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Diagnosis Destinations
Clin Linguist Phon. 2003 Sep;17(6):427-45. Toward an acoustic typology of motor speech disorders. Kent RD, Kim YJ. Waisman Center, Rm 435, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705-2280, USA. kent@waisman.wisc.edu Acoustic methods have progressed to the point that an acoustic typology of the motor speech disorders can be constructed from a parameteric assessment of the speech subsystems (e.g., phonation, nasal resonance, vowel articulation, consonant articulation, intonation, and rhythm). The results of this analysis can be interpreted in respect to global functions in speech (e.g., voice quality, intelligibility, and prosody). This paper reviews studies showing that specific acoustic analyses have demonstrated or potential value toward the overall goal of constructing acoustic profiles of dysarthria and apraxia of speech. Several different acoustic measures are relevant to the study of the motor speech disorders, and these are increasingly supported by normative data and by guidelines for clinical application. Examples of these applications are discussed for a variety of specific neurologic diseases or perceptual types of disorder. Acoustic studies are useful in the study of motor speech disorders and recent progress points to a parametric analysis. PMID: 14564830 [PubMed - in process] Am J Speech Lang Pathol. 2003 Aug;12(3):376-80. Diagnostic criteria of developmental apraxia of speech used by clinical speech-language pathologists. Forrest K. Department of Speech and Hearing Sciences, Indiana University, 200 South Jordan Avenue, Bloomington, IN 47401, USA. kforrest@indiana.edu The diagnostic criteria used to identify developmental apraxia of speech (DAS) have been at the center of controversy for decades. Despite the difficulty in determining the characteristics that differentiate DAS from other speech acquisition disorders, many children are identified with this disorder. The current report presents the criteria used by 75 speech-language pathologists to establish a diagnosis of DAS. Although 50 different characteristics were identified, 6 of these characteristics accounted for 51.5% of the responses. These characteristics included inconsistent productions, general oral-motor difficulties, groping, inability to imitate sounds, increasing difficulty with increased utterance length, and poor sequencing of sounds. These results are consistent with the general ambiguity of the diagnostic criteria of DAS and suggest that no single deficit is used among clinicians. PMID: 12971826 [PubMed - in process] Clin Linguist Phon. 2003 Jan-Feb;17(1):1-24. Planning of syllables in children with developmental apraxia of speech. Nijland L, Maassen B, Van Der Meulen S, Gabreels F, Kraaimaat FW, Schreuder R. Medical Psychology/Department of Paediatric Neurology, University Medical Centre St. Radboud, 6500 HB Nijmegen, The Netherlands. l.nijland@cukz.umcn.nl The aim of the present study was to investigate whether children with developmental apraxia of speech (DAS) show a deficit in planning syllables in speech production. Six children with DAS and six normally speaking (NS) children produced high- and low-frequency of occurrence syllable utterances, in which the syllable structure was systematically manipulated in an otherwise unchanging phoneme sequence. Anticipatory coarticulation, using second formant trajectories, and durational structure were analysed. The results showed stronger coarticulation in the children with DAS when compared to the normally speaking children. but in contrast to our expectations, in neither group was a systematic effect of syllable structure on the second format trajectory found. Effects of syllable structure did emerge for durational structure in that durational adjustments were found in the segments of the second syllable. These adjustments were less systematic in children with DAS when compared to normally speaking children. Furthermore, at the prosodic level, normally speaking children showed metrical contrasts that were not realized by the children with DAS. The latter results are interpreted as evidence for a problem in the planning of syllables in speech production of children with DAS, in particular concerning prosodic aspects, which is discussed in relation to the automation of speech production. PMID: 12737052 [PubMed - indexed for MEDLINE] J Speech Lang Hear Res. 2003 Feb;46(1):189-202. Related Articles, Links Acoustic and perceptual correlates of stress in nonwords produced by children with suspected developmental apraxia of speech and children with phonological disorder. Munson B, Bjorum EM, Windsor J. Department of Communication Disorders, University of Minnesota, Minneapolis 55455, USA. Munso005@umn.edu Previous research (L. Shriberg, D. Aram, & J. Kwiatkowski, 1997b, 1997c) has suggested that accuracy in producing linguistic stress reliably distinguishes between children with suspected developmental apraxia of speech (sDAS) and children with phonological disorder (PD). The current investigation tested this hypothesis by examining acoustic correlates of stress in trochaic (strong-weak) and iambic (weak-strong) nonwords produced by 5 children in each of these 2 groups. Four measures relating to stress production were examined: vowel duration, fundamental frequency (f0) at vowel midpoint, timing of the f0 peak relative to vowel onset, and intensity at vowel midpoint. In addition, perceptual judgments of accuracy of stress production were obtained. No group differences in the production of stress were found; however, listeners judged that the nonword repetitions of children with sDAS matched the target stress contour less often than did the repetitions of children with PD. Multiple regression analyses found that mean vowel duration, as well as the relative duration and relative f0 of stressed and stressless syllables, predicted listeners judgments of stress, although these variables only accounted for a small proportion of variance (21.8%). Thus, children with sDAS were able to produce acoustic differences between stressed tently perceptible to listeners. PMID: 12647898 [PubMed - indexed for MEDLINE] Pediatr Res. 2003 Mar;53(3):396-402. Verbal dyspraxia and galactosemia. Webb AL, Singh RH, Kennedy MJ, Elsas LJ. Emory University Graduate School of Arts and Sciences, Department of Biological and Biomedical Sciences, Division of Nutrition and Health Sciences, Atlanta, Georgia 30322, USA. Classical galactosemia is an autosomal recessive disorder resulting from deficient galactose-1-phosphateuridyl transferase (GALT) activity. Verbal dyspraxia is an unusual outcome in galactosemia. Here we validated a simplified breath test of total body galactose oxidation against genotype and evaluated five potential biochemical risk indicators for verbal dyspraxia in galactosemia: cumulative percentage dose (CUMPCD) of (13)CO(2) in breath, mean erythrocyte galactose-1-phosphate, highest erythrocyte galactose-1-phosphate, mean urinary galactitol, and erythrocyte GALT activity. Thirteen controls and 42 patients with galactosemia took a (13)C-galactose bolus, and the (CUMPCD) of (13)CO(2) in expired air was determined. Patients with <5% CUMPCD had mutant alleles that severely impaired human GALT enzyme catalysis. Patients with > or =5% CUMPCD had milder mutant human GALT alleles. Twenty-four patients consented to formal speech evaluation; 15 (63%) had verbal dyspraxia. Dyspraxic patients had significantly lower CUMPCD values (2.84 +/- 5.76% versus 11.51 +/- 7.67%; p < 0.008) and significantly higher mean erythrocyte galactose-1-phosphate (3.38 +/- 0.922 mg/dL versus 1.92 +/- 1.28 mg/dL; p = 0.019) and mean urinary galactitol concentrations (192.4 +/- 75.8 mmol/mol creatinine versus 122.0 +/- 56.4; p = 0.048) than patients with normal speech. CUMPCD values <5%, mean erythrocyte galactose-1-phosphate levels >2.7 mg/dL, and mean urinary galactitol levels >135 mmol/mol creatinine were associated with dyspraxic outcome with odds ratios of 21, 13, and 5, respectively. We conclude that total body oxidation of galactose to CO(2) in expired air reflects genotype and that this breath test is a sensitive predictor of verbal dyspraxia in patients with galactosemia. Publication Types:
PMID: 12595586 [PubMed - indexed for MEDLINE] Hum Brain Mapp. 2003 Mar;18(3):194-200. Bilateral brain abnormalities associated with dominantly inherited verbal and orofacial dyspraxia. Belton E, Salmond CH, Watkins KE, Vargha-Khadem F, Gadian DG. Developmental Cognitive Neuroscience Unit, Institute of Child Health, University College London, Great Ormond Street Hospital for Children, NHS Trust, The Wolson Centre, Mecklenburgh Square, London, United Kingdom. E.Belton@ich.ucl.ac.uk The KE family is a large three-generational pedigree in which half of the members suffer from a verbal and orofacial dyspraxia in association with a point mutation in the FOXP2 gene. This report extends previous voxel-based morphometric analyses of magnetic resonance imaging (MRI) scans (Watkins et al. [2002] Brain 125:465-478) using a bilateral conjunction analysis. This searches specifically for areas of grey matter density that differ bilaterally in the affected members compared with both matched controls and the unaffected family members. 3-D T1-weighted MRI datasets of 17 family members (10 affected, 7 unaffected) and matched controls were compared. The most significant findings were reduced grey matter density bilaterally in the caudate nucleus, the cerebellum, and the left and right inferior frontal gyrus in the affected members. In addition, increased grey matter density was found bilaterally in the planum temporale. These results confirm that a point mutation in FOXP2 is associated with several bilateral grey matter abnormalities in both motor and language related regions. The results also demonstrate the advantages of using a conjunction analysis when bilateral abnormalities are suspected. Copyright 2003 Wiley-Liss, Inc. PMID: 12599277 [PubMed - indexed for MEDLINE] Clin Linguist Phon. 2002 Sep;16(6):461-83. |
Related Articles, Links |
Journal: Brain and Language 2002 Mar;80(3):556-75
Task-related factors in oral motor control:
speech and oral diadochokinesis in dysarthria and apraxia of speech.
Ziegler W.
Clinical Neuropsychology Research Group, Neuropsychological Department, City Hospital Bogenhausen,
Munchen, Germany. wolfram.ziegler@extern.lrz-muenchen.de
This study was focused on the potential influence of task-related factors on oral motor performance in patients with speech disorders. Sentence production was compared with a nonspeech oral motor task, i.e...
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Speechville Express is a resource for families, educators, and medical professionals, offering information about language development in children, helping those who care for toddlers and young children who are late talkers, and connecting you with others who have been down this road. Language disorders and communication impairments included are apraxia, stuttering, pervasive developmental disorder, dysarthria, and aphasia, among others.
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