Oral Articulatory Control in Childhood Apraxia of Speech

Abstract

Purpose The purpose of this research was to examine spatial and temporal aspects of articulatory control in children with apraxia of speech (CAS), children with speech delay characterized by an articulation/phonological impairment (SD) and typically developing controls (TD) during speech tasks that increase in word length. Method The participants included 33 children between three and seven years of age (11 CAS, 11 SD, and 11 TD). A motion capture system was used to track jaw, lower lip and upper lip movement during a naming task. Movement duration, velocity, displacement, and variability were measured from accurate word productions. Results Movement variability was significantly higher in the children with CAS as compared to participants in the SD and TD groups. Differences in temporal control were seen between both groups of speech-impaired children and the TD controls during accurate word productions. As word length increased, movement duration and variability differed between the CAS and SD children. Conclusions These findings provide evidence that movement variability distinguishes children with CAS from speakers with SD. Kinematic differences between the CAS and SD participants suggest that these groups respond differently to linguistic challenges.

Desempenho de crianças com distúrbios dos sons da fala no instrumento "Avaliação dinâmica das habilidades motoras da fala"

“…Children with apraxia of speech present deficits as variability in the point of articulation increases, as well as word extension, showing difficulties even when cues are provided (24) , as it can be verified in Table 2. This was observed in the tasks involving different syllabic structures and consonant substitutions, but mainly in polysyllabic words, in which five of the six children with CAS presented difficulties in articulation and, consequently, in speech accuracy.…”

“…Speech patterns in children with PD include omission, substitution of vowels and consonants, additions, and distortions associated with articulatory impairment, as well as the systematic use of phonological process (24)(25)(26)(27) . Children with PD presented poorer performance in overall articulatory accuracy compared with those of children with typical speech acquisition (TSA), considering that the latter did not present substitutions in their utterances, as it can be verified in Table 5.…”

Respiratory training in an individual with amyotrophic lateral sclerosis

“…Approximately 85% of individuals with ALS experience dysphagia, or swallowing impairment, leading to malnutrition, dehydration, aspiration, pneumonia, reduced psychosocial health, and morbidity 2, 3. Progressive rigidity and weakness of the diaphragm, internal intercostals and abdominal muscles also contribute to impairments in the ability to generate adequate subglottic air pressure to produce a protective and effective cough 4, 5. We recently documented impaired airway defense mechanisms in ALS patients who aspirated on videofluoroscopic exam with no patient able to produce an effective cough response to remove tracheal aspirate 6.…”

“…We recently documented impaired airway defense mechanisms in ALS patients who aspirated on videofluoroscopic exam with no patient able to produce an effective cough response to remove tracheal aspirate 6. Given the recent findings denoting a predictive relationship between peak cough flow and cough volume acceleration on airway safety during swallowing in ALS,7 management strategies to improve or maintain subglottic air pressure generation and cough strength have been recommended to prolong pulmonary health and nutritional intake 5…”

“…Although historically controversial, recent animal9 and human data5 indicate a potential role for active interventions, performed early, at low intensities, to improve or maintain physiologic function and slow the rate of diminishing physiologic reserve in individuals with ALS. Expiratory muscle strength training (EMST) has been shown to improve subglottic air pressure generation, cough strength, and swallowing function in other neurodegenerative populations (see10 for review).…”