Aim-To determine whether NTrainer patterned orocutaneous therapy affects preterm infants' non-nutritive suck and/or oral feeding success.Subjects-Thirty-one preterm infants (mean gestational age 29.3 weeks) who demonstrated minimal non-nutritive suck output and delayed transition to oral feeds at 34 weeks post-menstrual age.Intervention-NTrainer treatment was provided to 21 infants. The NTrainer promotes nonnutritive suck output by providing patterned orocutaneous stimulation through a silicone pacifier that mimics the temporal organization of suck.Method-Infants' non-nutritive suck pressure signals were digitized in the NICU before and after NTrainer therapy and compared to matched controls. Non-nutritive suck motor pattern stability was calculated based on infants' time-and amplitude-normalized digital suck pressure signals, producing a single value termed the Non-Nutritive Suck Spatiotemporal Index. Percent oral feeding was the other outcome of interest, and revealed the NTrainer's ability to advance the infant from gavage to oral feeding.Results-Multilevel regression analyses revealed that treated infants manifest a disproportionate increase in suck pattern stability and percent oral feeding, beyond that attributed to maturational effects alone. Conclusion-TheNTrainer patterned orocutaneous therapy effectively accelerates non-nutritive suck development and oral feeding success in preterm infants who are at risk for oromotor dysfunction.

Neonatal motor behavior predicts both current neurological status and future neurodevelopmental outcomes. For speech pathologists, the earliest observable patterned oromotor behavior is suck. Suck production requires effective coordination of an infant's oral sensorimotor system and is subject to a variety of neuromodulatory inputs. Demonstration and practice of coordinated suck serves as a biomarker for oral feeding skills neural integrity and is being assessed for its relation to neurodevelopmental outcomes (speech, cognition, and learning) by research teams in the United States, Europe, Japan, and Brazil. Suck may also serve as an intervention point to prevent feeding disorders and mitigate speech-language delays and disorders.

Sensory deprivation and motor restriction associated with extensive oxygen therapy may lead to poor oromotor control in preterm infants. Non-nutritive suck is one of the first complex oromotor behaviors infants perform. This study determined the spatiotemporal variability of non-nutritive suck (NNS) pressure trajectories in three preterm groups with differing oxygen histories-one control group with minimal or no O 2 therapy, and two Respiratory Distress Syndrome (RDS) groups with either a mild/moderate (RDS1) or moderate/severe (RDS2) O 2 history. The Non-nutritive Suck Spatiotemporal Index (NNS STI) quantifies spatial and temporal variability across kinematic trajectories, and was calculated from digital representations of infants' suck pressure signals. An ANCOVA revealed a significant effect for group (p < .001) on the NNS STI measure, with RDS2 infants showing highly variable NNS patterning, and thus relatively underdeveloped suck. Extensive oxygen therapy, which alters the oral sensory environment and reduces motor experiences, disrupts the development of coordinated NNS in preterm infants. KeywordsPremature infant; Respiratory Distress Syndrome; Non-nutritive suck; Oromotor control; Spatiotemporal index; Suck variability; Suck central pattern generator; Oxygen therapy; Motor function Exceptionally premature infants are surviving at an increasing rate, but with the complication of facing extrauterine life with an underdeveloped nervous system and an inability to thrive without support. These infants often exhibit oromotor dyscoordination and are unable to suck and feed orally-a primary reason for extended stay in the neonatal intensive care unit.Timely oromotor development may be disrupted in infants with Respiratory Distress Syndrome (RDS), who are routinely subjected to abnormal tactile stimulation of sensitive peri-and *Corresponding author. University of Kansas, 1000 Sunnyside Avenue, Room 3001, Lawrence,., E-mail address: smbarlow@ku.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. , 1997). Trussing the lower face with tubes and tape also restricts the range and type of oral movements. In animal models, the combination of sensory deprivation and motor restriction has been shown to disrupt the development of key brain structures involved in sensorimotor control, including motor cortex and cerebellum (Pascual and Figueroa, 1996;Pascual et al., 1993Pascual et al., , 1998. This is consistent with the notion of a critical period during early postnatal life, when manipulations in trigeminal sensory systems may significantly alter the structure and functi...

When asked to speak clearly, talkers vary considerably in terms of the amount of intelligibility benefit achieved. The acoustic differences between clear and conversational speech also differ from talker to talker. The present study examined the extent to which clear speech acoustic modifications were consistent with talkers’ descriptions of the strategies they used in the clear speech condition during the recording of a large multitalker database [S. H. Ferguson, J. Acoust. Soc. Am. 116, 2365–2373 (2004)]. Specifically, talkers who did and did not report placing extra stress on keywords in clear speech were compared on a variety of duration, pitch, and amplitude metrics. Results will be discussed in terms of talker differences in awareness of and control of specific aspects of speech production. Clinical implications will also be discussed.

This preliminary study explored changes in prosodic variability during choral reading and investigated whether these changes are affected by the method of eliciting choral reading. Ten typical adult talkers recorded three reading materials (poetry, fiction and textbook) in three reading conditions: solo (reading aloud alone), track (reading aloud with a recording), and choral (reading aloud with another live talker). Measurements of fundamental frequency, amplitude, and vowel duration variability were performed. Compared to solo reading, choral reading featured decreased variability of fundamental frequency, amplitude, and vowel duration. In track reading, only decreased fundamental frequency variability was observed, while vowel duration variability increased. Track reading also contained significantly more errors than choral or solo reading. The reading material used did not significantly affect the prosodic features of talkers' speech, but did affect talkers' error rate. These results suggest that, in studies of choral reading as a fluency-evoking condition, track reading might not be an appropriate substitute. In addition, the text used may affect fluency in these conditions. These results also have theoretical implications for studies of how talkers manipulate and execute the prosodic features of speech.