Paula A. Square

Common Considerations In The Study of Limb, Verbal And Oral Apraxia

Contemporary empirical research regarding both verbal and limb apraxia is considered within the framework of a neuropsychological perspective which views the apraxias as involving dysfunctions of either a cognitive-linguistic system or a motor-production system. The apractic disorders are compared as they reflect disruptions to these two systems. Comparisons include types of errors observed, stimulus and response variables which influence the errors observed and the environmental conditions under which the observed errors occur.

A Set of Observational Measures for Rating Support and Participation in Conversation Between Adults with Aphasia and Their Conversation Partners

Abstract Conversation partners of individuals with aphasia, including health care professionals, families, and others, play a role that is as important for communication as the language disorder suffered by individuals with aphasia. Two complementary measures designed to capture elements of conversation between adults with aphasia and their speaking conversation partners have been developed. The first measure provides an index of the conversation partner’s skill in providing conversational support. The second provides an index of the level of participation in conversation by the person with aphasia. This article describes the development of the measures, including preliminary psychometric data, and discusses applications.

Speech motor control in fluent and dysfluent speech production of an individual with apraxia of speech and Broca's aphasia

Apraxia of speech (AOS) is typically described as a motor‐speech disorder with clinically well‐defined symptoms, but without a clear understanding of the underlying problems in motor control. A number of studies have compared the speech of subjects with AOS to the fluent speech of controls, but only a few have included speech movement data and if so, this was primarily restricted to the study of single articulators. If AOS reflects a basic neuromotor dysfunction, this should somehow be evident in the production of both dysfluent and perceptually fluent speech. The current study compared motor control strategies for the production of perceptually fluent speech between a young woman with apraxia of speech (AOS) and Brocas aphasia and a group of age‐matched control speakers using concepts and tools from articulation‐based theories. In addition, to examine the potential role of specific movement variables on gestural coordination, a second part of this study involved a comparison of fluent and dysfluent speech samples from the speaker with AOS. Movement data from the lips, jaw and tongue were acquired using the AG‐100 EMMA system during the reiterated production of multisyllabic nonwords. The findings indicated that although in general kinematic parameters of fluent speech were similar in the subject with AOS and Brocas aphasia to those of the age‐matched controls, speech task‐related differences were observed in upper lip movements and lip coordination. The comparison between fluent and dysfluent speech characteristics suggested that fluent speech was achieved through the use of specific motor control strategies, highlighting the potential association between the stability of coordinative patterns and movement range, as described in Coordination Dynamics theory.

Task demands and limb apraxia in stroke.

The present study was designed to examine the frequency and severity of apraxia in patients with left- or right-hemisphere stroke in both pantomime and imitation conditions and to compare the frequency of apraxia in each stroke group across the three patterns of apraxia described in Roys model (Roy, 1996). Ninety-nine stroke patients and 15 age-matched healthy adults performed eight transitive gestures to pantomime and to imitation. Gestural performance was quantified as accuracy on five performance dimensions; a composite score, an arithmetic combination of the five performance dimensions, was used as an index of the overall accuracy. Analyses revealed a comparable proportion of patients in each stroke group were classified as apraxic in the imitation condition, but a higher proportion of left stroke patients were apraxic in the pantomime condition. The severity of apraxia in each stroke group and the performance dimensions affected were, however, comparable. Analyses of the patterns of apraxia (pantomime alone, imitation alone or apraxia in both conditions) revealed a higher frequency of apraxia in both stroke groups for the pattern reflecting apraxia in both conditions, indicating that a disruption at the movement execution stage of gesture performance was most common.

Effects of PROMPT therapy on speech motor function in a person with aphasia and apraxia of speech

This research examined the effectiveness of PROMPT treatment, a tactile–kinaesthetic speech motor treatment, on the acquisition and generalisation of precision and automaticity of speech movements in an individual with Brocas aphasia and apraxia of speech. Using a single subject multiple probe design across behaviours, treatment effects and generalisation were examined for three linguistically different forms of sentences including imperatives, active declaratives, and interrogatives. Results indicated improved speech precision and sequencing of speech movements for trained and untrained sentences for imperative and active declarative forms only. There was no effect of treatment on the interrogatives. Findings are discussed in the context of motor facilitation and its relationship to the linguistic complexity of utterances. Furthermore, the relevance of the interface between motor– linguistic processes in individuals with aphasia and apraxia of speech and implications for resource allocation constructs are addressed.

Neuropsychology of Movement Sequencing Disorders and Apraxia

Publisher Summary This chapter describes neuropsychology of movement sequencing disorders and apraxia. Apraxia is a disorder affecting the ability to pantomime or execute previously familiar, intimate gestures, following brain damage. Familiar, well-known gestures involving the use of objects or interpersonal communication and novel, meaningless hand gestures are both affected. Identifying apraxia typically involves noting the occurrence of particular types of performance errors. One of the most well known is termed a body-part-as-object error in which the hand is used as if it were the object. Much of the work on apraxia points to the importance of damage to the left hemisphere, particularly the parietal, prefrontal, and supramarginal areas. This hemisphere is thought to subserve a praxis system used to control gestural movements with both hands as damage to this hemisphere, especially in the parietal area, produces apraxia bilaterally. Unimanual expressions of apraxia that usually affect the left hand arise primarily in the context of a right hemiparesis or callosal damage.

Case Study of the Redevelopment of Motor Speech Control Following Acquired Brain Damage in Early Childhood

This article presents retrospective longitudinal perceptual and acoustic analyses of the recovery of motor speech control in a right-handed 5-year-old male in the 46 weeks following acquired brain ...

Multi-sensory treatment for children with developmental motor speech disorders

What this paper adds? What is already known on the subject? Multi-sensory treatment approaches have been shown to impact outcome measures positively, such as accuracy of speech movement patterns and speech intelligibility in adults with motor speech disorders, as well as in children with apraxia of speech, autism and cerebral palsy. However, there has been no empirical study using multi-sensory treatment for children with speech sound disorders (SSDs) who demonstrate motor control issues in the jaw and orofacial structures (e.g. jaw sliding, jaw over extension, inadequate lip rounding/retraction and decreased integration of speech movements). What this paper adds? Findings from this study indicate that, for speech production disorders where both the planning and production of spatiotemporal parameters of movement sequences for speech are disrupted, multi-sensory treatment programmes that integrate auditory, visual and tactile–kinesthetic information improve auditory and visual accuracy of speech production. The training (practised in treatment) and test words (not practised in treatment) both demonstrated positive change in most participants, indicating generalization of target features to untrained words. It is inferred that treatment that focuses on integrating multi-sensory information and normalizing parameters of speech movements is an effective method for treating children with SSDs who demonstrate speech motor control issues.