My Client Talks! Do I Still Need to Consider AAC in my Treatment Planning? Speech Supplementation Strategies: AAC for Clients Who Talk!

2014 ◽  
Vol 23 (3) ◽  
pp. 124-131 ◽  
Author(s):  
Elizabeth K. Hanson
Keyword(s):  
Treatment Planning ◽  
Speech Intelligibility ◽  
Speech Disorders ◽  
Natural Speech ◽  
Alternative Communication ◽  
Motor Speech Disorders ◽  
Average Gain ◽  
Word Level ◽  
Sentence Level ◽  
Communication Breakdowns

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.

Natural Speech and AAC Intervention in Childhood Motor Speech Disorders: Not an Either/Or Situation

2014 ◽  
Vol 23 (3) ◽  
pp. 117-123 ◽  
Author(s):  
Elizabeth R. Oommen ◽  
John W. McCarthy
Keyword(s):  
Augmentative And Alternative Communication ◽  
Speech Disorders ◽  
Speech Development ◽  
Natural Speech ◽  
Alternative Communication ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Practical Applications ◽  
Speech Intervention

The future of natural speech development is uncertain for children with motor speech disorders (MSD). There is a strong desire to put plans in place as early as possible to anticipate long-term needs. Simultaneously, the knowledge that natural speech development may take time and effort and the idea that augmentative and alternative communication (AAC) can help to fill in the gap while such progress is being made makes sense on a foundational level. However, practical questions remain about the balance of natural speech intervention along with AAC use, particularly when both skills may require intervention and practice before functional benefits are realized. Although AAC stands for augmentative and alternative communication, what the acronym does not provide is an indication of how balance between augmenting natural speech and seeking more of an alternative is to be obtained. In this article, we review impairments in natural speech in children with MSDs. Through this lens, we navigate a path to understanding how, on a practical level, AAC and natural speech strategies can be implemented simultaneously and in a complementary fashion. Following an overview of literature, we move to a discussion of the dual paradigm approach. Finally, we conclude with practical applications of principles through a case study.

scholarly journals Effects of a Conversation-Based Intervention on the Linguistic Skills of Children With Motor Speech Disorders Who Use Augmentative and Alternative Communication

2017 ◽  
Vol 60 (7) ◽  
pp. 1980-1998 ◽  
Author(s):  
Gloria Soto ◽  
Michael T. Clarke
Keyword(s):  
Augmentative And Alternative Communication ◽  
Expressive Language ◽  
Speech Disorders ◽  
Expressive Vocabulary ◽  
Alternative Communication ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Grammatical Skills ◽  
Severe Motor ◽  
Expressive Language Delay

Purpose This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Method Eight children aged from 8 to 13 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant, in which they were supported to learn and use linguistic structures essential for the formation of clauses and the grammaticalization of their utterances, such as pronouns, verbs, and bound morphemes, in the context of personally meaningful and scaffolded conversations with trained clinicians. The conversations were videotaped, transcribed, and analyzed using the Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 1991). Results Results indicate that participants showed improvements in their use of spontaneous clauses, and a greater use of pronouns, verbs, and bound morphemes. These improvements were sustained and generalized to conversations with familiar partners. Conclusion The results demonstrate the positive effects of the conversation-based intervention for improving the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Clinical and theoretical implications of conversation-based interventions are discussed and future research needs are identified. Supplemental Materials https://doi.org/10.23641/asha.5150113

Measuring Speech Intelligibility in Children With Motor Speech Disorders

2020 ◽  
Vol 5 (4) ◽  
pp. 809-820 ◽  
Author(s):  
Kristen M. Allison
Keyword(s):  
Clinical Practice ◽  
Speech Intelligibility ◽  
Word Identification ◽  
Speech Disorders ◽  
Clinical Settings ◽  
Functional Communication ◽  
Speech Impairment ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Factors Affecting

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.

scholarly journals Speech assessment in Down's Syndrome Children

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M I M Foda ◽  
J F Nassar ◽  
M A S Baraka
Keyword(s):  
Down Syndrome ◽  
Speech Intelligibility ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Cross Sectional Study ◽  
Speech Disorders ◽  
Motor Speech ◽  
Cross Sectional ◽  
Motor Speech Disorders ◽  
Chromosomal Disorder

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.

Retrospective Examination of Failed Rate-Control Intervention

2002 ◽  
Vol 11 (1) ◽  
pp. 3-16 ◽  
Author(s):  
Robert C. Marshall ◽  
Colleen M. Karow
Keyword(s):  
Rate Control ◽  
Speech Intelligibility ◽  
Speech Rate ◽  
Speech Disorders ◽  
Background Information ◽  
Initial Assessment ◽  
Clinical Report ◽  
Motor Speech Disorders ◽  
Control Intervention ◽  
Retrospective Examination

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.

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.

Deaf and Hard-of-hearing Users Evaluating Designs for Highlighting Key Words in Educational Lecture Videos

2021 ◽  
Vol 14 (4) ◽  
pp. 1-24
Author(s):  
Sushant Kafle ◽  
Becca Dingman ◽  
Matt Huenerfauth
Keyword(s):  
Experimental Study ◽  
Key Words ◽  
Hard Of Hearing ◽  
Experimental Studies ◽  
Design Parameters ◽  
Educational Video ◽  
Word Level ◽  
Sentence Level ◽  
First Occurrence ◽  
Educational Videos

There are style guidelines for authors who highlight important words in static text, e.g., bolded words in student textbooks, yet little research has investigated highlighting in dynamic texts, e.g., captions during educational videos for Deaf or Hard of Hearing (DHH) users. In our experimental study, DHH participants subjectively compared design parameters for caption highlighting, including: decoration (underlining vs. italicizing vs. boldfacing), granularity (sentence level vs. word level), and whether to highlight only the first occurrence of a repeating keyword. In partial contrast to recommendations in prior research, which had not been based on experimental studies with DHH users, we found that DHH participants preferred boldface, word-level highlighting in captions. Our empirical results provide guidance for the design of keyword highlighting during captioned videos for DHH users, especially in educational video genres.

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