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.
UUV results were consistent with those of other variability indices and thus appear to capture motor control issues in a similar way. The results suggest that the UUV could be developed into an easy-to-use clinical tool that could function as a valid and reliable assessment and outcome measure.
Background Progressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach. A new model of care—ClearSpeechTogether—is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias. Method This feasibility study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over 2 weeks followed by 20 patient-led group sessions over 4 weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation. Results Nine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved reading intelligibility and increased participation and confidence. Participant interviews highlighted the value of group support internalisation of speech strategies and psycho-social wellbeing. Discussion ClearSpeechTogether presented a feasible, acceptable intervention for a small cohort of people with progressive ataxia. It matched or exceeded the outcomes previously reported following individual therapy. Particularly notable was the fact that this could be achieved through patient led practice without the presence of a clinician. Pending confirmation of our results by larger, controlled trials, ClearSpeechTogether could represent an effective approach to manage speech problems in ataxia.
Background: With respect to the clinical criteria for diagnosing childhood apraxia of speech (commonly defined as a disorder of speech motor planning and/or programming), research has made important progress in recent years. Three segmental and suprasegmental speech characteristics-error inconsistency, lengthened and disrupted coarticulation, and inappropriate prosody-have gained wide acceptance in the literature for purposes of participant selection. However, little research has sought to empirically test the diagnostic validity of these features. One major obstacle to such empirical study is the fact that none of these features is stated in operationalized terms. Purpose: This tutorial provides a structured overview of perceptual, acoustic, and articulatory measurement procedures that have been used or could be used to operationalize and assess these 3 core characteristics. Methodological details are reviewed for each procedure, along with a short overview of research results reported in the literature. Conclusion: The 3 types of measurement procedures should be seen as complementary. Some characteristics are better suited to be described at the perceptual level (especially phonemic errors and prosody), others at the acoustic level (especially phonetic distortions, coarticulation, and prosody), and still others at the kinematic level (especially coarticulation, stability, and gestural coordination). The type of data collected determines, to a large extent, the interpretation that can be given regarding the underlying deficit. Comprehensive studies are needed that include more than 1 diagnostic feature and more than 1 type of measurement procedure. F rom a historical perspective, childhood apraxia of speech (CAS) is a controversial clinical entity, with respect to both clinical signs and underlying deficit. In 1981, Guyette and Diedrich had concluded that "…No pathognomonic symptoms or necessary and sufficient conditions were found for the diagnosis…" (p. 44) and critically termed CAS as "a label in search of a population" (p. 39). Despite clinical studies to further characterize CAS (e.g.,
Auditory feedback plays an important role in speech motor learning. Previous studies investigating auditory feedback in speech development suggest that crucial steps are made in the development of auditory-motor integration around the age of 4. The present study investigated compensatory and adaptive responses to auditory perturbation in 4 to 9 year-old children compared to young adults (aged 19-29 years). Auditory feedback was perturbed by real-time shifting the first and second formant (F1 and F2) of the vowel /e:/ during the production of CVC words in a five-step paradigm (familiarization; baseline; ramp; hold; release). Results showed that the children were able to compensate and adapt in a similar or larger degree compared to the young adults, even though the proportion of speakers displaying a consistent compensatory response was higher in the group of adults. In contrast to previous reports, results did not show differences in token-to-token variability between children and adults.
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