Apraxia of speech and the study of speech production impairments: Can we avoid further confusion? Reply to Romani (2021)

Mailend, Marja-Liisa; Maas, Edwin; Story, Brad H.

doi:10.1080/02643294.2021.2009790

Cited by 2 publications

(2 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Maximum total score is 52 and the recommended cut-off value for an AOS diagnosis is ≥8 points ( 42 ). The descriptors for each level of rating are: (0) not observed in any task/no more than one occurrence”; (1) “infrequent/noted more than once”; (2) “frequent but not pervasive/noted in 20–50% of all utterances, but not on most tasks or utterances”; (3) “nearly always evident but not marked in severity/noted on many utterances on most tasks but not enough to decrease overall intelligibility” and (4) “nearly always evident and marked in severity/noted on most utterances on most tasks and severe enough to impact intelligibility.” The ASRS is increasingly used in studies of AOS, as for example by Clark et al ( 44 ), Mailend et al ( 45 ) and Staiger et al ( 46 ), and the total score has been found to be a reliable measure of AOS severity after stroke ( 47 ). However, some of the items on the ASRS require a certain level of speech production to be ratable in accordance with the formulations of level descriptors.…”

Section: Methodsmentioning

confidence: 99%

“…Considering earlier observed limitations in assessing individuals with severe AOS with the ASRS ( 48 ), the choice to use it in this study may seem irrational. However, because of the increasing support for the ASRS, becoming a standard instrument in the AOS literature ( 45 ), the ASRS was still our choice. To adjust the ratings in line with the severity level in the study sample, a number of modifications presented in Table 1 were applied.…”

Section: Methodological Considerations and Study Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Longitudinal changes in functional connectivity in speech motor networks in apraxia of speech after stroke

et al. 2022

View full text Add to dashboard Cite

ObjectiveThe cerebral substrates of apraxia of speech (AOS) recovery remain unclear. Resting state fMRI post stroke can inform on altered functional connectivity (FC) within cortical language networks. Some initial studies report reduced FC between bilateral premotor cortices in patients with AOS, with lowest FC in patients with the most severe AOS. However, longitudinal FC studies in stroke are lacking. The aims of the present longitudinal study in early post stroke patients with AOS were (i) to compare connectivity strength in AOS patients to that in left hemisphere (LH) lesioned stroke patients without a speech-language impairment, (ii) to investigate the relation between FC and severity of AOS, aphasia and non-verbal oral apraxia (NVOA) and (iii) to investigate longitudinal changes in FC, from the subacute phase to the chronic phase to identify predictors of AOS recovery.MethodsFunctional connectivity measures and comprehensive speech-language assessments were obtained at 4 weeks and 6 months after stroke in nine patients with AOS after a LH stroke and in six LH lesioned stroke patients without speech-language impairment. Functional connectivity was investigated in a network for speech production: inferior frontal gyrus (IFG), anterior insula (aINS), and ventral premotor cortex (vPMC), all bilaterally to investigate signs of adaptive or maladaptive changes in both hemispheres.ResultsInterhemispheric vPMC connectivity was significantly reduced in patients with AOS compared to LH lesioned patients without speech-language impairment. At 6 months, the AOS severity was associated with interhemispheric aINS and vPMC connectivity. Longitudinal changes in FC were found in individuals, whereas no significant longitudinal change in FC was found at the group level. Degree of longitudinal AOS recovery was strongly associated with interhemispheric IFG connectivity strength at 4 weeks.ConclusionEarly interhemispheric IFG connectivity may be a strong predictor of AOS recovery. The results support the importance of interhemispheric vPMC connection in speech motor planning and severity of AOS and suggest that also bilateral aINS connectivity may have an impact on AOS severity. These findings need to be validated in larger cohorts.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodological Considerations and Study Limitationsmentioning

confidence: 99%

Longitudinal changes in functional connectivity in speech motor networks in apraxia of speech after stroke

et al. 2022

View full text Add to dashboard Cite

show abstract

How to cut the pie is no piece of cake: Toward a process‐oriented approach to assessment and diagnosis of speech sound disorders

Littlejohn

Maas

2023

Intl J Lang & Comm Disor

View full text Add to dashboard Cite

Background‘Speech sound disorder’ is an umbrella term that encompasses dysarthria, articulation disorders, childhood apraxia of speech and phonological disorders. However, differential diagnosis between these disorders is a persistent challenge in speech pathology, as many diagnostic procedures use symptom clusters instead of identifying an origin of breakdown in the speech and language system.AimsThis article reviews typical and disordered speech through the lens of two well‐developed models of production—one focused on phonological encoding and one focused on speech motor planning. We illustrate potential breakdown locations within these models that may relate to childhood apraxia of speech and phonological disorders.Main ContributionThis paper presents an overview of an approach to conceptualisation of speech sound disorders that is grounded in current models of speech production and emphasises consideration of underlying processes. The paper also sketches a research agenda for the development of valid, reliable and clinically feasible assessment protocols for children with speech sound disorders.ConclusionThe process‐oriented approach outlined here is in the early stages of development but holds promise for developing a more detailed and comprehensive understanding of, and assessment protocols for speech sound disorders that go beyond broad diagnostic labels based on error analysis. Directions for future research are discussed.What this paper addsWhat is already known on the subject Speech sound disorders (SSD) are heterogeneous, and there is agreement that some children have a phonological impairment (phonological disorders, PD) whereas others have an impairment of speech motor planning (childhood apraxia of speech, CAS). There is also recognition that speech production involves multiple processes, and several approaches to the assessment and diagnosis of SSD have been proposed.What this paper adds to existing knowledge This paper provides a more detailed conceptualisation of potential impairments in children with SSD that is grounded in current models of speech production and encourages greater consideration of underlying processes. The paper illustrates this approach and provides guidance for further development. One consequence of this perspective is the notion that broad diagnostic category labels (PD, CAS) may each comprise different subtypes or profiles depending on the processes that are affected.What are the potential or actual clinical implications of this work? Although the approach is in the early stages of development and no comprehensive validated set of tasks and measures is available to assess all processes, clinicians may find the conceptualisation of different underlying processes and the notion of potential subtypes within PD and CAS informative when evaluating SSD. In addition, this perspective discourages either/or thinking (PD or CAS) and instead encourages consideration of the possibility that children may have different combinations of impairments at different processing stages.

show abstract

Apraxia of speech and the study of speech production impairments: Can we avoid further confusion? Reply to Romani (2021)

Cited by 2 publications

References 54 publications

Longitudinal changes in functional connectivity in speech motor networks in apraxia of speech after stroke

Longitudinal changes in functional connectivity in speech motor networks in apraxia of speech after stroke

How to cut the pie is no piece of cake: Toward a process‐oriented approach to assessment and diagnosis of speech sound disorders

Contact Info

Product

Resources

About