Marisa Lousada

Standardization of a phonetic-phonological test for European-Portuguese children.

Objective: To develop and standardize a phonetic-phonological test (Teste Fonético-Fonológico-Avaliação da Linguagem Pré-Escolar, TFF-ALPE) for the assessment of European-Portuguese (EP) children’s articulation and phonological abilities. Patients and Methods: In order to standardize TFF-ALPE, 768 children aged 3;0–6;11 participated in this study. The standardization, validity and reliability of TFF-ALPE were analyzed. Results: TFF-ALPE presents strong cohesion and has strong inter- and intrajudge reliability. There was also a strong correlation between the TFF-ALPE data and those obtained in other studies. The content validity was demonstrated by the description of the test domain and the items that comprise TFF-ALPE. Conclusion: TFF-ALPE is a valid and reliable phonetic-phonological assessment instrument that speech-language pathologists can use with EP-speaking children.

Intelligibility as a Clinical Outcome Measure Following Intervention with Children with Phonologically Based Speech-Sound Disorders.

BACKGROUND The effectiveness of two treatment approaches (phonological therapy and articulation therapy) for treatment of 14 children, aged 4;0-6;7 years, with phonologically based speech-sound disorder (SSD) has been previously analysed with severity outcome measures (percentage of consonants correct score, percentage occurrence of phonological processes and phonetic inventory). Considering that the ultimate goal of intervention for children with phonologically based SSD is to improve intelligibility, it is curious that intervention studies focusing on childrens phonology do not routinely use intelligibility as an outcome measure. It is therefore important that the impact of interventions on speech intelligibility is explored. AIMS This paper investigates the effectiveness of the two treatment approaches (phonological therapy and articulation therapy) using intelligibility measures, both in single words and in continuous speech, as the primary outcome. METHODS & PROCEDURES Fourteen children with phonologically based SSD participated in the intervention. The children were randomly assigned to phonological therapy or articulation therapy (seven children in each group). Two assessment methods were used for measuring intelligibility: a word identification task (for single words) and a rating scale (for continuous speech). Twenty-one unfamiliar adults listened and judged the childrens intelligibility. Reliability analyses showed overall high agreement between listeners across both methods. OUTCOMES & RESULTS Significant improvements were noted in intelligibility in both single words (paired t(6)=4.409, p=0.005) and continuous speech (asymptotic Z=2.371, p=0.018) for the group receiving phonology therapy pre- to post-treatment, but no differences in intelligibility were found for those receiving the articulation therapy pre- to post-treatment, either for single words (paired t(6)=1.763, p=0.128) or continuous speech (asymptotic Z=1.442, p=0.149). CONCLUSIONS & IMPLICATIONS Intelligibility measures were sensitive enough to show changes in the phonological therapy group but not in the articulation therapy group. These findings emphasize the importance of using intelligibility as an outcome measure to complement the results obtained with other severity measures when exploring the effectiveness of speech interventions. This study presents new evidence for the effectiveness of phonological therapy in improving intelligibility with children with SSD.

Temporal acoustic correlates of the voicing contrast in European Portuguese stops

This study focuses on the temporal analysis of stops /p b t d k g/ and devoicing analysis of voiced stops /b d g/ produced in different word positions by six native speakers of European Portuguese. The study explores acoustic properties related to voicing. The following acoustic properties were measured: voice onset time (VOT), stop duration, closure duration, release duration, voicing into closure duration, duration of the preceding vowel and duration of the following vowel. Results suggested that when [b d g] were devoiced, the acoustic properties stop duration, closure duration, duration of the following vowel, duration of the preceding vowel and duration of voicing into closure were relevant for the voicing distinction. Implications for research and practice in speech and language therapy are discussed. Further investigation is needed to find how the productions analysed in the present study were perceived by listeners, specifically productions of devoiced stops.

Análise temporal das oclusivas orais do Português Europeu: um estudo de caso de normalidade e perturbação fonológica

PURPOSE: this paper submits a study on the duration of the different phases of stops produced by two children, one of them with phonological disturbance (speaker 2). METHODS: the corpus includes 54 real words, with stop consonants in initial, medial and final position. In this study two of European Portuguese (EP) native speakers, aged between seven and eight years, took part. RESULTS: the results for the EP speaker 1 showed that the total duration of voiceless stop consonants was greater than voiced stop consonants. The VOT was, in general, larger for voiceless stops than in voiced stop consonant. Speaker 2 (with phonological disorder) devoiced the stop [g], and the stop consonant [d] was devoiced in initial position and voiced in medial and final position. The stop consonant [b] was normally voiced. CONCLUSION: most of the analyzed durations show similar values for both speakers.

Estimação das características espectrais relacionadas com o ponto de articulação de oclusivas utilizando a técnica multitaper

This study focuses on the spectral characteristics of the European Portuguese stops /p, b, t, d, k, g/ produced by six native speakers. We analysed the spectral peaks and troughs by means of multitaper spectra and performed a parameterisation of the stop spectra using slope and moment measures. In comparison to traditional spectral estimations, multitaper is more exact and, more importantly, not limited to a stationary signal length necessary for the analysis window. Therefore, it is well-suited for the rather short duration of the burst of a stop. Results show that the burst characteristics vary with place of articulation. While the global spectral frequencies match the data in classical literature, it is shown that other spectral measures in our data do not follow the typical classical spectral patterns. It is discussed whether these differences are due to the use of different methodology, or substantial cross-linguistic differences in the spectral characteristics.

The Table to Tablet (T2T) therapy software development approach

This paper presents the Table to Tablet (T2T) project therapy software development approach, which aims to provide a reliable and valid solution for speech and language therapists to work with children with speech sound disorders (SSD). The currently available intervention materials for this kind of paediatric disorder have not been tested or validated and digital materials are scarce. For the T2T project, new tabletop materials and web based intervention software have been developed and results from testing them in a group of seven children with SSD are currently being analysed. Future work will compare the effectiveness of a tabletop approach versus a digital one.

The clinical practice of speech and language therapists with children with phonologically based speech sound disorders

Children with speech sound disorders (SSD) represent a large number of speech and language therapists’ caseloads. The intervention with children who have SSD can involve different therapy approaches, and these may be articulatory or phonologically based. Some international studies reveal a widespread application of articulatory based approaches in children with different SSD. In Portugal no survey has been previously conducted about speech and language therapists (SLTs) practices when working with children with SSD, so it is still unknown how SLTs treat children with SSD. This study aims to explore the use of different intervention approaches of SLTs in Portugal, and to describe the approaches most frequently used in treating children who have phonologically based SSD. Data collection was conducted through a questionnaire available on the web platform Advanced Communication and Swallowing Assessment (ACSA; http://acsa.web.ua.pt), and data analysis was based on 88 responses, corresponding to 5% of the total Portuguese SLTs population. Results showed that the intervention approaches most used with children who have SSD are phonological awareness (97% of the participants), auditory discrimination (92%), meaningful minimal contrast therapy (75%) and parent-based work (58%). The great majority of SLTs combined several approaches in their intervention. There was also a high percentage of SLTs that used articulation based approaches, namely articulation work (31%) in cases of phonologically based disorders. Most (63%) SLTs used weekly interventions over a period of more than six months (51%). The data presented here agrees with the results obtained in South African, UK and USA studies in terms of the approaches most frequently used in intervention with children who have phonologically based SSD. Regarding the frequency and duration of intervention, there is a discrepancy between the results obtained and what is commonly used across research. The characteristics described by the Portuguese SLTs for establishing the differential diagnosis of SSD do not always reflect the evidence available in recent literature. The findings presented in this article revealed the intervention approaches that SLTs currently use to treat children with phonologically based SSD and the theoretical foundations that guide their clinical practice. This allows the reader to compare clinical practice of SLTs across countries and research studies.

Generalization and maintenance of treatment gains in primary progressive aphasia (PPA): a systematic review.

BACKGROUND Cognitive-linguistic treatments and interventions targeting communication have been developed within the context of primary progressive aphasia (PPA), however knowledge about the scope of generalization and maintenance of therapy gains considering PPA subtypes remains scarce and awaits systematic investigation. AIMS To analyse the effects of semantic therapy on generalization and maintenance of treatment outcomes in individuals with PPA, considering its different subtypes. METHODS & PROCEDURES Central, PubMed, Medline, Web of Knowledge and Scopus were used to retrieve articles of interest. A total of 25 non-randomized studies published between 2000 and 2016 met the eligibility criteria and therefore were included in this study. MAIN CONTRIBUTION This systematic review provides evidence-based information for clinical practice in PPA. Generalization and maintenance effects post-treatment for each PPA variant are analysed and discussed. Several factors are described as important to maximize the scope for generalization and maintenance of treatment gains. CONCLUSIONS & IMPLICATIONS Generalization is particularly hard to achieve in the semantic variant, as in the face of degraded semantic knowledge learning is rigid and context dependent. In contrast, non-fluent and logopenic variants offer better scope for generalization. Maintenance patterns do not seem to be influenced by PPA subtype, but rather by other factors such as continued practice, treatment length and frequency of sessions. In the future, clinicians should consider the PPA subtype when planning the treatment protocol.

Visual stimuli in intervention approaches for pre-schoolers diagnosed with phonological delay

Abstract The aim of this study was to develop and content validate specific speech and language intervention picture cards: The Letter-Sound (L&S) cards. The present study was also focused on assessing the influence of these cards on letter-sound correspondences and speech sound production. An expert panel of six speech and language therapists analysed and discussed the L&S cards based on several criteria previously established. A Speech and Language Therapist carried out a 6-week therapeutic intervention with a group of seven Portuguese phonologically delayed pre-schoolers aged 5;3 to 6;5. The modified Bland–Altman method revealed good agreement among evaluators, that is the majority of the values was between the agreement limits. Additional outcome measures were collected before and after the therapeutic intervention process. Results indicate that the L&S cards facilitate the acquisition of letter-sound correspondences. Regarding speech sound production, some improvements were also observed at word level. The L&S cards are therefore likely to give phonetic cues, which are crucial for the correct production of therapeutic targets. These visual cues seemed to have helped children with phonological delay develop the above-mentioned skills.

Phonological processes in Portuguese children with speech sound disorders

Abstract This study investigates the nature of phonological impairment in 20 pre- and early school Portuguese children with phonologically based Speech Sound Disorders (SSD). The phonological profile of these children was compared with the performance of 232 younger typically developing (TD) controls. Results showed differences in phonological acquisition of children with phonologically based SSD, namely a low percentage of correct consonants score and a higher percentage of occurrences of typical phonological processes. Children with phonologically based SSD also used phonological processes (e.g., backing and initial consonant deletion) that are considered unusual in normally developing children and were not observed in the TD group. Results for SSD children also showed that early acquisition consonants were substituted by later acquisitions. Children with SSD presented differences in phonological acquisition, unusual phonological processes, and replaced early acquisition consonants by later acquisition consonants. This knowledge is useful for speech and language therapists in the diagnosis and treatment of SSD.