Retrospective Examination of Failed Rate-Control Intervention

2002 ◽  
Vol 11 (1) ◽  
pp. 3-16 ◽  
Author(s):  
Robert C. Marshall ◽  
Colleen M. Karow

Individuals with motor-speech disorders are frequently admonished by clinicians to "slow down" to improve speech intelligibility and comprehensibility. Although most reports of rate-control therapy highlight the benefits of specific procedures, all patients are not candidates for these interventions. The subject of this clinical report is AC, a 40-year-old man who had spoken with an extremely rapid speech rate for 17 years following a traumatic brain injury but was never treated for the problem. Traditional rate-control interventions were not effective in slowing AC's speech rate nor in reducing its handicapping effects. In this report we supply background information on AC; initial assessment data from speech- language pathology, neurology, and neuropsychology; and describe rate-control interventions that were not effective with AC. A retrospective examination of this case was conducted to elucidate possible reasons why treatment was unsuccessful. This involved (a) an instrumental assessment of selected features of AC's speech rate (using equipment not available for the initial evaluation) and (b) a reinterpretation of other assessment information. Findings revealed how AC's speech differed from that of a normally speaking control subject and other normative data and provided insights on how he accomplished his rapid speech rate. This prompted us to consider (a) possible explanations for AC's fast rate, (b) reasons for failed rate-control intervention, and (c) what we learned from this case that would be useful to clinicians in management of similar patients.

2014 ◽  
Vol 23 (3) ◽  
pp. 124-131 ◽  
Author(s):  
Elizabeth K. Hanson

People with motor speech disorders often persist in using their natural speech to communicate despite low intelligibility and frequent communication breakdowns. Their speech may be functional in some situations, such as with familiar partners in quiet settings, but not across the variety of communication situations they face. Speech supplementation strategies, such as alphabet supplementation, allow speakers to augment their speech with additional cues. For example, alphabet supplementation, which means the speaker points to the first letter of each word while speaking, has been shown to increase speech intelligibility at the word level with an average gain of 11% and at the sentence level with an average gain of 26% (Hanson, Yorkston, & Beukelman, 2004). This form of AAC can help speakers bridge the gap between ineffective communication with natural speech and total reliance on alternative communication methods (Hanson, Yorkston, & Britton, 2011). The purpose of this article is to summarize the evidence in the area of speech supplementation, provide direction to integrate the strategies into treatment planning, and to suggest research directions for this rich area of study.


2020 ◽  
Vol 5 (4) ◽  
pp. 809-820 ◽  
Author(s):  
Kristen M. Allison

Purpose Reduced speech intelligibility limits functional communication for many children with motor speech disorders, and improving intelligibility is often a primary goal of intervention. Objective measurement of intelligibility is important for quantifying severity of speech impairment and tracking progress in therapy; however, there is little standardization of methods for measuring speech intelligibility in clinical settings. The purpose of this tutorial is to review different approaches to measuring speech intelligibility in children with motor speech disorders and to discuss the benefits and limitations of using each approach in clinical practice. Method Intelligibility is defined and compared to related constructs. Factors affecting intelligibility of children with motor speech disorders are reviewed. Methods for measuring intelligibility using word identification approaches and scaled ratings are discussed in detail, and their utility in clinical practice is compared. Results Word identification approaches to intelligibility measurement are optimal for tracking progress in therapy but are relatively time consuming. Scaled rating approaches may be adequate in cases where the goal is to obtain an overall measure of severity or for children who are unable to participate in structured testing. Conclusion Different approaches to intelligibility assessment are warranted depending on the clinical goal and characteristics of the child. Speech-language pathologists should consider multiple factors when selecting and interpreting intelligibility measures for their clients.


2020 ◽  
Vol 11 (2) ◽  
pp. 204
Author(s):  
Mohammad A. Damhoureyeh ◽  
Wesam B. Darawsheh ◽  
Wa’el N. Qa’dan ◽  
Yaser S. Natour

Studies conducted to establish normative data on speech rate; including speaking and articulation rate, for the Jordanian Arabic dialect are scarce. Aim: to establish preliminary normative data on speaking and articulation rate for the adult male and female Jordanian Arabic speakers. Methodology: The sample of the study comprised 51 participants (23 males and 28 females), age (18-25 yrs, mean 20.82 yrs ±1.52).  Spontaneous speech and reading samples were collected from participants. Results: Means of articulation rates during the tasks of spontaneous speech and reading passage were (140.07 w/m, 161.83 w/m, respectively), while the means of speaking rates during the tasks of spontaneous speech and reading passage were (124.51w/m, 141.36w/m, respectively). The ANOVA showed no significant differences (p=0.237) attributed to the effect gender on the articulation or the speaking rates in both tasks of spontaneous speech and reading passage. Pearson-r test showed moderate-strong positive correlations between articulation and speaking rates during both the reading passage and the spontaneous speech tasks (p<0.01, r = 0.416; p <0.001, r = 0.962, respectively). Conclusion: this study can be of a clinical significance in the evaluation and treatment of fluency, articulation and motor speech disorders.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M I M Foda ◽  
J F Nassar ◽  
M A S Baraka

Abstract Background Down syndrome (DS) is the most prevalent chromosomal disorder appearing in 1 in 800 use births. The incidence rate is higher in mothers of aging above 35-years-old and increases with further advances in maternal age. It is named after John Langdon Down, the British doctor who fully described the syndrome in 1866. Aim of the work The aim of this study was to analyze the speech of children with Down's syndrome, in order to detect types and significance of speech disorders affecting speech intelligibility: to assist in putting the best strategy for therapy. Patients and Method Study design: A cross sectional study. Participants The study was conducted through 2 unfamiliar adult raters on 30 children with Down's syndrome regardless of sex. They were recruited among cases attending the Phoniatric Outpatient Clinic, Ain Shams University who fulfilled the inclusion criteria and agreed to participate in the study. Conclusion and Recommendations Based on the obtained results, Children with Down's syndrome have specific health needs that must be identified to help their particular problems in communication. They present with deficits in receptive and expressive language. Also, speech is particularly impaired in high percentage of those children. Children with Down syndrome could not clearly deliver their speech as their peers. The findings confirmed that all the children with DS showed at least one speech disorder affecting their speech intelligibility. Recommendations Of course, the above observations can only be considered preliminary and many more data and researches are needed by clinicians as people with Down's syndrome can now live to be much older than they could in the past and most wish to reach their maximum potential. Therefore, the clinicians should apply their skills in the differential diagnosis of speech disorders to children with DS and search for measures for the other types of speech disorders can't be assessed in our work (like motor speech disorders which were present in a high percentage in our study group), allowing better interventions to target the cause of the disorder in each individual and improve their quality of life.


1986 ◽  
Vol 51 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Audrey L. Holland ◽  
Davida Fromm ◽  
Carol S. Swindell

Twenty-five "experts" on neurogenic motor speech disorders participated in a tutorial exercise. Each was given information on M, a patient who had communication difficulties as the result of stroke, and asked to complete a questionnaire about his problem. The information included a detailed case description, an audiotape of M's speech obtained at 4, 9, 13, and 17 days post-stroke, and test results from the Western Aphasia Battery, the Token Test, and a battery for apraxia of speech. The experts were in excellent agreement on M's primary problem, although it was called by seven different names. The experts were in poor agreement on his secondary problem(s), e.g., the presence and type of aphasia and dysarthria. The results suggest that labeling is difficult, even for "experts." Furthermore, the practicing clinician needs to be sensitive to the likelihood of more than one coexisting problem.


2011 ◽  
Author(s):  
Tsuneo Kato ◽  
Makoto Yamada ◽  
Nobuyuki Nishizawa ◽  
Keiichiro Oura ◽  
Keiichi Tokuda

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