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Purpose: To evaluate the reliability, validity, and diagnostic accuracy (sensitivity, specificity) of the Intelligibility in Context Scale in Saudi Arabic (ICS-SA) and English (ICS-E) as potential measures of functional speech intelligibility in bilingual preschool-aged Saudi Arabian children. Method: The study included 36 parent-child (aged 3;0 to 6;5 years; months) dyads who were bilingual speakers of Saudi Arabic and English, which included two groups—typically developing (TD, n = 29) and suspected speech sound disordered (sSSD, n = 7). The children's intelligibility was evaluated in both languages using the ICS-SA and ICS-E. Children's single-word productions were collected in both languages and calculated for percentage of consonants, vowels, and phonemes correct (i.e. PCC/PVC/PPC) to establish their speech-sound competence. Result: The mean scores for the entire sample (n = 36) were 4.43 (SD = 0.79) for the ICS-SA and 4.48 (SD = 0.79) for the ICS-E, showing that parents rated their children's intelligibility in both languages similarly. Both the ICS-SA and ICS-E demonstrated excellent internal consistency (α = 0.96 and α = 0.95, respectively). There was high inter-rater and test-retest reliability for the ICS-SA, while there was fair to high inter-rater and test-retest reliability in ICS-E. Significant correlations were found for the ICS-SA, but weak correlations were noted for the ICS-E, which indicated fair to moderate evidence of criterion validity. Construct validity efforts indicated a weak correlation with age on both the ICS-SA and ICS-E. The findings also indicated high discriminant accuracy for both the ICS-SA (0.86, 0.86) and ICS-E (0.71, 0.69). Conclusion: This study provides initial validation and reliability evidence for using the ICS-SA and ICS-E with Saudi Arabic- and English-speaking preschoolers, however, ICS-E scores suggest further testing is warranted. By extension, these findings expand the bilingual knowledge base and offer new tools for identifying children in Saudi Arabia who may be at risk for having a speech sound disorder. [ABSTRACT FROM AUTHOR]

Purpose: Diversity considerations are of paramount significance in the clinical assessment and treatment of speech disorders in bilingual children and adults who speak a less common language (and/or its dialects). While comprehensive assessment is essential for culturally and linguistically diverse (CLD) populations, this is clinically challenging due to the indeterminacy entailed in the process and incumbrances in access to resources. This clinical tutorial outlines key considerations necessary for holistic, ecological, and dynamic assessments of speech disorders internationally, focusing on Greek. Method: Pertinent literature is reviewed to provide the relevant theoretical backdrop for the ecosystemic protocol, both conceptually and schematically. Greek is utilized as an example language, aiming to underscore knowledge, tools, and other resources on clinically relevant aspects of dialectal, interlanguage (adult second language [L2]), and child multilingual (L2/third language) variation in Greek-dominant speakers. Results: The tutorial highlights facets of Greek speech and scripts a primary assessment model for clinical use mostly targeting clinicians that are not speakers or cognizant of the language, also viewing speech in linguistic diversity as a sociolinguistic construct. Recommendations for clinical practices are outlined proposing a specific action plan, exemplified by a case scenario. Conclusions: The demonstrated ecosystemic paradigm in holistic, ecological protocols for clinical assessment of speech disorder in CLD speakers addresses the need for nonlinear, multilevel assessment of variable language exposure and use; being sensitive to individual speaker specificities; the sociolinguistic environment; and employing people-first, culturally sensitive, and dynamic strategies in clinical assessment. The stance also simplifies disambiguation tasks regarding the difference disorder dichotomy, enhancing existing clinical procedures. [ABSTRACT FROM AUTHOR]

Objective: To develop tools for predicting velopharyngeal competence (VPC) based on auditory-perceptual assessment and its correlation with objective measures of velopharyngeal orifice area. Design: Methodological study. Participants and Methods: Sixty-two patients with repaired cleft palate, aged 6 to 45 years, underwent aerodynamic evaluation by means of the pressure-flow technique and audiovisual recording of speech samples. Three experienced speech-language pathologists analysed the speech samples by rating the following resonance, visual, and speech variables: hypernasality, audible nasal air emission, nasal turbulence, weak pressure consonants, facial grimacing, active nonoral errors, and overall velopharyngeal competence. The correlation between the perceptual speech variables and velopharyngeal orifice area estimates was analysed with Spearman's correlation coefficient. Two statistical models (discriminant and exploratory) were used to predict VPC based on the orifice area estimates. Sensitivity and specificity analyses were performed to verify the clinical applicability of the models. Results: There was a strong correlation between VPC (based on the orifice area estimates) and each speech variable. Both models showed 88.7% accuracy in predicting VPC. The sensitivity and specificity for the discriminant model were 92.3% and 97.2%, respectively, and 96.2% and 94.4% for the exploratory model. Conclusion: Two predictor models based on ratings of resonance, visual, and speech variables and a simple calculation of a composite variable, SOMA (Eng. "sum"), were developed and found to be efficient in predicting VPC defined by orifice estimates categories based on aerodynamic measurements. Both tools may contribute to the diagnosis of velopharyngeal dysfunction in clinical practice. [ABSTRACT FROM AUTHOR]

The human voice has the potential to serve as a valuable biomarker for the early detection, diagnosis, and monitoring of pediatric conditions. This scoping review synthesizes the current knowledge on the application of artificial intelligence (AI) in analyzing pediatric voice as a biomarker for health. The included studies featured voice recordings from pediatric populations aged 0–17 years, utilized feature extraction methods, and analyzed pathological biomarkers using AI models. Data from 62 studies were extracted, encompassing study and participant characteristics, recording sources, feature extraction methods, and AI models. Data from 39 models across 35 studies were evaluated for accuracy, sensitivity, and specificity. The review showed a global representation of pediatric voice studies, with a focus on developmental, respiratory, speech, and language conditions. The most frequently studied conditions were autism spectrum disorder, intellectual disabilities, asphyxia, and asthma. Mel-Frequency Cepstral Coefficients were the most utilized feature extraction method, while Support Vector Machines were the predominant AI model. The analysis of pediatric voice using AI demonstrates promise as a non-invasive, cost-effective biomarker for a broad spectrum of pediatric conditions. Further research is necessary to standardize the feature extraction methods and AI models utilized for the evaluation of pediatric voice as a biomarker for health. Standardization has significant potential to enhance the accuracy and applicability of these tools in clinical settings across a variety of conditions and voice recording types. Further development of this field has enormous potential for the creation of innovative diagnostic tools and interventions for pediatric populations globally. [ABSTRACT FROM AUTHOR]

Studies of children's consistency of word production allow identification of speech sound disorder. Inconsistent errors are reported for two groups of children: childhood apraxia of speech (CAS) due to difficulty with the motoric precision and consistency of speech movements; and inconsistent phonological disorder (IPD) attributed to impaired phonological planning. This paper describes the inconsistent productions of children with IPD in comparison to typically developing children. In two studies of suspected SSD (N = 135), 22 children pronounced ≥40% of 25 words inconsistently on three repeated trials. No participant had symptoms of CAS. They were monolingual and spoke Australian- or Irish-English. Assessment determined the proportions of words said consistently (i.e. the same across productions: all correct or with the same error) or inconsistently (i.e. differently across productions: at least one correct and one error or different errors in productions). Qualitative analyses examined error types and explored the effect of target words' characteristics on inconsistency. Children with IPD produced 52% of words with different errors. While 56% of all phoneme errors were developmental (age appropriate or delayed), atypical errors typified inconsistency: default sounds and word structure errors. Words with more phonemes, syllables and consonant clusters were vulnerable to inconsistency, but their frequency of occurrence had no effect. TD children and those with IPD had different quantitative and qualitative error profiles, confirming IPD as a diagnostic category of SSD. Qualitative analyses supported the hypothesised deficit in phonological planning of words' production for children with IPD. [ABSTRACT FROM AUTHOR]

Purpose: Motor deficits are widely documented among autistic individuals, and speech characteristics consistent with a motor speech disorder have been reported in prior literature. We conducted an auditory-perceptual analysis of speech production skills in low and minimally verbal autistic individuals as a step toward clarifying the nature of speech production impairments in this population and the potential link between oromotor functioning and language development. Method: Fifty-four low or minimally verbal autistic individuals aged 4–18 years were video-recorded performing nonspeech oromotor tasks and producing phonemes, syllables, and words in imitation. Three trained speech-language pathologists provided auditory perceptual ratings of 11 speech features reflecting speech subsystem performance and overall speech production ability. The presence, attributes, and severity of signs of oromotor dysfunction were analyzed, as were relative performance on nonspeech and speech tasks and correlations between perceptual speech features and language skills. Results and Conclusions: Our findings provide evidence of a motor speech disorder in this population, characterized by perceptual speech features including reduced intelligibility, decreased consonant and vowel precision, and impairments of speech coordination and consistency. Speech deficits were more associated with articulation than with other speech subsystems. Speech production was more impaired than nonspeech oromotor abilities in a subgroup of the sample. Oromotor deficits were significantly associated with expressive and receptive language skills. Findings are interpreted in the context of known characteristics of the pediatric motor speech disorders childhood apraxia of speech and childhood dysarthria. These results, if replicated in future studies, have significant potential to improve the early detection of language impairments, inform the development of speech and language interventions, and aid in the identification of neurobiological mechanisms influencing communication development. [ABSTRACT FROM AUTHOR]

This paper presents an operational annotation system for (dis)fluencies in typical and atypical speech, based on existing standard annotation schemes previously established in the literature. Grounded in a functional approach to (dis)fluency, we address some of the conceptual and technical limitations found in previous annotation models, and offer an integrated and inclusive system which is compatible with different multi-layered annotation software such as Praat or ELAN. Our aim is twofold: to create comparable annotated corpora both in typical and atypical speech, and to provide natural language processing and the health sector with applications for diagnostic and therapy in speech disorders. [ABSTRACT FROM AUTHOR]

The role of the basal ganglia has been a longstanding issue in neural language models. Huntington's disease (HD) shows primary impairment in the striatum and has previously been shown to affect the processing of phrase-structural hierarchies that are built by phrasal movement (e.g. in passives). Here we asked patients with HD to judge the acceptability of sentences containing different types of illicit phrasal movement, which were contrasted with semantic violations involving no movement. A logistic mixed-effects regression showed that patients had a profound impairment in judging incorrect but not correct sentences across all types of illicit movement, while the semantic condition was also affected, but significantly less so. Adding neuropsychological variables to the model did not improve predictions. These results demonstrate a loss of cognitive control, worsening with disease progression, over phrase-structural hierarchies, which extends to forms of meaning built at sentential levels. [ABSTRACT FROM AUTHOR]

In this contribution the use of web resources for the longitudinal study of speech rhythm of a ‘well-known’ person diagnosed with Parkinson’s disease, the American actor Alan Alda, is proposed. A corpus of 20 speech samples produced in the period between 1979 and 2021 was collected from the web. A rhythmical analysis was conducted, based on two parameters: the percentage of vocalic portion on the total duration of the utterance (%V) and the VtoV, the mean duration of the interval between two consecutive vowel onset points. The results of this study confirm an early alteration of rhythm in parkinsonian speech, with an abnormal increase of %V, already occurring some years before the clinical diagnosis. The observation of speech rhythm variation can therefore be considered as the basis for the realization of a sustainable and non-invasive procedure in support to early diagnosis of Parkinson’s disease. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates differences in American English consonants produced by patients who present with various dentofacial disharmonies (DFDs), including severe overbites (Class II), underbites (Class III), and anterior open bites. Previous studies have found that patients with these malocclusion types all produce lingual sibilants and plosives with increased spectral center of gravity and increased spectral variance relative to controls. This result is puzzling since some DFD groups differ from controls in opposite ways, and it is also difficult to interpret because spectral moment measures are affected by a wide range of speech and nonspeech factors. Method: To better understand the articulatory basis of these differences, we apply articulatorily interpretable spectral measures derived from multitaper spectra. Results: We find that all groups of DFD patients produce /s ʃ t tʃ/ with midfrequency spectral peaks that are less prominent than those of the control group, but peak frequency measures are largely the same across all groups. Conclusion: We conclude that the DFD patients differ more in sibilant noise source properties than in front cavity filter properties. [ABSTRACT FROM AUTHOR]

Transforming linguistic codes into articulated speech is thought to rely on different phonetic (motor speech) encoding/planning processes for practiced sequences and for unpracticed/uncommon speech sequences. However, transforming phonological codes into articulation likely involves processes beyond phonetic planning, going on even during articulation. Here we sought behavioural, acoustic and brain dynamics differences in the preparation of matched common/legal and uncommon/illegal speech sequences in 20 participants. Illegal syllables were initialised faster – contrary to what is generally expected -, had longer acoustic duration and differed from legal syllables in ERP waveform amplitudes and microstates in a time-window preceding and following the vocal onset. The pattern of results suggests that speech plans are of different size for legal and illegal syllables, and impact on the parametrisation of the corresponding motor programmes, allowing fast execution of the segmentalised illegal sequences for which incremental speech programming continues during articulation. [ABSTRACT FROM AUTHOR]

Purpose: This study used a semiautomated fine-grained temporal analysis to extract features of temporal oral diadochokinetic (DDK) performance across multiple modalities and tasks, from neurologically healthy and impaired individuals secondary to amyotrophic lateral sclerosis (ALS). The aims were to (a) delineate temporal oral DDK deficits relating to the neuromotor pathology of ALS and (b) identify the optimal task-feature combinations to detect speech impairment in ALS. Method: Mandibular myoelectric, kinematic, and acoustic data were acquired from 13 individuals with ALS and 10 healthy controls producing three alternating motion rate tasks and one sequential motion rate task. Twenty-seven features were extracted from the multimodal data, characterizing three temporal constructs: duration/rate, variability, and coordination. The disease impacts on these features were assessed across tasks, and the task eliciting the greatest disease-related change was identified for each feature. Such "optimal" task-feature combinations were fed into logistic regression to differentiate individuals with ALS from healthy controls. Results: Temporal deficits in ALS were characterized by (a) increased duration and variability and reduced coordination of jaw muscle activities, (b) increased duration and variability and altered temporal symmetry of jaw velocity profile, (c) increased muscle-burst-to-peak-velocity duration, and (d) increased motion-tovoice onset duration. These temporal features were differentially affected across tasks. The optimal task-feature combinations, which were further clustered into three composite factors reflecting temporal variability, coarser-grained duration, and finer-grained duration, differentiated ALS from controls with an F1 score of 0.86 (precision = 1.00, recall = 0.75). Conclusions: Temporal oral DDK deficits are likely attributed to a hierarchy of interrelated neurophysiological and biomechanical factors associated with the neuromotor pathology of ALS. These deficits, as assessed crossmodally, provide previously unavailable insights into the multifaceted timing impairment of oromotor performance in ALS. The optimal task-feature combinations targeting these deficits show promise as quantitative markers for (early) detection of speech impairment in ALS. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to (a) provide evidence for a theoretical model of between-language interaction in bilingual phonological production through the examination of substitution error patterns and to (b) provide developmental data on bilingual children with and without speech sound impairments for use in clinical assessment and diagnosis. Through the lens of markedness, or relative featural complexity, patterns of between-language interaction were observed to provide a foundation for clinical decision making in phonological assessment. Method: Seventy children, ages 3;11-6;7 (years; months), participated in this study: 63 typically developing bilingual Spanish-English--speaking children (x = 5;2) and seven bilingual Spanish-English--speaking children with speech sound impairments (x = 4;6). Substitution errors in single-word speech samples were analyzed in relation to their language-specific markedness values in terms of both targets avoided and substitutes produced. Both quantitative and descriptive analyses of substitution errors were performed. Results: Bilingual children, regardless of impairment status, abided by the phonological rules of their languages in English and Spanish productions. Findings indicated both typically developing children and children with speech sound impairments preferred the use of unmarked sounds that are shared across languages over the use of marked, language-specific sounds. Conclusions: Through the examination of substitution errors, evidence of between-language interaction and recognition of relative complexity emerged. These results have implications for clinical assessment and diagnosis of speech sound impairments in bilingual children. Supplemental Material and Presentation Video: https://doi.org/10.23641/asha.24640200 [ABSTRACT FROM AUTHOR]

Background: Phonetic transcription of disordered speech samples is especially crucial for the assessment and treatment of functional or organic speech‐sound disorders. Previous studies show that students who struggle with the identification and segmentation of speech sounds are more likely to encounter difficulties with clinical phonetic transcription. Aims: To clarify the connection between phonemic awareness and phonetic transcription in Mandarin‐speaking undergraduate students, as well as the improvement of these skills after phonetic transcription training. Methods & Procedures: A pretest–post‐test design was adopted for this study. The experimental group (n = 38) consisted of students majoring in audiology and speech–language pathology who were given 12 weeks of transcription training. The control group (n = 33) consisted of audiology and speech–language pathology majors who completed the same module a year earlier without undergoing the transcription training. Two instruments were used to assess their skills: (1) the Phonemic Awareness Skill Test (PA test) and (2) the Phonetic Transcription Skill Test (PT test) designed for the purposes of the present study. Outcomes & Results: Performance on most subtests of the PT and PA tests improved significantly at post‐test for the experiment group, although only PT training was provided. After phonetic transcription training, the relationship between phonemic addition abilities and phonetic transcription strengthened. Phonemic identification was found to be a predictor of undergraduate students' PT skills of disordered speech samples. Conclusions & Implications: Results from this study provide insights into the role of phonetic transcription training in improving phonemic awareness and phonetic transcription skills. What This Paper Adds: What is already known on the subject: Phonetic transcription of disordered speech samples is especially crucial for the assessment and treatment of functional or organic speech‐sound disorders. Phonemic awareness is not only an essential ability for reading alphabetic language but also associated with acquiring phonetic transcription skills. What this paper adds to existing knowledge: A dynamically changing association between phonemic transcription and phonetic transcription during transcription training was reported. Phonetic transcription training of disordered speech samples acted as a driving force for deeper relationships between the two skills. What are the potential or actual clinical implications of this work?: Training phonetic recognition and transcription equips future and practising speech–language pathologists with better skills in managing speech‐sound disorders. Implications for phonemic awareness training also have the potential to extend to the literacy skills of alphabetic language speakers. [ABSTRACT FROM AUTHOR]

This case report explores clinical treatment efficacy in a Cantonese-speaking child with 22q11.2 Deletion Syndrome where diagnosis and management of velopharyngeal dysfunction can be considered late. All treatment sessions were undertaken via telepractice during the peak of the COVID-19 pandemic in Hong Kong. A hybrid of specialized cleft palate speech treatment techniques and traditional treatment approaches in Speech Sound Disorders were utilized. Treatment intensity components including dose, dose form, session duration, and total intervention duration were documented. [ABSTRACT FROM AUTHOR]

Well-specified phonological representations are important for the development of spoken and written language. This study investigates the types of speech errors and the quality of phonological representations in Greek-speaking school-age children with high-functioning autism spectrum disorder (HF-ASD), as well as the relationship between stored phonological representations and speech output in this sample, according to Stackhouse and Wells' (1997) model. All participants completed a phonological and a naming test, and a non-word repetition task. A receptive phonological task was administered to a subgroup of HF-ASD and typically developing (TD) participants. According to performance in the phonological test, the HF-ASD children were categorised as ASD with Speech Sound Disorder (SSD) or ASD without SSD. The HF-ASD children made significantly more speech errors and showed significant difficulties in the repetition of non-words and the stored phonological representations compared to the TD group but had the same naming abilities with their TD peers. The ASD children with SSD and without SSD performed alike in the receptive task, indicating that both groups had unspecified phonological representations. These results support the hypothesis of distinct phonological representations for speech input and output and highlight the need of using receptive tasks to evaluate underlying phonological knowledge, a process which could allow clinicians to identify the level of speech breakdown. [ABSTRACT FROM AUTHOR]

Ataxias are a group of movement disorders that are characterized by progressive loss of balance, impaired coordination and speech disturbance, which together lead to markedly reduced quality of life. Speech disturbance is clinically diagnosed, but methods for objective assessment of severity are lacking. Using 71 sets of speech recordings from ataxia patients, we developed an automated classification system. With a tolerance of ±1 point, this classification system correctly predicted experts' ratings of speech disturbance according to item 4 of the Scale for Assessment and rating of ataxia (SARA) in 80% of cases. We thereby demonstrate feasibility of computer-assisted voice analysis for automated assessment of severity of speech disturbance. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study was to examine the efficacy of acceleration-based articulatory measures in characterizing the decline in speech motor control due to amyotrophic lateral sclerosis (ALS). Method: Electromagnetic articulography was used to record tongue and lip movements during the production of 20 phrases. Data were collected from 50 individuals diagnosed with ALS. Articulatory kinematic variability was measured using the spatiotemporal index of both instantaneous acceleration and speed signals. Linear regression models were used to analyze the relationship between variability measures and intelligible speaking rate (a clinical measure of disease progression). A machine learning algorithm (support vector regression, SVR) was used to assess whether acceleration or speed features (e.g., mean, median, maximum) showed better performance at predicting speech severity in patients with ALS. Results: As intelligible speaking rate declined, the variability of acceleration of tongue and lip movement patterns significantly increased (p < 0.001). The variability of speed and vertical displacement did not significantly predict speech performance measures. Additionally, based on R2 and root mean square error (RMSE) values, the SVR model was able to predict speech severity more accurately from acceleration features (R2 = 0.601, RMSE = 38.453) and displacement features (R2 = 0.218, RMSE = 52.700) than from speed features (R2 = 0.554, RMSE = 40.772). Conclusion: Results from these models highlight differences in speech motor control in participants with ALS. The variability in acceleration of tongue and lip movements increases as speech performance declines, potentially reflecting physiological deviations due to the progression of ALS. Our findings suggest that acceleration is a more sensitive indicator of speech deterioration due to ALS than displacement and speed and may contribute to improved algorithm designs for monitoring disease progression from speech signals. [ABSTRACT FROM AUTHOR]

The article discusses research which examined the development of hearing, speech and language in infants and toddlers born prematurely. The study determined the prevalence of speech and language disorders (SLD) and hearing loss in preterm children, early detection of SLD, and speech-language and pre-literacy deficits in premature children. It analyzed auditory measures and speech-language outcomes and described intervention methods such as enhanced speech environments and amplification.

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This study aims to determine whether adding an additional modality (ultrasound tongue imaging) improves the inter-rater reliability of phonetic transcription in childhood speech sound disorders (SSDs) and whether it enables the identification of different or additional errors in children's speech. Twenty-three English speaking children aged 5–13 years with SSDs of unknown origin were recorded producing repetitions of /aCa/ for all places of articulation with simultaneous audio and ultrasound. Two types of transcriptions were undertaken off-line: (1) ultrasound-aided transcription by two ultrasound-trained speech-language pathologists (SLPs) and (2) traditional phonetic transcription from audio recordings, completed by the same two SLPs and additionally by two different SSD specialist SLPs. We classified transcriptions and errors into ten different subcategories and compared: the number of consonants identified as in error by each transcriber; the inter-rater reliability; and the relative frequencies of error types identified by the different types of transcriber. Results showed that error-detection rates were different across the transcription types, with the ultrasound-aided transcribers identifying more errors than were identified using traditional audio-only transcription. Analysis revealed that these additional errors were identified on the dynamic ultrasound image despite being transcribed as correct, suggestive of subtle motor speech differences. Interrater reliability for classifying the type of error was substantial (κ = 0.72) for the ultrasound-aided transcribers and ranged from fair to moderate for the audio-only transcribers (κ = 0.38 to 0.52). Ultrasound-aided transcribers identified more instances of increased variability and abnormal timing errors than the audio-only transcribers. [ABSTRACT FROM AUTHOR]

This article describes the design of KommPaS, a web-based tool for the clinical assessment of communication impairment in persons with dysarthria. KommPaS (the German acronym for Communication-related Parameters in Speech Disorders) allows clinicians to recruit laypersons via crowdsourcing for the evaluation of samples of dysarthric speech with regard to communication relevant parameters, that is, intelligibility, naturalness, perceived listener effort, and efficiency (intelligible speech units per unit time). Moreover, a communication total score describing the KommPaS profile elevation, i.e., the arithmetic mean of the normalized KommPaS scores, is provided. Based on considerations regarding the theoretical underpinnings and methodological constraints of a clinical tool for the assessment of these parameters, the article describes how each theoretically and methodologically motivated feature is translated into design principles and how these principles are implemented in a web application. The paper reports efficiency data and details the data privacy and data security provisions that are essential in such an approach. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 10-year-old Asian boy who was admitted to Emergency Department with three weeks of unexplained left knee pain and swelling, intermittent headaches, and diarrhea. Diagnosis studies were conducted, computed tomography of head without contrast was performed. He was diagnosed with spontaneous bifrontal epidural hemorrhage secondary to vitamin C deficiency or scurvy and was treated accordingly.

Purpose: The purpose of this study was to explore the communication and social interaction experiences of adolescents with congenital motor speech disorders due to cerebral palsy or Down syndrome, with the aim of identifying clinical and research needs to support the development and implementation of speech-language interventions. Method: Five male youths (ages 14–18 years) with congenital motor speech disorders and one of their parents participated in face-to-face, semistructured interviews designed to understand communication and social experiences in daily life. Interviews were audio-recorded and orthographically transcribed offline. Content was coded according to topic areas emerging in the data. Themes were developed to illustrate the most salient and representative aspects of participants’ experiences according to the phenomenological tradition that recognizes that participants are experts in their “lived experience.” Results: Participants described the youths’ day-to-day communication experiences, including facilitators and barriers to successful social interactions. Thematic analysis revealed three main themes: (a) strong core relationships amidst sparse, superficial interactions in daily life; (b) the complicated picture of why; and (c) how speech-language pathologists can help. Conclusions: Participants reported that the impact of congenital motor speech disorders on social interactions and experiences became more apparent in adolescence than in earlier childhood. Addressing communication challenges to meet the unique social demands of this period requires tailored interventions that target multiple contributing factors beyond speech impairment, such as social communication skills, negative communication partner attitudes, and participation opportunities. Shifting practice toward a life participation approach to communication intervention stands to substantially improve the long-term social outcomes of adolescents with motor speech disorders. [ABSTRACT FROM AUTHOR]

• Aging affects comprehension of focus sentences in quiet and noise. • Younger adults perform similarly in focus conditions, not in noises. • Older adults show varied performance in focus conditions, not in noises. • Younger adults rarely confuse focus conditions, while older adults do. Older adults experiencing normal aging make up most patients seeking services at audiology clinics. While research acknowledges that the speech perception abilities of aging adults can be diminished in lower-level speech identification or discrimination, there is less concern about how aging affects higher-level speech understanding, particularly in tonal languages. This study aimed to explore the effects of aging on the comprehension of implied intentions conveyed through prosodic features in Mandarin focus sentences, both in quiet and noisy environments. Twenty-seven younger listeners (aged 17 to 26) and 27 older listeners (aged 58 to 77) participated in a focus comprehension task. Their task was to interpret SAVO (subject-adverbial-verb-object) sentences with five focus conditions (initial subject-focus, medial adverbial-focus, medial verb-focus, final object-focus, and neutral non-focus) across five background conditions: quiet, white noise (at 0 and −10-dB signal-to-noise ratios, SNRs), and competing speech (at 0 and −10-dB SNRs). Comprehension performances were analyzed based on accuracy rates, and underlying processing patterns were evaluated using confusion matrices. Younger listeners consistently excelled across focus conditions in quiet settings, but their scores declined in white noise at the SNR of −10-dB. Older adults exhibited variability in scores across focus conditions but not in background conditions. They scored lower than their younger counterparts, with the highest scores observed in the comprehension of sentences featuring a medial adverbial-focus. Analysis of confusion matrices revealed that younger adults seldom mistook focus conditions, whereas older adults tended to comprehend the other focused items as medial adverbials. Older listeners' performance reflects their over-reliance on top-down language knowledge, while their bottom-up acoustic processing decreases when interpreting Mandarin focus sentences. These findings provide evidence of active cognitive processing in prosody comprehension among aging adults and offer insights for diagnosing and intervening with speech disorders in clinical settings. [ABSTRACT FROM AUTHOR]

Aim: We evaluated the concurrent and predictive validity of questions to parents of 10-month-old children about babbling.Methods: Children with at least one native Swedish-speaking parent were eligible for inclusion in this prospective longitudinal study. The parents were asked three questions about babbling at a routine healthcare visit. If parents reported a lack of canonical babbling (CB), children were assessed by a speech and language pathologist to evaluate the questions' concurrent validity. We then examined whether the babbling questions predicted which children would fail the routine language screening at 2.5/3 years.Results: Fifteen of the 1126 children lacked CB according to the parent responses and the expert assessment confirmed 12 of these cases, providing a concurrent validity of 80%. The sensitivity to predict routine language screening was 8% (95% confidence interval 3-17), and the positive predictive value was 40% (95% confidence interval 20%-65%). However, only six of the children lacking CB at 10 months were among the 71 children who failed later language screening.Conclusion: This study suggests that the babbling questions could be included in the 10-month surveillance at the child health services as valid measures of babbling development, but they cannot predict language screening result at 2.5/3 years. [ABSTRACT FROM AUTHOR]

Speech impairment The disability rate in Indonesia is still relatively high and is one of the main health problems which reaches 30.38 million people or 14.2% of the Indonesian population. One of these types of disabilities is speech impairment. There are several possible causes for speech impairment, including the focal disturbance. This situation occurs because of disturbances in the vocal cords caused by injuries due to accidents and other conditions, such as throat cancer, which of course will reduce the productivity of the sufferer. Sign language can be used to communicate, but it still has limitations for normal individuals. In addition, speech synthesis using brain computer interface (BCI) based on electrocorticography (ECoG) has been developed. However, this method still has a weakness, namely invasive and allows the emergence of large enough scar tissue, so that it can reduce the quality of brain biopotential to be recorded. Therefore, a non-invasive EEG-based speech synthesis method was initiated. This method uses bLSTM as one of the components of the RNN model, so that it can construct syllables into words. This system consists of datasets, data filter programs, data segmentation programs, feature extraction programs, ANN and RNN deep learning model training programs, and text-to-speech programs. ANN and RNN form a 2-level deep learning. The testing accuracy and accuracy of the ANN are 26.04% and 20.83%, while the accuracy of the RNN is 81.25%. To improve these results, in the future, researchers can improve the data collection process and increase the number of the data, use the correct extraction feature, and compare several machine learning architectures, to produce optimal accuracy. [ABSTRACT FROM AUTHOR]

In recent years, due to the rise in the population and aging, the prevalence of neurological diseases is also increasing year by year. Among these patients with Parkinson's disease, stroke, cerebral palsy, and other neurological symptoms, dysarthria often appears. If these dysarthria patients are not quickly detected and treated, it is easy to cause difficulties in disease course management. When the symptoms worsen, they can also affect the patient's psychology and physiology. Most of the past studies on dysarthria detection used machine learning or deep learning models as classification models. This study proposes an integrated CNN-GRU model with convolutional neural networks and gated recurrent units to detect dysarthria. The experimental results show that the CNN-GRU model proposed in this study has the highest accuracy of 98.38%, which is superior to other research models. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate hearing health care professionals' (HHPs) speech testing practices in routine adult audiology services and better understand the facilitators and barriers to speech testing provision. Design: A cross-sectional questionnaire study was conducted. Study Sample: A sample (N = 306) of HHPs from the public (64%) and private (36%) sectors in the United Kingdom completed the survey. Results: In the United Kingdom, speech testing practice varied significantly between health sectors. Speech testing was carried out during the audiology assessment by 73.4% of private sector HHPs and 20.4% of those from the public sector. During the hearing aid intervention stage, speech testing was carried out by 56.5% and 26.5% of HHPs from the private and public sectors, respectively. Recognized benefits of speech testing included (a) providing patients with relatable assessment information, (b) guiding hearing aid fitting, and (c) supporting a diagnostic test battery. A lack of clinical time was a key barrier to uptake. Conclusions: Use of speech testing varies in adult audiology. Results from this study found that the percentage of U.K. HHPs making use of speech tests was low compared to that of other countries. HHPs recognized different benefits of speech testing in audiology practice, but the barriers limiting uptake were often driven by factors derived from decision makers rather than clinical rationale. Privately funded HHPs used speech tests more frequently than those working in the public sector where time and resources are under greater pressure and governed by guidance that does not include a recommendation for speech testing. Therefore, the inclusion of speech testing in national clinical guidelines could increase the consistency of use and facilitate the comparison of practice trends across centers. [ABSTRACT FROM AUTHOR]

Purposes: The purposes of this study were to determine whether the acoustic measures from glottal stops distinguished between controls and patients with unilateral vocal fold paresis/paralysis (UVFP) at initial evaluation and posttreatment/ observation, to explore the types of false vocal fold (FVF) movement during glottal stop production in UVFP, and to assess the agreement between normalization of various measures and reported voice normalization. Method: Patients with UVFP and controls were recorded acoustically and laryngoscopically speaking two sets of five repeated /i/s, controls once and patients with UVFP initially and posttreatment/observation. Averaged intensity differences and slopes for offsets (maximum voicing intensity to minimum glottal stop intensity) and onsets (minimum glottal stop intensity to maximum voicing intensity) were measured. FVF movements were rated separately for paretic and nonparetic sides. Patients were asked to report voice normalization posttreatment/ observation. Cohen's kappas were calculated for agreements between patientreported voice normalization and normalization of Voice-Related Quality of Life (V-RQOL), translaryngeal flow, four acoustic measures of glottal stop production, and FVF movement. Results: Significant differences (analysis of variance [ANOVA]; p < .014) were found for all acoustic measures between controls and patients with UVFP and between patients with UVFP initially and posttreatment/observation (paired t tests; p < .05). In addition, 78% of UVFP patients had no FVF movement on the paretic side initially, and 42% had bilateral dynamic FVF movement posttreatment/ observation. Cohen's kappa showed moderate agreement between voice normalization and V-RQOL, slight agreement with offset measures, and fair agreement with onset measures. Conclusion: This study provided proof of concept for using acoustic measures of glottal stops to distinguish between controls and patients with UVFP, both initially and posttreatment/observation. [ABSTRACT FROM AUTHOR]

'Dysarthria' is a group of motor speech disorders resulting from a disturbance in neuromuscular control. Most individuals with dysarthria cope with communicative restrictions due to speech impairments and reduced intelligibility. Thus, language‐sensitive measurements of intelligibility are important in dysarthria neurological assessment. The Frenchay Dysarthria Assessment, 2nd edition (FDA‐2), is a validated tool for the identification of the nature and patterns of oro‐motor movements associated with different types of dysarthria. The current study conducted a careful culture‐ and linguistic‐sensitive adaption of the two intelligibility subtests of the FDA‐2 to Hebrew (words and sentences) and performed a preliminary validation with relevant clinical populations. First, sets of Hebrew words and sentences were constructed, based on the criteria defined in FDA‐2, as well as on several other factors that may affect performance: emotional valence, arousal and familiarity. Second, the new subtests were validated in healthy older adults (n = 20), and in two clinical groups (acquired dysarthria, n = 15; and developmental dysarthria, n = 19). Analysis indicated that the new subtests were found to be specific and sensitive, valid and reliable, as scores significantly differ between healthy older adults and adults with dysarthria, correlated with other subjective measures of intelligibility, and showed high test–retest reliability. The words and sentences intelligibility subtests can be used to evaluate speech disorders in various populations of Hebrew speakers, thus may be an important addition to the speech–language pathologist's toolbox, for clinical work as well as for research purposes. What this paper adds: What is already known on the subject: 'Dysarthria' is a group of disorders reflecting impairments in the strength, speed and precision of movements required for adequate control of the various speech subsystems. Reduced speech intelligibility is one of the main consequences of all dysarthria subtypes, irrespective of their underlying cause. Indeed, most individuals with dysarthria cope with communicative restrictions due to speech impairments. Thus, language‐sensitive measurements of intelligibility are important in dysarthria assessment. The FDA‐2's words and sentences subtests present standardized and validated tools for the identification of the nature and patterns of oro‐motor movements associated with different types of dysarthria. What this paper adds to existing knowledge: The lack of assessment tools in Hebrew poses challenges to clinical evaluation as well as research purposes. The current study conducted a careful culture‐ and linguistic‐sensitive adaption of the FDA‐2 intelligibility subtests to Hebrew and performed a preliminary validation with relevant clinical populations. First, sets of Hebrew words and sentences were constructed, based on the criteria defined in FDA‐2, as well as on several other factors that may affect performance: emotional valence, arousal and familiarity. Second, the new subtests were validated in healthy older adults (n = 20), and in two clinical groups (adults with acquired dysarthria, n = 15; and young adults with developmental dysarthria, n = 19). What are the potential or actual clinical implications of this work?: Analyses indicated that the new word and sentence subtests are specific, sensitive, valid and reliable. Namely, (1) they successfully differentiate between healthy individuals and individuals with dysarthria; (2) they correlate with other subjective measures of intelligibility; and (3) they show high test–retest reliability. The words and sentences intelligibility subtests can be used to evaluate speech disorders in various populations of Hebrew speakers. Thus, they may be an important addition to the speech–language pathologist's toolbox, for clinical and research purposes. The methods described here can be emulated for the adaptation of speech assessment tools to other languages. [ABSTRACT FROM AUTHOR]

Objectives: Investigating the prevalence of speech and language disorders and the contributing factors can help determine the best treatment options suited to the needs of these patients. So far, no comprehensive study has been conducted on screening speech and reading disorders and Problems in the Structure and Function of Articulation Organs (PSFAOs) in children in Mashhad City, Iran. This study aims to screen for these disorders and investigate the effects of demographic factors on such disorders. Methods: Via the stratified-cluster sampling method, 2770 native Persian-speaking children participated in this study, of whom 1381 were girls and 1389 were boys, ranging from preschool to the third grade (3 to 9 years old). After obtaining the demographic information, the PSFAOs screening was performed for all participants using a semi-structured questionnaire taken from Paul et al.'s report (2017). Screening for a grade of dysphonia was then carried out for children with suspected voice disorders using the grade, roughness, breathiness, asthenia, and strain test. Fluency of speech screening for children with suspected fluency disorders was performed using the stuttering severity instrument - fourth edition test, and screening of reading skills for school children was performed using the screening inventory reading test. Analytical analysis was performed via the Chi-square test between study variables, including disorders and other variables. Two types of logistic regression models were used. The data were analyzed using survey data analysis of the Stata software, version 14.1, and P<0.05 was considered significant. Results: The prevalence of articulation disorders, voice disorders, stuttering, PSFAOs, reading disorders, and multiple disorders (presence of two or more disorders per person) was 1.62%, 1.99%, 1.69%, 1.1%, 8.21%, and 14.89%, respectively. Descriptive analysis showed that the prevalence of articulation disorders, voice disorders, stuttering, and multiple disorders was higher in boys compared to girls (P=0.000), while the prevalence of reading disorders and PSFAOs was higher in girls (P=0.000). Furthermore, articulation disorders and reading disorders were more common in first-graders. The prevalence of voice disorders, stuttering, and PSFAOs were higher in the third graders. The logistic regression analysis showed that boys were more likely to develop speech and language disorders compared to girls (OR=1.3, P=0.01), and first-, second-, and third-graders were less likely to have such disorders when compared to preschoolers (OR=0.8, P=0.03). Discussion: Compared to previous studies, the different rates of prevalence of the disorders studied in this investigation are related to differences in their methodology, the number of samples, age, linguistic and cultural characteristics of the subjects, and individual factors. In this study, the prevalence of the studied disorders was higher in boys, first-graders, and children with families of 4 or more. The development of speech and language skills is different between genders; slower maturation of male brains seems to predispose them to slower development of speech skills. The lower prevalence in school-age children may be because these disorders gradually resolve during the early years of childhood. Moreover, low family socioeconomic status and family size may be the contributing factors to speech and language disorders. [ABSTRACT FROM AUTHOR]

Purpose: Speech-language pathologists (SLPs) rely on auditory perception to form judgments on child speech. This can be challenging for graduate student clinicians with limited clinical experience as they often need to judge children's speech errors using their auditory perception. This study examined how consistently graduate student clinicians used a 3-point perceptual rating scale to judge child speech. Method: Twenty-four graduate student clinicians rated single words produced by children with typically developing speech and language skills and children with speech sound disorders. All participants rated the productions using a 3-point scale, where "2" was an accurate production, "1" was a close approximation, and "0" was an inaccurate production. Ratings were solely based on the auditory signal. These ratings were compared to a consensus rating formed by two experienced SLPs. Results: Graduate student clinicians reached substantial agreement with the expert SLP rating. They reached the highest percentage agreement when rating accurate productions, and the lowest agreement when rating inaccurate productions. Conclusions: Graduate student clinicians reached substantial agreement with expert SLP rating in judging child speech using a 3-point scale when provided with detailed descriptions of each rating category. These results are consistent with previous findings on the role that clinical experience plays in speech error perception tasks and highlight the need for additional listening training in speech-language pathology graduate programs. [ABSTRACT FROM AUTHOR]

Background: Picture‐naming tests (PNTs) evaluate linguistic impairment in dementia due to semantic memory impairment, impaired lexical retrieval or perceptual deficits. They also assess the decline in naming impairment at various stages of dementia and mild cognitive impairment (MCI) that occurs due to progressive cognitive impairment. With the increasing numbers of people with dementia globally, it is necessary to have validated naming tests and norms that are culturally and linguistically appropriate. Aims: In this cross‐sectional study we harmonized a set of 30 images applicable to the Indian context across five languages and investigated the picture‐naming performance in patients with MCI and dementia. Methods & Procedures: A multidisciplinary expert group formed by the Indian Council of Medical Research (ICMR) collaborated towards developing and adapting a picture naming test (PNT) known as the ICMR‐PNT in five Indian languages: Hindi, Bengali, Telugu, Kannada and Malayalam. Based on cross‐cultural adaptation guidelines and item‐wise factor analysis and correlations established separately across five languages, the final version of the ICMR‐PNT test was developed. A total of 368 controls, 123 dementia and 128 MCI patients were recruited for the study. Psychometric properties of the adapted version of the ICMR‐PNT were examined, and sensitivity and specificity were examined. Outcomes & Results: The ICMR‐PNT scores in all languages combined were higher in controls compared with patients with dementia and MCI (F2, 615 = 139.85; p < 0.001). Furthermore, PNT scores for MCI was higher in comparison with patients with dementia in all languages combined (p < 0.001). The area under the curve across the five languages ranged from 0.81 to 1.00 for detecting dementia. There was a negative correlation between Clinical Dementia Rating (CDR) and ICMR‐PNT scores and a positive correlation between Addenbrooke's Cognitive Examination—III (ACE‐III) and ICMR‐PNT scores in control and patient groups. Conclusions & Implications: The ICMR‐PNT was developed by following cross‐cultural adaptation guidelines and establishing correlations using item‐wise factor analysis across five languages. This adapted PNT was found to be a reliable tool when assessing naming abilities effectively in mild to moderate dementia in a linguistically diverse context. What this paper adds: What is already known on this subject: Picture‐naming evaluates language impairment linked to naming difficulties due to semantic memory, lexical retrieval or perceptual disturbances. As a result, picture naming tests (PNTs) play an important role in the diagnosis of dementia. In a heterogeneous population such as India, there is a need for a common PNT that can be used across the wide range of languages. What this study adds to existing knowledge: PNTs such as the Boston Naming Test (BNT) were developed for the educated, mostly English‐speaking, Western populations and are not appropriate for use in an Indian context. To overcome this challenge, a PNT was harmonized in five Indian languages (Hindi, Bengali, Telugu, Kannada and Malayalam) and we report the patterns of naming difficulty in patients with MCI and dementia. The ICMR‐PNT demonstrated good diagnostic accuracy when distinguishing patients with mild to moderate dementia from cognitively normal individuals. What are the potential or actual clinical implications of this work?: With the growing number of persons suffering from Alzheimer's disease and other forms of dementia around the world, its critical to have culturally and linguistically relevant naming tests and diagnosis. This validated ICMR‐PNT can be used widely as a clinical tool to diagnose dementia and harmonize research efforts across diverse populations. [ABSTRACT FROM AUTHOR]

Purpose: There is increasing interest in using automatic speech recognition (ASR) systems to evaluate impairment severity or speech intelligibility in speakers with dysarthria. We assessed the clinical validity of one currently available off-the-shelf (OTS) ASR system (i.e., a Google Cloud ASR API) for indexing sentence-level speech intelligibility and impairment severity in individuals with amyotrophic lateral sclerosis (ALS), and we provided guidance for potential users of such systems in research and clinic. Method: Using speech samples collected from 52 individuals with ALS and 20 healthy control speakers, we compared word recognition rate (WRR) from the commercially available Google Cloud ASR API (Machine WRR) to clinicianprovided judgments of impairment severity, as well as sentence intelligibility (Human WRR). We assessed the internal reliability of Machine and Human WRR by comparing the standard deviation of WRR across sentences to the minimally detectable change (MDC), a clinical benchmark that indicates whether results are within measurement error. We also evaluated Machine and Human WRR diagnostic accuracy for classifying speakers into clinically established categories. Results: Human WRR achieved better accuracy than Machine WRR when indexing speech severity, and, although related, Human and Machine WRR were not strongly correlated. When the speech signal was mixed with noise (noise-augmented ASR) to reduce a ceiling effect, Machine WRR performance improved. Internal reliability metrics were worse for Machine than Human WRR, particularly for typical and mildly impaired severity groups, although sentence length significantly impacted both Machine and Human WRRs. Conclusions: Results indicated that the OTS ASR system was inadequate for early detection of speech impairment and grading overall speech severity. While Machine and Human WRR were correlated, ASR should not be used as a one-toone proxy for transcription speech intelligibility or clinician severity ratings. Overall, findings suggested that the tested OTS ASR system, Google Cloud ASR, has limited utility for grading clinical speech impairment in speakers with ALS. [ABSTRACT FROM AUTHOR]

The study aimed at evaluating the diadochokinetic (DDK) skills of Greek-speaking preschool children with phonological disorder (PD) by means of a structured evaluation protocol and at proposing cut-off points for children at risk of speech impairment. The participants were 36 children with PD and 60 typically developing (TD) peers. The groups were matched on age and gender. The PD group performed significantly slower than the TD group in all speech DDK tasks but not in the oral-motor tasks. The ROC analysis showed a statistically significant positive discrimination for all speech tasks. The internal consistency of the protocol was excellent (Cronbach's α =.844), while complex stimuli showed a better discriminatory ability. The obtained results agree with Dodd's classification for speech sound disorders (SSDs). Different types of speech stimuli must be included in the evaluation of DDK performance as a clinical predictor for preschoolers with SSDs who face difficulties in speech maturation. [ABSTRACT FROM AUTHOR]

Purpose: Functional speech disorders (FSDs), a subtype of functional neurological disorders, are distinguishable from neurogenic motor speech disorders based on their clinical features, clinical course, and response to treatment. However, their differential diagnosis and management can be challenging. FSDs are not well understood, but growing evidence suggests a biopsychosocial basis distinct from structural lesions that cause neurogenic motor speech disorders. Method and Results: Following an overview of FSDs, four patients are described to illustrate the range of clinical manifestations, biopsychosocial contexts, and responses to treatment of FSDs. The path to differential diagnosis is discussed, with particular attention to positive features that led to the FSD diagnosis. Approaches to education, counseling, and management are discussed. Conclusions: This case series demonstrates that FSDs can present with a variety of manifestations including dysfluencies, articulation errors, dysphonia, rate and prosodic abnormalities, and combinations of disruptions in speech subsystems. FSDs may present in the context of known recent or remote physical or psychosocial trauma or, as in many cases, in the absence of an identifiable triggering event. FSDs are recognizable by positive clinical features and should not be considered a diagnosis of exclusion. With appropriate identification, counseling, and treatment, FSDs may resolve, sometimes rapidly; in some cases, treatment may be prolonged or ineffective. [ABSTRACT FROM AUTHOR]

Purpose: COVID-19 caused a worldwide conversion from in-person therapy to telehealth; however, limited evidence to support the efficacy of remotely delivering standardized tests puts the future of widespread telehealth use at risk. The aim of this study is to investigate the reliability of scoring a speech sound assessment administered in real-world scenarios including two examples of telehealth technology. Method: A total of thirty-nine 3- to 8-year-olds were administered the Goldman-Fristoe Test of Articulation-Third Edition. Licensed speech-language pathologists (SLPs) concurrently scored children's responses in person and in two telehealth conditions considered typical and enhanced. Mean standard scores and interrater reliability results were compared among the three conditions. Descriptive statistics were used to summarize the frequency of technology and behavior disruptions during administration and the results of an SLP telehealth perception survey. Results: All scoring conditions were found to be highly correlated, with mean differences revealing no systematic differences of one condition over- or underestimating another. Although response agreement was high (85%-87%), final sounds in words or sounds that are difficult to observe tended to attenuate reliability. Neither child nor technology disruptions affected SLPs' ability to score responses. Despite no significant differences between conditions on scoring reliability, SLP participants reported they continued to prefer in-person over a telehealth speech sound assessment. Conclusions: This study supports the provision of a pediatric speech sound assessment using consumer-grade equipment, as in-person, typical telehealth, and enhanced telehealth scoring conditions produced similar results. However, SLP participants' skeptical attitudes toward remote delivery of standardized tests reveal an ongoing barrier to widespread telehealth use. [ABSTRACT FROM AUTHOR]

Background: Acquired brain injury (ABI), especially to the right hemisphere, can result in difficulty using or understanding prosodic contours in speech. Prosody is used to convey emotional connotation or linguistic intent and includes pitch, loudness, rate, and voice quality. A disorder in the comprehension or production of prosody is known as aprosodia; despite the communication disability caused by prosodic disorders, the assessment and treatment of aprosodia following ABI has received scant attention. Aims: The aim of this scoping review is to gather and synthesise useful knowledge on aprosodia and provide therapists with an exhaustive document in order to guide clinical decision‐making encouraging active identification and treatment of this disorder. Methods & Procedures: This scoping review, conducted in accordance with PRISMA‐ScR guidelines, investigated the existing literature concerning the assessment and treatments of linguistic and affective aprosodia in adult patients after ABI. A systematic search in four electronic databases (PubMed, CINAHL, Web of Science, ScienceDirect) was conducted for articles written in English, French, or Italian published between 1970 and 2020. After all evaluative criteria were applied, 15 articles were included for final review. Outcomes & Results: Results show the presence of six assessment tools for affective aprosodia and five evaluation tools targeting affective and linguistic prosody. Assessment of aprosodia is generally accomplished through acoustic and perceptual approaches. Current treatments for prosodic disorders focus on expressive aprosodia and have applied mostly two different approaches: imitative and cognitive–linguistic methods. Conclusion & Implications: Findings suggest that aprosodia can be assessed by therapists through various techniques and may be amenable to behavioural treatments. Nevertheless, although there are several assessment tools available, no one currently offers a comprehensive assessment that incorporates an ecological dimension. It therefore seems necessary to continue research in this direction. The rehabilitation of receptive prosody abilities also remains to be explored. What this paper adds: What is already known on the subject: Prosody has a fundamental role in communication and conveys speakers' intentions and emotions. Therefore, a deficit of prosody (aprosodia) after acquired brain injury can reduce social participation and engagement. Assessment tools and rehabilitation treatments are necessary in order to improve this disorder and patients' quality of life. What this paper adds to existing knowledge: The evaluation tools currently available focuses mostly on affective aprosodia, whereas the linguistic prosody is less assessed. There exist two treatments for expressive aprosodia: motoric–imitative and cognitive–linguistic treatments; however, their efficacy is tested on small groups of patients. No treatments targeting receptive aprosodia were found. What are the potential or actual clinical implications of this work?: We need more sensitive and reliable tools and systematic evaluations of all the components of prosody (affective and linguistic, receptive and expressive prosody). We need researches who analyse bigger samples of patients after right hemisphere brain injury and we identified the need of more well‐designed studies and better understanding of the pathophysiology of aprosodia. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the practice patterns of private community speech–language pathologists (SLPs) when treating children with a repaired cleft of the palate with or without a cleft of the lip (CP ± L). Practices were explored in terms of diagnostics and treatment focus, treatment dosage and experienced difficulties when treating children with a CP ± L. Method: Eleven female private community SLPs, who lived in Flanders (i.e. the northern part of Belgium) and were aged between 23 and 62 years participated in this study. Data were collected from semi-structured face-to-face interviews. The qualitative software program NVivo 12 was used for data analysis. The interviews were analysed using an inductive thematic approach. Result: SLPs reported a lack of available information on speech-related cleft care. SLPs expressed the need to receive a referral letter from the hospital in order to make an adequate speech diagnosis. Most therapists reported that they performed an articulatory assessment combined with a language assessment. Most SLPs used a hybrid treatment model including a variety of intervention techniques. These techniques were not always in line with available scientific evidence. SLPs reported the desire to receive practical step-by-step guidelines on how to provide speech intervention to children with a CP ± L. In contrast, there was a strong consensus among the therapists that an individualised treatment plan is necessary. Conclusion: The results of this study have revealed gaps in the dissemination and implementation of scientific evidence relevant to speech services for children with a CP ± L (i.e. a research–practice gap) in Flanders. Research evidence needs to be adequately translated into clinical practice by providing concrete and practical guidelines. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to adapt and validate the Speech Handicap Index (SHI) into the Persian language. Patients and Methods: The original published English version of the SHI was translated into Persian using the translation protocol and guidelines of the International Quality of Life Assessment. One hundred participants with oral and oropharyngeal cancer and 40 healthy participants completed the Persian SHI. Forty participants of the patient group completed the Persian SHI a second time after a 2-weeks period to evaluate test-retest reliability. Content validity (content validity index and content validity ratio), internal consistency (Cronbach α coefficient), test-retest reliability (intraclass correlations), and construct validity (confirmatory factor analysis) were examined. Control group and patient group values were compared to determine the clinical validity. Results: A significant discrimination coefficient was found across all items, and the content and clinical validity were found to be acceptable. The Persian SHI showed a high internal consistency and test-retest reliability. The construct validity was within the acceptable range. Conclusions: The P-SHI is considered to be a valid and reliable questionnaire for speech assessment in Persian-speaking patients with head and neck cancer. [ABSTRACT FROM AUTHOR]

Objectives: Health status (HS)/ health-related quality of life measures, completed by self or proxy, are important outcome indicators. Most HS literature on children born preterm includes adolescents and adults with limited data at preschool age. This study aimed to describe parent-reported HS in a large national cohort of extreme preterm children at preschool age and to identify clinical and sociodemographic variables associated with HS.Methods: Infants born before 29 weeks' gestation between 2009 and 2011 were enrolled in a prospective longitudinal national cohort study through the Canadian Neonatal Network (CNN) and the Canadian Neonatal Follow-Up Network (CNFUN). HS, at 36 months' corrected age (CA), was measured with the Health Status Classification System for Pre-School Children tool completed by parents. Information about HS predictors was extracted from the CNN and CNFUN databases.Results: Of 811 children included, there were 79, 309 and 423 participants in 23-24, 25-26 and 27-28 weeks' gestational age groups, respectively. At 36 months' CA, 78% had a parent-reported health concern, mild in >50% and severe in 7%. Most affected HS attributes were speech (52.1%) and self-care (41.4%). Independent predictors of HS included substance use during pregnancy, infant male sex, Score for Neonatal Acute Physiology-II, bronchopulmonary dysplasia, severe retinopathy of prematurity, caregiver employment and single caregiver.Conclusion: Most parents expressed no or mild health concerns for their children at 36 months' CA. Factors associated with health concerns included initial severity of illness, complications of prematurity and social factors. [ABSTRACT FROM AUTHOR]

Purpose: This purpose of this study was to assess the frequency and types of phonological process errors in patients with velopharyngeal dysfunction (VPD) and the different types of palatal anomalies. Method: A total of 808 nonsyndromic patients with VPD, who underwent follow-up at the Center for Cleft Palate and Craniofacial Anomalies, from 2000 to 2016 were included. Patients were stratified into four age groups and five subphenotypes of palatal anomalies: cleft lip and palate (CLP), cleft palate (CP), submucous cleft palate (SMCP), occult submucous cleft palate (OSMCP), and non-CP. Phonological processes were compared among groups. Results: The 808 patients ranged in age from 3 to 29 years, and 439 (54.3%) were male. Overall, 262/808 patients (32.4%) had phonological process errors; 80 (59.7%) ages 3-4 years, 98 (40, 0%) ages 4.1-6 years, 48 (24.7%) 6.1-9 years, and 36 (15.3%) 9.1-29 years. Devoicing was the most prevalent phonological process error, found in 97 patients (12%), followed by cluster reduction in 82 (10.1%), fronting in 66 (8.2%), stopping in 45 (5.6%), final consonant deletion in 43 (5.3%), backing in 30 (3.7%), and syllable deletion and onset deletion in 13 (1.6%) patients. No differences were found in devoicing errors between palatal anomalies, even with increasing age. Phonological processes were found in 61/138 (44.20%) with CP, 46/118 (38.1%) with SMCP, 61/188 (32.4%) with non-CP, 70/268 (26.1%) with OSMCP, and 25/96 (26.2%) with CLP. Phonological process errors were most frequent with CP and least with OSMCP (p = .001). Conclusions: Phonological process errors in nonsyndromic VPD patients remained relatively high in all age groups up to adulthood, regardless of the type of palatal anomaly. Our findings regarding the phonological skills of patients with palatal anomalies can help clarify the etiology of speech and sound disorders in VPD patients, and contribute to general phonetic and phonological studies. [ABSTRACT FROM AUTHOR]

Background: Speech disturbances are a recognised aspect of schizophrenia that may have potential utility as a diagnostic indicator. Recent advances in quantitative speech assessment methods have led to more reproducible and precise metrics making this possible. The current study sought firstly to characterise the speech profile of schizophrenia patients using quantitative speech measures, then examine the diagnostic utility of these measures and explore their relationship to symptoms.Methods: Speech recordings from 43 schizophrenia/schizoaffective disorder (SZ) patients and 46 healthy controls (HC) were obtained and transcribed. Cognitive and symptom measures were also administered.Results: Compared to HCs, SZ patients had higher incidences of aberrance across five types of quantitative speech variables: utterances, single words, time/speaking rate, turns and formulation errors, but not pauses. Based on two machine learning algorithms, 21 speech variables across the same five speech variable types (again not including pauses) were identified as significant classifiers for a schizophrenia diagnosis with 90-100% specificity and 80-90% sensitivity for both models. Selective relationships were also observed between these speech variables and only positive, disorganisation, excitement and formal thought disorder symptoms.Conclusions: The findings support pervasive speech impairments in schizophrenia patients relative to HCs, and the potential diagnostic utility of these speech disturbances. Continued work is needed to build the evidence base for quantitative speech assessment as a future objective diagnostic tool for schizophrenia. It holds the promise of improved diagnostic accuracy leading to increased treatment efficacy and better patient outcomes. [ABSTRACT FROM AUTHOR]

To respond to the need of objective screening tools for motor speech disorders (MSD), we present the screening version of a speech assessment protocol (MonPaGe-2.0.s), which is based on semi-automated acoustic and perceptual measures on several speech dimensions in French. We validate the screening tool by testing its sensitivity and specificity and comparing its outcome with external standard assessment tools. The data from 80 patients diagnosed with different types of mild to moderate MSD and 62 healthy test controls were assessed against the normative data obtained on 404 neurotypical speakers, with Deviance Scores computed on seven speech dimensions (voice, speech rate, articulation, prosody, pneumophonatory control, diadochokinetic rate, intelligibility) based on acoustic and perceptual measures. A cut-off of the MonPaGe total deviance score (TotDevS) >2 allowed MSD to be diagnosed with specificity of 95% and an overall sensitivity of 83.8% on all patients pulled, reaching 91% when very mildly impaired patients were excluded. A strong correlation was found between the MonPaGe TotDevS and an external composite perceptual score of MSD provided by six experts. The MonPaGe screening protocol has proven its sensitivity and specificity for diagnosing presence and severity of MSD. Further implementations are needed to complement the characterization of impaired dimensions in order to distinguish subtypes of MSD. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the diagnostic accuracy of traditional measures of phonological ability developed for monolingual English-speaking children with their bilingual peers in both English and Spanish. We predicted that a composite measure, derived from a combination of English and Spanish phonological measures, would result in higher diagnostic accuracy than examining the individual phonological measures of bilingual children separately by language. Method: Sixty-six children, ages 3;3-6;3 (years; months), participated in this study: 29 typically developing bilingual Spanish-English--speaking children (x = 5;3), five bilingual Spanish-English--speaking children with speech sound disorders (x = 4;6), 26 typically developing monolingual English-speaking children (x = 4;8), and six monolingual English-speaking children with speech sound disorders (x = 4;9). Children were recorded producing single words using the Assessments of English and Spanish Phonology, and productions were phonetically transcribed and analyzed using the Logical International Phonetics Program. Overall consonants correct--revised; accuracy of early-, middle-, and late-developing sounds; and percent occurrence of phonological error patterns in both English and Spanish were calculated. Receiver operating characteristic curves and support vector machine models were applied to observe diagnostic accuracy, separately and combined, for each speaker group and each language. Results: Findings indicated the combination of measures improved diagnostic accuracy within both the English and Spanish of bilingual children and significantly increased accuracy when measures from both languages of bilingual children were combined. Combining measures for the productions of monolingual English-speaking children did not increase diagnostic accuracy. Conclusion: To prevent misdiagnosis of speech sound disorders in bilingual preschoolers, the composite phonological abilities of bilingual children need to be assessed across both gross and discrete measures of phonological ability. Supplemental Material: https://doi.org/10.23641/asha.16632604 [ABSTRACT FROM AUTHOR]

Purpose: The purposes of this study are to develop a novel multimodal framework for measuring variability at the muscular, kinematic, and acoustic levels of the motor speech hierarchy and evaluate the utility of this framework in detecting speech impairment in amyotrophic lateral sclerosis (ALS). Method: The myoelectric activities of three bilateral jaw muscle pairs (masseter, anterior temporalis, and anterior belly of digastric), jaw kinematics, and speech acoustics were recorded in 13 individuals with ALS and 10 neurologically healthy controls during sentence reading. Thirteen novel measures (six muscular, three kinematic, four acoustic), which characterized two different but interrelated aspects of variability--complexity and irregularity--were derived using linear and nonlinear methods. Exploratory factor analysis was applied to identify the latent factors underlying these measures. Based on the latent factors, three supervised classifiers--support vector machine (SVM), random forest (RF), and logistic regression (Logit)--were used to differentiate between the speech samples for patients and controls. Results: Four interpretable latent factors were identified, representing the complexity of jaw kinematics, the irregularity of jaw antagonists functioning, the irregularity of jaw agonists functioning, and the irregularity of subband acoustic signals, respectively. Based on these latent factors, the speech samples for patients and controls were classified with high accuracy (> 96% for SVM and RF; 88.64% for Logit), outperforming the unimodal measures. Two factors showed significant between-groups differences, as characterized by decreased complexity of jaw kinematics and increased irregularity of jaw antagonists functioning in patients versus controls. Conclusions: Decreased complexity of jaw kinematics presumably reflects impaired fine control of jaw movement, while increased irregularity of jaw antagonists functioning could be attributed to reduced synchronization of motor unit firing in ALS. The findings provide preliminary evidence for the utility of the multimodal framework as a novel quantitative assessment tool for detecting speech impairment in ALS and (potentially) in other neuromotor disorders. [ABSTRACT FROM AUTHOR]