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Background: Speech-sound development in preschoolers with unilateral cleft lip and palate (UCLP) as a group is delayed/disordered, and obstruents comprise the most vulnerable sound class., Aims: To evaluate the development of obstruent correctness (PCC-obs) and error types (cleft speech characteristics (CSCs) and developmental speech characteristics (DSCs)) from ages 3-5 and to investigate possible predictors (error types, velopharyngeal dysfunction (VPD) and gender) of PCC-obs at age 5 in two groups of children with UCLP., Methods & Procedures: Subgroup analysis was conducted within a multicentre randomized controlled trial (RCT) of primary surgery (Scandcleft Project). A total of 125 Danish children with UCLP received lip and soft palate repair around 4 months of age and early hard palate closure at 12 months (EHPC group) or late hard palate closure at 36 months (LHPC group). Audio and video recordings of a naming test were available for 108 children at ages 3 and 5, and recordings were transcribed phonetically by blinded raters., Outcomes & Results: PCC-obs scores increased significantly from ages 3-5 in both groups, but with small effect sizes in the EHPC group that had higher scores at age 3 than the LHPC group. DSCs decreased in both groups whereas CSCs only decreased in the LHPC group that had more CSCs at age 3 than the EHPC group. The frequency of CSCs at age 3 was a significant predictor of PCC-obs scores at age 5 in both groups. DSCs significantly improved the logistic regression model in the EHPC group, whereas VPD and gender did not significantly improve the model in either group., Conclusions & Implications: Although PCC-obs developed significantly from ages 3 to 5, children with UCLP as a group did not catch up to typically developing Danish children at age 5. Furthermore, the LHPC group at age 5 did not reach the 3-year level of the EHPC group, which means that delaying hard palate closure until age 3 is detrimental to obstruent development. Both CSCs and DSCs at age 3 were important predictors of PCC-obs at age 5 and should be considered when determining need for intervention., (© 2019 Royal College of Speech and Language Therapists.)

Objective: The objective of this study was to investigate the impact of international adoption (IA), age at palatoplasty (PR age), and velopharyngeal sufficiency (VPS) on articulation outcomes., Design: This was a cross-sectional, prospective, observational study., Setting: Outpatient hospital clinic., Participants: Fifty-one IA and 65 not-adopted (NA) children between the ages of 3 and 9 with nonsyndromic cleft palate with or without cleft lip., Main Outcome Measure(s): The Goldman-Fristoe Test of Articulation-2nd Edition (GFTA-2) standard score and cleft-related articulation errors (CREs)., Results: Articulation impairment was observed for 40% to 76% of NA children and 71% to 92% IA children, depending on age. PR age mean IA = 2.07 (0.86) years; NA = 1.23 (0.71) years. Children who were IA had poorer performance on the GFTA-2 ( B = -13.82, P = .015). Children who were IA were not significantly more likely to make CRE; rather, age at the time of assessment ( B = -.10, P = .002) and VPS ( B = .24, P = .021) were associated with CRE., Conclusions: Children who were IA demonstrated poorer articulation skills. Although primary palatoplasty was accomplished later among children who were IA, age at assessment and VP status (not PR age) were significantly correlated with articulation outcomes. Implications for timing of surgical intervention are discussed.

Background: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols., Aims: To assess the influence of different timing of hard palate closure in a two-stage procedure on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery, hearing and speech therapy., Methods & Procedures: A randomized controlled trial (RCT). Early hard palate closure (EHPC) at 12 months versus late hard palate closure (LHPC) at 36 months in a two-stage procedure was tested in a cohort of 126 Danish-speaking children born with non-syndromic UCLP. All participants had the lip and soft palate closed around 4 months of age. Audio and video recordings of a naming test were available from 113 children (32 girls and 81 boys) and were transcribed phonetically. Recordings were obtained prior to hard palate closure in the LHPC group. The main outcome measures were percentage consonants correct adjusted (PCC-A) and consonant errors from blinded assessments. Results from 36 Danish-speaking children without CP obtained previously by Willadsen in 2012 were used for comparison., Outcomes & Results: Children with EHPC produced significantly more target consonants correctly (83%) than children with LHPC (48%; p < .001). In addition, children with LHPC produced significantly more active cleft speech characteristics than children with EHPC (p < .001). Boys achieved significantly lower PCC-A scores than girls (p = .04) and produced significantly more consonant errors than girls (p = .02). No significant differences were found between groups regarding burden of treatment. The control group performed significantly better than the EHPC and LHPC groups on all compared variables., (© 2017 Royal College of Speech and Language Therapists.)

Purpose: Moebius Syndrome is a rare congenital neurological condition often characterized by multiple cranial nerve involvement. This case study presents an eight-year old girl with Moebius Syndrome (MC) who received 30 sessions of speech therapy. This occurred after presenting to clinic 11 months after left facial reanimation with gracilis thigh muscle transfer surgery. On examination, only flickers of left facial movement were observed. There was no movement on the right side of the face. As a consequence of the minimal movement, MC presented with drooling and unintelligible speech. The purpose of speech therapy was three fold: minimise the pooling of saliva, improve the placement of the articulators so that articulation of speech sounds would be more accurate, and gain advances in overall intelligibility., Methods: Therapy focussed on speech, facial movement and saliva management using a combination of speech drills, evidence-based articulation therapies, facial exercises with surface electromyography biofeedback, self-awareness training and compensatory saliva management strategies., Results: After a course of 30 one-hour speech therapy sessions, substantial improvements were seen in speech sound accuracy, overall intelligibility, facial movement and saliva control., Conclusions: The combination of surgery and speech therapy led to functional gains that surgery alone did not achieve. The impact of speech therapy on surgical outcomes in individuals with Moebius syndrome deserves further investigation., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background: Voice and speech disorders are one of the most important issues after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) patients. However, articulation features in this patient population remain unclear., Objective: We studied the articulation features of PD patients with STN-DBS., Methods: Participants were 56 PD patients treated with STN-DBS (STN-DBS group) and 41 patients treated only with medical therapy (medical-therapy-alone group). Articulation function was evaluated with acoustic and auditory-perceptual analyses. The vowel space area (VSA) was calculated using the formant frequency data of three vowels (/a/, /i/, and /u/) from sustained phonation task. The VSA reportedly reflects the distance of mouth/jaw and tongue movements during speech and phonation. Correlations between acoustic and auditory-perceptual measurements were also assessed., Results: The VSA did not significantly differ between the medical-therapy-alone group and the STN-DBS group in the off-stimulation condition. In the STN-DBS group, the VSA was larger in the on-stimulation condition than in the off-stimulation condition. However, individual analysis showed the VSA changes after stopping stimulation were heterogeneous. In total, 89.8% of the STN-DBS group showed a large VSA size in the on- than in the off-stimulation condition. In contrast, the VSA of the remaining patients in that group was smaller in the on- than the off-stimulation condition., Conclusions: STN-DBS may resolve hypokinesia of the articulation structures, including the mouth/jaw and tongue, and improve maximal vowel articulation. However, in the on-stimulation condition, the VSA was not significantly correlated with speech intelligibility. This may be because STN-DBS potentially affects other speech processes such as voice and/or respiratory process.

Background: Maintaining an external direction of focus during practice is reported to facilitate acquisition of non-speech motor skills, but it is not known whether these findings also apply to treatment for speech errors. This question has particular relevance for treatment incorporating visual biofeedback, where clinician cueing can direct the learner's attention either internally (i.e., to the movements of the articulators) or externally (i.e., to the visual biofeedback display)., Aims: This study addressed two objectives. First, it aimed to use single-subject experimental methods to collect additional evidence regarding the efficacy of visual-acoustic biofeedback treatment for children with /r/ misarticulation. Second, it compared the efficacy of this biofeedback intervention under two cueing conditions. In the external focus (EF) condition, participants' attention was directed exclusively to the external biofeedback display. In the internal focus (IF) condition, participants viewed a biofeedback display, but they also received articulatory cues encouraging an internal direction of attentional focus., Methods & Procedures: Nine school-aged children were pseudo-randomly assigned to receive either IF or EF cues during 8 weeks of visual-acoustic biofeedback intervention. Accuracy in /r/ production at the word level was probed in three to five pre-treatment baseline sessions and in three post-treatment maintenance sessions. Outcomes were assessed using visual inspection and calculation of effect sizes for individual treatment trajectories. In addition, a mixed logistic model was used to examine across-subjects effects including phase (pre/post-treatment), /r/ variant (treated/untreated), and focus cue condition (internal/external)., Outcomes & Results: Six out of nine participants showed sustained improvement on at least one treated /r/ variant; these six participants were evenly divided across EF and IF treatment groups. Regression results indicated that /r/ productions were significantly more likely to be rated accurate post- than pre-treatment. Internal versus external direction of focus cues was not a significant predictor of accuracy, nor did it interact significantly with other predictors., Conclusions: The results are consistent with previous literature reporting that visual-acoustic biofeedback can produce measurable treatment gains in children who have not responded to previous intervention. These findings are also in keeping with previous research suggesting that biofeedback may be sufficient to establish an external attentional focus, independent of verbal cues provided. The finding that explicit articulator placement cues were not necessary for progress in treatment has implications for intervention practices for speech-sound disorders in children., (© 2016 Royal College of Speech and Language Therapists.)

Objectives: The purpose of the current study was to assess the short-term effectiveness of short and intensive speech therapy provided to patients with cleft (lip and) palate (C(L)P) in terms of articulation and resonance., Methods: Five Ugandan patients (age: 7.3-19.6 years) with non-syndromic C(L)P received six hours of individualized speech therapy in three to four days. Speech therapy focused on correct phonetic placement and contrasts between oral and nasal airflow and resonance. Speech evaluations performed before and immediately after speech therapy, including perceptual and instrumental assessment techniques, were compared., Results: Post-therapy, improvement of speech was noted for most of the patients, although to varying degrees. Clinically relevant progress of objective nasalance values and/or articulation was obtained in four patients. Overall, two patients showed normal speech intelligibility, while three patients required additional speech therapy., Conclusion: These preliminary short-term results demonstrate that short and intensive speech therapy can be effective for patients with C(L)P in countries with limited access to speech-language therapy. However, further research is needed on the long-term effectiveness and the advantages of applying this treatment protocol in countries with good access to speech therapy., Learning Outcomes: The reader will be able to (1) list the challenges in resource poor-countries to achieve access to speech-language therapy services, (2) describe when the application of speech therapy is appropriate in patients with C(L)P, (3) describe the speech therapy that can be applied to reduce compensatory articulation and resonance disorders in patients with C(L)P, and (4) list the (possible) advantages of short, intensive speech therapy for both resource-poor and developed countries., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To compare the consonant production of Chinese-speaking cleft palate children with perceived hypernasal resonance (PHR) after palatoplasty and those with perceived normal resonance (PNR), and to assess the possible influence of language on articulation., Setting: Two hospital cleft lip and palate centers in mainland China., Participants: Thirty-one speakers were allocated into two groups based on perceptual judgment results of their resonance provided by three speech therapists: one group with PNR (n=20, average age=9.3 years), and another group with PHR (n=11, average age=8.3 years). All participants had no known hearing or cognitive deficits., Intervention: Articulation was evaluated using two Mandarin Chinese assessment tools, the Putonghua Segmental Phonology Test and the Deep Test for Cleft Palate Speakers in Putonghua. Speaker consonant accuracy was evaluated by two experienced speech therapists., Results: Compared to individuals with PNR, the PHR group exhibited more difficulties on production of unaspirated consonants, including/b/,/t/,/k/,/ts/,/tʂ/ and/tɕ/, than for aspirated consonants., Conclusion: The distinctive feature of aspiration in Mandarin phonology brought a language specific pattern to consonant production among those speakers with PHR after primary palatal closure., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Articulation is driven by various combinations of movements of the lip, tongue, soft palate, pharynx and larynx, where the tongue plays an especially important role. In patients with cerebrovascular disorder, lingual motor function is often affected, causing dysarthria. We aimed to evaluate the effect of visual biofeedback of posterior tongue movement on articulation rehabilitation in dysarthria patients with cerebrovascular disorder. Fifteen dysarthria patients (10 men and 5 women; mean age, 70.7 ± 10.3 years) agreed to participate in this study. A device for measuring the movement of the posterior part of the tongue was used for the visual biofeedback. Subjects were instructed to produce repetitive articulation of [ka] as fast and steadily as possible between a lungful with/without visual biofeedback. For both the unaffected and affected sides, the range of ascending and descending movement of the posterior tongue with visual biofeedback was significantly larger than that without visual biofeedback. The coefficient of variation for these movements with visual biofeedback was significantly smaller than that without visual biofeedback. With visual biofeedback, the range of ascent exhibited a significant and strong correlation with that of descent for both the unaffected and affected sides. The results of this study revealed that the use of visual biofeedback leads to prompt and preferable change in the movement of the posterior part of the tongue. From the standpoint of pursuing necessary rehabilitation for patients with attention and memory disorders, visualization of tongue movement would be of marked clinical benefit., (© 2015 John Wiley & Sons Ltd.)

Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored., Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate (UCLP) and its possible relationship with articulation/phonology at 3 and 5 years of age., Methods & Procedures: A total of 49 children, 29 with UCLP treated according to three different procedures for primary palatal surgery and a comparison group of 20 children (COMP), were included. Longitudinally recorded audio files were used for analysis. At ages 3 and 5, the children were presented with a single-word test of word naming and at age 5 also the Bus Story Test (BST). The BST was assessed according to a test manual. The single-word test was phonetically transcribed and the percentage of consonants correct adjusted for age (PCC-A) was calculated. Differences regarding the BST results within the UCLP group were analysed. The results were compared with the results of the COMP group, and also with norm values. In addition, the relationship between the results of the BST and the PCC-A scores at ages 3 and 5 years was analysed., Outcomes & Results: No significant group differences or correlations were found. However, 65.5% of the children in the UCLP group had an information score below 1 standard deviation from the norm value compared with 30% in the COMP group., Conclusions: A larger proportion of children in the UCLP group than in the COMP group displayed problems with retelling but the differences between the two groups were not significant. There was no association between the BST results in the children with UCLP and previous or present articulatory/phonological competence. Since group size was small in both groups, the findings need to be verified in a larger study., (© 2014 Royal College of Speech and Language Therapists.)

This study investigated speaking rate effects on articulatory pattern consistency in talkers with mild amyotrophic lateral sclerosis (ALS) to better understand speech rate declines during the early stages of speech deterioration. Eight talkers with mild ALS and 11 controls repeated a sentence at their typical rate, an accelerated rate, and a reduced rate. Lip and jaw movements were captured using a 3-D motion capture system. Results showed that talkers with ALS produced more consistent articulatory patterns during typical speech than did controls. Further, rate reduction resulted in diminished pattern consistency in both groups. Fast speech also elicited less consistent articulatory patterns in talkers with ALS. Controls, by contrast, tended to produce more consistent patterns during fast speech. Relatively inconsistent patterns during fast speech suggest that ALS may negatively affect articulatory control when the speech motor system operates near its performance limit. Relatively consistent patterns during typical speech indicate a successful adaption to disease-related articulatory deficits. Rate reduction does not appear to benefit articulatory stability during early stages of speech decline.

Studies have reported that individuals with Parkinson Disease (PD) have imprecise articulation of stop consonants due to either slowness of articulators or decreased closure strength. The moment of release for stop consonants, called the burst, has been previously studied in individuals with PD and in other disorders. Multiple bursts (MBs) on the same stop consonant have been reported previously in some motor speech disorders, but no studies are known to have examined MBs in individuals with PD. The current study looked at the occurrences of bursts and MBs in initial stop consonants produced by nine individuals with PD (ON and OFF medication) and nine control speakers. Individuals with PD produced fewer overall bursts compared to control participants. In terms of place of articulation, individuals with PD primarily had loss of bursts in bilabial stops. In addition, individuals with PD had more MBs than control speakers, primarily in alveolars. Finally, no dopamine-related medication effects were found for occurrences of bursts or MBs in individuals with PD. Overall, the study provided evidence for loss of bursts and presence of MBs for stop consonants produced by individuals with PD.

Objective: Optimal timing of palatal repair is still subject of discussion. Although literature provides some evidence that palatal closure prior to 6 months positively influence speech outcome in children with clefts, only few studies verified this hypothesis. The purpose of this study was to describe and compare articulation and resonance characteristics following early (≤6 months) and later (>6 months) palatal repair, performed using the Sommerlad technique., Methods: Comparison was made between 12 Ugandan children with isolated cleft (lip and) palate following early palatal repair (mean age: 3.3 m) and 12 Belgian patients with later palatal repair (mean age: 11.1 m), matched for cleft type, age and gender. A Ugandan and Belgian age- and gender-matched control group without clefts was included to control for language, culture and other environmental factors. Articulation assessments consisted of consonant inventories and phonetic and phonological analyses that were based on consensus transcriptions. In addition, resonance was evaluated by perceptual consensus ratings and objective mean nasalance values., Results: The Belgian and Ugandan control groups were comparable for the majority of the variables. Comparison of cleft palate groups revealed no clinically relevant significant group differences for consonant inventory or phonological processes. Phonetic analysis showed significantly more distortions in the Belgian cleft palate group due to higher occurrence frequencies for (inter)dental productions of apico-alveolar consonants. Neither perceptual consensus ratings of hypernasality, hyponasality, cul-de-sac resonance and nasal emission/turbulence, nor objective mean nasalance values for oral speech samples revealed significant group differences (p>0.05)., Conclusion: Articulation and resonance characteristics of young children following palatal repair before and after 6 months of age seem to be at least comparable., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Purpose: The purpose of this study was to assess the association between speech sound articulation and childhood stuttering in a relatively large sample of preschool-age children who do and do not stutter, using the Goldman-Fristoe Test of Articulation-2 (GFTA-2; Goldman & Fristoe, 2000)., Method: Participants included 277 preschool-age children who do (CWS; n=128, 101 males) and do not stutter (CWNS; n=149, 76 males). Generalized estimating equations (GEE) were performed to assess between-group (CWS versus CWNS) differences on the GFTA-2. Additionally, within-group correlations were performed to explore the relation between CWS' speech sound articulation abilities and their stuttering frequency and severity, as well as their sound prolongation index (SPI; Schwartz & Conture, 1988)., Results: No significant differences were found between the articulation scores of preschool-age CWS and CWNS. However, there was a small gender effect for the 5-year-old age group, with girls generally exhibiting better articulation scores than boys. Additional findings indicated no relation between CWS' speech sound articulation abilities and their stuttering frequency, severity, or SPI., Conclusions: Findings suggest no apparent association between speech sound articulation-as measured by one standardized assessment (GFTA-2)-and childhood stuttering for this sample of preschool-age children (N=277)., Educational Objectives: After reading this article, the reader will be able to: (1) discuss salient issues in the articulation literature relative to children who stutter; (2) compare/contrast the present study's methodologies and main findings to those of previous studies that investigated the association between childhood stuttering and speech sound articulation; (3) identify future research needs relative to the association between childhood stuttering and speech sound development; (4) replicate the present study's methodology to expand this body of knowledge., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Purpose: This study was conducted to evaluate the clinical utility of error variability for differentiating between apraxia of speech (AOS) and aphasia with phonemic paraphasia., Method: Participants were 32 individuals with aphasia after left cerebral injury. Diagnostic groups were formed on the basis of operationalized measures of recognized articulatory and prosodic characteristics of AOS and phonemic paraphasia. Sequential repetitions of multisyllabic words were elicited as part of a motor speech evaluation and transcribed phonetically. Four metrics of variability at the syllable and word levels were derived from these transcripts., Results: The measures yielded different magnitudes of variability. There were no group differences between participants who displayed speech profiles consistent with AOS and participants who displayed speech profiles indicative of aphasia with phonemic paraphasia. Rather, correlation coefficients and analyses of covariance showed that the variability metrics were significantly mediated by overall error rate. Additionally, variability scores for individuals with salient diagnoses of AOS and conduction aphasia were inconsistent with current diagnostic guidelines., Conclusions: The results do not support diagnostic validity of error variability for differentiating between AOS and aphasia with phonemic paraphasia. Future research using error variability metrics should account for overall error rate in the analysis and matching of participant groups.

Purpose: The goal of the current study was to examine the effect of homonymy (learning a second meaning for a known word form vs. learning a novel meaning and novel word form) and articulation accuracy (IN vs. OUT sounds) on word learning by preschool children. An added goal was to determine whether word frequency altered the effect of homonymy on word learning., Method: Twenty-nine 3- to 4-year-old children were taught homonyms and novel words. Stimuli further varied in whether homonymy was present in both the adult input and the child's output (as for IN sounds) versus present only in the child's output (as for OUT sounds)., Results: For IN sounds, children learned homonyms more rapidly than novel words. Moreover, the homonym advantage was modulated by word frequency, such that children learned a new meaning for a high-frequency word more accurately than they learned a new meaning for a low-frequency word. In contrast, for OUT sounds, there was no evidence that homonymy influenced learning., Conclusions: Homonymy in the adult input facilitates word learning by preschool children, whereas homonymy in the child's output alone does not. This effect is captured in a usage-based model of phonology and the lexicon.

Speech is the most common means of communication in humans. Any defect in accurate speech production ability results in the development of speech sound disorder (SSD), a condition that can significantly impair an individual's academic performance, social interactions, and relationships with peers and adults. This study investigated the genetic basis of SSD in three Pakistani families. We performed family-based genome-wide parametric linkage analysis and homozygosity mapping in three consanguineous families with SSD from the Punjab province of Pakistan. The Test for Assessment of Articulation and Phonology in Urdu (TAAPU) was used to analyze the speech articulation data and determine the Percentage Correct Consonants (PCC) score. The PCC score defined the affected and unaffected individuals in each family. Parametric linkage analysis revealed a linkage to chromosome 5 (5q21.3-5q23.1) with a significant logarithm of the odds (LOD) score of 3.13 in a Pakistani family with specific language impairment-97 (PKSLI-97) under an autosomal recessive mode of inheritance. The other two families showed a suggestive linkage at 6p22.1, 14q12, and 16q12.1 under the recessive mode of inheritance. Interestingly, homozygosity mapping showed a loss of heterozygosity in the linkage region at 5q15-5q23.1, shared among seven affected (mostly in the younger generation) and one unaffected individual of PKSLI-97. Our analysis identified the 6p22 locus previously implicated in dyslexia, childhood apraxia of speech (CAS), and language impairment, confirming the role of KIAA0319 and DCDC2 in this locus. These findings provide statistical evidence for the genomic regions associated with articulation disorder and offer future opportunities to further the role of genes in speech production. [ABSTRACT FROM AUTHOR]

Copyright of Teaching Innovations / Inovacije u Nastavi is the property of University of Belgrade, Faculty of Teacher Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study aimed to determine whether increased raising of the back of the tongue is evident in children with repaired cleft palate with or without cleft lip (CP+/-CL). We hypothesized that children with CP+/-CL would show increased raising of the tongue dorsum, a compensatory pattern. Method: Secondary data analysis of mid-sagittal ultrasound tongue imaging data from 31 children with CP+/-CL and 29 typically developing children were used. We annotated the consonants /ʃ, t, s, k/ at the point of maximum constriction in an /aCa/ environment. Children with CP+/-CL said the tokens 10 times, typically developing children said them once. We automatically fitted splines to the tongue contour and extracted the Dorsum Excursion Index (DEI) for each consonant. This metric measures the relative use of the tongue dorsum, with more posterior consonants having higher values. We compared DEI values across groups and consonants using a linear mixed effects model. DEI was predicted by the interaction of consonant (baseline: /ʃ/) and speaker type (baseline: TD), including by-speaker random slopes for consonant and random intercepts for speaker. Results: Overall DEI was not higher in children with CP+/-CL compared to typically developing children. Between groups the only significant difference was the position of /k/ relative to /ʃ/, where the difference between these two consonants was smaller in the children with CP+/-CL. Conclusions: There was no support for the hypothesis that increased raising of the tongue dorsum is a common characteristic in children with repaired CP+/-CL. However, individual children may present with this pattern. [ABSTRACT FROM AUTHOR]

The question of 'when' to treat speech sounds is often posed in the context of normative data. The new normative data suggest that speech sounds such as /ɹ/ and /l/ are acquired earlier than previously thought. The present study compared the treatment of late-acquired sounds between two age groups of English-speaking children: Young children (4–5) and Old children (7–8). Eight monolingual children with speech sound disorder (SSD) participated in the study. Each child received a criterion-based, standardised, two-phase therapy protocol. Treatment efficacy was measured by examining children's accuracy on real world speech probes. Treatment efficiency was measured by calculating the number of sessions required to meet the exit criterion and the mean session duration. For treatment efficacy, young children learned treated sounds as effectively as oldchildren did. For treatment efficiency, both groups required a comparable number of sessions, but young children required longer sessions than old children. The results suggest that delaying treatment of individual speech sounds is unnecessary and that a range of sounds should be considered as potential treatment targets. [ABSTRACT FROM AUTHOR]

Articulation disorder is a condition in which the mouth, tongue, vocal cords, and other parts of the body that play an important role in producing voice are damaged, resulting in the inability to produce sound. To diagnose articulation disorders, the movement and shape of each organ concerned with pronunciation are examined. If necessary, the underlying disease or disorder should be managed properly. In it, a speech therapist tests your pronunciation. The observation of conversation and the examination of the pronunciation of each syllable are used to distinguish between mistakes and the degree of articulation disorder. However, these processes are time consuming and labor intensive and are subjective judgments by experts. Therefore, it is important to investigate the characteristics of vocal signals by acoustic analysis of speech objectively. In this study, we focused on fluctuations in the period and amplitude of speech signals and predicted a model for detecting abnormal articulations using fluctuation measurement of the voice data in six healthy subjects and nine patients with an articulation disorder. We used inverse probability of treatment weighting to match the variability for the two groups using the inverse of propensity scores. As the results, the classification performance area under the curve was 0.781 (sensitivity: 0.781, specificity: 0.680) for healthy subjects and patients. We conclude that acoustic analyzing techniques are useful for diagnosing and treating articulation disorders. [ABSTRACT FROM AUTHOR]

Neurodegenerative motor diseases (NMDs) have devastating effects on the lives of patients and their loved ones, in part due to the impact of neurologic abnormalities on speech, which significantly limits functional communication. Clinical speech researchers have thus spent decades investigating speech features in populations suffering from NMDs. Features of impaired articulatory function are of particular interest given their detrimental impact on intelligibility, their ability to encode a variety of distinct movement disorders, and their potential as diagnostic indicators of neurodegenerative diseases. The objectives of this scoping review were to identify (1) which components of articulation (i.e. coordination, consistency, speed, precision, and repetition rate) are the most represented in the acoustic literature on NMDs; (2) which acoustic articulatory features demonstrate the most potential for detecting speech motor dysfunction in NMDs; and (3) which articulatory components are the most impaired within each NMD. This review examined literature published between 1976 and 2020. Studies were identified from six electronic databases using predefined key search terms. The first research objective was addressed using a frequency count of studies investigating each articulatory component, while the second and third objectives were addressed using meta-analyses. Findings from 126 studies revealed a considerable emphasis on articulatory precision. Of the 24 features included in the meta-analyses, vowel dispersion/distance and stop gap duration exhibited the largest effects when comparing the NMD population to controls. The meta-analyses also revealed divergent patterns of articulatory performance across disease types, providing evidence of unique profiles of articulatory impairment. This review illustrates the current state of the literature on acoustic articulatory features in NMDs. By highlighting the areas of need within each articulatory component and disease group, this work provides a foundation on which clinical researchers, speech scientists, neurologists, and computer science engineers can develop research questions that will both broaden and deepen the understanding of articulatory impairments in NMDs. [ABSTRACT FROM AUTHOR]

The purpose of the study was to investigate velopharyngeal timing in children with and without speech sound disorders (SSDs) of unknown etiology. Six preschool-aged children participated in the investigation. Three of the children had typically developing speech and language and three had SSDs of unknown etiology. Aerodynamic testing of the velopharyngeal mechanism was conducted during repetitions of the word “hamper” for six temporal variables. Two of the six temporal data points achieved statistical significance at the level of p < .05: duration of nasal airflow (p = .024) and start of oral pressure to end of oral pressure (p = .016). Per Cohen’s d, small effect sizes were noted for two variables, medium effect sizes were noted for one variable, and large effect sizes were noted for one variable. [ABSTRACT FROM AUTHOR]

Background: Rate force development is associated with performance and muscle composition in whole‐body muscle. Although rate force development on tongue muscle can be examined using tongue pressure waveform, there have been only few investigations on this topic. Objectives: This study's main purpose was to investigate the reliability of tongue pressure waveform analysis and its relationship with articulation and tongue muscle composition. In addition, we also investigated the association between tongue muscle composition and articulation. Methods: Forty‐five community‐dwelling individuals aged >20 years participated. We analysed tongue pressure waveform, including maximum tongue pressure (MTP), time to peak, mean rate of tongue force development and peak rate of tongue force development (PRTFD). We also assessed oral diadochokinesis. Magnetic resonance imaging of the tongue provided data on tongue muscle composition, including tongue volume, fat mass, lean muscle mass and fat percentage. We evaluated the reliability of tongue pressure waveform analysis. Moreover, we examined the coefficients between tongue pressure waveform analysis, oral diadochokinesis and tongue composition. Results: We detected a high reliability of MTP and PRTFD. MTP and PRTFD were significantly correlated with tongue muscle composition. MTP was not significantly correlated with oral diadochokinesis. PRTFD was significantly positively correlated with oral diadochokinesis. Tongue fat mass and fat percentage were negatively correlated with oral diadochokinesis of /ta/ and /ka/. Conclusions: Peak rate of tongue force development is a highly reliable method for tongue pressure analysis and is useful for elucidating the functional importance of tongue muscle function on articulation. We speculated that fatty infiltration of the tongue adversely affects articulation. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The aim was to evaluate the effect of a motor-based, hierarchically structured intervention directed at active nasal fricatives substituting /s/ in young children with normal palatal function. Method: An experimental single-subject design was replicated across three children, aged 4–6 years, with normal palatal function, who substituted oral /s/ with active nasal fricatives. Treatment was performed weekly by a speech-language pathologist and included home training conducted by parents. Audio documented probes were registered regularly and /s/-production evaluated as oral or nasal. Result: All children achieved 98–100% oral production of /s/ in six probed linguistic contexts at treatment end and exhibited good maintenance at follow-up. The four-year-olds showed gradual or inconsistent response and slower progress, the six-year-old direct response and faster progress. Conclusion: The study provides preliminary evidence suggesting positive intervention effects for treating active nasal fricatives in children with normal palatal function. However, possible confounding effects such as maturation or repeated testing could not be ruled out; thus, results need to be replicated with increased experimental control. Nevertheless, the study adds to the currently meagre empirical evidence-base for the population. Individual treatment response and progress patterns were found and data suggests that the intervention may be beneficial from age 4. [ABSTRACT FROM AUTHOR]

What role does the presence of facial speech play for children with dyslexia? Current literature proposes two distinctive claims. One claim states that children with dyslexia make less use of visual information from the mouth during speech processing due to a deficit in recruitment of audiovisual areas. An opposing claim suggests that children with dyslexia are in fact reliant on such information in order to compensate for auditory/phonological impairments. The current paper aims at directly testing these contrasting hypotheses (here referred to as "mouth insensitivity" versus "mouth reliance") in school-age children with and without dyslexia, matched on age and listening comprehension. Using eye tracking, in Study 1, we examined how children look at the mouth across conditions varying in speech processing demands. The results did not indicate significant group differences in looking at the mouth. However, correlation analyses suggest potentially important distinctions within the dyslexia group: those children with dyslexia who are better readers attended more to the mouth while presented with a person's face in a phonologically demanding condition. In Study 2, we examined whether the presence of facial speech cues is functionally beneficial when a child is encoding written words. The results indicated lack of overall group differences on the task, although those with less severe reading problems in the dyslexia group were more accurate when reading words that were presented with articulatory facial speech cues. Collectively, our results suggest that children with dyslexia differ in their "mouth reliance" versus "mouth insensitivity," a profile that seems to be related to the severity of their reading problems. [ABSTRACT FROM AUTHOR]

Repeating the movements associated with activities such as drawing or sports typically leads to improvements in kinematic behavior: these movements become faster, smoother, and exhibit less variation. Likewise, practice has also been shown to lead to faster and smoother movement trajectories in speech articulation. However, little is known about its effect on articulatory variability. To address this, we investigate the extent to which repetition and predictability influence the articulation of the frequent German word "sie" [zi] (they). We find that articulatory variability is proportional to speaking rate and the duration of [zi], and that overall variability decreases as [zi] is repeated during the experiment. Lower variability is also observed as the conditional probability of [zi] increases, and the greatest reduction in variability occurs during the execution of the vocalic target of [i]. These results indicate that practice can produce observable differences in the articulation of even the most common gestures used in speech. [ABSTRACT FROM AUTHOR]

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children (P <.05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research. [ABSTRACT FROM AUTHOR]

Featured Application: The impact of the tongue and lips status in malocclusion is neglected in adults. Orthodontic and orthognathic treatment leads to dental and visual correction of the face but leaves a functional deficiency in the form of a speech disorder. This study highlights the essential role of speech therapy in adults. Evaluation and correction of primary functions along with the quality of speech and speech therapy should be a part of the team treatment of malocclusion and facial skeletal deformities. Orthodontists correct dental malocclusion, but major facial skeleton deformations (skeletal malocclusion) are often subject to surgical correction. Several speech pathologies are associated with both of the occlusal anomalies mentioned above. The majority of articulation disorders and primary functions cannot be improved without skeletal correction. This study aimed to investigate the outcome of the multimodal and logopaedics treatment of Polish adults affected by skeletal malocclusion and speech-language pathology. A total of 37 adults affected by skeletal Class II and III malocclusion were included, along with the relationship between the malocclusion and speech deficiency (20 phonemes tested) in the subjects before and after surgical correction. The impact of surgery on pronunciation improvement and types of Polish phonemes most often misarticulated by Polish adults were also examined. Patients underwent combined treatment and received a full speech pathology examination. The treatment improved speech (p < 0.05), but the study did not prove that a specific surgery type was associated with pronunciation improvement. Some patients were provided with speech therapy during childhood, yet most had some minor difficulties with lip and tongue movements. Palatal, alveolar (p < 0.05), fricatives (p < 0.05), and labiodental consonant pronunciation (p < 0.05) improved. The surgical correction of malocclusion leads to better articulation of Polish consonants in adults and improves some primary functions. [ABSTRACT FROM AUTHOR]

The article discusses research on the relationship between speech perception and speech sound production (SSP) in children with visual impairments (VI) in the U.S. Findings include the inverse correlation between SSP scores and SS discrimination, and the cause of SSP deficits or delays. Also mentioned are the limitations of the study including the use of Wepman's Auditory Discrimination Test (ADT) and the diverse nature of children with VI.

Background: The current literature suggests a link between dummy (or pacifier) use and a number of both positive and detrimental consequences. Positive consequences include soothing effect and protection from sudden infant death syndrome (SIDS), while negative ones include increased risk of otitis media and dental malformation. However, there is little research surrounding the impact of dummy use on the development of speech sounds. Aims: To investigate whether duration (in number of months) and frequency per day of dummy use have an individual or combined effect on the development of a child's speech, and if so, in what way. Methods & Procedures: A total of 100 British‐English children aged 24–61 months and growing up in the UK were recruited through nurseries, playgroups and by word of mouth. Their parents were asked to complete a questionnaire about the duration and frequency of dummy use and factors known to influence the development of speech. Following this, the children's speech was assessed using the phonology section of the Diagnostic Evaluation of Articulation and Phonology (DEAP). Analysis of the DEAP was conducted to determine the percentage of consonants correct, number of age‐appropriate, delayed and atypical errors. Dummy use and speech outcome measures were then analysed qualitatively and quantitatively using mean and median group comparisons alongside multivariate generalized least squares and generalized negative binomial modelling approaches to test for significant associations. Outcomes & Results: The results showed that the majority of speech outcomes are not significantly associated with dummy use, however measured, in bivariate or multivariate analyses. However, there is a significant association between increased atypical errors and greater frequency of daytime dummy use. This association is strengthened by restricted sampling within the younger members of the sample, with this association not observable within children older than 38 months, the median sample age. Conclusions & Implications: The evidence base for any effects of dummy use on speech is very small. Dummy use may increase the number of atypical speech errors a young child makes. However, only the frequency of daytime use seems relevant, not the duration or night‐time use, and these errors may resolve over time. What this paper addsWhat is already known on this subjectThe use of a dummy with infants in Western countries is comparatively high (between 36‐85%). A number of positive and detrimental consequences of dummy use have been documented in the literature; however, research on the effect of dummy use on speech development is significantly lacking. Past studies have included small sample sizes or used single measures of speech outcomes, which may not be specific enough to reveal how speech may be affected. Many speech and language therapists speculate that the use of a dummy could be contributing to many of the conditions they treat, yet this claim remains largely unsubstantiated.Clinical implications of this studyThe study suggests that only prolonged use of a dummy over several hours and during the day may start to show any impact on speech; even then, professionals need to be aware that the evidence base for any speech effects is very small. Clinicians and other professionals who parents consult on dummy use should make sure to provide both the pros and cons of dummy use, in order to enable parents to make an informed decision. [ABSTRACT FROM AUTHOR]

Although speech–language pathologists increasingly make use of tablets in clinical practice, little research to date has evaluated the effectiveness or efficiency of tablet use for targeting speech sound goals. The twofold purpose of this study was to compare (a) the effectiveness and (b) the efficiency of speech sound intervention using tablets versus flashcards. Four kindergarten students with at least two similar speech sound errors participated in this adapted alternating treatments single subject design study that explored the functional relation between speech sound intervention that differed by modality of delivery (tablet vs. flashcards) and increased speech sound skill in elementary school children with speech sound errors. Flashcards and tablets were both effective single-word speech sound intervention modalities; however, for three of the four participants, flashcards were more efficient than tablets. [ABSTRACT FROM AUTHOR]

Objectives: While many attempts have been made to estimate body mass in hominins from lower limb bone dimensions, the upper limb has received far less attention in this regard. Here we develop new body mass estimation equations based on humeral articular breadths in a large modern human sample and apply them to 95 Plio‐Pleistocene specimens. Materials and Methods: Humeral head superoinferior and total distal articular mediolateral breadths were measured in a morphologically diverse sample of 611 modern human skeletons whose body masses were estimated from bi‐iliac breadth and reconstructed stature. Reduced major axis regressions were used to compute body mass estimation equations. Consistency of the resulting estimates with those derived previously using lower limb bone equations was assessed in matched Plio‐Pleistocene individuals or samples. Results: In the modern reference sample, the new humeral body mass estimation equations exhibit only slightly lower precision compared to the previously derived lower limb bone equations. They give generally similar estimates for Pleistocene Homo, after accounting for the different shape of the humeral head articular surface in archaic Middle and Late Pleistocene Homo, except for distal humeral estimates for Late Pleistocene specimens, which average somewhat below lower limb estimates. Humeral equations give body mass estimates for australopiths that appear much too high, except for Australopithecus sediba. A chimpanzee‐based distal humeral articular formula appears to work well for larger australopith specimens. Discussion The new formulae provide a more secure foundation for estimating hominin body mass from humeri than previously available equations. [ABSTRACT FROM AUTHOR]

The aim of this article is to examine speech-language pathologists' (SLPs) knowledge and competence using Percentage of Consonants Correct (PCC). Participants were recruited through posts on social media and message boards for the American Speech-Language-Hearing Association (ASHA) Special Interest Groups. In addition, surveys were emailed via the ASHA membership directory to SLPs in selected states who reported working in settings with a primarily pediatric population. The majority of SLPs reported a lack of academic and clinical training in the area of PCC. Participants demonstrated limited knowledge of the rules for calculating PCC in addition to decreased calculation ability and confidence. Because PCC is well-validated, SLPs would benefit from increased clinical and academic exposure to the measure; however, as many report that they do not use PCC, this calls into question its clinical practicality. The question remains if there is a need for a more expedient process by which to objectively quantify severity, such as use of an automated metric. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore how 7-year-olds describe speech in children born with cleft palate in their own words and to investigate whether they perceive signs of velopharyngeal incompetence (VPI) and articulation errors, and if so, which terminology they use. Methods/Participants: Twenty 7-year-olds participated in 6 focus group interviews where they listened to 8 speech samples with different types of cleft speech characteristics and described what they heard. The same speech samples had been assessed by speech-language pathologists and comprised normal speech, different degrees of VPI, oral articulation disorders, and glottal articulation. The interviews were analyzed with qualitative content analysis. Results: The analysis resulted in 4 interlinked categories: descriptions of speech, thoughts on personal traits, consequences for communication, and emotional reactions and associations. Each category contains 4 to 5 subcategories with the children's descriptions and reflections. Glottal articulation and severe signs of VPI caused the most negative emotional reactions and were described as sounding scary and incomprehensible and the children speculated on the risk of social rejection of the speakers. Retracted oral articulation was also noted and described but with a vocabulary similar to the professionals. Minor signs of VPI were not noted. Conclusions: Seven-year-olds are direct and straightforward in their reactions to cleft palate speech characteristics. More pronounced signs of VPI and articulatory difficulties, also minor ones, are noted. Clinically, articulatory impairments may be more important to treat than minor signs of VPI. [ABSTRACT FROM AUTHOR]

This survey addressed a twofold need: first, research into speech sound productions in children with visual impairments and, second, evidence upon which speech-language pathologists might base interventions for children with visual impairments. Fifteen speech-language pathologists responded to a survey about speech sound productions in caseload children with visual impairments. Respondents reported the speech characteristics of 46 children, their coexisting medical diagnoses and developmental conditions, the nature of their visual impairments, and therapy approaches used. Children and teens with visual impairments demonstrated speech sound production errors. It is not conclusive that errors resulted from having visual impairments. Respondents reported effective speech treatment techniques. This study contributes a detailed report of speech sound productions in children who, despite a diversity of coexisting diagnoses, had visual impairment in common. Findings provide a point of reference regarding speech sound productions in children with visual impairments, as well as efficacious treatments. [ABSTRACT FROM AUTHOR]

Background: Treatment outcome data for children with severe speech sound disorders with motor speech involvement (SSD‐MSI) are derived from Phase I clinical research studies. These studies have demonstrated positive improvements in speech production. Currently there is no research examining the optimal treatment dose frequency for this population. The results of this study, which is the first of its kind, will inform the delivery of effective services for this population. Aims: To investigate optimal treatment dose frequency for the Motor Speech Treatment Protocol (MSTP) for children with SSD‐MSI. Methods & Procedures: A total of 48 children (aged 43–47 months) with SSD‐MSI participated in the study. Participants received 45‐min MSTP intervention sessions either once per week (lower dose frequency) or twice per week (higher dose frequency) for a 10‐week period. Blinded outcome assessments were carried out at pre‐ and post‐intervention. Outcomes & Results: Treatment‐related change was assessed at body structures, functions and activities participation level as per the World Health Organization's International Classification of Functioning framework: Children and Youth Version (ICF‐CY) framework WHO (2007). These measures are related to articulation, functional communication and speech intelligibility. One‐way analysis of variance (ANOVA) revealed that for all variables the baseline scores were not statistically different (p > 0.05) between the two dose‐frequency groups. Overall, there was a significant main effect of Time (pre–post) across all variables (p < 0.01). However, repeated‐measures ANOVA did not result in any statistical interactions (Time × Dose frequency) for any of the variables tested (p > 0.05). Only marginal clinical advantages (< 4% change in intelligibility) were noted with the 10 extra sessions. Conclusions & Implications: Overall, the MSTP intervention approach in conjunction with home practice led to significant positive changes for all measures in children with SSD‐MSI. No statistical differences between high‐ and low‐dose‐frequency groups were observed for any of the variables. Clinical effects were examined using effect sizes, as well as changes in articulation, speech intelligibility and functional communication; these differed marginally between the two dose frequencies. This suggests limited benefits of 10 additional sessions per block. Thus, it is recommended that caregivers, speech–language therapists and policy‐makers perform a cost–benefit analysis before determining the dose frequency, when considering additional sessions per block. [ABSTRACT FROM AUTHOR]

Highlights • Nasalization, tongue height, & breathiness contribute independently to F1 variation. • Network modeling allows bottom-up grouping of articulatory-to-acoustic strategies. • Group separation for nasal-oral vowel distinctions based primarily on tongue height. • Group separation is not based on language background, but speaker-dependent patterns. • A "nasal" vowel is not just velum lowering: it is articulatorily multi-dimensional. Graphical abstract Abstract This study represents an exploratory analysis of a novel method of investigating variation among individual speakers with respect to the articulatory strategies used to modify acoustic characteristics of their speech. Articulatory data (nasalization, tongue height, breathiness) and acoustic data (F1 frequency) related to the distinction of three nasal-oral vowel contrasts in French were co-registered. Data were collected first from four Southern French (FR) speakers and, subsequently, from nine naïve Australian English listeners who imitated the FR productions. Articulatory measurements were mapped to F1 measurements using relative importance analysis (RIA), and the RIA coefficients were used to create similarity scores among all of the speakers. The similarity scores were then used to build network models for each nasal-oral vowel pair, using the spinglass algorithm to identify communities of shared articulatory-to-acoustic strategies within each network. The results show that network grouping is rarely based on language-dependent articulatory-to-acoustic strategies, but evidence of inter- and intra-speaker consistency is observed: Individual speakers tend to group together in their articulatory-to-acoustic strategies across vowel pairs, and most speakers have consistent articulatory-to-acoustic mappings across vowel pairs. Evidence is also observed which highlights the multi-dimensional nature of vowel nasality, rather than the uni-dimensional assumption of "nasal" vowels as merely oral vowels produced with a lowered velum. [ABSTRACT FROM AUTHOR]

Highlights • A modified version of the Frenchay Dysarthria Assessment scale (m-FDA) is introduced. • The m-FDA is suitable to evaluate dysarthric speech signals. • Dysarthric speech signals can be accurately modeled using i-vectors. • Longitudinal analyses confirm the robustness and suitability of the method. Abstract Background Parkinson's disease (PD) is a neurological disorder that produces motor and non-motor impairments. The evaluation of motor symptoms is currently performed following the third section of the Movement Disorder Society – Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III); however, only one item of that scale is related to speech impairments. It is necessary to develop a specific scale such that considers those aspects related to speech impairments of the patients. Aims (i) To introduce and evaluate the suitability of a modified version of the Frenchay Dysarthria Assessment (m-FDA) scale to quantify the dysarthria level of PD patients; (ii) to objectively model dysarthric speech signals considering four speech dimensions; (iii) to develop a methodology, based on speech processing and machine learning methods, to automatically quantify/predict the dysarthria level of patients with PD. Methods The speech recordings are modeled using features extracted from several dimensions of speech: phonation, articulation, prosody, and intelligibility. The dysarthria level is quantified using linear and non-linear regression models. Speaker models based on i-vectors are also explored. Results and conclusions The m-FDA scale was introduced to assess the dysarthria level of patients with PD. Articulation features extracted from continuous speech signals to create i-vectors were the most accurate to quantify the dysarthria level, with correlations of up to 0.69 between the predicted m-FDA scores and those assigned by the phoniatricians. When the dysarthria levels were estimated considering dedicated speech exercises such as rapid repetition of syllables (DDKs) and read texts, the correlations were 0.64 and 0.57, respectively. In addition, the combination of several feature sets and speech tasks improved the results, which validates the hypothesis about the contribution of information from different tasks and feature sets when assessing dysarthric speech signals. The speaker models seem to be promising to perform individual modeling for monitoring the dysarthria level of PD patients. The proposed approach may help clinicians to make more accurate and timely decisions about the evaluation and therapy associated to the dysarthria level of patients. The proposed approach is a great step towards unobtrusive/ecological evaluations of patients with dysarthric speech without the need of attending medical appointments. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate the impact of international adoption (IA), age at palatoplasty (PR age), and velopharyngeal sufficiency (VPS) on articulation outcomes. Design: This was a cross-sectional, prospective, observational study. Setting: Outpatient hospital clinic. Participants: Fifty-one IA and 65 not-adopted (NA) children between the ages of 3 and 9 with nonsyndromic cleft palate with or without cleft lip. Main Outcome Measure(s): The Goldman-Fristoe Test of Articulation—2nd Edition (GFTA-2) standard score and cleft-related articulation errors (CREs). Results: Articulation impairment was observed for 40% to 76% of NA children and 71% to 92% IA children, depending on age. PR age mean IA = 2.07 (0.86) years; NA = 1.23 (0.71) years. Children who were IA had poorer performance on the GFTA-2 (B = −13.82, P = .015). Children who were IA were not significantly more likely to make CRE; rather, age at the time of assessment (B = −.10, P = .002) and VPS (B = .24, P = .021) were associated with CRE. Conclusions: Children who were IA demonstrated poorer articulation skills. Although primary palatoplasty was accomplished later among children who were IA, age at assessment and VP status (not PR age) were significantly correlated with articulation outcomes. Implications for timing of surgical intervention are discussed. [ABSTRACT FROM AUTHOR]

The recent groundswell of American social protest illuminates the neoliberal constraints on constructing a people in the twenty-first century. Perhaps no one has better helped facilitate such discussion than Ernesto Laclau in his later work on populist reason. Here, I utilize Laclau's concept of the social demand to examine the rhetorical formation of Black Lives Matter within the cultural context of the post-racial mystique. Whereas Laclau argues concrete struggles transform into popular demands (metonymy), combining with other struggles to form a popular identity (metaphor), I argue Black Lives Matter illustrates an alternative model in which juxtaposition (irony), not popular demand, functions as the quilting point of rhetorical formation. Accordingly, the movement articulates its populist identity by subverting logics of racial equality through the rhetoric of irony. [ABSTRACT FROM AUTHOR]

Abstract: Background: Posterior nasal fricatives are a learned compensatory articulation error and commonly substituted for oral fricatives. Treatment of such articulation errors requires the modification or teaching of skilled movements. A motor‐based approach is designed to teach the complex motor skill movement sequences required in the production of sounds. Although motor learning research is well established, little has been done to determine how the approach changes the underlying physiology of articulatory movements. While the underlying anatomical configuration of the posterior nasal fricative has been described, no studies have quantified anatomic and physiological changes pre‐ and post‐treatment. Aims: To use magnetic resonance imaging (MRI) to visualize and quantify the results of motor‐based speech‐intervention approach on articulatory placement for the treatment of the posterior nasal fricative. Methods & Procedures: A 6‐year‐old male with a history of ear infections and posterior nasal fricative substitution for /s/ underwent six 1‐h sessions of a motor‐based treatment approach over the course of 2 weeks. Pre‐ and post‐treatment evaluation included perceptual and instrumental assessment of speech and resonance. Perceptual resonance was rated by two speech–language therapists and articulation was assessed at the single‐word level. Instrumental assessment included the See‐Scape, Nasometer II and MRI during the sustained phonation of /s/. Amira v5.6 Visualization and Volume modelling software used the midsagittal and oblique coronal plane to measure dimensions of the articulatory anatomy. Outcomes & Results: Interrater reliability was assessed using a Pearson product moment correlation (α = .05) and ranged from r = .91 to .95. Intra‐rater reliability was assessed using the intra‐class correlation coefficient (.976) demonstrating a high degree of reliability with a 95% confidence interval. Articulation improved from 0% accuracy for /s/ in isolation at baseline to 100% for /s/ at the word level and 95% accuracy during conversational speech by session 6. Post‐treatment results from this study revealed a greater shortening of the levator veli palatini (levator) muscle length during articulatory movements, more pronounced velar knee and dimple, decreased velar thickness, increased velar length and altered tongue position. Conclusions & Implications: This study demonstrated the use of pre‐ and post‐treatment imaging methodology to quantify articulatory changes following an intensive motor‐based treatment approach. MRI demonstrated quantifiable changes in articulatory placement. Individuals who exhibit non‐developmental and phoneme‐specific articulation errors, such as the posterior nasal fricative, may be excellent candidates for short‐term, intensive and frequent speech therapy sessions to remediate the production of the posterior nasal fricative. [ABSTRACT FROM AUTHOR]

Some children’s speech impairment resolves spontaneously. Others have persistent problems affecting academic and social development. Identifying early markers that reliably predict long-term outcome would allow better prioritization for preschool intervention. This article evaluates the significance of different types of speech errors, made by 93 four-year-olds in a longitudinal population cohort study, for performance at seven years. At four years, the non-age appropriate speech errors made on standardized assessments were categorized as: phonologically delayed (error patterns typical of younger children); or, some errors atypical of normal development, including consistent errors (e.g. word initial consonant deletion), inconsistent pronunciations of the same word, or lateral distortion of /s, z/). Delayed children, some with occasional interdental /s, z/ articulation errors, were more likely to resolve (67%) than those making atypical errors (35%) by seven years. Qualitative analyses indicated that children making few atypical errors were more likely to resolve, irrespective of total number of errors or whether they received intervention. The findings’ theoretical implications relate to deficits underlying phonological disorders. Clinical implications concern assessment measures and prioritization for intervention. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to present a tutorial on a diagnostic framework developed to assess children who stutter and exhibit co-existing disorders. While we have guidelines for treating these children, there are no specific guidelines for assessing them. We provide a rationale for the development of T-PALS with support from the literature. The T-PALS framework assesses 5 foundational key elements for the child: Temperament (T), Pragmatics (P), Articulation/phonology (A), Language (L), and Stuttering (S). Both qualitative and quantitative measures are used within each dimension. This framework is discussed with reference to using two clinical case examples. T-PALS observation data are presented as well as treatment suggestions for each case. We conclude that T-PALS may be a useful framework for both clinicians and researchers, working with children who present with stuttering and comorbid conditions. Clinicians are encouraged to reach beyond the traditional focus on solely assessing the stuttering behavior, even when that is the main concern for referral, and to consider a broader view of the child. It is hoped that this more integrative approach to assessment may yield a more holistic diagnostic picture of a dual diagnosis child from which treatment goals can be derived. • The T-PALS framework is explained to include the components of Temperament, Pragmatics, Language, Articulation, and Stuttering. • A view of each of component improves the SLP's ability to assess children who stutter and present with coexisting disorders. • Thorough assessment using T-PALS could lead to better treatment planning. • Using the T-PALS model, two case studies are provided of a preschooler and a school age child who stutter with coexisting concerns. [ABSTRACT FROM AUTHOR]

Objective The articulatory loop is a fundamental component of language function, involved in the short-term buffer of auditory information followed by its vocal reproduction. We characterized the network dynamics of the human articulatory loop, using invasive recording and stimulation. Methods We measured high-gamma activity 70–110 Hz recorded intracranially when patients with epilepsy either only listened to, or listened to and then reproduced two successive tones by humming. We also conducted network analyses, and analyzed behavioral responses to cortical stimulation. Results Presentation of the initial tone elicited high-gamma augmentation bilaterally in the superior-temporal gyrus (STG) within 40 ms, and in the precentral and inferior-frontal gyri (PCG and IFG) within 160 ms after sound onset. During presentation of the second tone, high-gamma augmentation was reduced in STG but enhanced in IFG. The task requiring tone reproduction further enhanced high-gamma augmentation in PCG during and after sound presentation. Event-related causality (ERC) analysis revealed dominant flows within STG immediately after sound onset, followed by reciprocal interactions involving PCG and IFG. Measurement of cortico-cortical evoked-potentials (CCEPs) confirmed connectivity between distant high-gamma sites in the articulatory loop. High-frequency stimulation of precentral high-gamma sites in either hemisphere induced speech arrest, inability to control vocalization, or forced vocalization. Vocalization of tones was accompanied by high-gamma augmentation over larger extents of PCG. Conclusions Bilateral PCG rapidly and directly receives feed-forward signals from STG, and may promptly initiate motor planning including sub-vocal rehearsal for short-term buffering of auditory stimuli. Enhanced high-gamma augmentation in IFG during presentation of the second tone may reflect high-order processing of the tone sequence. Significance The articulatory loop employs sustained reciprocal propagation of neural activity across a network of cortical sites with strong neurophysiological connectivity. [ABSTRACT FROM AUTHOR]

Background:Phonological disorders are common in 3-year-olds born with cleft palate compared to non-cleft peers. However, published results have been based on small samples. The purpose was to expand the knowledge on phonology of Swedish-speaking 3-year-olds with unilateral cleft lip and palate (UCLP), treated with primary palatal closure in one or two stages. Methods:The phonology of 26 children with UCLP was assessed with percentage consonants correct adjusted for age (PCC-A) and number of consistent phonological simplification processes (NCP) at age 3. Fifteen of the children were treated with minimal incision technique in one stage (OS) at 13 months and 11 with a two-stage closure (TS) with soft palate repair at 4 months and hard palate repair at 12 months. Their results were compared and then merged with previously obtained data from 10 children treated with OS and nine children treated with TS. Finally, the merged results were compared with those of 20 peers without UCLP. Results:No significant differences between the first two groups were found. In the merged results, NCP in the OS group was significantly lower than in the TS group. The UCLP group displayed significantly poorer results on PCC-A and NCP than peers without UCLP. Conclusion:Surgical procedure did not have a clear impact on phonology at age 3 years. Since children with UCLP are at risk of having impaired phonology at age 3, the results confirm the necessity of having both a phonological and articulatory approach when assessing and treating children born with cleft palate. [ABSTRACT FROM PUBLISHER]

Several studies have reported hyperactivation in frontal and striatal regions in individuals with reading disorder (RD) during reading-related tasks. Hyperactivation in these regions is typically interpreted as a form of neural compensation related to articulatory processing. Fronto-striatal hyperactivation in RD could however, also arise from fundamental impairment in reading related processes, such as phonological processing and implicit sequence learning relevant to early language acquisition. We review current evidence for the compensation hypothesis in RD and apply large-scale reverse inference to investigate anatomical overlap between hyperactivation regions and neural systems for articulation, phonological processing, implicit sequence learning. We found anatomical convergence between hyperactivation regions and regions supporting articulation, consistent with the proposed compensatory role of these regions, and low convergence with phonological and implicit sequence learning regions. Although the application of large-scale reverse inference to decode function in a clinical population should be interpreted cautiously, our findings suggest future lines of research that may clarify the functional significance of hyperactivation in RD. [ABSTRACT FROM AUTHOR]

Objectives To explore age differences in speech production in relation to orofacial physiology. Design Cross-sectional quasi-experimental group study. Setting General community. Participants Physically and cognitively healthy volunteers recruited from the community (N = 30), including 15 young (18-39) and 15 older (66-85) adults. Measurements Accuracy and speech rate were calculated during the production of sequences of syllables containing oral vowels, nasal vowels, or both. Lip and tongue muscular strength, muscular endurance, and tactile sensitivity were also measured. Results Older adults had a slower speech rate than younger adults and greater difficulty articulating nasal vowels. Analyses revealed that age-related decline in lip endurance is associated with decline in accuracy during speech production. Conclusion Older adults are not just slower than younger adults, they also exhibit specific articulatory difficulties. Although many physiological changes in orofacial functions occur in aging, only muscular endurance of the lips is related to age-related differences in speech production. This information is important for the development of speech interventions targeting older adults with speech motor disorders. [ABSTRACT FROM AUTHOR]

Background:Voice and speech disorders are one of the most important issues after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) patients. However, articulation features in this patient population remain unclear. Objective: We studied the articulation features of PD patients with STN-DBS. Methods: Participants were 56 PD patients treated with STN-DBS (STN-DBS group) and 41 patients treated only with medical therapy (medical-therapy-alone group). Articulation function was evaluated with acoustic and auditory-perceptual analyses. The vowel space area (VSA) was calculated using the formant frequency data of three vowels (/a/, /i/, and /u/) from sustained phonation task. The VSA reportedly reflects the distance of mouth/jaw and tongue movements during speech and phonation. Correlations between acoustic and auditory-perceptual measurements were also assessed. Results: The VSA did not significantly differ between the medical-therapy-alone group and the STN-DBS group in the off-stimulation condition. In the STN-DBS group, the VSA was larger in the on-stimulation condition than in the off-stimulation condition. However, individual analysis showed the VSA changes after stopping stimulation were heterogeneous. In total, 89.8% of the STN-DBS group showed a large VSA size in the on- than in the off-stimulation condition. In contrast, the VSA of the remaining patients in that group was smaller in the on- than the off-stimulation condition. Conclusions: STN-DBS may resolve hypokinesia of the articulation structures, including the mouth/jaw and tongue, and improve maximal vowel articulation. However, in the on-stimulation condition, the VSA was not significantly correlated with speech intelligibility. This may be because STN-DBS potentially affects other speech processes such as voice and/or respiratory process. [ABSTRACT FROM AUTHOR]