Moving up from the segment: A comment on Aichert and Ziegler’s Syllable frequency and syllable structure in apraxia of speech, Brain and Language, 88, 148–159, 2004

Introduction Pitch variation, which refers to one's ability to vary fundamental frequency (F0) within or between syllables when speaking, has not been investigated in children with childhood apraxia of speech (CAS). However, pitch variation plays an important role in tone languages, as varying F0 patterns communicate different lexical meanings. This study investigated pitch variation abilities in individuals with CAS via the tone-sequencing tasks (TSTs), focusing on task performance and the effects of syllable structure, lexical status, and tones. Method Three Cantonese-speaking children with CAS (aged 3;7–5;8 [years;months]) and six children without CAS participated in the study. Children without CAS were divided into two control groups, comprising those with speech and/or language impairment or typical development. TSTs consisted of 56 sets of five repetitions of stimuli. The stimuli varied in syllable structure, lexical status, and tones. Percentage of tones correct (PTC), consistency scores, F0 values, and acoustic repetition duration were measured. Results The CAS group performed more poorly than the control groups on the TST with respect to tone accuracy, consistency, and repetition duration. No interaction effects between group and syllable structure or group and lexical status were found. No significant difference was found on F0 values across time between Tone 1 and Tone 2 syllables in the CAS group. However, interaction effects between group and time points of F0 values on Tone 2 syllables were found. Discussion The results suggest that children with CAS have difficulty with pitch variation, which was revealed on the TST with respect to tone accuracy, consistency, and repetition duration. Moreover, children with CAS have difficulty in varying F0 values to produce high-rising tones and tend to use high-level tones to substitute. Clinically, the TST may be useful to assist in the diagnosis of CAS. Isolated vowel stimuli may be useful to test young children or children with severe impairment. Future investigations and development of a normed tool for children with CAS are suggested.

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Syllable- and Rhythm-Based Approaches in the Treatment of Apraxia of Speech

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld20.3.59 ◽

2010 ◽

Vol 20 (3) ◽

pp. 59-66 ◽

Cited By ~ 3

Author(s):

Wolfram Ziegler ◽

Ingrid Aichert ◽

Anja Staiger

Keyword(s):

Language Production ◽

Treatment Approach ◽

Theoretical Work ◽

Spoken Language ◽

Apraxia Of Speech ◽

Single Word ◽

Syllable Frequency ◽

Experimental Learning ◽

New Treatment ◽

Complex Target

This paper presents new treatment approaches for patients with apraxia of speech (AOS), which are based on current theoretical work relating to the pathomechanism of AOS. Particularly, we focus on the question of which speech units and structural properties are involved in the error mechanism of speakers with apraxia. Based on a psycholinguistic model of spoken language production (Levelt, Roelofs, & Meyer, 1999), we review data from single-word production experiments and from analyses of spontaneous speech demonstrating an impact on (a) the degree of “over-learnedness” of syllables (syllable frequency), (b) the internal structure of syllables (syllable complexity), and (c) supra-syllabic, metrical aspects of utterances (word stress) on error production in AOS. In the second section, we present two experimental learning studies and a treatment study that take these results into consideration. The first learning experiment suggests that syllables are more natural units than segments in the treatment of patients with severe AOS. Based on the results of the second learning study, we recommend a treatment approach which uses formally related training syllables in the reacquisition of complex target syllables. Finally, results of a treatment study using a metrical pacing technique led to the assumption that fluency and segmental accuracy could be enhanced by external rhythmic cues.

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Is there a syllable frequency effect in aphasia or in apraxia of speech or both?

Aphasiology ◽

10.1080/02687030701820469 ◽

2008 ◽

Vol 22 (11) ◽

pp. 1191-1200 ◽

Cited By ~ 25

Author(s):

Marina Laganaro

Keyword(s):

Frequency Effect ◽

Apraxia Of Speech ◽

Syllable Frequency

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Perceptual Characteristics of Consonant Production in Apraxia of Speech and Aphasia

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-18-0169 ◽

2019 ◽

Vol 28 (4) ◽

pp. 1411-1431 ◽

Cited By ~ 3

Author(s):

Lauren Bislick ◽

William D. Hula

Keyword(s):

Error Rate ◽

Error Rates ◽

Group Differences ◽

Diagnostic Process ◽

Apraxia Of Speech ◽

Contextual Variables ◽

Error Type ◽

Type Distribution ◽

Phonetic Features ◽

Syllable Position

Purpose This retrospective analysis examined group differences in error rate across 4 contextual variables (clusters vs. singletons, syllable position, number of syllables, and articulatory phonetic features) in adults with apraxia of speech (AOS) and adults with aphasia only. Group differences in the distribution of error type across contextual variables were also examined. Method Ten individuals with acquired AOS and aphasia and 11 individuals with aphasia participated in this study. In the context of a 2-group experimental design, the influence of 4 contextual variables on error rate and error type distribution was examined via repetition of 29 multisyllabic words. Error rates were analyzed using Bayesian methods, whereas distribution of error type was examined via descriptive statistics. Results There were 4 findings of robust differences between the 2 groups. These differences were found for syllable position, number of syllables, manner of articulation, and voicing. Group differences were less robust for clusters versus singletons and place of articulation. Results of error type distribution show a high proportion of distortion and substitution errors in speakers with AOS and a high proportion of substitution and omission errors in speakers with aphasia. Conclusion Findings add to the continued effort to improve the understanding and assessment of AOS and aphasia. Several contextual variables more consistently influenced breakdown in participants with AOS compared to participants with aphasia and should be considered during the diagnostic process. Supplemental Material https://doi.org/10.23641/asha.9701690

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Bang for Your Buck: A Single-Case Experimental Design Study of Practice Amount and Distribution in Treatment for Childhood Apraxia of Speech

Journal of Speech Language and Hearing Research ◽

10.1044/2019_jslhr-s-18-0212 ◽

2019 ◽

Vol 62 (9) ◽

pp. 3160-3182 ◽

Cited By ~ 4

Author(s):

Edwin Maas ◽

Christina Gildersleeve-Neumann ◽

Kathy Jakielski ◽

Nicolette Kovacs ◽

Ruth Stoeckel ◽

...

Keyword(s):

Single Case ◽

Evidence Base ◽

Distributed Practice ◽

Single Subject ◽

Single Subject Design ◽

Apraxia Of Speech ◽

Childhood Apraxia Of Speech ◽

Opposite Pattern ◽

Massed Practice ◽

Treatment Conditions

Purpose The aim of this study was to examine 2 aspects of treatment intensity in treatment for childhood apraxia of speech (CAS): practice amount and practice distribution. Method Using an alternating-treatments single-subject design with multiple baselines, we compared high versus low amount of practice, and massed versus distributed practice, in 6 children with CAS. Conditions were manipulated in the context of integral stimulation treatment. Changes in perceptual accuracy, scored by blinded analysts, were quantified with effect sizes. Results Four children showed an advantage for high amount of practice, 1 showed an opposite effect, and 1 showed no condition difference. For distribution, 4 children showed a clear advantage for massed over distributed practice post treatment; 1 showed an opposite pattern, and 1 showed no clear difference. Follow-up revealed a similar pattern. All children demonstrated treatment effects (larger gains for treated than untreated items). Conclusions High practice amount and massed practice were associated with more robust speech motor learning in most children with CAS, compared to low amount and distributed practice, respectively. Variation in effects across children warrants further research to determine factors that predict optimal treatment conditions. Finally, this study adds to the evidence base supporting the efficacy of integral stimulation treatment for CAS. Supplemental Material https://doi.org/10.23641/asha.9630599

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A Phonomotor Approach to Apraxia of Speech Treatment

American Journal of Speech-Language Pathology ◽

10.1044/2020_ajslp-19-00116 ◽

2020 ◽

Vol 29 (4) ◽

pp. 2109-2130

Author(s):

Lauren Bislick

Keyword(s):

Phase I ◽

Treatment Effects ◽

Single Case ◽

Motor Planning ◽

The Other ◽

Multimodal Approach ◽

Apraxia Of Speech ◽

Duration Of Treatment ◽

Treatment Gains ◽

Future Work

Purpose This study continued Phase I investigation of a modified Phonomotor Treatment (PMT) Program on motor planning in two individuals with apraxia of speech (AOS) and aphasia and, with support from prior work, refined Phase I methodology for treatment intensity and duration, a measure of communicative participation, and the use of effect size benchmarks specific to AOS. Method A single-case experimental design with multiple baselines across behaviors and participants was used to examine acquisition, generalization, and maintenance of treatment effects 8–10 weeks posttreatment. Treatment was distributed 3 days a week, and duration of treatment was specific to each participant (criterion based). Experimental stimuli consisted of target sounds or clusters embedded nonwords and real words, specific to each participants' deficit. Results Findings show improved repetition accuracy for targets in trained nonwords, generalization to targets in untrained nonwords and real words, and maintenance of treatment effects at 10 weeks posttreatment for one participant and more variable outcomes for the other participant. Conclusions Results indicate that a modified version of PMT can promote generalization and maintenance of treatment gains for trained speech targets via a multimodal approach emphasizing repeated exposure and practice. While these results are promising, the frequent co-occurrence of AOS and aphasia warrants a treatment that addresses both motor planning and linguistic deficits. Thus, the application of traditional PMT with participant-specific modifications for AOS embedded into the treatment program may be a more effective approach. Future work will continue to examine and maximize improvements in motor planning, while also treating anomia in aphasia.

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