Clinical Utility of Repeated Urimal Test of Articulation and Phonation for Patients with Childhood Apraxia of Speech

Childhood apraxia of speech (CAS) causes inconstant oromotor production. We investigated the clinical efficacy of repeated urimal test of articulation and phonation (U-TAP) in CAS patients. Twenty-eight children were recruited: 19 with CAS and 9 with functional articulation disorder (FAD). Four age-matched typically developing children were also recruited. U-TAP was performed twice repeatedly, and the error rate of consonant accuracy (CA) was measured. Preschool Receptive-Expressive Language Scale (PRES) was also performed. The mean U-TAP CA showed a significant difference between the three groups, with 42.04% for CAS, 77.92% for FAD, and 99.68% for the normal group (p < 0.05). The mean difference between the two U-TAP CAs was 10.01% for CAS, 0.82% for FAD, and no difference for the normal group, revealing a significant intergroup difference between CAS and FAD (p < 0.05). For the expressive and receptive PRES scores, CAS group showed significantly decreased results compared to FAD and normal group. Only in the CAS group, expressive PRES showed significant decrease rather than receptive PRES score. The CAS group showed a significant difference in the two U-TAP CA compared to the FAD and normal groups. This result implies that repeated U-TAP can be useful for supportive diagnostic tool for CAS by detecting poor reliability of phonation.

Speech Outcome Analysis after Primary Cleft Palate Repair: Interim Siriraj Hospital Audit

Objective: To evaluate the speech outcomes after primary cleft palate repair in a single tertiary medical institution of Thailand.Materials and Methods: A prospective cohort study was performed. Patients who had cleft palate with/without cleft lip and underwent primary cleft palate repair were included. Speech assessment was performed using the Pittsburgh weighted speech score (PWSS) by a speech-language pathologist.Results: Forty patients (21 males and 19 females) who underwent primary cleft palate repair at Siriraj Hospital were included. The median age at the time of speech evaluation was 7 years. The median age at primary cleft palate surgery was 12 months. The predominant cleft palate type was Veau 3 (47.5%). Oronasal fistula occurred 40%. Two-flap palatoplasty and intravelar veloplasty were the most common procedures. Median PWSS was 7, in which the competence velopharyngeal mechanism was found 5%, borderline competence 10%, borderline incompetence 32.5%, and incompetence velopharyngeal mechanism 52.5%. Among the velopharyngeal incompetence group, articulation disorder was the most common disorder with median score of 3. Besides, the median scores for hypo/hyper-nasality, nasal emission, phonation, and facial grimace disorder were 1, 2, 0 and 0, respectively. There was no statistically significant association between velopharyngeal incompetence and cleft types, age at primary surgery, type of operation, the width of cleft palate and prevalence of postoperative oronasal fistula or otitis media effusion.Conclusion: Velopharyngeal incompetence has been commonly identified after cleft palate repair in our institute. The articulation disorder is the most common characteristic.

Articulation Battery Test For Tamil Speech Disorder Signals

Articulation disorder is referred as difficulty occurs in the pronunciation of specific speech sounds. An irregular coordination of the movement of tongue, lips, palate, jaw, respiratory system, vocal tract, height of the larynx, air flow through nasal leads to the incorrect production of speech sounds. The objective of this paper is to propose a computational model based on Recurrent Neural Network (RNN) algorithm to categorize the phonological patterns of Tamil speech articulation disorder signals into four predefined groups, namely, substitution, omission, distortion and addition. The methodology of the proposed work is described as follows. (1) List of articulation disorder test words suggested by Speech Language Pathologists (SLPs) is selected for this experimental study. (2) Real time speech signals that comprise of Tamil vowels (Uyir eluthukkal) and consonants (Meiyeluthukkal) are collected from people with articulation disorder. (3) Acoustic noise and weak signals are eliminated by applying Low pass filter to acquire the filtered speech signal. (4) Mel-Frequency Cepstral Coefficients (MFCCs) technique is implemented to extract the prominent features from denoised signals. (5) Principal Component Analysis (PCA) method is employed to choose fine-tune feature subset. (6) The refined features are employed to calibrate RNN model for classification. Results show that RNN model achieves 90.25% classification accuracy when compared to other artificial neural network algorithms.

Speech-aid prosthesis in velopharyngeal incompetency patient with cleft palate: can speech aids be applicable for adult patient?

Background Velopharyngeal incompetence (VPI) therapy for cleft palate (speech therapy alone, speech therapy using speech aids, or combined therapy such as speech therapy using a pharyngeal flap), is more effective in younger patients than in adult patients. Speech therapy is known as very difficult for patients who still have VPI as an adult. Because of the possibility of subsequent speech disorders, the timing of surgery for cleft palate is accelerating. Herein, we present a case of an adult with articulation disorder due to VPI who was treated by speech therapy and a speech-aid prosthesis. Case presentation A woman who underwent cleft palate surgery at 8 years of age still had difficulty with articulation due to VPI as a 24-year-old adult because of a lack of continuous speech therapy. We decided to use a speech-aid application using palatal lift, and a reduction program was conducted four times, along with simultaneous speech therapy, over a period of 1 year and 7 months. During the therapy period, she was able to speak normally within a relatively short period of time, and after implementation of the reduction program, the therapy was completed by completely removing the device. Long-term observations have shown normal speech function without recurrence, even after the device was removed. Conclusion As seen in this case, speech therapy using speech aids can show a good result for adult patients with cleft palate who missed the usual timing for the treatment of articulation disorders, depending on the situation. Therefore, it is hereby reported as a therapy option worthy of consideration.

The Effect of Blocked Versus Serial Practice in the Treatment of Developmental Motor-Based Articulation Disorder

The application of specific motor learning principles (MLPs) in treatment for developmental motor-based articulation disorder in children has not been reported to date. The aims were to determine treatment effects of a novel hybrid intervention approach for a single participant with motor-based articulation disorder, and to examine the role of specific MLP, namely blocked versus serial practice schedules, in performance, generalization, and maintenance of speech skills. Results suggested that the novel hybrid treatment approach produced measurable gains in most instances. However, there were no systematic differences between the different practice schedules. Possible reasons for these specific treatment and generalization effects were explored.

Lambdacism, Rhotacism and Sigmatism in Preschool Children: Frequency and Distribution

BACKGROUND: Speech sound appears first in the child’s speech development and is the primary means of expression. Articulation disorders can hinder the comprehensibility of children’s speech. The speech, in turn, can limit the child’s inclusion in the social and educational environment. AIM: To establish frequency and distribution of lambdacism, rhotacism and sigmatism or their combination in preschool children and the frequency and distribution of these articulation disorders among boys and girls. MATERIAL AND METHODS: A retrospective analysis of data from preventive examination for early diagnosis of impairments of hearing, speech and sounds in preschool children has been carried out. In the selected sample, only the data for children diagnosed with lambdacism, rhotacism, sigmatism or their combination are analysed. The data is statistically examined, represented in tables and figures and analysed descriptively. RESULTS: In the analysed sample, the greater presence of lambdacism was observed before rhotacism and sigmatism. Most commonly, these three types of articulation disorder appear alone, as isolated cases, instead of a combination of two out of the three impairments. They are more common in boys than in girls. CONCLUSION: Timely diagnosis and rehabilitation of lambdacism, rhotacism and sigmatism or their combination in preschool children will enable easier and faster integration of the children in the social and educational environment without leaving lasting consequences

The influence of the dynamics and the level of maturity of the cortical functions as a prerequisite for the development of speech in children

Introduction/Objective. The development of speech is the result of interaction of different systems of the cortex, which gradually acquires the ability of phonological presentation and motor control, in the presence of a series of physical and physiological changes in the morphology of the articulation system. The objective of the study was to examine the impact of laterality and cortical responses on the development of speech in children. Methods. Research is a quasi-experimental design with two groups. The sample covered 60 children from Belgrade, of both sexes, ages 5.5?7 years, divided into two groups, experimental (30) and control (30). We used the following instruments: test for assessing laterality and ascertaining evoked potentials. Results. On the visual lateralization subtest there was a statistically significant difference (?2 = 7.56, p < 0.05) between the observed groups. The visual evoked potentials on all measured parameters gave a statistically significant difference between the groups: waveform cortical responses ? left (?2 = 30.00, df = 1, p < 0.05); cortical responses ? right (?2 = 6.667, df = 1 , p < 0.05); waveform amplitude ? left (?2 = 13.469, df = 1, p < 0.05); amplitude ? right (?2 = 40.00, df = 1, p < 0.05), somatosensory potentials (?2 = 18.261, df = 1, p <0.05); waveform amplitude (?2 = 12.000, df = 1, p < 0.05); waveform latency (?2 = 5.455, df = 1, p < 0.05). Conclusion. Visual laterality, as well as visual and somatosensory cortical responses to stimuli is better in children without the present articulation disorder, which could be used for timely prevention planning.