Speech Sound Disorders: What's Motor Got To Do With It?

2016 ◽  
Vol 1 (1) ◽  
pp. 75-87 ◽  
Author(s):  
Maria I. Grigos
Keyword(s):  
Speech Sound ◽  
Apraxia Of Speech ◽  
Speech Impairment ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Sound System ◽  
Motor Speech Disorder ◽  
The Relationship ◽  
Speech Motor

Speech sound disorders (SSDs) are commonly viewed as involving impaired articulation and/or phonological skills. Speech language pathologists working with individuals with (SSDs) assess the articulation of speech sounds and the coordination of articulatory structures with other components of the speech mechanism, including the phonatory, respiratory, and resonatory subsystems. The sound system of the language and the rules that govern how phonemes are combined are equally critical for clinicians to explore. While the terms “articulation” and “phonology” provide clinicians with a framework for classification, children who are broadly identified with (SSDs) may also display characteristics of a motor speech impairment, which can obscure the decision making process with respect to both diagnosis and treatment. One such motor speech disorder is childhood apraxia of speech (CAS). The focus of this paper is to discuss motor speech deficits in children and to review research that aims to distinguish motor speech patterns in children with (SSDs) with and without CAS. We will also address the relationship between emerging speech motor and linguistic skills.

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.

scholarly journals Language Skill Mediates the Relationship Between Language Load and Articulatory Variability in Children With Language and Speech Sound Disorders

2018 ◽  
Vol 61 (12) ◽  
pp. 3010-3022 ◽  
Author(s):  
Janet Vuolo ◽  
Lisa Goffman
Keyword(s):  
Language Impairment ◽  
Specific Language Impairment ◽  
Language Disorder ◽  
Speech Sound ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Speech Sound Disorder ◽  
Childhood Apraxia Of Speech ◽  
Retrieval Task ◽  
The Relationship

Purpose The aim of the study was to investigate the relationship between language load and articulatory variability in children with language and speech sound disorders, including childhood apraxia of speech. Method Forty-six children, ages 48–92 months, participated in the current study, including children with speech sound disorder, developmental language disorder (aka specific language impairment), childhood apraxia of speech, and typical development. Children imitated (low language load task) then retrieved (high language load task) agent + action phrases. Articulatory variability was quantified using speech kinematics. We assessed language status and speech status (typical vs. impaired) in relation to articulatory variability. Results All children showed increased articulatory variability in the retrieval task compared with the imitation task. However, only children with language impairment showed a disproportionate increase in articulatory variability in the retrieval task relative to peers with typical language skills. Conclusion Higher-level language processes affect lower-level speech motor control processes, and this relationship appears to be more strongly mediated by language than speech skill.

scholarly journals Atraso motor de fala não especificado: revisão integrativa

2020 ◽  
Vol 9 (10) ◽  
pp. e2249108480
Author(s):  
Gabriela Brum dos Santos ◽  
Marileda Barichello Gubiani ◽  
Leticia Arruda Nóro ◽  
Helena Bolli Mota
Keyword(s):  
Motor Control ◽  
Speech Sound ◽  
Speech Disorders ◽  
Speech Motor Control ◽  
Apraxia Of Speech ◽  
Speech Sound Disorder ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Speech Motor

Objetivo: realizar uma revisão bibliográfica sobre o atraso motor de fala não especificado, como ele é avaliado e ainda como se diferencia de outras desordens motoras da fala. Estratégia de pesquisa: Trata-se de uma revisão integrativa da literatura. Realizou-se a busca nas bases SciELO, PubMed, Medine e Scopus no mês de novembro de 2019. Para as quatro bases foram utilizados os seguintes construtos e descritores: “motor speech disorders” OR “childhood apraxia of speech” OR “childhood apraxia of speech cas” OR “developmental dyspraxia” OR “speech sound disorder” AND “speech motor control”, além da utilização de dois filtros: sujeitos até 18 anos e humanos. Critérios de seleção: Artigos publicados em português, inglês ou espanhol foram incluídos, sendo ou não de periódicos de acesso livre. Foram excluídos artigos que não estavam relacionados ao atraso motor de fala não especificado e estudos de revisão de literatura. Resultados: Foram encontrados56 artigos nas bases de dados, sendo 33 da base Scopus, 19 da PubMed, 3 da SciElo e 1 da Medline. Após análise e seleção pelos critérios de inclusão, foram selecionados 14 estudos. Posteriormente a leitura integral dos artigos, 8 estudos foram excluídos, pois não respondiam as perguntas norteadoras da pesquisa, obtendo-se um n de 6 estudos. Conclusão: Muitas crianças com atraso significativo na fala são diagnosticadas erroneamente, sendo o DMS-NOS a desordem de maior prevalência na infância.

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.

scholarly journals Predicting Intelligibility: An Investigation of Speech Sound Accuracy in Childhood Apraxia of Speech

CommonHealth ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 44-56
Author(s):  
Kyra Skoog ◽  
Edwin Maas
Keyword(s):  
Speech Sound ◽  
Primary Outcome Measure ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Treatment Research ◽  
Speech Accuracy ◽  
Communicative Success ◽  
Listening Experiment ◽  
The Impact ◽  
The Relationship

Background: Childhood apraxia of speech (CAS) is a pediatric speech disorder that significantly affects communication and life participation. Most CAS treatment research uses speech accuracy as primary outcome measure, on the assumption that accuracy predicts communicative success. However, this relationship has not yet been examined in this population, limiting our understanding of the impact of available treatments. Purpose: The purpose of this study is to explore the relationship between speech accuracy and intelligibility in children with CAS. Intelligibility is defined here as the proportion of words correctly understood by an unfamiliar listener. Methods: Adult listeners, who were unfamiliar with children with CAS, listened to recordings of children with CAS producing single words, and typed what they heard the child say. Separately, and prior to the listening experiment, the children’s words were scored for accuracy using various measures, including the percent phonemes (sounds) correct (PPC), percent consonants correct (PCC), and percent vowels correct (PVC). The relationship between these accuracy measures and intelligibility were examined descriptively. Results: Preliminary findings suggest that there is a positive relationship between intelligibility and PPC and PCC in children with CAS. Conclusions: Implications of these findings for clinical practice as well as future treatment research are discussed.

scholarly journals Differences Between School-Age Children With Apraxia of Speech and Other Speech Sound Disorders on Multisyllable Repetition

2020 ◽  
Vol 5 (4) ◽  
pp. 794-808 ◽  
Author(s):  
Nina R. Benway ◽  
Jonathan L. Preston
Keyword(s):  
Speech Sound ◽  
Previous Literature ◽  
School Age Children ◽  
School Age ◽  
Apraxia Of Speech ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Speech Corpus ◽  
Word Structure ◽  
Speech Features

Purpose The aim of the study was to evaluate whether features of childhood apraxia of speech (CAS) identified in previous literature could be replicated in a sample of school-age children. Method A literature review was conducted to identify candidate speech features that have been previously considered when differentiating CAS from other types of speech sound disorders (SSDs). The candidate features recoverable from blinded transcriptions of multisyllable word repetitions (MSWRs) were applied to a cohort of 61 children aged 7–17 years, previously classified as having CAS ( n = 21) or non-CAS SSD ( n = 40). Results One hundred and ninety-four features had been explored in previous literature to assess their ability to differentiate CAS from other SSDs. Fifteen perceptual features were selected from this list to be applied to performance on the MSWR. In this sample, children with CAS differed from children with SSD on the prevalence of voicing changes, percentage of structurally correct words, correct lexical stress, and syllable deletions within a speech corpus derived from the MSWR task. Conclusion Although previous literature points to numerous features as differentiating CAS from other SSDs, only a portion of those features were replicated in this sample of school-age children. Features of CAS that affect segmental accuracy, prosody, and word structure may be likely to persist into late childhood and early adolescence.

A Framework of Motoric Complexity: An Investigation in Children With Typical and Impaired Speech Development

2020 ◽  
Vol 63 (10) ◽  
pp. 3326-3348
Author(s):  
Julie Case ◽  
Maria I. Grigos
Keyword(s):  
Speech Production ◽  
Speech Sound ◽  
Speech Development ◽  
Speech Sound Disorders ◽  
Childhood Apraxia Of Speech ◽  
Motor Variability ◽  
Kinematic Data ◽  
Sound Sequence ◽  
Impaired Speech ◽  
Speech Motor

Introduction The current work presents a framework of motoric complexity where stimuli differ according to movement elements across a sound sequence (i.e., consonant transitions and vowel direction). This framework was then examined in children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development (TD). Method Twenty-four children (CAS, n = 8; SSD, n = 8; TD, n = 8), 5–6 years of age, participated in this study. The children produced words that varied in motoric complexity while transcription, acoustic, and kinematic data were collected. Multidimensional analyses were conducted to examine speech production accuracy, speech motor variability, and temporal control. Results Analyses revealed poorer accuracy, longer movement duration, and greater speech motor variability in children with CAS than TD (across all measures) and other SSDs (accuracy and variability). All children demonstrated greater speech motor variability and longer duration as movement demands increased within the framework of motoric complexity. Diagnostic grouping did not mediate performance on this task. Conclusions Results of this study are believed to reveal gradations of complexity with increasing movement demands, thereby supporting the proposed framework of motoric complexity. This work also supports the importance of considering motoric properties of sound sequences when evaluating speech production skills and designing experimental and treatment stimuli.

The Effect of Practice on Variability in Childhood Apraxia of Speech: A Multidimensional Analysis

2021 ◽  
pp. 1-19
Author(s):  
Julie Case ◽  
Maria I. Grigos
Keyword(s):  
Speech Sound ◽  
Multidimensional Analysis ◽  
Practice Effects ◽  
Typical Development ◽  
Apraxia Of Speech ◽  
Speech Impairment ◽  
Movement Variability ◽  
Childhood Apraxia Of Speech ◽  
Context Of Learning ◽  
The Impact

Purpose Variability has been interpreted in differing ways according to context (e.g., development, speech impairment, and learning). A challenge arises when interpreting variability in the context of learning for children with speech impairment characterized by high movement variability, as in childhood apraxia of speech (CAS). The objective of this study is to investigate changes in variability in CAS with practice in comparison to patterns seen in children with non-CAS speech sound disorders (SSD) and typical development. Method Speech production variability was examined in 24 children (5–6 years of age) with CAS, non—CAS SSD, and typical development in production of nonwords of varied motoric complexity. Multidimensional analyses were performed using measures of token-to-token speech consistency (percent word consistency), acoustic variability (acoustic spatiotemporal index), and movement variability (lip aperture spatiotemporal index). Changes in variability were examined in each group of children by comparing the first half to the last half of nonword tokens in the same data collection session. The impact of token complexity on practice effects was also explored across groups of children. Results All children displayed increased speech consistency within this practice period ( p = .01). Only children with CAS displayed increased movement variability following practice ( p = .01). Differences in acoustic and kinematic variability were observed across complexity levels in all groups, though these did not interact with practice effects. Discussion These findings suggest that increased movement variability in children with CAS might be facilitating perceptual consistency. It is believed that this finding reflects an inefficient strategy adapted by children with CAS in the absence of motor-based cueing and feedback to guide speech performance with practice.

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