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Background: It is unclear whether oral diadochokinetic rate (oral-DDK) performance is affected by different languages within a multilingual country. Aims: This study investigated the effects of age, sex, and stimulus type (real word in L1, L2 vs. non-word) on oral-DDK rates among healthy Malaysian-Malay speakers in order to establish language- and age-sensitive norms. The second aim was to compared the nonword 'pataka' oral-DDK rates produced by Malaysian-Malay speakers on currently available normative data for Hebrew speakers and Malaysian-Mandarin speakers. Methods & Procedures: Oral-DDK performance of 90 participants (aged 20-77 years) using nonword ('pataka'), Malay real word ('patahkan'), and English real word ('buttercake') was audio recorded. The number of syllables produced in 8 seconds was calculated. Mixed analysis of variance (ANOVA) was conducted to examine the effects of stimulus type (nonword, Malay, and English real word), sex (male, female), age (younger, 20-40 years; middle, 41-60 years; older, [greater than or equal to]61 years), and their interactions on the oral-DDK rate. Data obtained were also compared with the raw data of Malaysian-Mandarin and Hebrew speakers from the previous studies. Outcomes & Results: A normative oral-DDK rate has been established for healthy Malaysian-Malay speakers. The oral-DDK rate was significantly affected by stimuli (p < 0.001). Malay real word showed the slowest rate, whereas there was no significant difference between English real word and nonword. The oral-DDK rate for Malay speakers was significantly higher than Mandarin and Hebrew speakers across stimuli (all p < 0.01). Interestingly, oral-DDK rates were not affected by age group for Malay speakers. Conclusions & Implications: Stimuli type and language affect the oral-DDK rate, indicating that speech-language therapists should consider using language-specific norms when assessing multilingual speakers.

Background: Parkinson's disease (PD) has an impact on speech production, manifesting in various ways including alterations in voice quality, challenges in articulating sounds and a decrease in speech rate. Numerous investigations have been conducted to ascertain the oral‐diadochokinesis (O‐DDK) rate in individuals with PD. However, the existing literature lacks exploration of such O‐DDK rates in Malaysia and does not provide consistent evidence regarding the advantage of real‐word repetition. Aims: To explore the effect of gender, stimuli type and PD status and their interactions on the O‐DDK rates among Malaysian‐Malay speakers. Methods & Procedures: O‐DDK performance of 62 participants (29 individuals with PD and 33 healthy elderly) using a non‐word ('pataka'), a Malay real‐word ('patahkan') and an English real‐word ('buttercake') was audio recorded. The number of syllables produced in 8 s was counted. A hierarchical linear modelling was performed to investigate the effects of stimuli type (non‐word, Malay real‐word, English real‐word), PD status (yes, no), gender (male, female) and their interactions on the O‐DDK rate. The model accounted for participants' age as well as the nesting of repeated measurements within participants, thereby providing unbiased estimates of the effects. Outcomes & Results: The stimuli effect was significant (p < 0.0001). Malay real‐word showed the lowest O‐DDK rate (5.03 ± 0.11 syllables/s), followed by English real‐word (5.25 ± 0.11 syllables/s) and non‐word (5.42 ± 0.11 syllables/s). Individuals with PD showed a significantly lower O‐DDK rate compared to healthy elderly (4.73 ± 0.15 syllables/s vs. 5.74 ± 0.14 syllables/s, adjusted p < 0.001). A subsequent analysis indicated that the O‐DDK rate declined in a quadratic pattern. However, neither gender nor age effects were observed. Additionally, no significant two‐way interactions were found between stimuli type, PD status and gender (all p > 0.05). Therefore, the choice of stimuli type has no or only limited effect considering the use of O‐DDK tests in clinical practice for diagnostic purposes. Conclusions & Implications: The observed slowness in O‐DDK among individuals with PD can be attributed to the impact of the movement disorder, specifically bradykinesia, on the physiological aspects of speech production. Speech‐language pathologists can gain insights into the impact of PD on speech production and tailor appropriate intervention strategies to address the specific needs of individuals with PD according to disease stages. WHAT THIS PAPER ADDS: What is already known on this subject: The observed slowness in O‐DDK rates among individuals with PD may stem from the movement disorder's effects on the physiological aspects of speech production, particularly bradykinesia. However, there is a lack of consistent evidence regarding the influence of real‐word repetition and how O‐DDK rates vary across different PD stages. What this study adds to existing knowledge: The O‐DDK rates decline in a quadratic pattern as the PD progresses. The research provides insights into the advantage of real‐word repetition in assessing O‐DDK rates, with Malay real‐word showing the lowest O‐DDK rate, followed by English real‐word and non‐word. What are the potential or actual clinical implications of this work?: Speech‐language pathologists can better understand the evolving nature of speech motor impairments as PD progresses. This insight enables them to design targeted intervention strategies that are sensitive to the specific needs and challenges associated with each PD stage. This finding can guide clinicians in selecting appropriate assessment tools for evaluating speech motor function in PD patients. [ABSTRACT FROM AUTHOR]

Purpose: Preschoolers born preterm are at an increased risk for the development of language impairments. The primary objective of this study was to document the expressive language skills of preschoolers born preterm through 2 assessment procedures, language sample analysis, and standardized assessment. A secondary objective was to investigate the role of nonlinguistic factors in standardized assessment scores. Method: The language skills of 29 children born preterm (mean gestational age of 31 weeks) were compared to a group of 29 preschoolers born full term. Language samples were collected during free play and objective measures of semantic and grammatical skills were calculated. Likewise, grammatical and semantic measures of language were obtained from a standardized assessment. Information on nonlinguistic factors, including attention, hyperactivity, and nonverbal intelligence quotient, was also collected. Results: The results of analyses of variance indicated that the children in the PT group had significantly poorer performance than the children born full term on all of the measures of language skill obtained from the language sample analysis. Group differences were found for only 1 measure of language skill obtained from the standardized assessments. Nonverbal factors were not found to account for group differences in assessment scores. Conclusions: Generally, the children born preterm performed more poorly when language skill was measured via language sample analysis than standardized assessment. These findings underscore the importance of using language sample analysis in conjunction with standardized assessment in the evaluation of children's developing language skills.

Purpose: Expiratory muscle strength training (EMST) is increasingly being used to treat voice, cough, and swallowing deficits in a wide range of conditions. However, a multitude of aero-resistive EMST models are commercially available, and the absence of side-by-side comparative data interferes with clinicians' ability to assess which model is best suited to a particular client's needs. The primary aim of this research was to test and compare the pressure and flow parameters of six currently available EMST models to help inform clinical decision making. Method: We identified and tested five devices of each of six different EMST models to generate benchmark data for minimum trigger pressures across settings. The reliability was tested within each device and between five devices of the same model across settings using coefficient of variation. Results: All six models required higher pressures to initiate flow at the highest setting compared to the lowest setting, as expected. Detailed descriptive statistics for each model/setting combination include average flow-triggering pressure for each model/setting and the variability across trials within a device and across devices of the same model. From these, ranked order of the least to most stable EMST model was derived. Conclusions: Systematic testing of several commercially available expiratory resistance training devices yielded clinical benchmarks and reliability data to aid clinicians in selecting an appropriate therapy device and regimen for a client based on their available airflow and air pressure as well as reliability of the device. These findings allow clinicians to directly compare key parameters across EMST devices. [ABSTRACT FROM AUTHOR]

Purpose: Perioral biomechanics, labial kinematics, and associated electromyographic signals were sampled and characterized in individuals with Parkinson's disease (PD) as a function of medication state. Method: Passive perioral stiffness was sampled using the OroSTIFF system in 10 individuals with PD in a medication ON and a medication OFF state and compared to 10 matched controls. Perioral stiffness, derived as the quotient of resultant force and interoral angle span, was modeled with regression techniques. Labial movement amplitudes and integrated electromyograms from select lip muscles were evaluated during syllable production using a 4-D computerized motion capture system. Results: Multilevel regression modeling showed greater perioral stiffness in patients with PD, consistent with the clinical correlate of rigidity. In the medication-OFF state, individuals with PD manifested greater integrated electromyogram levels for the orbicularis oris inferior compared to controls, which increased further after consumption of levodopa. Conclusions: This study illustrates the application of biomechanical, electrophysiological, and kinematic methods to better understand the pathophysiology of speech motor control in PD.

Purpose: Adequate velopharyngeal control is essential for speech, but may be impaired in Parkinson's disease (PD). Bilateral subthalamic nucleus deep brain stimulation (STN DBS) improves limb function in PD, but the effects on velopharyngeal control remain unknown. We tested whether STN DBS would change aerodynamic measures of velopharyngeal control, and whether these changes were correlated with limb function and stimulation settings. Methods: Seventeen PD participants with bilateral STN DBS were tested within a morning session after a minimum of 12 h since their most recent dose of anti-PD medication. Testing occurred when STN DBS was on, and again 1 h after STN DBS was turned off, and included aerodynamic measures during syllable production, and standard neurological ratings of limb function. Results: We found that PD participants exhibited changes with STN DBS, primarily consistent with increased intraoral pressure (n=7) and increased velopharyngeal closure (n=5). These changes were modestly correlated with measures of limb function, and were correlated with stimulation frequency. Conclusion: Our findings suggest that STN DBS may change velopharyngeal control during syllable production in PD, with greater benefit associated with low frequency stimulation. However, DBS demonstrates a more subtle influence on speech-related velopharyngeal control than limb motor control. This distinction and its underlying mechanisms are important to consider when assessing the impact of STN DBS on PD. Learning outcomes: As a result of this activity, the participant will be able to (1) describe the effects of deep brain stimulation on limb and speech function; (2) describe the effects of deep brain stimulation on velopharyngeal control; and (3) discuss the possible reasons for differences in limb outcomes compared with speech function with deep brain stimulation of the subthalamic nucleus. (Contains 4 tables and 1 figure.)

Purpose: Functional orofacial behaviors vary in their force endpoint and rate of recruitment. This study assessed the gating of orofacial cutaneous somatosensation during different cyclic lip force recruitment rates. Understanding how differences in the rate of force recruitment influences trigeminal system function is an important step toward furthering the knowledge of orofacial sensorimotor control. Method: Lower lip vibrotactile detection thresholds (LL-VDTs) were sampled in response to sinusoidal inputs delivered to the lip vermilion at 5, 10, 50, and 150 Hz while adult participants engaged in a baseline condition (no force), 2 low-level lip force recruitment tasks differing by rate (0.1 Hz or 2 Hz), and passive displacement of the lip as a control to approximate the mechanosensory consequences of voluntary movement. Results: LL-VDTs increased significantly for test frequencies at or below 50 Hz during voluntary lip force recruitment. LL-VDT shifts were positively related to changes in the rate of lip force recruitment, whereas passively imposed displacements of the lip were ineffective in shifting LL-VDTs. Conclusions: These findings are considered in relation to published reports of force-related sensory gating in orofacial and limb systems and the potential role of somatosensory gating along the trigeminal system during orofacial behaviors.

Purpose: The objective of this study was to extend previous published findings in the authors' laboratory using a new automated technology to quantitatively characterize nonparticipatory perioral stiffness in healthy male adults. Method: Quantitative measures of perioral stiffness were sampled during a nonparticipatory task using a computer-controlled linear servo motor to impose a series of tensile displacements over a span of approximately 24 mm at the oral angle in 20 healthy young male adults. Perioral electromyograms were simultaneously sampled to confirm nonparticipation or passive muscle state. Perioral stiffness, derived as a quotient from resultant force ([delta]F) and oral span ([delta]X), was modeled with regression techniques and subsequently compared to previously reported perioral stiffness data for female adults. Results: Multilevel regression analysis revealed a significant quadratic relation between the perioral stiffness and interangle span; however, no significant difference was found between adult males and females. Conclusion: These normative measures will have application to future studies designed to objectively assess the effects of pathology (i.e., progressive neuromotor disease, traumatic brain insult) and intervention (pharmacologic, neurosurgical, and reconstructive surgery of the face [i.e., cleft lip, trauma, missile injuries]) on facial animation and speech kinematics.

This study examined responsiveness of the suck central pattern generator to external stimulation, based on premise that early control of sucking and smiling sets stage for more differentiated use of orofacial muscle system for speech. A device for the stimulation of intraoral tissues in neonates, called the actifier, features a wide frequency range for mechanical stimulation and the capacity for transducing jaw compression during sucking. (Author/PB)