Error Variability and the Differentiation Between Apraxia of Speech and Aphasia With Phonemic Paraphasia

2013 ◽  
Vol 56 (3) ◽  
pp. 891-905 ◽  
Author(s):  
Katarina L. Haley ◽  
Adam Jacks ◽  
Kevin T. Cunningham
Keyword(s):  
Error Rate ◽  
Clinical Utility ◽  
Correlation Coefficients ◽  
Cerebral Injury ◽  
Group Differences ◽  
Future Research ◽  
Diagnostic Validity ◽  
Apraxia Of Speech ◽  
Motor Speech ◽  
Conduction Aphasia

Purpose This study was conducted to evaluate the clinical utility of error variability for differentiating between apraxia of speech (AOS) and aphasia with phonemic paraphasia. Method Participants were 32 individuals with aphasia after left cerebral injury. Diagnostic groups were formed on the basis of operationalized measures of recognized articulatory and prosodic characteristics of AOS and phonemic paraphasia. Sequential repetitions of multisyllabic words were elicited as part of a motor speech evaluation and transcribed phonetically. Four metrics of variability at the syllable and word levels were derived from these transcripts. Results The measures yielded different magnitudes of variability. There were no group differences between participants who displayed speech profiles consistent with AOS and participants who displayed speech profiles indicative of aphasia with phonemic paraphasia. Rather, correlation coefficients and analyses of covariance showed that the variability metrics were significantly mediated by overall error rate. Additionally, variability scores for individuals with salient diagnoses of AOS and conduction aphasia were inconsistent with current diagnostic guidelines. Conclusions The results do not support diagnostic validity of error variability for differentiating between AOS and aphasia with phonemic paraphasia. Future research using error variability metrics should account for overall error rate in the analysis and matching of participant groups.

Perceptual Characteristics of Consonant Production in Apraxia of Speech and Aphasia

2019 ◽  
Vol 28 (4) ◽  
pp. 1411-1431 ◽  
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

scholarly journals Motor Speech Disorders and Communication Limitations in Progressive Supranuclear Palsy

2021 ◽  
pp. 1-12
Author(s):  
Heather M. Clark ◽  
Rene L. Utianski ◽  
Farwa Ali ◽  
Hugo Botha ◽  
Jennifer L. Whitwell ◽  
...  
Keyword(s):  
Progressive Supranuclear Palsy ◽  
Rating Scale ◽  
Speech Disorders ◽  
Future Research ◽  
Apraxia Of Speech ◽  
Prosodic Features ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Targeted Interventions ◽  
Communicative Effectiveness

Purpose This study describes motor speech disorders and associated communication limitations in six variants of progressive supranuclear palsy (PSP). Method The presence, nature, and severity of dysarthria and apraxia of speech (AOS) were documented, along with scores on the Apraxia of Speech Rating Scale–Version 3 (ASRS-3) for 77 (40 male and 37 female) patients with PSP. Clinician-estimated and patient-estimated communication limitations were rated using the Motor Speech Disorders Severity Rating (MSDSR) Scale and the Communicative Effectiveness Survey (CES), respectively. Descriptive statistics were calculated for each of these dependent variables. One-tailed t tests were conducted to test mean differences in ASRS-3 and CES between participants with and without AOS and between participants with and without dysarthria. Spearman rank correlations were calculated between ASRS-3 scores and clinical judgments of AOS and dysarthria severity and between MSDSR and CES ratings. Results Nine participants (12%) had normal speech. Eighty-seven percent exhibited dysarthria; hypokinetic and mixed hypokinetic–spastic dysarthria were observed most frequently. AOS was observed in 19.5% of participants across all variants, but in only 10% exclusive of the PSP speech and language variant. Nearly half presented with AOS in which neither phonetic nor prosodic features clearly predominated. The mean ASRS-3 score for participants with AOS was significantly higher than for those without and correlated strongly with clinician judgment of AOS severity. Mean ASRS-3 was higher for participants with dysarthria than for those without but correlated weakly with dysarthria severity. Mean MSDSR and CES ratings were lower in participants with AOS compared to those without and moderately correlated with each other. Conclusions Motor speech disorders that negatively impact communicative effectiveness are common in PSP and occur in many variants. This is the first description of motor speech disorders across PSP variants, setting the stage for future research characterizing neuroanatomical correlates, progression of motor speech disorders, and benefits of targeted interventions. Supplemental Material https://doi.org/10.23641/asha.14111837

The Labeling Problem in Aphasia

1986 ◽  
Vol 51 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Audrey L. Holland ◽  
Davida Fromm ◽  
Carol S. Swindell
Keyword(s):  
Speech Disorders ◽  
Case Description ◽  
Test Results ◽  
Apraxia Of Speech ◽  
Poor Agreement ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Communication Difficulties ◽  
Token Test ◽  
Primary Problem

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.

scholarly journals Involvement of Microglia in the Pathophysiology of Intracranial Aneurysms and Vascular Malformations—A Short Overview

2021 ◽  
Vol 22 (11) ◽  
pp. 6141
Author(s):  
Teodora Larisa Timis ◽  
Ioan Alexandru Florian ◽  
Sergiu Susman ◽  
Ioan Stefan Florian
Keyword(s):  
Immune Cells ◽  
Arteriovenous Malformations ◽  
Intracranial Aneurysms ◽  
Immune Cell ◽  
Vascular Malformations ◽  
Cerebral Injury ◽  
Future Research ◽  
Mortality And Morbidity ◽  
The Central Nervous System ◽  
The Brain

Aneurysms and vascular malformations of the brain represent an important source of intracranial hemorrhage and subsequent mortality and morbidity. We are only beginning to discern the involvement of microglia, the resident immune cell of the central nervous system, in these pathologies and their outcomes. Recent evidence suggests that activated proinflammatory microglia are implicated in the expansion of brain injury following subarachnoid hemorrhage (SAH) in both the acute and chronic phases, being also a main actor in vasospasm, considerably the most severe complication of SAH. On the other hand, anti-inflammatory microglia may be involved in the resolution of cerebral injury and hemorrhage. These immune cells have also been observed in high numbers in brain arteriovenous malformations (bAVM) and cerebral cavernomas (CCM), although their roles in these lesions are currently incompletely ascertained. The following review aims to shed a light on the most significant findings related to microglia and their roles in intracranial aneurysms and vascular malformations, as well as possibly establish the course for future research.

How Might We Screen for Psychological Factors in People With Pelvic Pain? An e-Delphi Study

2021 ◽  
Author(s):  
Angela Pontifex ◽  
Caris Savin ◽  
Caitlin Park ◽  
Alina Filipe Nunes ◽  
K Jane Chalmers ◽  
...  
Keyword(s):  
Focus Group ◽  
Pelvic Pain ◽  
Delphi Method ◽  
Delphi Study ◽  
Psychological Factors ◽  
Clinical Utility ◽  
Delphi Process ◽  
Future Research ◽  
Exclusion Criteria ◽  
Group Design

Abstract Objective Persistent pelvic pain is a complex condition often influenced by psychological factors that can alter treatment outcomes. These factors are potentially modifiable; however, currently there is no instrument to screen for them in these individuals. The purpose of this study was to determine (1) which psychological factors should be screened in individuals with persistent pelvic pain and (2) the most appropriate statements to represent these psychological factors. Methods The study used a focus group design followed by an electronic-Delphi (e-Delphi) process. A focus group consisting of 8 experts was conducted to determine the relevant psychological factors to screen. These results informed round 1 of the e-Delphi process, consisting of a panel of 14 pain/pelvic pain experts. The e-Delphi process consisted of 3 rounds of online surveys and 2 teleconference discussions to establish consensus on the most appropriate statement to screen for each of the psychological factors. Results The focus group identified 13 relevant psychological factors. During the e-Delphi process, relevant screening statements were assessed using a 100-point allocation system. Experts could reword and suggest new statements. Statements were assessed for consensus and stability and were eliminated as the rounds progressed if they met the exclusion criteria. At the termination of round 3, there were 15 statements remaining. Conclusions The final list of 15 statements will assist clinicians in screening for psychological factors and is an important step for clinicians in providing psychologically informed care to people with persistent pelvic pain. Future research should determine the psychometric properties of the statements to determine their clinical utility as a questionnaire. Impact This study has refined a list of statements to help screen for psychological factors in individuals with persistent pelvic pain. Developed robustly using an e-Delphi method, this list is an important first step forward for clinicians to provide psychologically informed care to these individuals.

scholarly journals Psychometric Properties of the MyotonPRO in Dementia Patients with Paratonia

Gerontology ◽  
2017 ◽  
Vol 64 (4) ◽  
pp. 401-412 ◽  
Author(s):  
Hans Drenth ◽  
Sytse U. Zuidema ◽  
Wim P. Krijnen ◽  
Ivan Bautmans ◽  
Cees van der Schans ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Functional Mobility ◽  
Future Research ◽  
Minimal Detectable Change ◽  
Muscle Properties ◽  
Dementia Patients ◽  
Longitudinal Outcome

Background: Paratonia is a distinctive form of hypertonia, causing loss of functional mobility in early stages of dementia to severe high muscle tone and pain in the late stages. For assessing and evaluating therapeutic interventions, objective instruments are required. Objective: Determine the psychometric properties of the MyotonPRO, a portable device that objectively measures muscle properties, in dementia patients with paratonia. Methods: Muscle properties were assessed with the MyotonPRO by 2 assessors within one session and repeated by the main researcher after 30 min and again after 6 months. Receiver operating characteristic curves were constructed for all MyotonPRO outcomes to discriminate between participants with (n = 70) and without paratonia (n = 82). In the participants with paratonia, correlation coefficients were established between the MyotonPRO outcomes and the Modified Ashworth Scale for paratonia (MAS-P) and muscle palpation. In participants with paratonia, reliability (intraclass correlation coefficient) and agreement values (standard error of measurement and minimal detectable change) were established. Longitudinal outcome from participants with paratonia throughout the study (n = 48) was used to establish the sensitivity for change (correlation coefficient) and responsiveness (minimal clinical important difference). Results: Included were 152 participants with dementia (mean [standard deviation] age of 83.5 [98.2]). The area under the curve ranged from 0.60 to 0.67 indicating the MyotonPRO is able to differentiate between participants with and without paratonia. The MyotonPRO explained 10-18% of the MAS-P score and 8-14% of the palpation score. Interclass correlation coefficients for interrater reliability ranged from 0.57 to 0.75 and from 0.54 to 0.71 for intrarater. The best agreement values were found for tone, elasticity, and stiffness. The change between baseline and 6 months in the MyotonPRO outcomes explained 8-13% of the change in the MAS-P scores. The minimal clinically important difference values were all smaller than the measurement error. Conclusion: The MyotonPRO is potentially applicable for cross-sectional studies between groups of paratonia patients and appears less suitable to measure intraindividual changes in paratonia. Because of the inherent variability in movement resistance in paratonia, the outcomes from the MyotonPRO should be interpreted with care; therefore, future research should focus on additional guidelines to increase the clinical interpretation and improving reproducibility.

Functional Behavior Assessment Rating Scales: Intrarater Reliability with Students with Emotional or Behavioral Disorders

2003 ◽  
Vol 28 (4) ◽  
pp. 386-400 ◽  
Author(s):  
Sally M. Barton-Arwood ◽  
Joseph H. Wehby ◽  
Philip L. Gunter ◽  
Kathleen L. Lane
Keyword(s):  
Behavioral Disorders ◽  
Rating Scales ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Functional Behavior Assessment ◽  
Behavior Assessment ◽  
Future Research ◽  
Intrarater Reliability ◽  
Functional Behavior ◽  
Emotional Or Behavioral Disorders

This study evaluated the intrarater reliability of two functional behavior assessment rating scales: the Motivation Assessment Scale and the Problem Behavior Questionnaire. Teachers rated 30 students from 10 self-contained classrooms for students with emotional or behavioral disorders on three separate occasions using both rating scales. Pearson correlation coefficients and exact and adjacent agreement percentages indicated variable and inconsistent ratings across administrations and rating scales. The authors discuss possible reasons for inconsistencies, as well as implications for practice and future research.

scholarly journals Systematic Review and Metaanalysis of Patient Self-Report versus Trained Assessor Joint Counts in Rheumatoid Arthritis

2009 ◽  
Vol 36 (12) ◽  
pp. 2635-2641 ◽  
Author(s):  
JENNIFER L. BARTON ◽  
LINDSEY A. CRISWELL ◽  
RACHEL KAISER ◽  
YEA-HUNG CHEN ◽  
DEAN SCHILLINGER
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Self Report ◽  
Future Research ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Trained Assessor ◽  
Tender Joint Counts

Objective.Patient self-report outcomes and physician-performed joint counts are important measures of disease activity and treatment response. This metaanalysis examines the degree of concordance in joint counts between trained assessors and patients with rheumatoid arthritis (RA).Methods.Studies eligible for inclusion met the following criteria: English language; compared patient with trained assessor joint counts; peer-reviewed; and RA diagnosis determined by board-certified or board-eligible specialist or met 1987 American College of Rheumatology criteria. We searched PubMed and Embase to identify articles between 1966 and January 1, 2008. We compared measures of correlation between patients and assessors for either tender/painful or swollen joint counts. We used metaanalysis methods to calculate summary correlation estimates.Results.We retrieved 462 articles and 18 were included. Self-report joint counts were obtained by a text and/or mannequin (picture) format. The summary estimates for the Pearson correlation coefficients for tender joint counts were 0.61 (0.47 lower, 0.75 upper) and for swollen joint counts 0.44 (0.15, 0.73). Summary results for the Spearman correlation coefficients were 0.60 (0.30, 0.90) for tender joint counts and 0.54 (0.35, 0.73) for swollen joint counts.Conclusion.A self-report tender joint count has moderate to marked correlation with those performed by a trained assessor. In contrast, swollen joint counts demonstrate lower levels of correlation. Future research should explore whether integrating self-report tender joint counts into routine care can improve efficiency and quality of care, while directly involving patients in assessment of RA disease activity.

scholarly journals Interrelationship of linear dimensions as growth corollary of pama croaker Otolithoides pama in the Bay of Bengal

2021 ◽  
Vol 32 (2) ◽  
pp. 287-292
Author(s):  
ZOARDER FARUQUE AHMED ◽  
MST. KANIZ FATEMA ◽  
UMME HABIBA AZ ZOHORA ◽  
MANSURA AKTER JOBA ◽  
FERDOUS AHAMED
Keyword(s):  
Bay Of Bengal ◽  
Correlation Coefficients ◽  
Future Research ◽  
Strongly Correlated ◽  
Regression Analyses ◽  
Allometric Growth ◽  
Linear Dimensions ◽  
Length Relationship ◽  
Gender Categories ◽  
Very High

Growth pattern of pama croaker Otolithoides pama population in the Bay of Bengal was determinedas the corollary of relationships between standard length (SL) and total length (TL), the two most prevalentlyused linear dimensions of fin fish species. Monthly pama croaker samples were collected from the industrialfisheries in the Bay of Bengal. The length-length relationship was constructed algebraically in the form ofy=a+bx. Relationships between SL and TL for male, female and unsexed populations were separatelyestablished. Sex ratio between male and female did not deviate from the parity (?2 test; p>0.05). The SL andTL ranges of male were 7.2-22 cm and 9.5-28 cm respectively, and the SL and TL ranges of female were6.8-20 cm and 8.4-25.7 cm respectively. Intercept and slope varied monthly in all length-length relationshipsregardless of gender categories. The generalized SL-TL relationships of male, female and unsexedpopulations were TL=1.214SL+0.761(R=0.989), TL=1.212SL-0.770(R=0.990) and TL=1.203SL+0.904(R=0.987) respectively. The correlation coefficients of both monthly and generalized regression analyses ofall sex types were very high (R?0.852) which explained that the relationships between the two lengthdimensions were strongly correlated. The growth corollary appeared both as isometric and allometric formonthly populations. Allometric growth was apparent in July, August and September in all gender types,while isometric growth was deduced in other months. This study would be useful for future research in orderto make comparisons with the relevant aspects of O. pama population between years and locations in the Bayof Bengal.

scholarly journals Childhood Apraxia of Speech. Developmental Speech Patterns. A Wide Retrospective Study

2020 ◽  
Vol 11 (3sup1) ◽  
pp. 54-68
Author(s):  
Elad Vashdi ◽  
◽  
Amit Avramov ◽  
Špela Falatov ◽  
Huang Yi-Chen ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Sound Production ◽  
Speech Disorder ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Entry Level ◽  
Motor Speech Disorder ◽  
Speech Patterns

Patterns of a phenomenon define the entity. If one understands the patterns of the maze, he can find his way there. Patterns of colors on a dress will hold its characters and soul. Understanding the expressive patterns of a developmental syndrome enables treating it with success. It is true for treating Childhood Apraxia of speech (CAS) as well. CAS as motor-speech disorder involves difficulties in sounds production for speech purposes. The difficulties can be demonstrated in patterns that would be specific to CAS. These patterns can distinguish one phenomenon from another. A retrospective research was conducted based on 277 entry level evaluations of children diagnosed with CAS or suspected of CAS who visited a private clinic between 2006 and 2013. The analysis included speech variables alongside background and environmental variables. This article is dealing with speech patterns of children with motor speech disorder. Among the patterns examined are vowels ladder, single syllable ladder, Blowing and SSP (single sound production), Oral motor and SSP, Consonant group ladder and Consonants Exploratory factor analysis. The findings demonstrated the relationship and order of vowels, consonants and single syllables among Hebrew speaking children diagnosed with motor speech disorder. The Consonants Exploratory factor analysis gave validity to the existence of unique consonant groups. Further discussion regarding every result and its implication is included. Understanding the unique patterns of consonants and vowels strength among children with CAS can help clinicians in the decision-making process and goals targeting.

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