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Preston JL, Caballero NF, Leece MC, Wang D, Herbst BM, Benway NR. A Randomized Controlled Trial of Treatment Distribution and Biofeedback Effects on Speech Production in School-Age Children With Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3414-3436. [PMID: 37611182 DOI: 10.1044/2023_jslhr-22-00622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE This study examines how ultrasound biofeedback and intensive treatment distribution affect speech sound generalization during an evidence-based treatment, Speech Motor Chaining, for children with persisting speech errors associated with childhood apraxia of speech (CAS). METHOD In a 2 × 2 factorial randomized controlled trial, children ages 9-17 years meeting CAS criteria were randomized to receive (a) a distributed treatment (20 sessions twice weekly over 10 weeks) or intensive treatment (20 hr in 5 weeks, with 10 hr in Week 1) and (b) treatment with or without biofeedback. Due to the COVID pandemic, some participants were randomized to distributed/intensive telepractice treatment only. The primary outcome was percent target sounds correct on untreated phrases (i.e., generalization) at the 10-week time point. More than 50,000 narrow phonetic transcriptions were analyzed. RESULTS Forty-eight participants completed treatment. Intensive treatment significantly increased generalization at all time points. The effect of biofeedback was significant at 5 weeks from the start of treatment but not significant at the primary 10-week time point. However, when comparing each group immediately after their 20 hr of treatment finished, generalization was significantly greater in intensive over distributed treatment and greater in ultrasound over no-ultrasound treatment (with a significant interaction favoring intensive treatment with ultrasound). Only the advantage of intensive treatment remained significant 5 weeks after groups finished treatment. There was no significant difference between face-to-face and telepractice modalities. CONCLUSIONS When the number of treatment hours is fixed, an intensive schedule of Speech Motor Chaining facilitated greater improvement than a distributed schedule. Ultrasound biofeedback initially accelerated learning, but the benefits may dissipate as treatment continues or after it ends.
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Grigos MI, Case J, Lu Y, Lyu Z. Dynamic Temporal and Tactile Cueing: Quantifying Speech Motor Changes and Individual Factors That Contribute to Treatment Gains in Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3359-3376. [PMID: 37379241 DOI: 10.1044/2023_jslhr-22-00658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
PURPOSE Speech motor skill is refined over the course of practice, which is commonly reflected by increased accuracy and consistency. This research examined the relationship between auditory-perceptual ratings of word accuracy and measures of speech motor timing and variability at pre- and posttreatment in children with childhood apraxia of speech (CAS). Furthermore, the degree to which individual patterns of baseline probe word accuracy, receptive language, and cognition predicted response to treatment was explored. METHOD Probe data were collected from seven children with CAS (aged 2;5-5;0 [years;months]) who received 6 weeks of Dynamic Temporal and Tactile Cueing (DTTC) treatment. Using a multidimensional approach to measuring speech performance, auditory-perceptual (whole-word accuracy), acoustic (whole-word duration), and kinematic (jaw movement variability) analyses were conducted on probe words produced pre- and posttreatment. Standardized tests of receptive language and cognition were administered pretreatment. RESULTS There was a negative relationship between auditory-perceptual measures of word accuracy and movement variability. Higher word accuracy was associated with lower jaw movement variability following intervention. There was a strong relationship between word accuracy and word duration at baseline, which became less robust posttreatment. Furthermore, baseline word accuracy was the only child-specific factor to predict response to DTTC treatment. CONCLUSIONS Following a period of motor-based intervention, children with CAS appeared to refine speech motor control in conjunction with improvements in word accuracy. Those who demonstrated the poorest performance at treatment onset displayed the greatest degree of gains. Taken together, these results reflect a system-wide change following motor-based intervention.
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Affiliation(s)
- Maria I Grigos
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Julie Case
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY
| | - Ying Lu
- Department of Applied Statistics, Social Science, and Humanities, New York University, NY
| | - Zhuojun Lyu
- Department of Applied Statistics, Social Science, and Humanities, New York University, NY
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McCabe P, Beiting M, Hitchcock ER, Maas E, Meredith A, Morgan AT, Potter NL, Preston JL, Moorer L, Aggarwal P, Ballard K, Smith LB, Caballero NF, Cabbage K, Case J, Caspari S, Chenausky KV, Cook S, Grzelak E, Gomez M, Hagopian A, Highman C, Hodits A, Iuzzini-Seigel J, LeVos-Carlson J, Lewis BA, Mayro P, Mehta J, Miller G, Mory KD, Murray E, Overby MS, Pasquel-Lefebvre L, Peavy D, Raaz CV, Rea B, Ford DS, Smith L, Swartz MT, Taberski M, Terband H, Thomas DC, Valentine H, Tellingen MV, Velleman S, Wang E, White S, Wong ECH, Grigos MI. Research Priorities for Childhood Apraxia of Speech: A Long View. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3255-3268. [PMID: 39173052 DOI: 10.1044/2024_jslhr-24-00196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
This article introduces the Journal of Speech, Language, and Hearing Research Special Issue: Selected Papers From the 2022 Apraxia Kids Research Symposium. The field of childhood apraxia of speech (CAS) has developed significantly in the past 15 years, with key improvements in understanding of basic biology including genetics, neuroscience, and computational modelling; development of diagnostic tools and methods; diversity of evidence-based interventions with increasingly rigorous experimental designs; and understanding of impacts beyond impairment-level measures. Papers in this special issue not only review and synthesize the some of the substantial progress to date but also present novel findings addressing critical research gaps and adding to the overall body of knowledge. A second aim of this prologue is to report the current research needs in CAS, which arose from symposium discussions involving researchers, clinicians, and Apraxia Kids community members (including parents of children with CAS). Four primary areas of need emerged from discussions at the symposium. These were: (a) What questions should we ask? (b) Who should be in the research? (c) How do we conduct the research? and (d) How do we move from research to practice? Across themes, symposium attendees emphasized the need for CAS research to better account for the diversity of people with CAS and improve the timeliness of implementation of high-level evidence-based practice across the lifespan. It is our goal that the articles and prologue discussion in this special issue provide an appreciation of advancements in CAS research and an updated view of the most pressing needs for future research.
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Affiliation(s)
- Patricia McCabe
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Molly Beiting
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | | | | | | | - Angela T Morgan
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
- Royal Children's Hospital, Parkville, Victoria, Australia
| | | | - Jonathan L Preston
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | | | | | - Kirrie Ballard
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Nicole F Caballero
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | | | | | | | | | | | - Ewa Grzelak
- Poznan University of Medical Sciences, Poland
| | - Maryane Gomez
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Chantelle Highman
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, AustraliaPortland, OR
| | | | | | | | | | | | | | | | | | - Elizabeth Murray
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Remarkable Speech + Movement, Padstow, New South Wales, Australia
| | - Megan S Overby
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Remarkable Speech + Movement, Padstow, New South Wales, Australia
| | | | - Derrick Peavy
- Department of Communication Sciences and Disorders, Syracuse University, NY
- Apraxia Kids, Pittsburgh, PA
| | | | - Brooke Rea
- Childhood Apraxia & Speech Therapy Centre, Guelph, Ontario, Canada
| | | | - Lynn Smith
- Alberta Health Services, Edmonton, Canada
| | | | | | - Hayo Terband
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City
| | - Donna C Thomas
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | | | | | - Shelley Velleman
- Department of Communication Sciences and Disorders, University of Vermont, Burlington
| | | | | | - Eddy C H Wong
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hung Hom
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Benway NR, Preston JL. Artificial Intelligence-Assisted Speech Therapy for /ɹ/: A Single-Case Experimental Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:2461-2486. [PMID: 39173110 DOI: 10.1044/2024_ajslp-23-00448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
PURPOSE This feasibility trial describes changes in rhotic production in residual speech sound disorder following ten 40-min sessions including artificial intelligence (AI)-assisted motor-based intervention with ChainingAI, a version of Speech Motor Chaining that predicts clinician perceptual judgment using the PERCEPT-R Classifier (Perceptual Error Rating for the Clinical Evaluation of Phonetic Targets). The primary purpose is to evaluate /ɹ/ productions directly after practice with ChainingAI versus directly before ChainingAI and to evaluate how the overall AI-assisted treatment package may lead to perceptual improvement in /ɹ/ productions compared to a no-treatment baseline phase. METHOD Five participants ages 10;7-19;3 (years;months) who were stimulable for /ɹ/ participated in a multiple (no-treatment)-baseline ABA single-case experiment. Prepractice activities were led by a human clinician, and drill-based motor learning practice was automated by ChainingAI. Study outcomes were derived from masked expert listener perceptual ratings of /ɹ/ from treated and untreated utterances recorded during baseline, treatment, and posttreatment sessions. RESULTS Listeners perceived significantly more rhoticity in practiced utterances after 30 min of ChainingAI, without a clinician, than directly before ChainingAI. Three of five participants showed significant generalization of /ɹ/ to untreated words during the treatment phase compared to the no-treatment baseline. All five participants demonstrated statistically significant generalization of /ɹ/ to untreated words from pretreatment to posttreatment. PERCEPT-clinician rater agreement (i.e., F1 score) was largely within the range of human-human agreement for four of five participants. Survey data indicated that parents and participants felt hybrid computerized-clinician service delivery could facilitate at-home practice. CONCLUSIONS This study provides evidence of participant improvement for /ɹ/ in untreated words in response to an AI-assisted treatment package. The continued development of AI-assisted treatments may someday mitigate barriers precluding access to sufficiently intense speech therapy for individuals with speech sound disorders. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26662807.
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Affiliation(s)
- Nina R Benway
- Department of Electrical and Computer Engineering, University of Maryland, College Park, MD
| | - Jonathan L Preston
- Department of Communication Sciences and Disorders, Syracuse University, NY
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Case J, Caspari S, Aggarwal P, Stoeckel R. A Goal-Writing Framework for Motor-Based Intervention for Childhood Apraxia of Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1590-1607. [PMID: 38754036 DOI: 10.1044/2024_ajslp-24-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
PURPOSE There are multiple frameworks for goal writing that are applicable to the practice of speech-language pathology. Motor-based speech disorders are a subset of speech sound disorders that are thought to require specific elements of intervention that are typically not addressed in the traditional frameworks used in the clinical setting. The purpose of this tutorial is to review general approaches of goal writing and suggest additional elements that may be used to improve the efficiency and effectiveness of treatment for childhood motor speech disorders, specifically childhood apraxia of speech (CAS). METHOD Existing models of goal writing were reviewed to ascertain elements common to most of these models. A basic framework was chosen and modified to include behaviors, conditions, and approaches to goal measurement tailored to the clinical needs of children with CAS. A resource for clinical decision making for children with CAS was developed to inform goal writing at the onset of treatment and adaptations that occur over the course of treatment. Case studies are presented to demonstrate how the presented framework can be applied to writing goals for motor-based treatment for two different children with CAS. DISCUSSION Children with CAS require a specialized approach to intervention, which requires goals to reflect the unique clinical needs of this population. This tutorial offers resources that use the best available research evidence and current understanding of effective treatment practices for CAS to guide clinical decision making for motor-based intervention and goal writing. This tutorial is intended to guide treatment planning across varied settings to facilitate progress and optimize treatment outcomes for children with CAS.
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Affiliation(s)
- Julie Case
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY
| | - Susan Caspari
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
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Grigos MI, Case J, Lu Y, Lyu Z. Dynamic Temporal and Tactile Cueing in Young Children With Childhood Apraxia of Speech: A Multiple Single-Case Design. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1042-1071. [PMID: 38512002 PMCID: PMC11005957 DOI: 10.1044/2024_jslhr-23-00415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/12/2023] [Accepted: 01/12/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE Childhood apraxia of speech (CAS) is a multivariate motor speech disorder that requires a motor-based intervention approach. There is limited treatment research on young children with CAS, reflecting a critical gap in the literature given that features of CAS are often in full expression early in development. Dynamic Temporal and Tactile Cueing (DTTC) is a treatment approach designed for children with severe CAS, yet the use of DTTC with children younger than 3 years of age has not been examined. METHOD A multiple single-case design was employed to examine the use of DTTC in seven children with CAS (aged 2.5-5 years) over the course of 6 weeks of intervention. Changes in word accuracy were measured in treated words from baseline to posttreatment and from baseline to maintenance (6 weeks posttreatment). Generalization of word accuracy changes to matched untreated words was also examined. A linear mixed-effects model was used to estimate the change in word accuracy for treated and untreated words across all children from baseline to posttreatment and to maintenance. A quasi-Poisson regression model was used to estimate mean change and calculate effect sizes for treated and untreated words. RESULTS Group-level analyses revealed significant changes in word accuracy for treated and untreated words at posttreatment and maintenance. At the child level, six of seven children displayed medium-to-large effect sizes where word accuracy increased in an average of 3.4/5 words across all children. Each child displayed some degree of generalization to untreated targets, specifically for words with the same syllable shape as the treated words. CONCLUSIONS These results demonstrate that DTTC can yield positive change in some young children with CAS. Key differences in each child's performance are highlighted.
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Affiliation(s)
- Maria I. Grigos
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Julie Case
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY
| | - Ying Lu
- Department of Applied Statistics, Social Science, and Humanities, New York University, NY
| | - Zhuojun Lyu
- Department of Applied Statistics, Social Science, and Humanities, New York University, NY
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McCabe P, Preston JL, Evans P, Heard R. A Pilot Randomized Control Trial of Motor-Based Treatments for Childhood Apraxia of Speech: Rapid Syllable Transition Treatment and Ultrasound Biofeedback. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:629-644. [PMID: 36848673 PMCID: PMC10171856 DOI: 10.1044/2022_ajslp-22-00144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/08/2022] [Accepted: 11/29/2022] [Indexed: 05/12/2023]
Abstract
PURPOSE Both Rapid Syllable Transition Treatment (ReST) and ultrasound biofeedback are effective approaches to treating childhood apraxia of speech (CAS). The purpose of the study was to compare outcomes from these two motor-based treatment approaches for school-age children with CAS. METHOD In a single site, single blind randomized control trial, 14 children with CAS ages 6-13 years were randomly assigned to 12 sessions over 6 weeks of either of ultrasound biofeedback treatment (with a speech motor chaining practice structure) or ReST. Treatment was delivered at The University of Sydney by students trained and supervised by certified speech-language pathologists. Transcriptions from blinded assessors were used to compare the two groups on speech sound accuracy (percent phonemes correct) and prosodic severity (lexical stress errors and syllable segregation) in untreated words and sentences at three time points: pretreatment, immediately posttreatment, and 1-month posttreatment (i.e., retention). RESULTS Both groups showed significant improvement on treated items indicating a treatment effect. At no time was there a difference between groups. Both groups showed a significant improvement in speech sound accuracy on untreated words and sentences from pre to post and neither group showed an improvement in prosody pre-post. Changes to speech sound accuracy were retained by both groups at 1-month follow-up. Significant improvement in prosodic accuracy was reported at the 1-month follow-up. CONCLUSIONS ReST and ultrasound biofeedback were equally effective. Either ReST or ultrasound biofeedback may be viable treatment options for school-age children with CAS. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22114661.
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Affiliation(s)
| | | | - Pippa Evans
- The University of Sydney, New South Wales, Australia
- The University of Queensland, Brisbane, Australia
| | - Rob Heard
- The University of Sydney, New South Wales, Australia
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Kotlarek KJ, Krueger BI. Treatment of Speech Sound Errors in Cleft Palate: A Tutorial for Speech-Language Pathology Assistants. Lang Speech Hear Serv Sch 2023; 54:171-188. [PMID: 36599098 DOI: 10.1044/2022_lshss-22-00071] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Cleft palate is one of the most common birth defects in the United States. Most of these children receive speech therapy by preschool and school-based clinicians. The purpose of this article is to provide a comprehensive tutorial for speech-language pathology assistants (SLPAs) regarding treatment techniques and principles for children with cleft palate. METHOD It has been reported that 68% of preschoolers with repaired cleft palate received speech therapy. Preschool and school-based speech-language pathologists (SLPs) have reported a strong desire for practical professional development and continuing education resources regarding treatment of children with cleft palate. Thus, it seems likely that SLPAs may feel similarly unequipped to provide effective treatment for children with cleft palate. Obligatory and learned speech errors commonly found in children with cleft palate are described. Elicitation strategies for compensatory articulations are detailed. The implementation of evidence-based articulation and phonological treatment approaches is described in a step-by-step manner. "Red flags" that may arise during treatment and require input from the supervising SLP are highlighted. RESULTS SLPAs will learn elicitation techniques for compensatory articulations and implement evidence-based treatment approaches to improve the speech accuracy of children with cleft palate. CONCLUSION It is important for all school-based clinicians to be familiar with speech therapy for individuals with cleft palate.
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Farquharson K, McIlraith A, Tambyraja S, Constantino C. Using the Experience Sampling Method to Examine the Details of Dosage in School-Based Speech Sound Therapy. Lang Speech Hear Serv Sch 2022; 53:698-712. [PMID: 35302900 DOI: 10.1044/2021_lshss-21-00130] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this project was to collect practice-based evidence regarding dosage in speech sound therapy sessions in school-based settings. Dosage is the number of trials within a therapy session for any one particular child. School-based speech-language pathologists (SLPs) face a variety of obstacles to service delivery, often making the implementation of evidence-based practices difficult. To that end, we were interested in exploring how therapy parameters, such as group size and session frequency were associated with dosage. METHOD Using the experience sampling method, we queried school-based SLPs (n = 90) across the United States. SLPs participated via a phone application, which randomly alerted them to participate 3 times per day for 5 days. SLPs also completed a demographic questionnaire that included information regarding caseload size and job satisfaction. RESULTS We report results from 670 therapy sessions. Results revealed that the therapy parameter of group size was negatively related to dosage. The SLP parameter of caseload size was positively related to dosage, but this was a small association. The child parameter of comorbidity was negatively related to dosage. CONCLUSIONS Our results support that as group size increases, children receive smaller doses of speech sound practice. Similarly, children who have a reported comorbidity received smaller doses compared to children who have an isolated speech sound disorder. We discuss implications for school-based practitioners and researchers.
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Affiliation(s)
| | | | - Sherine Tambyraja
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus
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Chung H, Kim Y. Acoustic characteristics of Korean-English bilingual speakers' /l/ and the relationship to their foreign accent ratings. JOURNAL OF COMMUNICATION DISORDERS 2021; 94:106157. [PMID: 34653724 DOI: 10.1016/j.jcomdis.2021.106157] [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: 04/21/2021] [Revised: 09/24/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE The current study examined acoustic characteristics of English /l/ produced by Korean speakers who speak English as their second language (KE). Comparisons were made to patterns of their Korean /l/ and English /l/ produced by monolingual speakers of American English (AE). Vowel context and word position effects on acoustic differences among the three /l/ sounds were examined in relation to the degree of foreign accentedness of KE speakers. METHODS Korean and English word-initial and -final /l/ in two vowel contexts (high front vs. low back) were produced by 12 KE female adult speakers in a carrier phrase. A comparison group of 10 AE speakers produced English /l/. F1 and F2 values of each /l/ production were extracted at the /l/ midpoint and were compared to each other. Euclidean distances across the productions were also examined in relation to the degrees of foreign accentedness of KE speakers. RESULTS KE speakers' English /l/ showed significantly lower F2-F1 values than their Korean /l/ across word position and vowel context but significantly higher F2-F1 values than AE speakers' English word-initial /l/. Euclidean distance between KE speakers' English and Korean /l/, and KE and AE speakers' English /l/ correlated significantly with KE speakers' degree of foreign accentedness across word position and vowel context. CONCLUSION Results indicate that the influence of Korean on KE speakers' English /l/ productions varied by word position and vowel context, as well as the degree of their foreign accentedness ratings. This finding suggests the context-dependent nature of /l/ productions and highlights the need for considering a speakers' degree of foreign accent when exploring English /l/ patterns of KE speakers.
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Affiliation(s)
- Hyunju Chung
- Department of Communication Sciences and Disorders, Louisiana State University, 73 Hatcher Hall, Field House Drive, Baton Rouge, LA 70803, United States.
| | - Yunjung Kim
- School of Communication Science and Disorders, Florida State University, 201W. Bloxham St; Office 509, Tallahassee, FL 32301, United States
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Case J, Grigos MI. The Effect of Practice on Variability in Childhood Apraxia of Speech: A Multidimensional Analysis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1477-1495. [PMID: 33826355 DOI: 10.1044/2021_ajslp-20-00167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Variability has been interpreted in differing ways according to context (e.g., development, speech impairment, and learning). A challenge arises when interpreting variability in the context of learning for children with speech impairment characterized by high movement variability, as in childhood apraxia of speech (CAS). The objective of this study is to investigate changes in variability in CAS with practice in comparison to patterns seen in children with non-CAS speech sound disorders (SSD) and typical development. Method Speech production variability was examined in 24 children (5-6 years of age) with CAS, non-CAS SSD, and typical development in production of nonwords of varied motoric complexity. Multidimensional analyses were performed using measures of token-to-token speech consistency (percent word consistency), acoustic variability (acoustic spatiotemporal index), and movement variability (lip aperture spatiotemporal index). Changes in variability were examined in each group of children by comparing the first half to the last half of nonword tokens in the same data collection session. The impact of token complexity on practice effects was also explored across groups of children. Results All children displayed increased speech consistency within this practice period (p = .01). Only children with CAS displayed increased movement variability following practice (p = .01). Differences in acoustic and kinematic variability were observed across complexity levels in all groups, though these did not interact with practice effects. Discussion These findings suggest that increased movement variability in children with CAS might be facilitating perceptual consistency. It is believed that this finding reflects an inefficient strategy adapted by children with CAS in the absence of motor-based cueing and feedback to guide speech performance with practice.
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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 City
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Wilczyński J, Ślęzak G. Level of Vocabulary Development and Selected Elements Regarding Sensory Integration and Balance in 5-Year-Old Girls and Boys. CHILDREN (BASEL, SWITZERLAND) 2021; 8:200. [PMID: 33800019 PMCID: PMC7999570 DOI: 10.3390/children8030200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/16/2022]
Abstract
The aim of this research was to assess relationships between the level of vocabulary and selected elements of sensory integration and balance in 5-year-old girls and boys, showing the differences between them. The study group consisted of 290 5-year-old children (172 boys and 118 girls) with different levels of vocabulary development and selected disturbances in sensory integration and balance processes. To evaluate the developmental deficits of speech with regard to vocabulary, the Children's Dictionary Test was used. The Clinical Test of Sensory Integration and Balance was also employed. In our research's overall assessment, 118 children, i.e., 41%, had a low level of vocabulary, while 108 (37%) had an average level and 64 (22%) had a high level. However, the average score of all examined children (3.71 stens) indicates a low level of vocabulary development. Less developed vocabulary skills included the ability to create subordinate words and define concepts. There were no significant differences in the level of vocabulary between girls and boys. We observed disorders concerning selected elements of sensory integration and balance in most of the children, and more often in boys. There were statistically significant relationships between the level of vocabulary and selected disorders of sensory integration and balance; however, they were not unambiguous. Children with the lowest level of vocabulary in overall assessment obtained significantly the worst results in the Clinical Test of Sensory Integration and Balance (CTSIB) open eyes, hard surface test. However, in the closed eyes, hard surface test, the lowest score was obtained by children with a high overall assessment. In turn, in the open eyes, soft surface test, the lowest score was noted for children with average overall assessment. In the complex CTSIB test, the lowest score was achieved by children with low ability to define concepts. The problem of the relationship between vocabulary level of and sensory integration as well as balance requires further research. The demonstrated significant relationships between some aspects of vocabulary level and selected elements of sensory integration as well as balance confirm the need to care for the overall psychomotor sphere of a child.
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Affiliation(s)
- Jacek Wilczyński
- Laboratory of Posturology, Collegium Medicum, Jan Kochanowski University in Kielce, Al. IX Wieków Kielc 19, 25–317 Kielce, Poland
| | - Grzegorz Ślęzak
- Municipal Psychological and Pedagogical Clinic Complex, Kielce, 75–215 Koszalin, Poland;
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Preston JL, Benway NR, Leece MC, Hitchcock ER, McAllister T. Tutorial: Motor-Based Treatment Strategies for /r/ Distortions. Lang Speech Hear Serv Sch 2020; 51:966-980. [PMID: 32783706 PMCID: PMC7842851 DOI: 10.1044/2020_lshss-20-00012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/09/2022] Open
Abstract
Purpose This tutorial summarizes current best practices in treating American English /r/ distortions in children with residual speech errors. Method To enhance the effectiveness of clinicians' cueing and feedback, the phonetics of /r/ production is reviewed. Principles of acquisition, which can inform how to practice /r/ in the early stages of therapy, are explained. Elements of therapy that lack scientific support are also mentioned. Results Although there is significant variability in /r/ production, the common articulatory requirements include an oral constriction, a pharyngeal constriction, tongue body lowering, lateral bracing, and slight lip rounding. Examples of phonetic cues and shaping strategies are provided to help clinicians elicit these movements to evoke correct /r/ productions. Principles of acquisition (e.g., blocked practice, frequent knowledge of performance feedback) are reviewed to help clinicians structure the earliest stages of treatment to establish /r/. Examples of approaches that currently lack scientific support include nonspeech oral motor exercises, tactile cues along the mylohyoid muscle, and heterogeneous groupings in group therapy. Conclusion Treatment strategies informed by phonetic science and motor learning theory can be implemented by all clinicians to enhance acquisition of /r/ for children with residual errors. Supplemental Material https://doi.org/10.23641/asha.12771329.
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Affiliation(s)
| | - Nina R. Benway
- Department of Communication Sciences & Disorders, Syracuse University, NY
| | - Megan C. Leece
- Department of Communication Sciences & Disorders, Syracuse University, NY
| | - Elaine R. Hitchcock
- Department of Communication Sciences and Disorders, Montclair State University, NJ
| | - Tara McAllister
- Department of Communicative Sciences and Disorders, New York University, NY
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Case J, Grigos M. How the Study of Speech Motor Control Can Inform Assessment and Intervention in Childhood Apraxia of Speech. ACTA ACUST UNITED AC 2020. [DOI: 10.1044/2020_persp-19-00114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
The study of speech motor control has led to great advancements in the current understanding of childhood apraxia of speech (CAS). There remains a significant need to bridge the gap between theory and practice to fully understand the clinical implications of past research.
Method
This review article reviews the speech motor control research in CAS and discusses how these works have offered key information about the underlying motor deficits (Grigos et al., 2015; Terband et al., 2019), the influence of structured practice on speech performance (Case & Grigos, 2016; Grigos & Case, 2018), and the role of task complexity (Case, 2019; Case & Grigos, 2016; Grigos & Case, 2018). We highlight salient points from this existing literature and clinical implications to the assessment and treatment of CAS.
Conclusion
The study of speech motor control has shed light on a number of key factors related to CAS. Even within perceptually accurate speech, children with CAS display differences in movement patterning and timing control. Assessment must aim to more directly tax speech motor skills to obtain a thorough and accurate illustration of production deficits. Intervention is challenged with the task of not only improving production accuracy but also facilitating more efficient motor planning and programming. Motor-based intervention that applies motor learning principles and introduces variability across motor, phonetic, and prosodic contexts is believed to achieve this goal, though research is needed to better understand changes in speech motor control with treatment.
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Affiliation(s)
- Julie Case
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY
| | - Maria Grigos
- Department of Communicative Sciences and Disorders, New York University, New York
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