Syllabic Diadochokinesis in Adults With and Without Traumatic Brain Injury: Severity, Stability, and Speech Considerations

Abstract

Purpose Syllabic diadochokinesis (DDK) is a standard assessment task for motor speech disorders. This study aimed to compare rate and regularity of DDK according to the presence or absence of traumatic brain injury (TBI) and severity of TBI, examine the stability of DDK over time, and explore associations between DDK and extemporaneous speech. Method Military service members and veterans were categorized into three groups: no history of TBI (control), uncomplicated mild TBI (mTBI), and moderate through severe (including penetrating) TBI (msTBI). Participants produced rapid alternating-motion and sequential-motion syllable repetitions during one or two sessions. A semi-automated protocol determined syllabic rate and regularity. Perceptual ratings of selected participants' connected speech samples were compared to DDK results. Results Two hundred sixty-three service members and veterans provided data from one session and 69 from two sessions separated by 1.9 years ( SD = 1.0). DDKs were significantly slower overall for mTBI and msTBI groups compared to controls. Regularity of productions did not differ significantly across groups. A significant Group × Task interaction revealed that the msTBI group produced sequential-motion syllable repetitions but not alternating-motion repetitions with greater regularity, whereas the opposite occurred for control and mTBI groups. DDK results did not differ significantly between sessions. Perceptual speech analysis for 30 participants, including 20 with atypical or questionable DDK performance, revealed two participants with mildly abnormal speech. Conclusions Overall, DDK productions are slower than normal in adults with moderate, severe, and penetrating TBI and are stable over time. Regularity of productions did not differentiate groups, although this result differed according to task. There were surprisingly few people identified with disordered speech, making comparisons to DDK data tenuous, and indicating that dysarthria is a rare complication in a population of adults with mostly uncomplicated mTBI who are not selected from referrals to a speech-language pathology clinic.

Articulation Rate, Pauses, and Disfluencies in Professional Fighters: Potential Speech Biomarkers for Repetitive Head Injury

“…The Rainbow Passage has a reading grade level of 5.5, 53 and although all participants completed at least the 10th grade, their reading ability was not assessed. To minimize the impact of these factors, we plan to examine diadochokinetic rates for repeated speech syllables to capture speech motor behavior as has been done recently for military service members and veterans with TBI 54 and athletes with sports-related concussion. 55 In addition, we are examining verbal fluency and discourse characteristics to more fully understand cognitive and linguistic deficits in fighters.…”

The Syllable And Word In Diadochokinetic Javanese - Indonesia Speakers

“…Diadochokinetic is a choice to predict an individual's speaking performance. Specifically, in adult individual, diadochokinetic performance informs speaking ability in individuals with speech motor disorder (Duffy, 2013;Shipley & McAfee, 2021;Solomon et al, 2021). Not too different from adult individual, the performance of diadochokinetic activity in child is the indicator of speaking performance (Kent et al, 1987).…”

“…The problem of speech motor disorders, dysarthria or apraxia, need diagnosis examination as information in deciding differential diagnosis (Duffy, 2013). Some other conditions having used diadochokinetic as a part of speech evaluation are, among others, individual with traumatic brain injury (Solomon et al, 2021), voice disorder (Lombard & Solomon, 2020;Maturo et al, 2012); dyslexia (Duranovic & Sehic, 2013); child with auditory disorder or cochlear implant (Eskander et al, 2013); Parkinson's Disease (Gómez et al, 2019); anatomic disorder, e.g. cleft lip and palate and velocardiofacial syndrome (Kummer et al, 2007); phonological disorder (Tafiadis et al, 2021); and individual with schizophrenic problem (Putzhammer et al, 2005).…”

On the Primary Influences of Age on Articulation and Phonation in Maximum Performance Tasks

“…Diadochokinesis is generally described as the ability to make antagonistic movements in quick succession, and is used in speechlanguage pathology testing to provide valuable clinical information regarding neuromuscular control and coordination. The task is also widely used as a base for detecting early signs of disease-related speech impairment (Karlsson and Hartelius 2019;Karlsson et al 2020;Novotny et al 2020;Rong 2020;Solomon et al 2021). How age affects oral diadochokinesis has not been thoroughly investigated, but some results suggest that syllable repetitions/papapa, tatata, kakaka/(Alternating Motion Rates, AMR) and/patakapataka/ (Sequential Motion Rates, SMR) produced by older adults are slower and more variable both in duration and amplitude compared to younger adults (Amerman and Parnell 1992;Parnell and Amerman 1987).…”