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Background: Fetal alcohol spectrum disorders (FASD) are a highly prevalent spectrum of patterns of congenital defects resulting from prenatal exposure to alcohol. Approximately 90% of the cases involve speech impairment. Yet, to date, no detailed symptom profiles nor dedicated treatment plans are available for this population., Purpose: This study set out to chart the speech and speech motor characteristics in boys with FASD to profile the concomitant speech impairment and identify possible underlying mechanisms., Method: Ten boys with FASD (4.5-10.3 years old) and 26 typically developing children (4.1-8.7 years old; 14 boys, 12 girls) participated in the study. Speech production and perception, and oral motor data were collected by standardized tests., Results: The boys with FASD showed reduced scores on all tasks as well as a deviant pattern of correlations between production and perception tasks and intelligibility compared with the typically developing children. Speech motor profiles showed specific problems with nonword repetition and tongue control., Conclusions: Findings indicate that the speech impairment in boys with FASD results from a combination of deficits in multiple subsystems and should be approached as a disorder rather than a developmental delay. The results suggest that reduced speech motor planning/programming, auditory discrimination, and oral motor abilities should be considered in long-term, individually tailored treatment.

Background: This study investigated the effect of speech therapy in a heterogeneous group of adults with intellectual disability., Method: Thirty-six adults with mild and moderate intellectual disabilities (IQs 40-70; age 18-40 years) with reported poor speech intelligibility received tailored training in articulation and listening skills delivered in two 3-month periods. Pre- to post-changes in speech intelligibility and receptive vocabulary were assessed using standardized tasks., Results: The results showed a positive effect of treatment on speech intelligibility and receptive vocabulary, irrespective of severity of intellectual disability, hearing loss and intellectual disability aetiology., Conclusions: Speech therapy for people with intellectual disability can be effective at adult age and hearing loss should not prevent treatment. Continued attention to speech can help augment verbal communication skills in this population., (© 2017 John Wiley & Sons Ltd.)

Purpose: Childhood apraxia of speech (CAS) is diagnosed on the basis of specific speech characteristics, in the absence of problems in hearing, intelligence, and language comprehension. This does not preclude the possibility that children with this speech disorder might demonstrate additional problems., Method: Cognitive functions were investigated in 3 domains: complex sensorimotor and sequential memory functions, simple sensorimotor functions, and nonrelated control functions. Seventeen children with CAS were compared with 17 children with normal speech development at 2 occasions within 15 months., Results: The children with CAS showed overall lower scores but similar improvement at Occasion 2 compared with the typically developing controls, indicating an overall delay in the development of cognitive functions. However, a specific deviant development in sequential abilities was found as well, indicated by significantly lower scores at Occasion 2 as compared with younger control children at Occasion 1. Furthermore, the scores on the complex sensorimotor and sequential memory tasks were significantly correlated with the severity of the speech impairment., Conclusions: These results suggest that CAS involves a symptom complex that not only comprises errors of sequencing speech movements but implicates comorbidity in nonverbal sequential functioning in most children with CAS.

Background: In individuals with an intellectual disability, speech dysfluencies are more common than in the general population. In clinical practice, these fluency disorders are generally diagnosed and treated as stuttering rather than cluttering., Purpose: To characterise the type of dysfluencies in adults with intellectual disabilities and reported speech difficulties with an emphasis on manifestations of stuttering and cluttering, which distinction is to help optimise treatment aimed at improving fluency and intelligibility., Method: The dysfluencies in the spontaneous speech of 28 adults (18-40 years; 16 men) with mild and moderate intellectual disabilities (IQs 40-70), who were characterised as poorly intelligible by their caregivers, were analysed using the speech norms for typically developing adults and children. The speakers were subsequently assigned to different diagnostic categories by relating their resulting dysfluency profiles to mean articulatory rate and articulatory rate variability., Results: Twenty-two (75%) of the participants showed clinically significant dysfluencies, of which 21% were classified as cluttering, 29% as cluttering-stuttering and 25% as clear cluttering at normal articulatory rate. The characteristic pattern of stuttering did not occur., Conclusion: The dysfluencies in the speech of adults with intellectual disabilities and poor intelligibility show patterns that are specific for this population. Together, the results suggest that in this specific group of dysfluent speakers interventions should be aimed at cluttering rather than stuttering., Learning Outcomes: The reader will be able to (1) describe patterns of dysfluencies in the speech of adults with intellectual disabilities that are specific for this group of people, (2) explain that a high rate of dysfluencies in speech is potentially a major determiner of poor intelligibility in adults with ID and (3) describe suggestions for intervention focusing on cluttering rather than stuttering in dysfluent speakers with ID., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Purpose: Childhood apraxia of speech (CAS) has been associated with a wide variety of diagnostic descriptions and has been shown to involve different symptoms during successive stages of development. In the present study, the authors attempted to associate the symptoms of CAS in a particular developmental stage with particular information-processing deficits by using computational modeling with the Directions Into Velocities of Articulators (DIVA) model. The hypothesis was that the speech production system in CAS suffers from poor feed-forward control and, consequently, an increased reliance on the feedback control subsystem., Method: In a series of computer simulations, the authors systematically varied the ratio between feed-forward and feedback control during production attempts in the acquisition of feed-forward motor commands. The simulations were evaluated acoustically on 4 selected key symptoms of CAS., Results: Results showed that increasing the reliance on feedback control causes increased severity of these 4 symptoms of CAS: deviant coarticulation, speech sound distortion, searching articulation, and increased variability., Conclusions: The findings support the idea that the key symptoms found in CAS could result from an increased reliance on feedback control due to poor feed-forward commands. Two possible root causes of degraded feed-forward control in CAS are discussed: reduced somatosensory information and increased levels of neural noise.

It has long been recognized that from the first months of life auditory perception plays a crucial role in speech and language development. Only in recent years, however, is the precise mechanism of auditory development and its interaction with the acquisition of speech and language beginning to be systematically revealed. This paper presents the results of a series of studies exploring the relevance of electrophysiological measurements for the objective diagnosis of children with language and speech disorders. In the first, retrospective, study, an inventory was made of clinical neurological, neuropsychological, logopedic and neurophysiological findings obtained from 43 children referred to the Paediatric Neurology Centre for the diagnosis of their speech and language deficits. Neurophysiological abnormalities were found in 95% of these children, among these deviant auditory evoked potentials (AEVPs). The second study demonstrated developmental trends in the waveform of the cortical AEVPs up to age 6 years; the implications for longitudinal studies are discussed. Preliminary results from the third study show emerging differences in auditory event-related potentials (AERPs) for young children who are at risk for developmental dyslexia based on their family history. These findings underscore the clinical usefulness of neurophysiological measures for the diagnosis of speech-language disorders. Clinical protocols are further developed and tested.

The aim of this study was to assess auditory and phonetic perceptual processing of vowels in children with apraxic disorders, who demonstrated clinically with only a speech output deficit. Two experiments were conducted. In the preparatory Experiment 1 series of vowels were constructed by moving formant frequencies away from the extreme values in the vowel space in the direction of a 'neutral-vowel position'. These were presented to adults and children with no speech-language involvement. Based on identification performance low-redundancy vowels were selected, which served as the end-points of two vowel continua: /i/-/i/ and /a/-/a/. In Experiment 2 these continua were used in identification and discrimination tasks, presented to 11 children with apraxic speech problems (aged 6:11 to 9:6 years) and 12 normally developing children. The results showed poorer perception of vowels for the children with apraxic speech problems than for the control children for both continua. Identification functions indicated poorer phonetic processing; discrimination functions indicated poorer auditory processing. Furthermore, a combination of perception measures (identification and discrimination) proved to have a high differential and clinical value for the assessment of children with apraxic speech problems. The results support the view that subtle (subclinical) auditory processing deficits make part of speech output disorders.

Background: Differential diagnosis and treatment planning of developmental speech disorders (DSD) remains a major challenge in paediatric speech-language pathology. Different classification systems exist, in which subtypes are differentiated based on their theoretical cause and in which the definitions generally refer to speech production processes. Accordingly, various intervention methods have been developed aiming at different parts of the speech production process. Diagnostic classification in these systems, however, is primarily based on a description of behavioural speech symptoms rather than on underlying deficits. Purpose: In this paper, we present a process-oriented approach to diagnosis and treatment planning of DSD. Our framework comprises two general diagnostic categories: developmental delay and developmental disorder. Within these categories, treatment goals/targets and treatment methods are formulated at the level of processes and rules/representations. Conclusion: A process-oriented approach to diagnosis and treatment planning holds important advantages, offering direct leads for treatment aimed at the underlying impairment, tailored to the specific needs of the individual and adjusted to the developmental trajectory. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the authors address several articles in the journal involving topics such as speech motor control, the evolution of speech, and speech disorders.

Purpose: This review summarizes research on disorders of speech production in Down syndrome (DS) for the purposes of informing clinical services and guiding future research. Method: Review of the literature was based on searches using MEDLINE, Google Scholar, PsycINFO, and HighWire Press, as well as consideration of reference lists in retrieved documents (including online sources). Search terms emphasized functions related to voice, articulation, phonology, prosody, fluency, and intelligibility. Conclusions: The following conclusions pertain to four major areas of review: voice, speech sounds, fluency and prosody, and intelligibility. The first major area is voice. Although a number of studies have reported on vocal abnormalities in DS, major questions remain about the nature and frequency of the phonatory disorder. Results of perceptual and acoustic studies have been mixed, making it difficult to draw firm conclusions or even to identify sensitive measures for future study. The second major area is speech sounds. Articulatory and phonological studies show that speech patterns in DS are a combination of delayed development and errors not seen in typical development. Delayed (i.e., developmental) and disordered (i.e., nondevelopmental) patterns are evident by the age of about 3 years, although DS-related abnormalities possibly appear earlier, even in infant babbling. The third major area is fluency and prosody. Stuttering and/or cluttering occur in DS at rates of 10%-45%, compared with about 1% in the general population. Research also points to significant disturbances in prosody. The fourth major area is intelligibility. Studies consistently show marked limitations in this area, but only recently has the research gone beyond simple rating scales. [ABSTRACT FROM AUTHOR]

Background: This review gives an overview of studies on speech difficulties in adults with Down syndrome to identify causes and major determinants of poor speech intelligibility for this group and to suggest areas requiring further research. Material and Methods: Exactly 39 published articles were selected by using the following MEsH search terms: speech disorders, articulatory apraxia, phonological impairment, articulation disorders, short-term memory, speech articulation disorders, and speech intelligibility. Articles were grouped for analysis based on themes related to underlying causes of speech difficulties and the diagnosis and treatment of speech difficulties. Future research needs are also presented. Results: Speech problems in adults with Down syndrome are not clearly defined. There is no specific data on underlying mechanisms that negatively impact on speech and there is no systematic assessment procedure available for evaluating the speech of adults with Down syndrome. Few studies have investigated treatment possibilities for speech disorders in adults and future research is needed into speech difficulties in adults with Down syndrome. Conclusions: Research is required into therapeutic programs to improve the speech of adults with Down syndrome. One clinical consideration as to why this research is lacking might be that the speech problem is seen as a characteristic of the Down syndrome itself rather than being seen as the result of distinct underlying deficits that may be sensitive to speech therapy. To aid therapeutic program development, longitudinal studies of adolescents and adults with Down syndrome are required. Special attention could be given to investigating oral-motor characteristics and apraxia of speech. [ABSTRACT FROM AUTHOR]

Developmental apraxia of speech (DAS) is generally classified as a 'speech motor' disorder. Direct measurement of articulatory movement is, however, virtually non-existent. In the present study we investigated the coordination between articulators in children with DAS using kinematic measurements. The results of articulatory coordination in CCV and CVC syllable productions showed systematic effects of place of articulation in the relative phase values in normally speaking children. Deviant and more variable relative phase values as found in the children with DAS are an indication of coordination problems. The relative phase values are discussed with respect to phonological vs. motoric involvement. [ABSTRACT FROM AUTHOR]

Determines the relation between perception and production errors for place of articulation in developmental apraxia of speech in children. Stimuli; Identification; Discrimination.