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 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.

scholarly journals The Nature of Error Consistency in Individuals With Acquired Apraxia of Speech and Aphasia

2017 ◽  
Vol 26 (2S) ◽  
pp. 611-630 ◽  
Author(s):  
Lauren Bislick ◽  
Malcolm McNeil ◽  
Kristie A. Spencer ◽  
Kathryn Yorkston ◽  
Diane L. Kendall
Keyword(s):  
Error Rate ◽  
Motor Planning ◽  
Stimulus Presentation ◽  
Apraxia Of Speech ◽  
Error Type ◽  
Presentation Condition ◽  
Design Error ◽  
Error Location ◽  
Phonetic Errors ◽  
Consistent Error

Purpose The primary characteristics used to define acquired apraxia of speech (AOS) have evolved to better reflect a disorder of motor planning/programming. However, there is debate regarding the feature of relatively consistent error location and type. Method Ten individuals with acquired AOS and aphasia and 11 individuals with aphasia without AOS participated in this study. In the context of a 2-group experimental design, error consistency was examined via 5 repetitions of 30 multisyllabic words. The influence of error rate, severity of impairment, and stimulus presentation condition (blocked vs. random) on error consistency was also explored, as well as between-groups differences in the types of errors produced. Results Groups performed similarly on consistency of error location; however, adults with AOS demonstrated greater variability of error type in a blocked presentation condition only. Stimulus presentation condition, error rate, and severity of impairment did not influence error consistency in either group. Groups differed in the production of phonetic errors (e.g., sound distortions) but not phonemic errors. Conclusions Overall, findings do not support relatively consistent errors as a differentiating characteristic of AOS.

Ultrasound Biofeedback Treatment for Persisting Childhood Apraxia of Speech

2013 ◽  
Vol 22 (4) ◽  
pp. 627-643 ◽  
Author(s):  
Jonathan L. Preston ◽  
Nickole Brick ◽  
Nicole Landi
Keyword(s):  
Treatment Program ◽  
Speech Sound ◽  
Performance Criterion ◽  
Performance Criteria ◽  
Ultrasound Images ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Word Level ◽  
Tongue Movements ◽  
Biofeedback Treatment

Purpose The purpose of this study was to evaluate the efficacy of a treatment program that includes ultrasound biofeedback for children with persisting speech sound errors associated with childhood apraxia of speech (CAS). Method Six children ages 9–15 years participated in a multiple baseline experiment for 18 treatment sessions during which treatment focused on producing sequences involving lingual sounds. Children were cued to modify their tongue movements using visual feedback from real-time ultrasound images. Probe data were collected before, during, and after treatment to assess word-level accuracy for treated and untreated sound sequences. As participants reached preestablished performance criteria, new sequences were introduced into treatment. Results All participants met the performance criterion (80% accuracy for 2 consecutive sessions) on at least 2 treated sound sequences. Across the 6 participants, performance criterion was met for 23 of 31 treated sequences in an average of 5 sessions. Some participants showed no improvement in untreated sequences, whereas others showed generalization to untreated sequences that were phonetically similar to the treated sequences. Most gains were maintained 2 months after the end of treatment. The percentage of phonemes correct increased significantly from pretreatment to the 2-month follow-up. Conclusion A treatment program including ultrasound biofeedback is a viable option for improving speech sound accuracy in children with persisting speech sound errors associated with CAS.

Morphological Awareness Skills of Second- and Third-Grade Students With and Without Speech Sound Disorders

2020 ◽  
Vol 51 (3) ◽  
pp. 603-616
Author(s):  
Kenn Apel ◽  
Victoria S. Henbest
Keyword(s):  
Word Reading ◽  
Speech Sound ◽  
Morphological Awareness ◽  
Literacy Skills ◽  
Receptive Vocabulary ◽  
Real Word ◽  
Speech Sound Disorders ◽  
Word Level ◽  
Third Grade Students ◽  
Pseudoword Reading

Purpose Morphological awareness is the ability to consciously manipulate the smallest units of meaning in language. Morphological awareness contributes to success with literacy skills for children with typical language and those with language impairment. However, little research has focused on the morphological awareness skills of children with speech sound disorders (SSD), who may be at risk for literacy impairments. No researcher has examined the morphological awareness skills of children with SSD and compared their skills to children with typical speech using tasks representing a comprehensive definition of morphological awareness, which was the main purpose of this study. Method Thirty second- and third-grade students with SSD and 30 with typical speech skills, matched on age and receptive vocabulary, completed four morphological awareness tasks and measures of receptive vocabulary, real-word reading, pseudoword reading, and word-level spelling. Results Results indicated there was no difference between the morphological awareness skills of students with and without SSD. Although morphological awareness was moderately to strongly related to the students' literacy skills, performance on the morphological awareness tasks contributed little to no additional variance to the children's real-word reading and spelling skills beyond what was accounted for by pseudoword reading. Conclusions Findings suggest that early elementary-age students with SSD may not present with concomitant morphological awareness difficulties and that the morphological awareness skills of these students may not play a unique role in their word-level literacy skills. Limitations and suggestions for future research on the morphological awareness skills of children with SSD are discussed.

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

Lexical and phonological development in children with childhood apraxia of speech – a commentary on Stoel-Gammon's ‘Relationships between lexical and phonological development in young children’*

2010 ◽  
Vol 38 (1) ◽  
pp. 82-86 ◽  
Author(s):  
SHELLEY L. VELLEMAN
Keyword(s):  
Young Children ◽  
Speech Sound ◽  
Interesting Case ◽  
Prognostic Indicators ◽  
Phonological Development ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech Disorder ◽  
Remediation Strategies

Although not the focus of her article, phonological development in young children with speech sound disorders of various types is highly germane to Stoel-Gammon's discussion (this issue) for at least two primary reasons. Most obvious is that typical processes and milestones of phonological development are the standards and benchmarks against which we measure disorder and delay. Factors that impact children without disorders may suggest underlying causes or co-occurring symptoms of speech sound deficits, prognostic indicators of improvement, appropriate remediation strategies or some combination of these. Equally important is the fact that studying children with disorders can help us to verify and, in some cases, even unpack relationships among factors that are so closely interwoven in children who develop their phonologies at the typically very rapid rate that their individual influences cannot be discerned. Childhood Apraxia of Speech (CAS) is a particularly interesting case in point because, while it is universally accepted to be a motor speech disorder, symptoms include deficits in speech perception and often in literacy-related skills as well.

Treating Speech Subsystems in Childhood Apraxia of Speech With Tactual Input: The PROMPT Approach

2013 ◽  
Vol 22 (4) ◽  
pp. 644-661 ◽  
Author(s):  
Philip S. Dale ◽  
Deborah A. Hayden
Keyword(s):  
Standardized Tests ◽  
Treatment Approach ◽  
Speech Sound ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Within Subjects ◽  
Speech Control ◽  
Criterion Referenced

Purpose Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT; Hayden, 2004; Hayden, Eigen, Walker, & Olsen, 2010)—a treatment approach for the improvement of speech sound disorders in children—uses tactile-kinesthetic-proprioceptive (TKP) cues to support and shape movements of the oral articulators. No research to date has systematically examined the efficacy of PROMPT for children with childhood apraxia of speech (CAS). Method Four children (ages 3;6 [years;months] to 4;8), all meeting the American Speech-Language-Hearing Association (2007) criteria for CAS, were treated using PROMPT. All children received 8 weeks of 2 × per week treatment, including at least 4 weeks of full PROMPT treatment that included TKP cues. During the first 4 weeks, 2 of the 4 children received treatment that included all PROMPT components except TKP cues. This design permitted both between-subjects and within-subjects comparisons to evaluate the effect of TKP cues. Gains in treatment were measured by standardized tests and by criterion-referenced measures based on the production of untreated probe words, reflecting change in speech movements and auditory perceptual accuracy. Results All 4 children made significant gains during treatment, but measures of motor speech control and untreated word probes provided evidence for more gain when TKP cues were included. Conclusion PROMPT as a whole appears to be effective for treating children with CAS, and the inclusion of TKP cues appears to facilitate greater effect.

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 In Time with the Beat: Entrainment in Patients with Phonological Impairment, Apraxia of Speech, and Parkinson’s Disease

2021 ◽  
Vol 11 (11) ◽  
pp. 1524
Author(s):  
Ingrid Aichert ◽  
Katharina Lehner ◽  
Simone Falk ◽  
Mona Späth ◽  
Mona Franke ◽  
...  
Keyword(s):  
Research Question ◽  
Speech Sound ◽  
Speech Disorders ◽  
Stress Pattern ◽  
Sentence Completion ◽  
Control Group ◽  
Apraxia Of Speech ◽  
Response Latencies ◽  
Speech Rhythm ◽  
Target Words

In the present study, we investigated if individuals with neurogenic speech sound impairments of three types, Parkinson’s dysarthria, apraxia of speech, and aphasic phonological impairment, accommodate their speech to the natural speech rhythm of an auditory model, and if so, whether the effect is more significant after hearing metrically regular sentences as compared to those with an irregular pattern. This question builds on theories of rhythmic entrainment, assuming that sensorimotor predictions of upcoming events allow humans to synchronize their actions with an external rhythm. To investigate entrainment effects, we conducted a sentence completion task relating participants’ response latencies to the spoken rhythm of the prime heard immediately before. A further research question was if the perceived rhythm interacts with the rhythm of the participants’ own productions, i.e., the trochaic or iambic stress pattern of disyllabic target words. For a control group of healthy speakers, our study revealed evidence for entrainment when trochaic target words were preceded by regularly stressed prime sentences. Persons with Parkinson’s dysarthria showed a pattern similar to that of the healthy individuals. For the patient groups with apraxia of speech and with phonological impairment, considerably longer response latencies with differing patterns were observed. Trochaic target words were initiated with significantly shorter latencies, whereas the metrical regularity of prime sentences had no consistent impact on response latencies and did not interact with the stress pattern of the target words to be produced. The absence of an entrainment in these patients may be explained by the more severe difficulties in initiating speech at all. We discuss the results in terms of clinical implications for diagnostics and therapy in neurogenic speech disorders.

Sign in / Sign up

Export Citation Format

Share Document