Honorific Speech Impairment: A Characteristic Sign of Frontotemporal Dementia

Purpose Our purpose was to create a comprehensive review of speech impairment in frontotemporal dementia (FTD), primary progressive aphasia (PPA), and progressive apraxia of speech in order to identify the most effective measures for diagnosis and monitoring, and to elucidate associations between speech and neuroimaging. Method Speech and neuroimaging data described in studies of FTD and PPA were systematically reviewed. A meta-analysis was conducted for speech measures that were used consistently in multiple studies. Results The methods and nomenclature used to describe speech in these disorders varied between studies. Our meta-analysis identified 3 speech measures which differentiate variants or healthy control-group participants (e.g., nonfluent and logopenic variants of PPA from all other groups, behavioral-variant FTD from a control group). Deficits within the frontal-lobe speech networks are linked to motor speech profiles of the nonfluent variant of PPA and progressive apraxia of speech. Motor speech impairment is rarely reported in semantic and logopenic variants of PPA. Limited data are available on motor speech impairment in the behavioral variant of FTD. Conclusions Our review identified several measures of speech which may assist with diagnosis and classification, and consolidated the brain–behavior associations relating to speech in FTD, PPA, and progressive apraxia of speech.

Download Full-text

Communicative Performance of Adolescents with Severe Speech Impairment

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.5403.403 ◽

1989 ◽

Vol 54 (3) ◽

pp. 403-421 ◽

Cited By ~ 7

Author(s):

Beth M. Dalton ◽

Jan L. Bedrosian

Keyword(s):

Data Analysis ◽

Peer Interactions ◽

Consistent Pattern ◽

Clinical Implications ◽

Speech Impairment ◽

Communication Mode ◽

Mode Function ◽

Communicative Performance ◽

Therapy Room ◽

Communication Board

The communicative performance of 4 preoperational-level adolescents, using limited speech, gestures, and communication board techniques, was examined in a two-part investigation. In Part 1, each subject participated in an academic interaction with a teacher in a therapy room. Data were transcribed and coded for communication mode, function, and role. Two subjects were found to predominantly use the speech mode, while the remaining 2 predominantly used board and one other mode. The majority of productions consisted of responses to requests, and the initiator role was infrequently occupied. These findings were similar to those reported in previous investigations conducted in classroom settings. In Part 2, another examination of the communicative performance of these subjects was conducted in spontaneous interactions involving speaking and nonspeaking peers in a therapy room. Using the same data analysis procedures, gesture and speech modes predominated for 3 of the subjects in the nonspeaking peer interactions. The remaining subject exhibited minimal interaction. No consistent pattern of mode usage was exhibited across the speaking peer interactions. In the nonspeaking peer interactions, requests predominated. In contrast, a variety of communication functions was exhibited in the speaking peer interactions. Both the initiator and the maintainer roles were occupied in the majority of interactions. Pertinent variables and clinical implications are discussed.

Download Full-text

The Development of Speech-Language Pathology in Zambia: A Reflection on the Current Landscape and Two Contrasting Training Models

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig17.63 ◽

2017 ◽

Vol 2 (17) ◽

pp. 63-72

Author(s):

Suzanna Bright ◽

Chisomo Selemani

Keyword(s):

Multidimensional Poverty ◽

Capital City ◽

Service Development ◽

Speech Impairment ◽

Implementation Challenges ◽

Training Models ◽

The Disabled ◽

Disability Prevalence ◽

Service Gap ◽

Communication Disability

Functional approaches to disability measurement in Zambia reveals an overall disability prevalence rate of 13.4%, 4% of whom are recorded as having “speech impairment” (Zambia Federation of the Disabled [ZAFOD], 2006). Further, multidimensional poverty assessments indicate that 48.6% of Zambia's approximately 16 million citizens are impoverished. Currently, there are three internationally qualified speech-language pathologists (SLPs) providing services within Zambia's capital city, Lusaka. Given these statistics, it follows that a significant number of Zambian's, experiencing communication disability, are unable to access specialist assessment and support. Over the past decade, Zambia has seen two very different approaches to address this service gap—firstly, a larger scale top-down approach through the implementation of a formal master's degree program and more recently a smaller scale, bottom-up approach, building the capacity of existing professionals working in the field of communication disability. This article provides an overview of both programs and the context, unique to Zambia, in which they have developed. Authors describe the implementation challenges encountered and program successes leading to a discussion of the weakness and merits to both programs, in an attempt to draw lessons from which future efforts to support communication disability and SLP service development in Majority World contexts may benefit.

Download Full-text