Hayo Terband

Auditory-motor interactions in pediatric motor speech disorders: Neurocomputational modeling of disordered development

BACKGROUND/PURPOSE Differentiating the symptom complex due to phonological-level disorders, speech delay and pediatric motor speech disorders is a controversial issue in the field of pediatric speech and language pathology. The present study investigated the developmental interaction between neurological deficits in auditory and motor processes using computational modeling with the DIVA model. METHOD In a series of computer simulations, we investigated the effect of a motor processing deficit alone (MPD), and the effect of a motor processing deficit in combination with an auditory processing deficit (MPD+APD) on the trajectory and endpoint of speech motor development in the DIVA model. RESULTS Simulation results showed that a motor programming deficit predominantly leads to deterioration on the phonological level (phonemic mappings) when auditory self-monitoring is intact, and on the systemic level (systemic mapping) if auditory self-monitoring is impaired. CONCLUSIONS These findings suggest a close relation between quality of auditory self-monitoring and the involvement of phonological vs. motor processes in children with pediatric motor speech disorders. It is suggested that MPD+APD might be involved in typically apraxic speech output disorders and MPD in pediatric motor speech disorders that also have a phonological component. Possibilities to verify these hypotheses using empirical data collected from human subjects are discussed. LEARNING OUTCOMES The reader will be able to: (1) identify the difficulties in studying disordered speech motor development; (2) describe the differences in speech motor characteristics between SSD and subtype CAS; (3) describe the different types of learning that occur in the sensory-motor system during babbling and early speech acquisition; (4) identify the neural control subsystems involved in speech production; (5) describe the potential role of auditory self-monitoring in developmental speech disorders.

Auditory feedback perturbation in children with developmental speech sound disorders

BACKGROUND/PURPOSE Several studies indicate a close relation between auditory and speech motor functions in children with speech sound disorders (SSD). The aim of this study was to investigate the ability to compensate and adapt for perturbed auditory feedback in children with SSD compared to age-matched normally developing children. METHOD 17 normally developing children aged 4.1-8.7 years (mean=5.5, SD=1.4), and 11 children with SSD aged 3.9-7.5 years (mean=5.1, SD=1.0) participated in the study. Auditory feedback was perturbed by real-time shifting the first and second formant of the vowel /e/ during the production of CVC words in a five-step paradigm (practice/familiarization; start/baseline; ramp; hold; end/release). RESULTS At the group level, the normally developing children were better able to compensate and adapt, adjusting their formant frequencies in the direction opposite to the perturbation, while the group of children with SSD followed (amplifying) the perturbation. However, large individual differences lie underneath. Furthermore, strong correlations were found between the amount of compensation and performance on oral motor movement non-word repetition tasks. CONCLUSIONS Results suggested that while most children with SSD can detect incongruencies in auditory feedback and can adapt their target representations, they are unable to compensate for perturbed auditory feedback. These findings suggest that impaired auditory-motor integration may play a key role in SSD. LEARNING OUTCOMES The reader will be able to: (1) describe the potential role of auditory feedback control in developmental speech disorders (SSD); (2) identify the neural control subsystems involved in feedback based speech motor control; (3) describe the differences between compensation and adaptation for perturbed auditory feedback; (4) explain why auditory-motor integration may play a key role in SSD.

Cognitive functions in Childhood Apraxia of Speech

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

Dysfluencies in the speech of adults with intellectual disabilities and reported speech difficulties

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

Rate-Related Kinematic Changes in Younger and Older Adults

Aims: This study aimed to investigate the effects of speech rate changes on kinematic characteristics and stability of speech movements in younger and older speakers using electromagnetic midsagittal articulography. Patients and Methods: Eight young adults and 8 older adults engaged in a series of syllable repetition tasks of /pa/, /sa/ and /ta/ obtained at self-paced slow, habitual and fast speech rates, as well as in a series of metronome-guided speech rates, ranging from 2 to 4 syllables per second. The kinematic parameters duration, amplitude and peak velocity were obtained for opening and closing movements. Results: Older speakers were able to increase speech rate to the same degree or higher compared to younger speakers in both pacing conditions. Kinematic data show that older adults increased duration and decreased peak velocity in closing movements of alveolar constrictions at slower rates more prominently than younger adults. The results on movement stability revealed no differences between age groups. Conclusions: The results suggest that an age-related difference in speed-accuracy trade-off can be ruled out. Differences in kinematic characteristics point towards the possibility that older adults aimed to facilitate a closed-loop control system to maintain movement stability at slower speech rates.

Impact of communication partner familiarity and speech accuracy on parents’ ratings of their child for the Intelligibility in Context Scale: Dutch

Abstract Purpose: The aim of this study was to examine the role of familiarity of a communication partner on Dutch parents’ perception of their child’s intelligibility, for children with typically-developing speech (TD) or speech sound disorder (SSD). Method: Participants were 67 Dutch-speaking children (48–84 months), 48 with TD and 19 with SSD. Item scores on the parent-rated Intelligibility in Context Scale: Dutch (ICS-NL) were compared between groups and related to naive listeners’ ratings of children’s intelligibility (IR), and a measure of speech accuracy (i.e. percentage of consonants correct-adjusted, PCC-A). Result: Statistical analysis yielded a significant Group by Familiarity interaction on the ICS-NL. Parents rated the intelligibility of their child with SSD as higher with more familiar communication partners than less familiar, more so than parents of children with TD. In the SSD group, IR was more strongly correlated with ICS-NL item scores for less familiar partners. PCC-A was only correlated with ICS-NL item 7 (strangers). Conclusion: Parents perceive their children as more intelligible with people in close relationships, likely due to their higher familiarity with the child’s speech. Children’s relationships should be considered with respect to communicative participation. PCC-A may be a less reliable predictor of participation in family and community life.

Speech Characteristics and Intelligibility in Adults with Mild and Moderate Intellectual Disabilities

Purpose: Adults with intellectual disabilities (ID) often show reduced speech intelligibility, which affects their social interaction skills. This study aims to establish the main predictors of this reduced intelligibility in order to ultimately optimise management. Method: Spontaneous speech and picture naming tasks were recorded in 36 adults with mild or moderate ID. Twenty-five naïve listeners rated the intelligibility of the spontaneous speech samples. Performance on the picture-naming task was analysed by means of a phonological error analysis based on expert transcriptions. Results: The transcription analyses showed that the phonemic and syllabic inventories of the speakers were complete. However, multiple errors at the phonemic and syllabic level were found. The frequencies of specific types of errors were related to intelligibility and quality ratings. Conclusions: The development of the phonemic and syllabic repertoire appears to be completed in adults with mild-to-moderate ID. The charted speech difficulties can be interpreted to indicate speech motor control and planning difficulties. These findings may aid the development of diagnostic tests and speech therapies aimed at improving speech intelligibility in this specific group.