age groups differed from the remainder of the sample on the frequency of the following phonological patterns: cluster reduction, liquid gliding, fricative deletion-coda, and weak-syllable deletion. Performance was similar between groups starting at 5;0 years old. CONCLUSION This study confirmed that nasal and stop consonants are acquired first, followed by fricatives and, finally, liquids. We suggest that future studies replicate our investigation in larger samples and younger age groups.
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Sugden E, Baker E, Munro N, Williams AL. Involvement of parents in intervention for childhood speech sound disorders: a review of the evidence. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2016; 51:597-625. [PMID: 27017993 DOI: 10.1111/1460-6984.12247] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 12/15/2015] [Accepted: 01/06/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Internationally, speech and language therapists (SLTs) are involving parents and providing home tasks in intervention for phonology-based speech sound disorder (SSD). To ensure that SLTs' involvement of parents is guided by empirical research, a review of peer-reviewed published evidence is needed. AIMS To provide SLTs and researchers with a comprehensive appraisal and analysis of peer-reviewed published intervention research reporting parent involvement and the provision of home tasks in intervention studies for children with phonology-based SSD. METHODS & PROCEDURES A systematic search and review was conducted. Academic databases were searched for peer-reviewed research papers published between 1979 and 2013 reporting on phonological intervention for SSD. Of the 176 papers that met the criteria, 61 were identified that reported on the involvement of parents and/or home tasks within the intervention. These papers were analysed using a quality appraisal tool. Details regarding the involvement of parents and home tasks were extracted and analysed to provide a summary of these practices within the evidence base. MAIN CONTRIBUTION Parents have been involved in intervention research for phonology-based SSD. However, most of the peer-reviewed published papers reporting this research have provided limited details regarding what this involved. This paucity of information presents challenges for SLTs wishing to integrate external evidence into their clinical services and clinical decision-making. It also raises issues regarding treatment fidelity for researchers wishing to replicate published intervention research. CONCLUSIONS & IMPLICATIONS The range of tasks in which parents were involved, and the limited details reported in the literature, present challenges for SLTs wanting to involve parents in intervention. Further high-quality research reporting more detail regarding the involvement of parents and home tasks in intervention for SSD is needed.
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Affiliation(s)
| | - Elise Baker
- The University of Sydney, Sydney, NSW, Australia
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Thapa KB, Okalidou A, Anastasiadou S. Teachers' screening estimations of speech-language impairments in primary school children in Nepal. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2016; 51:310-327. [PMID: 26757345 DOI: 10.1111/1460-6984.12209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 08/11/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND The prevalence of speech-language impairments in children have been estimated for several languages, primarily in developed countries. However, prevalence data is lacking for developing countries, such as Nepal. AIMS (1) To obtain teacher estimates of incidence and overall prevalence of speech-language impairments and its subtypes as a function of gender, age and grade level; and (2) to validate the screening instrument on Nepalese children. METHODOLOGY The adapted teachers' screening instrument, namely adapted Teachers' Speech and Language Referral Checklist (a-TSLRC), was administered in 2776 (690 and 2086) primary school children aged 5;00-11;11 years (mean = 8;11 years). The screening was conducted at four different points in time, i.e. Incidences I and II, and each incidence consisted of a testing and a retesting phase. Prior to this, teachers were trained in forum meetings, and an information sheet containing an overview of speech-language impairments, and guidelines/criteria for marking the occurrence of speech-language impairments in the TSLRC were disseminated. OUTCOMES & RESULTS Overall prevalence of speech-language impairments in children was estimated as 8.11%. Specifically, overall speech problems were estimated as 4.68%, and language problems as 8.0%. Additionally, the prevalence by subtypes of speech-language impairments as categorized in the TSLRC were reported to be 2.95% for an articulation/phonological problems, 2.09% for stuttering, 3.42% for a voice problems, 4.97% for a receptive language problems and 7.74% for an expressive language problems. The internal consistency among items was sufficient and a good intra-rater reliability was obtained. CONCLUSIONS & IMPLICATIONS The study indicates that the overall results of speech-language impairments in children via the adapted in-Nepalese criterion-referenced instrument are supported by international studies. In addition, justifiable reliability and validity was obtained. Therefore, based on these overall evidence, this instrument can be useful for the screening of speech-language impairments in primary school children in Nepal.
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Affiliation(s)
- Krishna Bahadur Thapa
- University of Macedonia, Department of Educational and Social Policy, 156 Egnatias Street, P.O. Box 1591, Salonika 540 06, Greece
| | - Areti Okalidou
- University of Macedonia, Department of Educational and Social Policy, 156 Egnatias Street, P.O. Box 1591, Salonika 540 06, Greece
| | - Sofia Anastasiadou
- University of Western Macedonia, Department of Preschool Education, 3rd km Florinas-Nikis, P.O. Box 21, 53100 Florina, Greece
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Ceron MI, Bonini JB, Keske-Soares M. Progresso terapêutico de sujeitos submetidos a terapia fonológica pelo modelo de oposições múltiplas: comparação do progresso terapêutico. REVISTA CEFAC 2015. [DOI: 10.1590/1982-0216201514414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este trabalho tem como objetivo analisar e comparar o progresso terapêutico apresentado por crianças submetidas ao Modelo de Oposições Múltiplas estimuladas na terapia com os mesmos sons-alvo. Participaram deste relato de caso duas crianças com desvio fonológico, sendo um menino (S1) e uma menina (S2), com idades de 4:2 e 4:11, respectivamente. Os dados da fala foram coletados por meio da avaliação fonológica. Para o tratamento, foi utilizado o Modelo de Oposições Múltiplas durante 25 sessões com os mesmos sons-alvo, todos pertencentes a classe das fricativas. As substituições e omissões no inventário fonológico de cada criança foram analisadas, assim como a ocorrência de processos fonológicos pré e pós-terapia. Observou-se que o sujeito que apresentava mais substituições (S1) foi o que apresentou maiores aquisições de fonemas no inventário fonológico. O S1 foi o que apresentou maior ocorrência de processos em sua fala, tanto pré quanto pós-terapia, o que dificultava a inteligibilidade de fala para o ouvinte. Os processos que envolveram a classe das líquidas foram os que apresentaram um maior percentual de ocorrência, mesmo após a terapia. O Modelo de Oposições Múltiplas possibilitou um adequado progresso no tratamento dessas crianças com desvio fonológico, proporcionando uma expansão no inventário fonológico e uma diminuição de ocorrência de processos fonológicos apesar de haver diferenças quanto a evolução apresentada por cada uma.
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Gildersleeve-Neumann C, Goldstein BA. Cross-linguistic generalization in the treatment of two sequential Spanish-English bilingual children with speech sound disorders. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2015; 17:26-40. [PMID: 24798057 DOI: 10.3109/17549507.2014.898093] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
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.
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Mcleod S, Baker E. Speech-language pathologists' practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders. CLINICAL LINGUISTICS & PHONETICS 2014; 28:508-531. [PMID: 25000375 DOI: 10.3109/02699206.2014.926994] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A survey of 231 Australian speech-language pathologists (SLPs) was undertaken to describe practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders (SSD). The participants typically worked in private practice, education, or community health settings and 67.6% had a waiting list for services. For each child, most of the SLPs spent 10-40 min in pre-assessment activities, 30-60 min undertaking face-to-face assessments, and 30-60 min completing paperwork after assessments. During an assessment SLPs typically conducted a parent interview, single-word speech sampling, collected a connected speech sample, and used informal tests. They also determined children's stimulability and estimated intelligibility. With multilingual children, informal assessment procedures and English-only tests were commonly used and SLPs relied on family members or interpreters to assist. Common analysis techniques included determination of phonological processes, substitutions-omissions-distortions-additions (SODA), and phonetic inventory. Participants placed high priority on selecting target sounds that were stimulable, early developing, and in error across all word positions and 60.3% felt very confident or confident selecting an appropriate intervention approach. Eight intervention approaches were frequently used: auditory discrimination, minimal pairs, cued articulation, phonological awareness, traditional articulation therapy, auditory bombardment, Nuffield Centre Dyspraxia Programme, and core vocabulary. Children typically received individual therapy with an SLP in a clinic setting. Parents often observed and participated in sessions and SLPs typically included siblings and grandparents in intervention sessions. Parent training and home programs were more frequently used than the group therapy. Two-thirds kept up-to-date by reading journal articles monthly or every 6 months. There were many similarities with previously reported practices for children with SSD in the US, UK, and the Netherlands, with some (but not all) practices aligning with current research evidence.
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Affiliation(s)
- Sharynne Mcleod
- Research Institute for Professional Practice, Learning and Education, Charles Sturt University, Bathurst, NSW , Australia and
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Brumbaugh KM, Smit AB. Treating Children Ages 3–6 Who Have Speech Sound Disorder: A Survey. Lang Speech Hear Serv Sch 2013; 44:306-19. [PMID: 23843655 DOI: 10.1044/0161-1461(2013/12-0029)] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
In a national survey, speech-language pathologists (SLPs) were asked about service delivery and interventions they use with children ages 3–6 who have speech sound disorder (SSD).
Method
The survey was e-mailed to 2,084 SLPs who worked in pre-elementary settings across the United States. Of these, 24% completed part or all of the survey, with 18% completing the entire survey.
Results
SLPs reported that they provided children ages 3–6 who had SSD with 30 or 60 min of treatment time weekly, regardless of group or individual setting. More SLPs indicated that they used traditional intervention than other types of intervention. However, many SLPs also reported using aspects of phonological interventions and providing phonological awareness training. Fewer SLPs indicated that they used nonspeech oral motor exercises than in a previous survey (Lof & Watson, 2008). Recently graduated SLPs were no more familiar with recent advances in phonological intervention than were their more experienced colleagues.
Discussion
This study confirms previous findings (Mullen & Schooling, 2010) about the amount of service provided to children ages 3–6 who have SSD. Issues related to the use of traditional and phonological intervention with children who have phonological disorder are discussed, along with concerns related to evidence-based practice and research needs.
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Savoldi A, Ceron MI, Keske-Soares M. Quais são as melhores palavras para compor um instrumento de avaliação fonológica? AUDIOLOGY - COMMUNICATION RESEARCH 2013. [DOI: 10.1590/s2317-64312013000300009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Julgar quais palavras seriam adequadas à realidade social e/ou linguística para compor um instrumento de avaliação fonológica infantil para o Português Brasileiro. MÉTODOS: Partindo de uma lista inicial de 722 palavras do léxico infantil e avaliações fonológicas disponíveis, utilizadas atualmente, juízes especialistas julgaram as melhores palavras para compor o instrumento, de acordo com seu conhecimento teórico e prático. Formou-se uma nova lista com 316 palavras selecionadas, que foram ilustradas e analisadas por juízes não especialistas (crianças), quanto à familiaridade e eliciação corretas, através de escala Likert. RESULTADOS: A análise dos juízes especialistas obteve uma concordância fraca com valor de Kappa equivalente a 0,378, resultando em 316 palavras selecionadas. O julgamento dos juízes não especialistas resultou na lista de palavras mais indicadas para compor um instrumento de avaliação fonológica, utilizando critérios de porcentagem de acerto quanto à familiaridade e eliciação. CONCLUSÃO: Foram selecionadas pelas análises dos juízes 116 palavras, com respectivas ilustrações, para compor o instrumento de avaliação fonológica.
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Hodson BW. Enhancing Phonological Patterns of Young Children With Highly Unintelligible Speech. ACTA ACUST UNITED AC 2011. [DOI: 10.1044/leader.ftr2.16042011.16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Baker E, McLeod S. Evidence-Based Practice for Children With Speech Sound Disorders: Part 1 Narrative Review. Lang Speech Hear Serv Sch 2011; 42:102-39. [PMID: 20844274 DOI: 10.1044/0161-1461(2010/09-0075)] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
This article provides a comprehensive narrative review of intervention studies for children with speech sound disorders (SSD). Its companion paper (Baker & McLeod, 2011) provides a tutorial and clinical example of how speech-language pathologists (SLPs) can engage in evidence-based practice (EBP) for this clinical population.
Method
Studies reporting speech sound intervention for children with SSDs published from 1979 to 2009 were identified and coded.
Results
One hundred thirty-four intervention studies were identified. Intervention typically was conducted by an SLP in a one-to-one individual format for 30- to 60-min sessions 2 to 3 times per week. Total duration of intervention (from assessment to discharge) was reported for 10 studies and ranged from 3 to 46 months. Most studies were either Level IIb (quasi-experimental studies, 41.5%) or Level III (nonexperimental case studies, 32.6%). Single-case experimental design (29.6%) was the most frequently used experimental research design. There were 7 distinct approaches to target selection and 46 distinct intervention approaches, with 23 described in more than 1 publication. Each approach was associated with varying quantities and levels of evidence, according to research design.
Conclusion
Collaborative research reflecting higher levels of evidence using rigorous experimental designs is needed to compare the relative benefits of different intervention approaches.
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