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Purpose: Verbal fluency, a task frequently employed in neuropsychological assessment, provides important word productivity data but little information about subjective effort associated with demand monitoring and resource allocation. In two experiments, this study investigated the effects of task variables (semantic vs. phonemic cues; alternating vs. nonalternating conditions) and personal factors (fear of negative evaluation and trait anxiety) on subjective effort for a wide variety of verbal fluency tasks in neurotypical individuals. Method: Twenty-one adults completed eight verbal fluency tasks in Experiment 1. The tasks were selected to examine effort reported for verbal fluency that differed in (a) cue types and (b) the disruptions of clustering strategies. In Experiment 2, a separate group of 50 adults completed two verbal fluency tasks twice in separate sessions. Participants also completed social–emotional measures including fear of negative evaluation and trait anxiety. Working memory was assessed as a control variable. Results: Experiment 1 showed greater effort for completing semantic than phonemic cue tasks and greater effort for alternating than nonalternating conditions. Alternating semantic verbal fluency yielded the greatest effort among all tasks. Differences in effort could not be accounted for by performance alone. Experiment 2 showed that greater fear toward negative evaluation was associated with greater effort. The relationship between fear and effort was not related to trait anxiety or moderated by performance levels or repeated testing. Conclusions: Knowledge about factors that impact subjective effort in neurotypical individuals is fundamental to accurate interpretation of effort reported by clinical populations. This study demonstrated the multifaceted nature of subjective effort that could not be accounted for by performance alone. In addition to task variables, effort assessment needs to consider the impact of social–emotional factors such as fear toward negative evaluation.

Objective The happy–sad task adapts the classic day–night task by incorporating two early acquired emotional concepts (“happy” and “sad”) and demonstrates elevated inhibitory demands for native speakers. The task holds promise as a new executive function measure for assessing inhibitory control across the lifespan, but no studies have examined the influence of language of test administration on performance. Method Seventy adult native English speakers and 50 non-native speakers completed the computerized day–night and the new happy–sad tasks administered in English. In two conditions, participants were categorized pictorial stimuli either in a congruent manner (“happy” for a happy face) or in a more challenging, incongruent manner (“sad” for a happy face). Lexical decision performance was obtained to estimate levels of English language proficiency. Results Native speakers and non-native speakers performed comparably except for the critical incongruent condition of the happy–sad task, where native speakers responded more slowly. A greater congruency effect for the happy–sad task was found for native than for non-native speakers. Lexical decision performance was associated with performance on the challenging incongruent conditions. Conclusion This study reinforced the usefulness of the happy–sad task as a new measure in evaluating inhibitory control in adult native-speakers. However, the language of test administration needs to be considered in assessment because it may lead to performance differences between native and non-native speakers.

Traumatic brain injury (TBI) leads to a wide array of behavioral and cognitive deficits. Individuals with TBI often demonstrate difficulties with the recognition and expression of emotion communicated through multiple modalities including facial expression, vocal prosody, and linguistic content. Deficits in emotional communication contribute to a pattern of social pragmatic communication problems, leading to decreased psychosocial function. Growing evidence supports intervention targeting affective processing. This article summarizes the current evidence for evaluation and treatment of affective processing disorders in TBI.

Aims and objectives: Semantic verbal fluency taps into vocabulary knowledge but often elicits poorer performance in bilingual speakers tested in a second language (L2). Few studies have examined verbal fluency tasks that target abstract words and examined test–retest reliability. The present study examined the performance gap between English speakers and Chinese-English speakers on classic semantic, action, and emotional verbal fluency. Methodology: English data were collected for six verbal fluency tasks from 41 English speakers and 18 Chinese-English speakers who spoke English as L2. Verbal fluency performance was reassessed one week later to examine test–retest reliability. Data and analysis: Verbal productivity, valence and arousal, test–retest reliability, and cross-session consistency in producing similar responses in repeated testing were analyzed. Morphological complexity of verbal responses also was compared because Chinese is morphologically simpler than English and emotional verbal fluency may trigger morphologically complex words. Findings/conclusions: Productivity gaps between groups were reliable for all tasks despite practice effects but were smaller for action and emotional verbal fluency. Words produced by Chinese-English speakers were more positive generally and less arousing for specific categories (e.g., “happy”). Both speaker groups were equally likely to produce variable responses with repeated testing, especially for emotional verbal fluency. Words produced by Chinese-English speakers were morphologically simpler than those produced by English speakers for emotional verbal fluency. Originality: Past work on semantic verbal fluency has focused on the retrieval of neutral and concrete words. This is the first study to assess the reliability in performance gaps between speakers tested in L1 and speakers tested in L2 on verbal fluency that targets the retrieval of abstract and emotional-laden words. Significance: Verbal fluency is one of the most frequently employed tasks in neuropsychological assessments. The findings demonstrate the effects of language proficiency on performance across verbal fluency variants, group differences in valence and arousal, the effects of repeated testing, and the effects of linguistic features on responses produced.

Objective Native speakers frequently outperform non-native speakers on classic semantic verbal fluency tasks that target concrete non-emotional word retrieval. Much less is known about performance differences in retrieval of emotional words, which are abstract and crucial to social–emotional competence. This study compared native and non-native speakers’ verbal productivity on emotional and non-emotional verbal fluency tasks. Method Forty-seven native and 37 non-native speakers of English participated in the study. Participants completed seven semantic verbal fluency tasks in English including classic semantic (e.g., “animals”), action (e.g., “things people do”), and emotional variants (e.g., “things that make people happy”). Subjective and objective measures of English proficiency, information about language usage, and cognitive measures (working memory) were obtained for each participant. Results Verbal productivity for classic semantic, action, and emotional verbal fluency was lower for non-native speakers. Smaller language-specific vocabulary in non-native speakers did not moderate positivity biases in emotional verbal fluency. Subjective and objective language proficiency measures were less predictive of performance on the emotional than the non-emotional verbal fluency tasks. Conclusion Non-native speakers perform more poorly than native speakers on semantic verbal fluency in English for both emotional and non-emotional variants. Positivity biases are not moderated by language proficiency and are reliable features of emotional verbal fluency. Proficiency measures may be less effective in predicting generation of emotional than neutral words.

Purpose Emotional verbal fluency (Emo-VF) has the potential to expand neuropsychological assessment by providing information about affective memory retrieval. The usability of Emo-VF is limited, however, by significant variations in task administration and the lack of information about Emo-VF responses. This study investigated verbal productivity and the lexical-semantic properties of responses on positive and negative Emo-VF tasks. Comparing Emo-VF to non–Emo-VF tasks used regularly in neuropsychological assessment provided additional information about the basic characteristics of Emo-VF tasks. Method Twenty-five adult native speakers provided verbal responses to three Emo-VF (“happy,” “sad,” “negative emotions”) and two non–Emo-VF categories (“animals,” “things people do”). Verbal productivity was measured at the word and syllable levels. Multiple large-scale data corpora were used to estimate the lexical-semantic properties of the verbal responses. Results There was a robust positivity bias in verbal productivity within Emo-VF tasks. Emo-VF tasks tended to elicit longer words than “animals” and “things people do,” which might impact the results of verbal productivity analyses, especially in comparisons with “things people do.” Within Emo-VF tasks, negative Emo-VF elicited words from a wider range of valence than positive Emo-VF tasks. Similarities (e.g., word length and complexity) and differences (e.g., concreteness, age of acquisition) were found between positive and negative Emo-VF tasks. Conclusions The study provided information about the basic characteristics of Emo-VF tasks, which included evidence for a robust positivity bias, suggestions for analyses of verbal productivity (e.g., consideration of word length), and lexical-semantic properties associated with positive and negative Emo-VF tasks using corpora data.

Background: Traumatic brain injury (TBI) results in verbal recall deficits and impaired processing of emotion encoded in facial appearance, prosody and the linguistic content of messages. Emotion facilitates memory (emotional memory advantage) for non-brain injured (NBI) individuals but the impact of emotion on verbal recall for linguistically encoded stimuli in TBI has not been explored.Aims: The purpose of this study was to determine the effects of stimulus emotional content on verbal recall of words and paragraphs in TBI compared to NBI individuals.Methods and procedures: Six 10-item lists, each with five emotional and five neutral words, and six paragraphs (three emotional, three neutral) were counterbalanced and presented in random order to 20 individuals with TBI and 44 NBI. The number of words from lists and the number of content units from paragraphs were compared for the two groups.Outcomes and results: The NBI participants recalled more words from the lists and content units from the par...

Objective The purpose of this study was to compare the performance of bilingual speakers on an emotional verbal fluency task to category and letter verbal fluency tasks. A second purpose was to compare performances on these tasks to language proficiency ratings. Method Twelve verbal fluency tasks were administered to 21 Spanish-English bilingual speakers. Results were analyzed for differences between fluency types (category, letter, and emotional) and languages (English and Spanish). Results Participants generated the most items in category fluency tasks and the least items in emotional fluency tasks. The number of items generated for letter and emotional fluency tasks were not significantly different, but both were significantly lower than the number of items generated in category fluency. More items were generated for positive emotions than for negative emotions. Differences between languages for category and letter fluency tasks were significantly correlated with differences in language proficiency ratings, but this finding was not found for emotional fluency tasks. Conclusions Self-ratings of proficiency and language dominance correlated significantly with performance on category and letter fluency tasks and may be useful predictors of differences between languages on these tasks. Emotional fluency was not significantly correlated with language proficiency ratings, suggesting that performance on emotional fluency may be more significantly affected by emotional processing ability. The emotional verbal fluency task has potential as a component of neuropsychological evaluations to screen easily and quickly for emotional processing deficits, including those associated with traumatic brain injury and depression. Additionally, results support a positivity bias in language and cognition processes.

Background: Identifying associations or links between encoded stimuli can influence whether those stimuli are successfully retrieved at a later time.Aims: The purpose of this study was to investigate the influence of semantic and phonological lexical targets on recall in individuals with mild to moderate traumatic brain injury (TBI) and to identify if individuals with TBI form associations when recalling related information.Methods & Procedures: Forty-seven individuals, 14 with TBI, completed the Deese–Roediger–McDermott (DRM) word retrieval paradigm in which six digitally recorded word lists were presented auditorily. Three of the lists contained semantically related words and three contained phonologically related words.Outcomes & Results: Non-brain-injured (NBI) participants recalled significantly more phonological and semantic stimuli than participants with TBI. Phonologically related stimuli resulted in increased intrusions for both TBI and NBI participants. For participants with TBI, age and...

This study investigated differences between healthy bilingual participants and bilingual participants with traumatic brain injury (TBI) on verbal fluency tasks. The performance of three Spanish-English bilingual speakers with traumatic brain injury was compared to the performance of 30 neurotypical bilingual speakers on tasks of category and letter verbal fluency in English and Spanish. Responses were analyzed for total number of correct productions, differences in correct productions between languages, average cluster size, total number of switches, and rates of language choice errors. The data were analyzed using predicted scores from regression equations based on neurotypical data and modified t-tests. Analyses revealed significantly lower total output than predicted by the regression equations for both task types and in both languages for one TBI participant. The same participant demonstrated significantly lower total number of switches than the neurotypical group. Two participants demonstrated higher rates of language choice errors than the neurotypical group. There were no significant differences between TBI participants and the neurotypical group for average cluster size. There were no significant differences between predicted and obtained values for differences between English and Spanish total number correct in each task type. Results are discussed in the context of individual cognitive and linguistic profiles of the TBI participants.

Background and Purpose: In this proof-of-concept pilot study, transcranial direct current stimulation (tDCS) was used as an adjuvant to speech therapy in an intensive comprehensive aphasia program (ICAP). Methods: Using a double-blind, sham controlled, between-group design, 1 mA of direct current was delivered via NEO-24 PiStim gel electrodes using a Starstim tDCS device.The anode was placed over the inferior frontal gyrus (FC5), with the cathode placed over the supra-orbital frontal area (AF8) of the contralesional side during the first 20 minutes of daily intensive speech therapy for a period of 15 consecutive weekdays, commencing on day-1 of an 8-week ICAP. Pre- and post-treatment standardized assessments and discourse analysis, as well as bi-weekly trained and untrained probes, were used as outcome measures. Results: Six subjects were analyzed; three received ICAP-tDCS and three received ICAP-sham. Five subjects were male. Ages ranged from 50 to 67 years. Time post-stroke at enrollment ranged from 8 months to 5.2 years. Subjects receiving ICAP-tDCS treatment demonstrated significantly higher improvement than ICAP-sham patients on the Boston Naming Test ( p=0.05), trained and untrained probes (p=0.05, untrained absolute increase p=0.05, percent increase p=0.38), and picture-description discourse (absolute increase p=0.05, percent increase p=0.38). There was no difference in the improvement of Western Aphasia Battery-AQ between ICAP-tDCS and ICAP-sham patients (absolute and percent increases both p=0.28). No adverse effects of tDCS or intensive behavioral training were reported. Following completion of the initial 3 weeks of adjunctive tDCS and tDCS-sham treatment, all subjects continued participation in the ICAP therapy with behavioral intervention only, and concluded the 8-week program. Conclusions: In this proof-of-concept pilot rehabilitation study, we demonstrate significant language improvements in chronic post-stroke aphasia, following intensive speech therapy combined with tDCS. Results should be confirmed in a larger randomized clinical trial.

The effects of age and sex on the ability to identify the emotion portrayed in videotaped affectively loaded sentences were investigated in 60 normal adults divided into three age groups. Sentence stimuli were either (1) affectively congruent, wherein extralinguistic features agreed with the literal sentence content; or (2) affectively ambiguous in which extralinguistic features did not agree with the literal sentence content. Statistical analyses revealed no significant effects of age or gender on the ability to correctly identify affect, but participants demonstrated significantly better performance in an audio–video compared with an audio-only condition. Analysis of ratios reflecting a systematic bias, determined from correct responses to the ambiguous sentences, suggested that with increasing age and particularly for males, responses more frequently are based on literal rather than extralinguistic features of the stimulus. Whereas younger subjects, and particularly female subjects, rely more h...

Background: Emotional information in communicative messages is conveyed through a combination of linguistic and paralinguistic cues. Listeners must simultaneously process affective prosody, facial expressions, body gestures, and semantic information in order to determine the speaker's emotional intent. Findings from recent research support the involvement of subcortical structures in unimodal emotion recognition; however, given the propensity for emotional information to be conveyed across multiple modalities simultaneously, clinical advances require an understanding of how subcortical and cortical structures are involved in the recognition of multi-modal stimuli. Aims: To determine if individuals with and without a history of brain damage demonstrate affective processing biases on ambiguous and congruous multi-modal emotive stimuli.1 Methods & Procedures: Twenty individuals with brain damage and five individuals without a history of brain injury (NC) were included in the study. Participants with brain da...

Purpose To investigate the hypothesis that vowel production is more variable in adults with acquired apraxia of speech (AOS) relative to healthy individuals with unimpaired speech. Vowel formant frequency measures were selected as the specific target of focus. Method Seven adults with AOS and aphasia produced 15 repetitions of 6 American English vowels in /hVC/ context ( hid, head, hat, hot, hub, hoot ). Vowel formant frequency measures (F1, F2) were Bark transformed and compared with data from archival sources. Results Measures of vowel acoustics in speakers with AOS did not differ from those of unimpaired speakers, including absolute Bark formant values, vowel space area, intervowel distance, and individual trial-to-trial formant variability. Conclusion Comparison with normative acoustic measures suggested that vowel production at the word level is unimpaired in the current speakers with AOS, supporting previous studies that have shown vowel production is relatively intact in AOS.

Background: Subtle changes in communicative function may be an early sign of an underlying neurological condition. Although early detection is encouraged to prevent illness, decrease morbidity, and reduce disability, early detection does not typically include periodic cognitive‐communicative assessment. Aim: The goal of this research was to determine whether subtle linguistic markers in discourse production would differentiate groups of participants with and without cognitive impairment. Additionally, the relationships among participant variables, performance on standardised cognitive and linguistic measures, and performance on an experimental discourse production task were examined. Methods & Procedures: A total of 30 neurologically healthy younger adults, 22 neurologically healthy older adults, 10 adults with mild cognitive impairment (MCI), and 10 persons with neurological damage (PWND) participated in the study. A discourse production task, “Trip to New York”, and several standardised measures includi...

Background: The assessment of aphasia in bilingual speakers is complicated by the need to measure language impairment in each language, as well as defining how one language recovers in relation to another. The Bilingual Aphasia Test (BAT) is a criterion‐referenced measure designed to provide the requisite data needed to measure the impairment of bilingual speakers with aphasia while minimising the effects of pre‐morbid differences in language skill. Aims: The purpose of this study was to examine the performance of neurologically normal adult bilingual speakers on the short version of the BAT (English and American Spanish). Methods & Procedures: A total of 22 adults ranging in age from 51 to 77 completed the BAT as well as a series of measures of language history, proficiency, and use. Outcomes & Results: Results indicated that the group scored higher in English than in Spanish on the BAT. BAT performance was consistent with higher proficiency in English than Spanish, as indicated by responses to language ...

Vowel inventories and error patterns for three children with suspected developmental apraxia of speech (DAS) were analysed over a 3-year period using phonetic transcriptions of connected speech samples. The children demonstrated complete English vowel inventories except for rhotics. However, accuracy of vowel targets in connected speech did not normalize during this period. No consistent patterns of vowel errors were found. There was no decrease in vowel accuracy with increased utterance length or syllable complexity. Findings indicate persistence of vowel inaccuracy in the presence of a relatively complete vowel inventory. This longitudinal data can help to build consensus on use of vowels as a potential clinical marker for differential diagnosis of DAS.

This clinical study investigated the behavioral adjustment of a group of 19 children 6.5 to 14.5 years old from Morocco with voice disorders. The CAPE-V, Iowa Patients’ Voice Index, and Child Voice-Related Quality of Life scales were completed for each child by the investigator, and parents and teachers completed adaptations of the Child Behavior CheckList. Case study analyses revealed precipitating or maintaining psychological factors for voice disorders for five of the children.

Background: Apraxia of speech (AOS) is an acquired sensorimotor disorder characterised by an impairment in the ability to program purposeful movements for speech in the absence of muscle weakness or paralysis. Due to motor programming difficulties, individuals with AOS make more errors as the complexity of a phoneme, syllable, word, or phrase increases. They also tend to produce short words and exhibit "syllabic speech", the production of syllables lacking prosody with intersyllabic pauses. While the syllable is a fundamental unit of speech in AOS, little is known about the syllable shapes used by individuals with AOS in discourse. Aims: The aim of this study was to determine if individuals with AOS produce shorter words with simpler syllable structure in spontaneous speech compared to neurologically normal individuals. Methods & Procedures: Five speakers with AOS and Broca's aphasia and five gender- and age-matched neurologically normal individuals participated in the study. One hundred conversational tu...

The purpose of this study was to investigate the influence of conversational language demands on lexical retrieval in the discourse of bilingual speakers with aphasia. Specifically, we explored how...

Background: Equivalent language knowledge is assumed in interpreting assessment results from bilingual speakers with aphasia, regardless of pre‐morbid language experience. Aims: The purpose of this study was to investigate the affect of pre‐morbid language skill, estimated from the performance of 20 neurologically normal bilinguals, on picture identification and naming in four bilingual speakers of Spanish and English with aphasia. Methods & Procedures: Statistical and qualitative analyses of proficiency, language use patterns, literacy, and concentrated language experience were investigated in relation to between‐language differences in picture identification and naming. Outcomes & Results: Three patterns of impairment were identified: higher scores in English consistent with pre‐morbid skill, higher scores in Spanish inconsistent with pre‐morbid skill, and variable performance inconsistent with pre‐morbid skill. Conclusions: Results suggest that interpretation of language impairment in adult bilingual s...

Affective processing ability was examined in right and left hemisphere brain-damaged subjects with cortical lesions that were grouped according to the presence or absence of concomitant subcortical basal ganglia damage. The ability to process affective speech prosody, emotional facial expressions, and linguistically coded emotional messages was measured in isolated identification tasks. Results indicated that subjects with damage to subcortical structures in addition to cortical left or right hemisphere brain damage had difficulty processing emotional words, facial expressions, and prosodic intonations. Subjects with cortical damage only, regardless of side of lesion (left or right), performed without significant difficulty across all tasks. There were hemispheric differences found in the cortical-subcortical groups. The left cortical-subcortical subjects had the greatest difficulty processing linguistic information and the right cortical-subcortical subjects had the most difficulty processing facial expr...

The assessment of communication disorders is, by necessity, a behavioural description process. Standardized measures provide quantitative data that contribute to the identification of communication disorders, but test scores and normative comparisons are insufficient for describing the effects of impairment on performance in communicative settings. The importance of ecological validity in tests for communication disorders, the need for systematic observation and the potential biases in testing diverse populations are considered within the framework of identification and differential diagnosis of speech and language disorders. There are also communicative disorders that are clinically recognized, but which cannot be reliably identified following standardized testing and systematic observation in communicative settings. For these disorders, there is a continuing need for research based on behavioural description to develop a theoretical understanding of the disorder that can guide reliable assessment, identification and intervention.

Ten mentally retarded adults with Down's Syndrome were assigned to American Indian Gestural Code (Amer-Ind) and American Sign Language (ASL) teaching groups to compare sign comprehension, imitation, and retrieval learning in relation to system characteristics (iconicity, motoric complexity of signs) and subject specific factors (language and motoric ability). Twenty lexical items, significantly different in iconicity and motor difficulty for the two gestural systems, were taught to the subjects during 20 thirty-minute sessions. Statistical analyses revealed significant differences in individual subject performance at five session measurement intervals but no significant differences between the two groups. Subject factors rather than differences in sign system characteristics appeared to be the best predictors of language/gestural code learning for the mentally retarded adults.

Developmental apraxia of speech (DAS) is a neurologically based disorder in the programming of sequential articulatory movements. This definition, based purely on motoric limitations, is fraught with controversy concerning aetiology, clinical manifestations, treatment, and even identification of the disorder as a separate clinical entity. An understanding of developmental apraxia depends on consistent utilization of a group of symptoms for diagnosis so that data-based results can be used to generate inferences about the disorder. Results from studies of children who are diagnosed with developmental apraxia, but who may not be apraxic, complicates application to theories attempting to account for observed symptoms. A longitudinal study of children with DAS has been under way at the University of Texas at Austin since 1985. Of 22 children referred as apraxic, a diagnosis has been confirmed in only four. Phonological and language evaluation data for five clients evaluated during this project are presented. O...

Stress-marking strategies employed by subjects with apraxia of speech were compared to those of matched normal controls, for real disyllabic words produced in isolation and in sentences, across acoustic variables of fundamental frequency, syllable duration, and vocal intensity. Heterogeneity of stress marking in terms of acoustic trading relationships was observed in both the apraxic and normal subjects. Strategies varied depending on whether words were produced in isolation or in sentences, and whether the first or second syllable was stressed. Allowing for marked durational increases in apraxia, there were negligible differences in stress marking between groups. However, some idiosyncratic strategies and a tendency toward reduced durational contrast between stressed and unstressed syllables were observed.

The phonological competence of four children, aged 5-7 years old, who demonstrated a cluster of symptoms consistent with a diagnosis of developmental apraxia of speech (DAS), was contrasted to that of four normal children. Four rhyming tasks were used to assess the ability of the children to both spontaneously generate rhyming words to targets and to judge the (in)appropriateness of a rhyme in both a word series and forced-choice word pairs. The DAS children revealed a severe deficit in rhyming ability across all tasks and had rhyming abilities markedly inferior to those shown by normal children. The rhyming results were interpreted as possibly indicative of an impoverishment of an internalized phonemic representation system, which precludes accessing and evoking the needed sound image for the vowel + coda for a rhyme. These results, while preliminary in nature, lend support to a conceptualization of DAS as a fundamental disorder of the segmental phonological level of language that impacts on all hierarchically relevant language components. The hypothesis that the underlying etiology of DAS is a developmental dysmorphology of the neural substrates that mediate such basic phonological representational structure is discussed.

Changes in consonant and syllable-level error patterns of three children diagnosed with childhood apraxia of speech (CAS) were investigated in a 3-year longitudinal study. Spontaneous speech samples were analyzed to assess the accuracy of consonants and syllables. Consonant accuracy was low overall, with most frequent errors on middle- and late-developing sounds. Omissions and substitutions were the dominant error types. Analysis of syllables revealed higher frequencies of error on complex mono- and polysyllables. Multiple regression analyses revealed that consonant accuracy is predicted by syllable shape accuracy and polysyllable frequency. Improvement was noted over time, although irregular patterns of consonant and syllable-level errors persisted across the period studied. Findings suggest that consonant errors in CAS are related to syllable-level deficits, namely difficulty constructing syllabic frames for speech production targets. Learning outcomes: On the basis of this article, the reader will be able to (1) describe the deficits in consonant production demonstrated by the participants, (2) analyze the relationship between consonant production and syllable-level patterns of error and (3) consider the value of addressing syllable construction as a therapeutic goal.

Variability in the speech production patterns of children with developmental apraxia of speech (DAS) was investigated in a three-year longitudinal study of three children with DAS. A metric was developed to measure token-to-token variability in repeated word productions from connected speech samples. Results suggest that high levels of total token and error token variability and low levels of word target stability and token accuracy characterize the disorder. Overall levels of variability and patterns of change over time differed between participants. Longitudinal patterns were indicative of decreasing total token variability and increasing token accuracy. However, change was not consistently unidirectional for two of the three children in the study, suggesting day-to-day performance differences in addition to within-session variability.

Three children with developmental apraxia of speech (DAS) identified the number of syllables in words, judged intrasyllabic sound positions, and constructed syllable shapes within monosyllabic frames. Results suggest that DAS children demonstrate an apparent breakdown in the ability to perceive “syllableness” and to access and compare syllable representations with regard to position and structure. Based on these findings, DAS is viewed as a disorder characterized by an impoverished phonological representation system. Learning outcomes: On the basis of this article, the reader will be able to (1) describe the deficits in syllabic perception demonstrated by some participants with DAS; (2) examine the utility of metalinguistic tasks in the differential diagnosis of DAS; and (3) evaluate the findings with respect to competing theoretical perspectives on DAS.

Conversational discourse samples were obtained from four aphasic and four neurologically normal Hispanic bilinguals in monolingual English, monolingual Spanish, and bilingual contexts to identify codeswitching patterns. Analysis of the samples based on the Matrix Language Frame (MLF) Model (Myers-Scotton, 1993a) revealed consistent matching of the language context by the aphasic and normal subjects. The aphasic subjects demonstrated a greater frequency of MLF constituents and codeswitching patterns not evident in the speech samples of the normal subjects. Results suggest an increased dependence on both languages for communication following neurological impairment.

Referential and conversational speech tasks were used to investigate the speech, language, and communication skills of five neurologic-ally normal and five demented subjects. Measures of communication success, efficiency, and learning were derived from referential task performance. Communication behaviours were categorized and quantified from utterances of the conversation and referential tasks. Analysis of results revealed relatively intact speech and grammar for the demented subjects despite disruptions in the success and efficiency of communicative interaction. The results support the clinical observation of impaired communication and preserved speech and grammar skills in dementia.

The errors of ten apraxic speakers on a single word task were analyzed to determine the effects of articulatory and linguistic variables on speech production. Results suggested that phoneme difficulty but not phoneme position or grammatical class significantly affected the errors of the subjects. A significant low positive correlation between mean word abstraction and the errors of the apraxic speakers was observed although correlations for the grammatical classes decreased with increases in abstraction. These findings were interpreted to suggest that impaired motor speech programming may be affected by linguistic and articulatory variables.

Ten adults with apraxia of speech responded to sentences of an article (pronoun) + noun + verb + article (pronoun) + noun design. Each sentence was presented and then re-presented with the noun in Noun Phrase 1 (NP 1 ) or Noun Phrase 2 (NP 2 ) omitted. The subjects' task was to orally produce the omitted word. Sentences were either active or passive and the omitted noun was a concrete, abstract, or nonsense word. Results revealed significantly more errors in NP 1 than NP 2 , more errors on nonsense and abstract nouns than on concrete nouns, and more errors on passive than on active voice sentences. Linguistic bases for these findings are discussed.

Thirteen patients clinically diagnosed as Broca's aphasics, were administered a vowel bite block task to ascertain their on-line compensatory articulation ability. Formant frequencies for F1 and F2 were obtained from a pitch-synchronous spectral analysis of digitized vowel waveforms. Bite block/i/productions were consistently characterized by higher F1 and lower F2 frequencies compared to normal vowel productions. Undershooting of tongue elevation and fronting explains this result. No consistent pattern of "off-target" productions were found for/a/tokens. A multiple correlation analysis among clinically derived quantitative measures (BDAE score, oral and verbal apraxia), experimentally derived measures (bite block performance, articulatory reaction time), and neurological measures (brain lesion volume) was highly successful despite a relatively small sample size. Compensatory articulation was significantly related to both oral apraxia scores (r = -.70) and the BDAE total score (r = -.51). A multiple regression analysis nearly reached statistical significance (p = .11) in predicting bite block performance, with oral apraxia the most powerful predictor variable. Descriptive accounts of loci of brain lesion vis-à-vis compensatory articulation ability are given to delimit brain areas thought to possibly mediate this articulatory adaptive skill. Preliminary speculation supports the notion that an intact Area 44 is a prerequisite for successful compensatory ability.

The purpose of this study was to investigate communicative effectiveness in aphasia. Five patients with Broca's aphasia and five neurologically normal subjects participated in referential communication and spontaneous conversation tasks. Performance on the referential tasks was used to derive measures of communication success, learning, and efficiency. A representative sample of utterances from the referential tasks and 100 utterances from the spontaneous conversation task also were analyzed to determine the frequency of operationally defined errors in speech, lexical access, grammar, content, discourse, and use. Results suggest that patients with Broca's aphasia retain communicative effectiveness in the presence of significant speech and language deficits and experimentally imposed constraints on the use of visual and gestural communication modalities.

The phonemic substitution errors of ten apractic speakers were analyzed to investigate the effects of markedness on speech production patterns. Results revealed that: more errors were produced on phonemes high in markedness; more changes in markedness were from marked to unmarked than unmarked to marked; and errors and directional changes in markedness were positively correlated with ease of articulation. The findings were interpreted as a systematic effort by the apractic speakers to reduce the complexity of articulatory gestures required to produce phonemes.

Summary.-Five neurologically normal and five apractic subjects were required to develop and maintain target intraoral pressure Levels during 5-sec. trials. The apractic subjects showed increased latencies in gaining the target and reduced maintenance time and increased variabiliry in attempts to stay at target. Results suggest that physiologically based assessment tasks provide sensitive indices of the degree of oral apraxia in pacients with left-hemisphere brain damage. Knowledge of oral apractic deficits in ~atients with left-hemisphere brain damage is based primarily on rating-scale judgements of performance on oral movement tasks. Although results from studies using rating scales have been important in establishing the high incidence of oral apraxia in Broca's aphasia and the differential effects of aphasia type on isolated compared to sequential oral movements, they have not provided the finegrained analysis necessary to make qualitative decisions regarding the severity of involvement. The purpose of this study was to investigate oral apraxia in patients with Broca's aphasia utilizing an aerodynamic monitoring task. Five subjects with Broca's aphasia and apraxia selected on the basis of performance on the Boston Diagnostic Aphasia Examination (Goodglass & Kaplan, 1972), computerized tomography and neurological examination, and five neurologically normal subjects participated in a series of tasks char required sequential coordinated movements of the respiratory apparatus and upper alru8ay Each subject was seated in a dental chair in front of a Tektronix RM 564 storage oscilloscope with dual beam trace amplifier. Two 6-in. pieces of Intramedic .070-in tubing were placed in the subject's mouth and sealed with the lips. One piece of tubing was connected to a Statham 131 TC pressure transducer and the other served as a "bleed" tube to allow airflow during the course of the tasks. The subjects were required to inspire as fully as possible and blow into the pieces of tubing with maximum force for 3 sec. Each trial was recorded on the storage oscilloscope and on a Honeywell 1858 Visicorder. The subject's mean maximum intraoral pressure was calculated over the 3-sec. trials and was used to set target levels of 25%, 50%, and 75% of mean peak intraoral pressure for the experimental tasks. The subjects were required to match and track a target cursor set at each of these target levels on a dual beam oscilloscope with another cursor which reflected the intraoral pressure applied to the transducer. The three levels were randomized for each subject and five 5-sec. trials were completed at each of the three target levels. Oscillographic records of the 15 trials of each subject were used to determine onset time, maintenance time, and variability in performance of the tasks. Onset time was measured from the triggering of the target cursor to the point at

The purpose of the study was to investigate the intelligibility of two voice output communication aids. Twenty words and 20 sentences, synthesized with the Personal Communicator and with the SpeechPAC, were presented to 20 listeners. Listener transcriptions of the stimuli were used to compare the intelligibility of the two communication aids. Analysis of variance revealed significantly higher intelligibility scores for the Personal Communicator compared to the SpeechPAC and higher scores for sentences than for words. The implications of these findings for selection of augmentative communication devices is discussed.