scholarly journals Perceptually Salient Sound Distortions and Apraxia of Speech: A Performance Continuum

2017 ◽  
Vol 26 (2S) ◽  
pp. 631-640 ◽  
Author(s):  
Katarina L. Haley ◽  
Adam Jacks ◽  
Jessica D. Richardson ◽  
Julie L. Wambaugh
Keyword(s):  
Left Hemisphere ◽  
Sound Production ◽  
Dynamic Performance ◽  
Speech Sound ◽  
Speaking Rate ◽  
Apraxia Of Speech ◽  
External Criterion ◽  
Syllable Duration ◽  
Left Hemisphere Stroke ◽  
A Performance

Purpose We sought to characterize articulatory distortions in apraxia of speech and aphasia with phonemic paraphasia and to evaluate the diagnostic validity of error frequency of distortion and distorted substitution in differentiating between these disorders. Method Study participants were 66 people with speech sound production difficulties after left-hemisphere stroke or trauma. They were divided into 2 groups on the basis of word syllable duration, which served as an external criterion for speaking rate in multisyllabic words and an index of likely speech diagnosis. Narrow phonetic transcriptions were completed for audio-recorded clinical motor speech evaluations, using 29 diacritic marks. Results Partial voicing and altered vowel tongue placement were common in both groups, and changes in consonant manner and place were also observed. The group with longer word syllable duration produced significantly more distortion and distorted-substitution errors than did the group with shorter word syllable duration, but variations were distributed on a performance continuum that overlapped substantially between groups. Conclusions Segment distortions in focal left-hemisphere lesions can be captured with a customized set of diacritic marks. Frequencies of distortions and distorted substitutions are valid diagnostic criteria for apraxia of speech, but further development of quantitative criteria and dynamic performance profiles is necessary for clinical utility.

Recovering With Acquired Apraxia of Speech: The First 2 Years

2016 ◽  
Vol 25 (4S) ◽  
Author(s):  
Katarina L. Haley ◽  
Jennifer N. Shafer ◽  
Tyson G. Harmon ◽  
Adam Jacks
Keyword(s):  
Qualitative Analysis ◽  
Lived Experience ◽  
Sound Production ◽  
Speech Sound ◽  
Cognitive Effort ◽  
Speaking Rate ◽  
Apraxia Of Speech ◽  
Dynamic Relationship ◽  
Speech Features ◽  
The Relationship

Purpose This study was intended to document speech recovery for 1 person with acquired apraxia of speech quantitatively and on the basis of her lived experience. Method The second author sustained a traumatic brain injury that resulted in acquired apraxia of speech. Over a 2-year period, she documented her recovery through 22 video-recorded monologues. We analyzed these monologues using a combination of auditory perceptual, acoustic, and qualitative methods. Results Recovery was evident for all quantitative variables examined. For speech sound production, the recovery was most prominent during the first 3 months, but slower improvement was evident for many months. Measures of speaking rate, fluency, and prosody changed more gradually throughout the entire period. A qualitative analysis of topics addressed in the monologues was consistent with the quantitative speech recovery and indicated a subjective dynamic relationship between accuracy and rate, an observation that several factors made speech sound production variable, and a persisting need for cognitive effort while speaking. Conclusions Speech features improved over an extended time, but the recovery trajectories differed, indicating dynamic reorganization of the underlying speech production system. The relationship among speech dimensions should be examined in other cases and in population samples. The combination of quantitative and qualitative analysis methods offers advantages for understanding clinically relevant aspects of recovery.

scholarly journals Feature-driven classification reveals potential comorbid subtypes within childhood apraxia of speech

2020 ◽  
Author(s):  
Catherine Stein ◽  
Penelope Benchek ◽  
Gabrielle Miller ◽  
Noémi B. Hall ◽  
Dhanya Menon ◽  
...  
Keyword(s):  
Sound Production ◽  
Neurodevelopmental Disorder ◽  
Speech Sound ◽  
Hierarchical Cluster ◽  
Educational Interventions ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Poor Reading ◽  
Word Repetition ◽  
Reading Measures

Abstract Background Childhood apraxia of speech (CAS) is a neurodevelopmental disorder with heterogeneous communication and other comorbid manifestations. While previous studies have characterized speech deficits associated with CAS, few studies have examined variability in reading and language and/or other developmental comorbidities. We sought to identify comorbid subgroups within CAS that could be clinically relevant as well as genetically distinctive. Methods In a group of 31 children with CAS and 8 controls, we performed hierarchical cluster analysis utilizing measures of articulation, vocabulary, and reading. We also conducted a chart review of the children with CAS to examine other clinical characteristics in these children and their association with subgroup membership. Results We identified 3 comorbid subgroups within CAS of varying severity. The high severity subgroup was characterized by poor reading and vocabulary, and the moderate severity subgroup by poor reading and non-word repetition but average vocabulary, compared to the mild severity subgroup. Subgroups were indistinguishable with respect to speech sound production, the hallmark of CAS, all demonstrating poor articulation. Children in the most severe subgroup were more likely to have early problems feeding (p=0.036). Conclusions Children with CAS may potentially be classified into comorbidity groups based on performance on vocabulary and reading measures, providing additional insight into the heterogeneity within CAS with implications for educational interventions.

Error Consistency in Acquired Apraxia of Speech With Aphasia: Effects of the Analysis Unit

2018 ◽  
Vol 61 (2) ◽  
pp. 210-226 ◽  
Author(s):  
Katarina L. Haley ◽  
Kevin T. Cunningham ◽  
Catherine Torrington Eaton ◽  
Adam Jacks
Keyword(s):  
Speech Sound ◽  
Apraxia Of Speech ◽  
Error Type ◽  
Unit Of Analysis ◽  
Word Level ◽  
Sound Levels ◽  
Error Location ◽  
Consistency Results ◽  
Clinical Diagnoses ◽  
Left Hemisphere Stroke

Purpose Diagnostic recommendations for acquired apraxia of speech (AOS) have been contradictory concerning whether speech sound errors are consistent or variable. Studies have reported divergent findings that, on face value, could argue either for or against error consistency as a diagnostic criterion. The purpose of this study was to explain discrepancies in error consistency results based on the unit of analysis (segment, syllable, or word) to help determine which diagnostic recommendation is most appropriate. Method We analyzed speech samples from 14 left-hemisphere stroke survivors with clinical diagnoses of AOS and aphasia. Each participant produced 3 multisyllabic words 5 times in succession. Broad phonetic transcriptions of these productions were coded for consistency of error location and type using the word and its constituent syllables and sound segments as units of analysis. Results Consistency of error type varied systematically with the unit of analysis, showing progressively greater consistency as the analysis unit changed from the word to the syllable and then to the sound segment. Consistency of error location varied considerably across participants and correlated positively with error frequency. Conclusions Low to moderate consistency of error type at the word level confirms original diagnostic accounts of speech output and sound errors in AOS as variable in form. Moderate to high error type consistency at the syllable and sound levels indicate that phonetic error patterns are present. The results are complementary and logically compatible with each other and with the literature.

scholarly journals Feature-driven classification reveals potential comorbid subtypes within childhood apraxia of speech

2020 ◽  
Author(s):  
Catherine Stein ◽  
Penelope Benchek ◽  
Gabrielle Miller ◽  
Noémi B. Hall ◽  
Dhanya Menon ◽  
...  
Keyword(s):  
Sound Production ◽  
Neurodevelopmental Disorder ◽  
Speech Sound ◽  
Hierarchical Cluster ◽  
Educational Interventions ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Poor Reading ◽  
Word Repetition ◽  
Reading Measures

Abstract Background: Childhood apraxia of speech (CAS) is a neurodevelopmental disorder with heterogeneous communication and other comorbid manifestations. While previous studies have characterized speech deficits associated with CAS, few studies have examined variability in reading and language and/or other developmental comorbidities. We sought to identify comorbid subgroups within CAS that could be clinically relevant as well as genetically distinctive. Methods: In a group of 31 children with CAS and 8 controls, we performed hierarchical cluster analysis utilizing measures of articulation, vocabulary, and reading. We also conducted a chart review of the children with CAS to examine other clinical characteristics in these children and their association with subgroup membership. Results: We identified 3 comorbid subgroups within CAS of varying severity. The high severity subgroup was characterized by poor reading and vocabulary, and the moderate severity subgroup by poor reading and non-word repetition but average vocabulary, compared to the mild severity subgroup. Subgroups were indistinguishable with respect to speech sound production, the hallmark of CAS, all demonstrating poor articulation. Children in the most severe subgroup were more likely to have early problems feeding (p=0.036). Conclusions: Children with CAS may potentially be classified into comorbidity groups based on performance on vocabulary and reading measures, providing additional insight into the heterogeneity within CAS with implications for educational interventions.

scholarly journals Pure Apraxia of Speech After Resection Based in the Posterior Middle Frontal Gyrus

Neurosurgery ◽  
2020 ◽  
Vol 87 (3) ◽  
pp. E383-E389 ◽  
Author(s):  
Edward F Chang ◽  
Garret Kurteff ◽  
John P Andrews ◽  
Robert G Briggs ◽  
Andrew K Conner ◽  
...  
Keyword(s):  
Sound Production ◽  
Premotor Cortex ◽  
Speech Sound ◽  
Middle Frontal Gyrus ◽  
Apraxia Of Speech ◽  
Imaging Data ◽  
Dorsal Premotor Cortex ◽  
Human Connectome Project ◽  
Language Area ◽  
Classical Language

Abstract BACKGROUND AND IMPORTANCE Apraxia of speech is a disorder of articulatory coordination and planning in speech sound production. Its diagnosis is based on deficits in articulation, prosody, and fluency. It is often described concurrent with aphasia or dysarthria, while pure apraxia of speech is a rare entity. CLINICAL PRESENTATION A right-handed man underwent focal surgical resection of a recurrent grade III astrocytoma in the left hemisphere dorsal premotor cortex located in the posterior middle frontal gyrus. After the procedure, he experienced significant long-term speech production difficulties. A battery of standard and custom language and articulatory assessments were administered, revealing intact comprehension and naming abilities, and preserved strength in orofacial articulators, but considerable deficits in articulatory coordination, fluency, and prosody—consistent with diagnosis of pure apraxia of speech. Tractography and resection volumes compared with publicly available imaging data from the Human Connectome Project suggest possible overlap with area 55b, an under-recognized language area in the dorsal premotor cortex and has white matter connectivity with the superior longitudinal fasciculus. CONCLUSION The case reported here details a rare clinical entity, pure apraxia of speech resulting from resection of posterior middle frontal gyrus. While not a classical language area, emerging literature supports the role of this area in the production of fluent speech, and has implications for surgical planning and the general neurobiology of language.

scholarly journals Feature-driven classification reveals potential comorbid subtypes within childhood apraxia of speech

2020 ◽  
Author(s):  
Catherine Stein ◽  
Penelope Benchek ◽  
Gabrielle Miller ◽  
Noémi B. Hall ◽  
Dhanya Menon ◽  
...  
Keyword(s):  
Sound Production ◽  
Neurodevelopmental Disorder ◽  
Speech Sound ◽  
Hierarchical Cluster ◽  
Educational Interventions ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Poor Reading ◽  
Word Repetition ◽  
Reading Measures

Abstract Background Childhood apraxia of speech (CAS) is a neurodevelopmental disorder with heterogeneous communication and other comorbid manifestations. While previous studies have characterized speech deficits associated with CAS, few studies have examined variability in reading and language and/or other developmental comorbidities. We sought to identify comorbid subgroups within CAS that could be clinically relevant as well as genetically distinctive. Methods In a group of 31 children with CAS and 8 controls, we performed hierarchical cluster analysis utilizing measures of articulation, vocabulary, and reading. We also conducted a chart review of the children with CAS to examine other clinical characteristics in these children and their association with subgroup membership. Results We identified 3 comorbid subgroups within CAS of varying severity. The high severity subgroup was characterized by poor reading and vocabulary, and the moderate severity subgroup by poor reading and non-word repetition but average vocabulary, compared to the mild severity subgroup. Subgroups were indistinguishable with respect to speech sound production, the hallmark of CAS, all demonstrating poor articulation. Children in the most severe subgroup were more likely to have early problems feeding (p=0.036). Conclusions Children with CAS may potentially be classified into comorbidity groups based on performance on vocabulary and reading measures, providing additional insight into the heterogeneity within CAS with implications for educational interventions.

scholarly journals Feature-driven classification reveals potential comorbid subtypes within childhood apraxia of speech

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Catherine M. Stein ◽  
Penelope Benchek ◽  
Gabrielle Miller ◽  
Noémi B. Hall ◽  
Dhanya Menon ◽  
...  
Keyword(s):  
Sound Production ◽  
Neurodevelopmental Disorder ◽  
Speech Sound ◽  
Hierarchical Cluster ◽  
Educational Interventions ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Poor Reading ◽  
Word Repetition ◽  
Reading Measures

Abstract Background Childhood apraxia of speech (CAS) is a neurodevelopmental disorder with heterogeneous communication and other comorbid manifestations. While previous studies have characterized speech deficits associated with CAS, few studies have examined variability in reading and language and/or other developmental comorbidities. We sought to identify comorbid subgroups within CAS that could be clinically relevant as well as genetically distinctive. Methods In a group of 31 children with CAS and 8 controls, we performed hierarchical cluster analysis utilizing measures of articulation, vocabulary, and reading. We also conducted a chart review of the children with CAS to examine other clinical characteristics in these children and their association with subgroup membership. Results We identified 3 comorbid subgroups within CAS of varying severity. The high severity subgroup was characterized by poor reading and vocabulary, and the moderate severity subgroup by poor reading and non-word repetition but average vocabulary, compared to the mild severity subgroup. Subgroups were indistinguishable with respect to speech sound production, the hallmark of CAS, all demonstrating poor articulation. Children in the most severe subgroup were more likely to have early problems feeding (p = 0.036). Conclusions Children with CAS may potentially be classified into comorbidity groups based on performance on vocabulary and reading measures, providing additional insight into the heterogeneity within CAS with implications for educational interventions.

Reading Risk in Children With Speech Sound Disorder: Prevalence, Persistence, and Predictors

2020 ◽  
Vol 63 (11) ◽  
pp. 3714-3726
Author(s):  
Sherine R. Tambyraja ◽  
Kelly Farquharson ◽  
Laura Justice
Keyword(s):  
At Risk ◽  
Sound Production ◽  
Speech Therapy ◽  
Speech Sound ◽  
Reading Difficulties ◽  
School Age Children ◽  
Speech Sound Disorder ◽  
Word Decoding ◽  
School Year ◽  
School Based

Purpose The purpose of this study was to determine the extent to which school-age children with speech sound disorder (SSD) exhibit concomitant reading difficulties and examine the extent to which phonological processing and speech production abilities are associated with increased likelihood of reading risks. Method Data were obtained from 120 kindergarten, first-grade, and second-grade children who were in receipt of school-based speech therapy services. Children were categorized as being “at risk” for reading difficulties if standardized scores on a word decoding measure were 1 SD or more from the mean. The selected predictors of reading risk included children's rapid automatized naming ability, phonological awareness (PA), and accuracy of speech sound production. Results Descriptive results indicated that just over 25% of children receiving school-based speech therapy for an SSD exhibited concomitant deficits in word decoding and that those exhibiting risk at the beginning of the school year were likely to continue to be at risk at the end of the school year. Results from a hierarchical logistic regression suggested that, after accounting for children's age, general language abilities, and socioeconomic status, both PA and speech sound production abilities were significantly associated with the likelihood of being classified as at risk. Conclusions School-age children with SSD are at increased risk for reading difficulties that are likely to persist throughout an academic year. The severity of phonological deficits, reflected by PA and speech output, may be important indicators of subsequent reading problems.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

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