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The purpose of this study was to examine the functional implications of childhood apraxia of speech (CAS) as experienced by children and their parents.Using a mixed qualitative/quantitative design, 40 parents responded to two Likert-scale questionnaires and four phenomenological questions about their personal experiences and their perceptions of their children's (ages 3-16 years) experiences of living with CAS.Quantitative data indicated that although parents reported concern about their children's speech production as expected, they also expressed that CAS affected their children's every day activities and social interactions. Four key themes emerged from the parents' qualitative responses (1) concerns about their children's intelligibility, (2) challenges with peer relationships, (3) reliance on parent to be the child's "voice" and (4) emotional responses such as frustration.Parents' perceptions of the functional implications of CAS focussed on their children's peer interactions, their own need to be the voice for their children, and the broader functional impact of CAS on their children in daily activities. These functional implications of CAS may play a role in supporting the clinical management of those with CAS by implementing peer-related activities, functional social situations and parent education/support during intervention.

The temporal alignment of speech and gesture is widely acknowledged as primary evidence of the integration of spoken language and gesture systems. Yet there is a disconnect between the lack of experimental research on the variables that affect the temporal relationship of speech and gesture and the overwhelming acceptance that speech and gesture are temporally coordinated. Furthermore, the mechanism of the temporal coordination of speech and gesture is poorly represented. Recent experimental research suggests that gestures overlap prosodically prominent points in the speech stream, though the effects of other variables such as perturbation of speech are not yet studied in a controlled paradigm. The purpose of the present investigation was to further investigate the mechanism of this interaction according to a dynamic systems framework. Fifteen typical young adults completed a task that elicited the production of contrastive prosodic stress on different syllable positions with and without delayed auditory feedback while pointing to corresponding pictures. The coordination of deictic gestures and spoken language was examined as a function of perturbation, prosody, and position of the target syllable. Results indicated that the temporal parameters of gesture were affected by all three variables. The findings suggest that speech and gesture may be coordinated due to internal pulse-based temporal entrainment of the two motor systems.

Purpose Despite the widespread use of hand movements as visual and kinesthetic cues to facilitate accurate speech produced by individuals with speech sound disorders (SSDs), no experimental investigation of gestural cues that mimic that spatiotemporal parameters of speech sounds (e.g., holding fingers and thumb together and “popping” them to cue /p/) currently exists. The purpose of this study was to examine the effectiveness of manual mimicry cues within a multisensory intervention of persisting childhood apraxia of speech (CAS). Method A single-subject ABAB withdrawal design was implemented to assess the accuracy of vowel + /r/ combinations produced by a 21-year-old woman with persisting CAS. The effect of manual mimicry gestures paired with multisensory therapy consisting of verbal instructions and visual modeling was assessed via clinician and naïve listener ratings of target sound accuracy. Results According to the perceptual ratings of the treating clinician and 28 naïve listeners, the participant demonstrated improved speech sound accuracy as a function of the manual mimicry/multisensory therapy. Conclusions These data offer preliminary support for the incorporation of gestural cues in therapy for CAS and other SSDs. The need for continued research on the interaction of speech and manual movements for individuals with SSDs is discussed.

Few empirical findings or technical guidelines are available on the current transition from analog to digital audio recording in childhood speech sound disorders. Of particular concern in the present context was whether a transition from analog- to digital-based transcription and coding of prosody and voice features might require re-standardizing a reference database for research in childhood speech sound disorders. Two research transcribers with different levels of experience glossed, transcribed, and prosody-voice coded conversational speech samples from eight children with mild to severe speech disorders of unknown origin. The samples were recorded, stored, and played back using representative analog and digital audio systems. Effect sizes calculated for an array of analog versus digital comparisons ranged from negligible to medium, with a trend for participants' speech competency scores to be slightly lower for samples obtained and transcribed using the digital system. We discuss the implications of these and other findings for research and clinical practise.

A growing literature supports the notion that manual gestures and speech are entrained, with one movement modulating the spatiotemporal properties of the other. For instance, Krahmer and Swerts (2007) demonstrated that gestures elicited unintentional prosodic stress production in healthy adult speakers. Understanding this relationship in individuals with motor speech disorders could inform both the underlying neuromotor impairment and the design of efficacious interventions. For example, two of the hallmark characteristics of childhood apraxia of speech (CAS) are atypical prosody and vowel distortions (ASHA, 2007). Given the impact of prosodic stress on vowel formants (e.g., Hay et al., 2006), enhanced prosody elicited through gestures may improve vowel clarity and consistency. The current investigation was designed to explore the relationship between manual and speech gestures in CAS by evaluating the consequences of deictic (pointing) gestures on vowel acoustics. Participants included children with CAS ...

Purpose In this study, the authors investigated the hypothesis that the perceived tight temporal synchrony of speech and gesture is evidence of an integrated spoken language and manual gesture communication system. It was hypothesized that experimental manipulations of the spoken response would affect the timing of deictic gestures. Method The authors manipulated syllable position and contrastive stress in compound words in multiword utterances by using a repeated-measures design to investigate the degree of synchronization of speech and pointing gestures produced by 15 American English speakers. Acoustic measures were compared with the gesture movement recorded via capacitance. Results Although most participants began a gesture before the target word, the temporal parameters of the gesture changed as a function of syllable position and prosody. Syllables with contrastive stress in the 2nd position of compound words were the longest in duration and also most consistently affected the timing of gestures, as measured by several dependent measures. Conclusion Increasing the stress of a syllable significantly affected the timing of a corresponding gesture, notably for syllables in the 2nd position of words that would not typically be stressed. The findings highlight the need to consider the interaction of gestures and spoken language production from a motor-based perspective of coordination.

PurposeThe authors sought to describe longitudinal changes in Percentage of Consonants Correct—Revised (PCC–R) after severe pediatric traumatic brain injury (TBI), to compare the odds of normal-range PCC–R in children injured at older and younger ages, and to correlate predictor variables and PCC–R outcomes.MethodIn 56 children injured between age 1 month and 11 years, PCC–R was calculated over 12 monthly sessions beginning when the child produced ≥ 10 words. At each session, the authors compared odds of normal-range PCC–R in children injured at younger (≤ 60 months) and older (> 60 months) ages. Correlations were calculated between final PCC–R and age at injury, injury mechanism, gender, maternal education, residence, treatment, Glasgow Coma Score, and intact brain volume.ResultsPCC–Rs varied within and between children. Odds of normal-range PCC–R were significantly higher for the older than for the younger group at all sessions but the first; odds of normal-range PCC–R were 9 to 33 times higher in the older group in sessions 3 to 12. Age at injury was significantly correlated with final PCC–R.ConclusionOver a 12-month period, severe TBI had more adverse effects for children whose ages placed them in the most intensive phase of PCC–R development than for children injured later.

Three- to five-year-old children produce speech that is characterized by a high level of variability within and across individuals. This variability, which is manifest in speech movements, acoustics, and overt behaviors, can be input to subgroup discovery methods to identify cohesive subgroups of speakers or to reveal distinct developmental pathways or profiles. This investigation characterized three distinct groups of typically developing children and provided normative benchmarks for speech development. These speech development profiles, identified among 63 typically developing preschool-aged speakers (ages 36–59 mo), were derived from the children's performance on multiple measures. These profiles were obtained by submitting to a k-means cluster analysis of 72 measures that composed three levels of speech analysis: behavioral (e.g., task accuracy, percentage of consonants correct), acoustic (e.g., syllable duration, syllable stress), and kinematic (e.g., variability of movements of the upper lip, lower lip, and jaw). Two of the discovered group profiles were distinguished by measures of variability but not by phonemic accuracy; the third group of children was characterized by their relatively low phonemic accuracy but not by an increase in measures of variability. Analyses revealed that of the original 72 measures, 8 key measures were sufficient to best distinguish the 3 profile groups.

As part of a large‐scale study that aims to create a data‐driven model of speech delay of unknown origin (SD) in preschool children, this investigation analyzed two‐ and three‐syllable nonword repetitions by 50 3‐ to 5‐year‐old children, half of whom are typically developing (TD). The syllable repetition task was composed of four different words, bama, bada, bamana, and manaba, selected both for articulatory simplicity and to maximize displacement of the external articulators for kinematic analyses. While children in the TD group were significantly more accurate in both two‐ and three‐syllable repetitions than children in the SD group, neither group was able to repeat three‐syllable nonwords with particular acumen. Children in the TD group were 55% accurate, while children in the SD group were only 22% accurate. Measures of repetition accuracy, acoustics, nasalence, external articulatory kinematics, and respiration contribute to a hierarchical agglomerative clustering model that generates hypotheses about potential subclinical categories within the SD and TD groups.