Search

Hearing loss is one of modern society's most understated and overlooked clinical conditions, with several hundred million people (per WHO) around the world requiring rehabilitation to address "disabling hearing loss." Another large segment of sign language user is 'hearing nonverbal children.' They are nonverbal due to conditions such as down syndrome, autism, cerebral palsy, trauma, and brain disorders or speech disorders. [ABSTRACT FROM AUTHOR]

Assessing vocabulary skills is a crucial aspect of educational interventions for students with disabilities, as it directly influences their academic progress, overall communication abilities, and quality of life. This study aims to explore professionals' perceptions regarding the vocabulary assessments used with students with disabilities. By gaining insights into their perspectives and experiences, we can improve the assessment process and enhance instructional practices, ultimately contributing to a better Quality of Life (QoL) for these students. Data were collected through a survey questionnaire completed by 375 professionals working in the field of special education. The findings indicate that professionals in the private sector express higher satisfaction levels and demonstrate better proficiency in applying vocabulary assessment tools compared to those in the public sector. Furthermore, the results reveal that professionals specializing in speech and language disorders report higher satisfaction levels compared to professionals in other specialized areas. [ABSTRACT FROM AUTHOR]

Background: One of the most prevalent oral health issues affecting mankind is tooth loss. Besides extractions due to periodontal disease and caries, accidents and lack of dental knowledge can also result in tooth loss. Nevertheless, no known published studies have examined how edentulous patients in Uganda have lived with tooth loss. The objective of the present study was to investigate experiences of tooth loss among Ugandan edentulous patients attending Makerere University Dental Hospital. Methods: This was a cross-sectional qualitative study using purposive recruitment of respondents. A total of 15 respondents were chosen from a variety of socio-economic groups. Qualitative data were collected using oral interviews in form of note taking and an audio-recorder. The data collected comprised the causes of tooth loss, the physical and psychological effects of losing teeth, the difficulties in managing oral hygiene when one is toothless, coping mechanisms, and supportive interventions after losing natural teeth. The collected data were transcribed and analyzed thematically using a software, Atlas Ti. The generated qualitative data were summarized as text, while demographic characteristics were presented in a table. Results: Oral infections such as periodontal disease (which destroy tooth supporting tissues), tooth decay and trauma from accidents were reportedly the main causes of tooth loss. In case of tooth pain as a first symptom, most patients choose self-medication with over-the-counter drugs and home remedies. They only consult dental professionals when the condition deteriorates. Tooth loss was associated with problems of eating, facial aesthetics and low self-esteem. Conclusion: The present study found that tooth loss was caused by periodontal disease, tooth decay and trauma from accidents. Loss of teeth was escalated by poor health seeking behavior. Tooth loss resulted in pain, eating difficulties, speech difficulties, poor facial appearance and consequently low self-esteem. [ABSTRACT FROM AUTHOR]

Background: Speech sound disorders (SSDs) in children are heterogeneous. Differentiating children with SSDs into distinct subtypes is important so that each child receives a treatment approach well suited to the particular difficulties they are experiencing. Aims: To study the distinct underlying processes that differentiate phonological processing, phonological planning or motor planning deficits. Method: The literature on the nature of SSDs is reviewed to reveal diagnostic signs at the level of distal causes, proximal factors and surface characteristics. Main Contribution: Subtypes of SSDs may be identified by linking the surface characteristics of the children's speech to underlying explanatory proximal factors. The proximal factors may be revealed by measures of speech perception skills, phonological memory and speech–motor control. The evidence suggests that consistent phonological disorder (CPD) can be identified by predictable patterns of speech error associated with speech perception errors. Inconsistent phonological disorder (IPD) is associated with a deficit in the selection and sequencing of phonemes, that is, revealed as within‐word inconsistency and poor phonological memory. The motor planning deficit that is specific to childhood apraxia of speech (CAS) is revealed by transcoding errors on the syllable repetition task and an inability to produce [pətəkə] accurately and rapidly. Conclusions & Implications: Children with SSDs form a heterogeneous population. Surface characteristics overlap considerably among those with severe disorders, but certain signs are unique to particular subtypes. Careful attention to underlying causal factors will support the accurate diagnosis and selection of personalized treatment options. WHAT THIS PAPER ADDS: What is already known on the subject: SSD in children are heterogenous, with numerous subtypes of primary SSD proposed. Diagnosing the specific subtype of SSD is important in order to assign the most efficacious treatment approach for each child. Identifying the distinct subtype for each child is difficult because the surface characteristics of certain subtypes overlap among categories (e.g., CPD or IPD; CAS). What this paper adds to the existing knowledge: The diagnostic challenge might be eased by systematic attention to explanatory factors in relation to the surface characteristics, using specific tests for this purpose. Word identification tasks tap speech perception skills; repetition of short versus long strings of nonsense syllables permits observation of phonological memory and phonological planning skills; and standard maximum performance tests provide considerable information about speech motor control. What are the potential or actual clinical implications of this work?: Children with SSDs should receive comprehensive assessments of their phonological processing, phonological planning and motor planning skills frequently, alongside examinations of their error patterns in connected speech. Such assessments will serve to identify the child's primary challenges currently and as they change over developmental time. [ABSTRACT FROM AUTHOR]

Background: In response to the call for papers under the theme "What is in a name" proposed by the Scientific Child Speech Committee of the International Association of Communication Sciences and Disorders (IALP), the current paper discusses taxonomy and its relation to speech sound disorders (SSD) from a cross‐linguistic perspective. Aims: This paper starts with a brief description of specific SSD frameworks and nomenclature. Methods & Procedures: The authors draw from international theoretical and clinical research which underscore the importance of taxonomy systems in SSD. Outcomes & Results: The current papers stresses the importance of the contribution to differential diagnosis and prognosis of children with protracted speech profiles on the bases of taxonomy profiles and systems for SSD. Conclusions & Implications: The advantages and shortcomings of taxonomy in SSD are also discussed from a cross‐linguistic context. The language of focus includes the Greek dialectal variation of Cypriot‐Greek. WHAT THIS PAPER ADDS: The paper adds to the importance of taxonomy and SSD subsystems which allow differential diagnosis of SSD and the implementation of appropriate intervention methods. What is already known on this subject: The use of various taxonomy systems regarding SSD are widely available for English‐speaking populations. Such systems in the cross‐linguistic framework remain underexplored. What this paper adds to existing knowledge: The paper underscores the need for the development, adaptation and use of taxonomy systems that will add to the existing databases and taxonomy subsystems used in English What are the potential or actual clinical implications of this work?: Potential clinical implications include the development and implementation of taxonomy systems in profile SSD productions in children. [ABSTRACT FROM AUTHOR]

Background: The publication of phase 2 of the CATALISE project in 2017 clarified terminology for children with developmental language disorder (DLD) or delay but unintentionally muddied the water for children with unintelligible speech. A diagnostic label of DLD (phonology) indicates poor prognosis and phonological disorder that persists into middle childhood. However, in contrast to other diagnostic labels that fall under the overarching term of speech sound disorder (SSD), DLD (phonology) does not elucidate the characteristics of the child's speech nor does it point us in the direction of appropriate intervention. Aims: The aim of this paper is to discuss terminology in SSD leading to an evidence‐based model which builds on the model of DLD developed in CATALISE, supports descriptive diagnosis and signposts intervention. Methods: Following a focused review of literature proposing or describing terminology for SSD, an expert group of researchers in developmental SSD proposed a revised model of existing terminology. Groups of UK speech and language therapists (SLTs) who provide services for children with SSD were asked to comment on its acceptability and feasibility. Discussion: A three‐level terminology model was developed. This comprised an overarching Level 1 term; Level 2 terms that differentiated SSD of unknown origin from SSD with associated or underlying conditions; and specific diagnostic terms at Level 3 to support further assessment and intervention decisions. Consulted SLTs generally expressed agreement with the proposed terminology and a willingness to adopt it in practice. Conclusions: Existing terminology for childhood SSD provides a good basis for clinical decision‐making. A modified version of Dodd's (2005) terminology was found to be acceptable to UK SLTs. There is an evident overlap of SSD with CATALISE terminology. However more detailed and specialist terminology than 'DLD (phonology)' is required to support clinical decision‐making. It is proposed that endorsement by the UK Royal College of Speech and Language Therapists would obviate the need for a Delphi process. What this paper adds: What is already known on this subject: Over nearly a hundred years, as our knowledge and understanding of speech sound disorder (SSD) has increased, so has the terminology that is used to describe those disorders. Current terminology not only describes subtypes of SSD but can also signpost us to effective interventions. With the publication, in 2017, of phase 2 of CATALISE a new term of 'developmental language disorder (DLD) (phonology)' was introduced with the unintentional consequence of challenging more specific descriptive terms for SSD. What this paper adds: In the context of CATALISE and DLD (phonology), the history and nature of SSD terminology are reappraised. Building on the model of DLD developed in CATALISE, a tiered model that supports descriptive diagnosis and signposts intervention is proposed for discussion. Clinical implications of this study: The proposed model of terminology for SSD provides descriptive and detailed labels that will support accuracy in differential diagnosis of developmental SSD by speech and language therapists. Furthermore, a decision‐making tree for SSD demonstrates the pathway from diagnostic use of the terminology to the selection of evidence‐based, effective interventions. [ABSTRACT FROM AUTHOR]

Background: Speech in individuals with cleft lip and/or palate (CLP) is a complex myriad of presenting symptoms. It is uniquely associated with the structural difference of velopharyngeal insufficiency (VPI), together with a wide and heterogeneous range of other aetiologies which often co‐occur. The nature of the speech sound disorder (SSD) including VPI may also change over the course of an individual's care pathway. Differences in terminology and approaches to analysis are currently used, resulting in confusion internationally. Additionally, current diagnostic labels and classification systems in SSD do not capture the complexity and full nature of speech characteristics in CLP. Aims: This paper aims to explore the different aetiologies of cleft palate/VPI speech and to relate aetiology with speech characteristic(s). In so doing, it attempts to unravel the different terminology used in the field, describing commonalities and differences, and identifying overlaps with the speech summary patterns used in the United Kingdom and elsewhere. The paper also aims to explore the applicability of current diagnostic labels and classification systems in the non‐cleft SSD literature and illustrate certain implications for speech intervention in CLP. Methods and Procedures: The different aetiologies were identified from the literature and mapped onto cleft palate/VPI speech characteristics. Different terminology and approaches to analysis are defined and overlaps described. The applicability of current classification systems in SSD is discussed including additional diagnostic labels proposed in the field. Outcomes and Results: Aetiologies of cleft palate/VPI speech identified include developmental (cognitive‐linguistic), middle ear disease and fluctuating hearing loss, altered oral structure, abnormal facial growth, VPI‐structural (abnormal palate muscle) and VPI‐iatrogenic (maxillary advancement surgery). There are four main terminologies used to describe cleft palate/VPI speech: active/passive and compensatory/obligatory, which overlap with the four categories used in the UK speech summary patterns: anterior oral cleft speech characteristics (CSCs), posterior oral CSCs, non‐oral CSCs and passive CSCs, although not directly comparable. Current classification systems in non‐cleft SSD do not sufficiently capture the full nature and complexity of cleft palate/VPI speech. Conclusions and Implications: Our attempt at identifying the heterogeneous range of aetiologies provides clinicians with a better understanding of cleft palate/VPI speech to inform the management pathway and the nature and type of speech intervention required. We hope that the unravelling of the different terminology in relation to the UK speech summary patterns, and those used elsewhere, reduces confusion and provides more clarity for clinicians in the field. Diagnostic labels and classification require international agreement. WHAT THIS PAPER ADDS: What is already known on the subject: Speech associated with cleft palate/velopharyngeal insufficiency (VPI) is a complex myriad of speech characteristics with a wide and heterogeneous range of aetiologies. Different terminology and speech summary patterns are used to describe the speech characteristics. The traditional classification of cleft palate/VPI speech is Articulation Disorder, although evidence is building for Phonological Disorder and contrastive approaches in cleft speech intervention. What this paper adds to existing knowledge: This paper explores the range of aetiologies of cleft palate/VPI speech (e.g., altered oral structure, abnormal facial growth, abnormal palate muscle and iatrogenic aetiologies) and attempts to relate aetiology with speech characteristic(s). An attempt is made at unravelling the different terminology used in relation to a well‐known and validated approach to analysis, used in the United Kingdom and elsewhere. Complexities of current diagnostic labels and classifications in Speech Sound Disorder to describe cleft palate/VPI speech are discussed. What are the potential or actual clinical implications of this work?: There needs to be a common language for describing and summarising cleft palate/VPI speech. Speech summary patterns based on narrow phonetic transcription and correct identification of aetiology are essential for the accurate classification of the speech disorder and identification of speech intervention approaches. There is an urgent need for research to identify the most appropriate type of contrastive (phonological) approach in cleft lip and/or palate. [ABSTRACT FROM AUTHOR]

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. Aims: This 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 Contribution: This 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. Conclusion: The 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 adds: What 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. [ABSTRACT FROM AUTHOR]

An introduction to articles in the issue is presented on topics including the scarcity of disordered speech samples for model training which is an obstacle to developing artificial intelligence (AI)-driven assistive technologies for individuals with speech disabilities, automatic speech recognition (ASR) systems that can be used in real-time conversations by these individuals, and challenges to advance ASR communication tools for those with speech impairments.

Purpose: This study examines the effectiveness of automatic speech recognition (ASR) for individuals with speech disorders, addressing the gap in performance between read and conversational ASR. We analyze the factors influencing this disparity and the effect of speech mode-specific training on ASR accuracy. Method: Recordings of read and conversational speech from 27 individuals with various speech disorders were analyzed using both (a) one speaker-independent ASR system trained and optimized for typical speech and (b) multiple ASR models that were personalized to the speech of the participants with disordered speech. Word error rates were calculated for each speech model, read versus conversational, and subject. Linear mixed-effects models were used to assess the impact of speech mode and disorder severity on ASR accuracy. We investigated nine variables, classified as technical, linguistic, or speech impairment factors, for their potential influence on the performance gap. Results: We found a significant performance gap between read and conversational speech in both personalized and unadapted ASR models. Speech impairment severity notably impacted recognition accuracy in unadapted models for both speech modes and in personalized models for read speech. Linguistic attributes of utterances were the most influential on accuracy, though atypical speech characteristics also played a role. Including conversational speech samples in model training notably improved recognition accuracy. Conclusions: We observed a significant performance gap in ASR accuracy between read and conversational speech for individuals with speech disorders. This gap was largely due to the linguistic complexity and unique characteristics of speech disorders in conversational speech. Training personalized ASR models using conversational speech significantly improved recognition accuracy, demonstrating the importance of domain-specific training and highlighting the need for further research into ASR systems capable of handling disordered conversational speech effectively. [ABSTRACT FROM AUTHOR]

Purpose: The Speech Accessibility Project (SAP) intends to facilitate research and development in automatic speech recognition (ASR) and other machine learning tasks for people with speech disabilities. The purpose of this article is to introduce this project as a resource for researchers, including baseline analysis of the first released data package. Method: The project aims to facilitate ASR research by collecting, curating, and distributing transcribed U.S. English speech from people with speech and/or language disabilities. Participants record speech from their place of residence by connecting their personal computer, cell phone, and assistive devices, if needed, to the SAP web portal. All samples are manually transcribed, and 30 per participant are annotated using differential diagnostic pattern dimensions. For purposes of ASR experiments, the participants have been randomly assigned to a training set, a development set for controlled testing of a trained ASR, and a test set to evaluate ASR error rate. Results: The SAP 2023-10-05 Data Package contains the speech of 211 people with dysarthria as a correlate of Parkinson's disease, and the associated test set contains 42 additional speakers. A baseline ASR, with a word error rate of 3.4% for typical speakers, transcribes test speech with a word error rate of 36.3%. Fine-tuning reduces the word error rate to 23.7%. Conclusions: Preliminary findings suggest that a large corpus of dysarthric and dysphonic speech has the potential to significantly improve speech technology for people with disabilities. By providing these data to researchers, the SAP intends to significantly accelerate research into accessible speech technology. [ABSTRACT FROM AUTHOR]

Purpose: A well-established set of language-specific norms for phonological development is imperative in the assessment of child speech sound difficulties. Currently, English norms are used clinically (in the absence of norms for local languages) to determine if a child displays age-appropriate, delayed or disordered speech patterns in Sinhala. This preliminary exploratory study aimed to document phonological processes observed in typically developing Sinhalaspeaking children aged 3;0–6;11 (years;months). Method: The Test of Articulation and Phonology–Sinhala, a picture-based assessment, was devised by the researchers and administered to 102 Sinhalaspeaking children from three geographical locations (Colombo, Kandy, and Gampaha). The quantitative measures included percent consonants correct, percent vowels correct, and percent phonemes correct, while the qualitative analysis identified phonological processes. Results: The quantitative results showed a marked influence of age on phoneme production accuracy with over 75% consonants correct by 3 years 6 months. The qualitative findings demonstrate common typical phonological processes and less common phonological processes in Sinhala compared to the speech pathology and cross-linguistic literature. Common phonological processes included fronting, stopping, and weak syllable deletion widely documented in linguistic and speech-language pathology literature. Many shared phonological processes were observed between Sinhala and Sri Lankan Tamil, the two main local languages, including fronting of retroflex sounds and lateralization. The phonological process of denasalization of prenasalized stops was observed in Sinhala, with no documentation of the phonological process found within the mainstream speech-language pathology literature. Conclusion and Implications: These findings reinforce the need to document and use language-specific typical phonological processes in Sinhala given the implications for early and accurate identification of speech difficulties and intervention. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATION FOR REHABILITATIONThis study aimed to describe the nature of interactions between health care professionals and a young adult with autism spectrum disorder with limited speech during an inpatient stay. An observational study was conducted to describe the interactions between a young adult on the autism spectrum and 14 of his inpatient health care providers. Naturalistic video-recordings were taken, and behavioral coding was completed to measure the frequency and type of communication turns taken. The providers took 93% of conversational turns. Most provider turns (76%) were non-obligatory in nature and did not invite the young adult to engage in turn-taking. The young adult only had access to his communication system during one of the 27 interactions (4%); however, when he had access to his system, he demonstrated higher levels of turn-taking. Health care providers should offer patients with limited speech more communicative turns, provide adequate wait time, and ensure communication systems are available during all inpatient interactions.Inpatient health care providers dominated interactions with a young adult with autism and limited speech.Most inpatient health care provider turns did not present an opportunity for the patient to respond.The young adultcould not access his communication system for most interactions.Inpatient health care providers dominated interactions with a young adult with autism and limited speech.Most inpatient health care provider turns did not present an opportunity for the patient to respond.The young adultcould not access his communication system for most interactions. [ABSTRACT FROM AUTHOR]

Background & Objective: Oral stage dysphagia mostly caused by frontal lobe lesions. We investigated the relationship between oral hesitation and cognitive impairment after frontal lobe stroke. Methods: We consecutively collected 946 patients with stroke from January 2016 to December 2020. Among them, 38 patients had only frontal lobe lesions. Video fluoroscopic swallowing study (VFSS) was performed in 5 stages from water to solid food. Patients who progressed to solid food are very rare, so we focused on liquid and soft food. Diagnosis of stroke was limited to cases in which cerebral infarction or haemorrhage had been verified by magnetic resonance imaging (MRI). Cognitive impairment was evaluated by MMSE in patients with frontal lobe lesions. Result: Of the total 946 patients, 35 patients with frontal lobe lesions were enrolled in the study. Of them, 22 were judged to have cognitive impairment. The oral hesitation of the liquid component was analysed, and a conclusion was drawn that the group with cognitive impairment showed significant oral hesitation than the group without cognitive impairment. On the other hand, in the case of soft food, it was found that there was no correlation between cognition and oral hesitation. Conclusion: It was confirmed that oral hesitation during swallowing in patients with frontal lobe stroke had a meaningful relationship with cognition, and oral hesitation during swallowing was significantly higher in liquid swallowing rather than soft food. [ABSTRACT FROM AUTHOR]

The intelligibility of speech is a primary component to assess the severity level of Dysarthria, a speech disorder, which is caused not only due to weakness in vocal motor muscles but also difficulty in controlling its movements. Prior information about the severity of Dysarthria, aids the therapist during the rehabilitation process. This paper introduces a novel hybrid architecture comprising Gaussian Mixture Model and Neural Network (GMM-NN) for categorizing Dysarthric severity into four classes based on speech intelligibility. Mel Frequency Cepstral Coefficients (MFCC) extracted from the segmented speech signals are used to train the classifier. The proposed model produced a 1.9% improvement in accuracy when compared to the baseline Gaussian Mixture Model (GMM). The Gaussian Mixture Model Deep Neural Network (GMM-DNN) and Gaussian Mixture Model Feed Forward Neural Network (GMM-FFNN) architectures showed an accuracy of 96.7% and 96.42% with F1 scores of 0.9649, 0.9604 respectively. [ABSTRACT FROM AUTHOR]

Background: Our study aims to understand whether depression, either in pregnancy or lifetime, affects cognitive biases (comprising the attentional focus and affective state) and mentalizing features (ability to understand children's internal mental states, thereby detecting and comprehending their behavior and intention), in maternal speech during mother‐infant interaction in the first postnatal year. Methods: We recruited 115 pregnant women (44 healthy, 46 with major depressive disorder [MDD] in pregnancy, and 25 with a history of MDD but healthy pregnancy) at 25 weeks' gestation. Three‐minute videos were recorded at 8 weeks and 12 months postnatally for each dyad. Maternal speech was transcribed verbatim and coded for cognitive biases and mentalizing comments using the Parental Cognitive Attributions and Mentalization Scale (PCAMs). Results: Women suffering from antenatal depression showed a decreased proportion of mentalizing comments compared with healthy women, at both 8 weeks (0.03 ± 0.01 vs. 0.07 ± 0.01, P = 0.002) and 12 months (0.02 ± 0.01 vs. 0.04 ± 0.01, P = 0.043). Moreover, compared with healthy women, both those with antenatal depression and those with a history of depression showed decreased positive affection in speech (0.13 ± 0.01 vs. 0.07 ± 0.01 and 0.08 ± 0.02, respectively P = 0.003 and P = 0.043), and made significantly fewer comments focused on their infants' experience at 8 weeks (0.67 ± 0.03 vs. 0.53 ± 0.04 and 0.49 ± 0.05, respectively P = 0.015 and P = 0.005). In linear regression models women's socioeconomic difficulties and anxiety in pregnancy contribute to these associations, while postnatal depression did not. Conclusions: Both antenatal depression and a lifetime history of depression are associated with a decreased quality of women's speech to their infants, as shown by less focus on their infant's experience, decreased positive affection, and less able to mentalize. Examining maternal speech to their infants in the early postnatal months may be particularly relevant to identify women who could benefit from strategies addressing these aspects of the interactive behavior and thus improve infant outcome in the context of depression. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResultConclusionTo examine the effectiveness of communication-oriented group therapy for non-progressive dysarthria regarding functional speech and communicative participation.Prospective two-arm randomised controlled trial, targeting communication-oriented dysarthria group therapy (DGT). A non-specific social group program served as the control condition/group (CG). Participants’ speech was assessed immediately before and after completing the respective three week program, using a standardised diagnostic test (objective outcome measure). Participants rated the extent of their communication participation immediately before and after group therapy, as well as three months after program completion (subjective outcome measure).Fifty-six persons aged 40–88 years with mild to severe dysarthria (median duration 29 days) from an inpatient facility participated. Prior to the intervention, self-rated communication participation correlated with severity of dysarthria. Immediately after the intervention, DGT participants achieved significantly higher scores than the CG on both outcome measures. After three months, the difference between groups in the subjective outcome measure was no longer significant.Participation in DGT resulted in improved speech and better communication participation. Results suggest that three weeks may be too short to ensure maintenance of treatment gains. Also, reduced opportunity for social interaction due to COVID-19 restrictions may have influenced the results. [ABSTRACT FROM AUTHOR]

Objective: To compare the levels of functional impairments, discomfort and satisfaction experienced by those treated with full-mouth customized lingual appliances (Lingual appliances), full-mouth self-ligating bracket (Labial appliances), or upper lingual and lower labial appliances (Mixed appliances) using questionnaires. Materials and methods: Patients within one year of the end of treatment were included in the survey and given a questionnaire concerning different kinds of discomfort and difficulties during the treatment process. The questionnaires focused on the following aspects including speech difficulty, pain (lip, cheek or tongue), difficulty in chewing, difficulty in tooth brushing and overall aesthetics and comfortability. Ordinary one-way ANOVA Tukey's multiple comparison tests and Kruskal–Wallis tests were employed to analyze the data. Results: A total of 115 patients participated in the study. In terms of functional impairments and discomfort, the rate and degree of speech difficulty was significantly higher in the Lingual appliances Group than that in the Labial appliances Group. But there was no difference among the three groups for difficulty in chewing and tooth brushing. Both lingual and labial appliances caused a similar level of overall pain, however, those treated with lingual appliances experienced more tongue pain, and those treated with labial appliances experienced more cheek and lip pain. The most common sites of irritation were the tongue lateral and tongue tip in the Lingual appliances Group, tongue lateral and cheek in the Mixed appliances Group, and cheek and lower lip in the Labial appliances Group. In total, patients gave highest scores to mixed appliances for comfortability and lowest scores to labial appliances for aesthetics when it came to satisfaction. Conclusions: Lingual and labial appliances caused similar level of overall pain. Taking into account the overall comfortability, aesthetics and cost, the mixed appliances may be suitable for some patients who have aesthetic and comfort pursuits. [ABSTRACT FROM AUTHOR]

Background: Marchiafava-Bignami disease (MBD) is an exceptionally rare condition, a fact that should pique the professional curiosity of medical practitioners. In recent years, case reports of this disease have been infrequent, and no comprehensive analysis or summary of the characteristics of the published cases has been conducted. Methods: We collected the medical records of three patients treated at our hospital from March 2022 to March 2023. Furthermore, we searched PubMed for "case reports" from January 2017 to March 2023 and included 30 cases. By retrospectively analyzing these 33 cases, we summarized the characteristics of the disease. Results: Based on our analysis, we found that MBD primarily affects middle-aged men and typically has an acute or subacute onset, with the primary clinical manifestations being disturbances of consciousness, speech disorders, cognitive impairment, and psychiatric or behavioral abnormalities, often leading to misdiagnosis of psychiatric disorders. Most patients have a history of alcohol consumption or malnutrition. Head CT or MRI revealed symmetric lesions in the corpus callosum, with the splenium being the most commonly affected area. Lesions might also involve white matter outside the corpus callosum, and a wider range of lesions suggested a poor prognosis. However, the prognosis is generally favorable with timely and adequate administration of B vitamins, providing reassurance to medical professionals and patients alike. Conclusion: The early recognition and treatment of Marchiafava-Bignami disease are paramount, as they can significantly improve the prognosis. This underscores the critical need for prompt clinical intervention in the early stages of the disease, instilling a sense of urgency and significance in the work of medical professionals. [ABSTRACT FROM AUTHOR]

Behavioral speech tasks have been widely used to understand the mechanisms of speech motor control in typical speakers as well as in various clinical populations. However, determining which neural functions differ between typical speakers and clinical populations based on behavioral data alone is difficult because multiple mechanisms may lead to the same behavioral differences. For example, individuals with cerebellar ataxia (CA) produce atypically large compensatory responses to pitch perturbations in their auditory feedback, compared to typical speakers, but this pattern could have many explanations. Here, computational modeling techniques were used to address this challenge. Bayesian inference was used to fit a state feedback control (SFC) model of voice fundamental frequency (fo) control to the behavioral pitch perturbation responses of speakers with CA and typical speakers. This fitting process resulted in estimates of posterior likelihood distributions for five model parameters (sensory feedback delays, absolute and relative levels of auditory and somatosensory feedback noise, and controller gain), which were compared between the two groups. Results suggest that the speakers with CA may proportionally weight auditory and somatosensory feedback differently from typical speakers. Specifically, the CA group showed a greater relative sensitivity to auditory feedback than the control group. There were also large group differences in the controller gain parameter, suggesting increased motor output responses to target errors in the CA group. These modeling results generate hypotheses about how CA may affect the speech motor system, which could help guide future empirical investigations in CA. This study also demonstrates the overall proof-of-principle of using this Bayesian inference approach to understand behavioral speech data in terms of interpretable parameters of speech motor control models. Author summary: Cerebellar ataxia is a condition characterized by a loss of coordination in the control of muscle movements, including those required for speech, due to damage in the cerebellar region of the brain. Behavioral speech experiments have been used to understand this disorder's impact on speech motor control, but the results can be ambiguous to interpret. In this study, we fit a computational model of the neural speech motor control system to the speech data of speakers with cerebellar ataxia and the data of typical speakers to determine what differences in model parameters best explain how the two groups differ in their control of vocal pitch. We found that group differences may be explained by increased sensitivity to auditory feedback prediction errors (differences between the actual sound speakers hear of their own speech as they produce it and the sound they expected to hear) and increased motor response in individuals with cerebellar ataxia. These computational results help us understand how cerebellar ataxia impacts speech motor control, and this general approach can also be applied to study other neurological speech disorders. [ABSTRACT FROM AUTHOR]

Background Aim Materials & Methods Results Discussion Conclusion Developmental stuttering, a multifactorial speech disorder with remarkable rate of spontaneous recovery pose challenges for gene discoveries. Exonic variants in GNPTAB, GNPTG, and NAGPA involved in lysosomal pathway and AP4E1, IFNAR1, and ARMC3‐signaling genes reported till date explain only ∼2.1% – 3.7% of persistent stuttering cases.We aimed to identify additional genetic determinants of stuttering in a multiplex family by exome sequencing (n = 27) and further validation on additional extended family members (n = 21).We employed hypothesis‐free and pathway‐based analyses.A novel heterozygous exonic variant NM_016256.4:c.322G > A in NAGPA with reduced penetrance and predicted pathogenicity segregated with the phenotype in a large subset of the family. Reanalysis to identify additional disease‐causing variant(s) revealed exonic heterozygous variants each in RIMS2 and XYLT1 in severely affected members; and IGF2R variant in a small subset of the family. Furthermore, pathway‐based analysis uncovered NM_022089.4:c.3529G > A in ATP13A2 (PARK9) in affected members; and variants in GNPTAB and GNPTG of minor significance in a few affected members.Genotype–phenotype correlation efforts suggest that the combined effect of gene variants at multiple loci or variants in a single gene in different subsets of the pedigree (genetic heterogeneity) may be contributing to stuttering in this family. More importantly, variants identified in ATP13A2, a Parkinson's disease gene also implicated in lysosomal dysfunction, and RIMS2 suggests for the first time a likely role of dopamine signaling in stuttering.Screening for these variants in independent stuttering cohorts would be astute. [ABSTRACT FROM AUTHOR]

Childhood apraxia of speech (CAS) is a severe and rare form of speech sound disorder (SSD). CAS is typically sporadic, but may segregate in families with broader speech and language deficits. We hypothesize that genetic changes may be involved in the etiology of CAS. We conduct whole-genome sequencing in 27 families with CAS, 101 individuals in all. We identify 17 genomic regions including 19 unique copy number variants (CNVs). Three variants are shared across families, but the rest are unique; three events are de novo. In four families, siblings with milder phenotypes co-inherited the same CNVs, demonstrating variable expressivity. We independently validate eight CNVs using microarray technology and find many of these CNVs are present in children with milder forms of SSD. Bioinformatic investigation reveal four CNVs with substantial functional consequences (cytobands 2q24.3, 6p12.3-6p12.2, 11q23.2-11q23.3, and 16p11.2). These discoveries show that CNVs are a heterogeneous, but prevalent, cause of CAS. Copy number variations identified in families with childhood apraxia of speech and other speech sound disorders provide a deeper understanding of the genetic basis for naturally acquired speech. [ABSTRACT FROM AUTHOR]

Background: Children with speech sound disorders (SSD) form a heterogeneous group, with respect to severity, etiology, proximal causes, speech error characteristics, and response to treatment. Infants develop speech and language in interaction with neurological maturation and general perceptual, motoric, and cognitive skills in a social-emotional context. Purpose: After a brief introduction into psycholinguistic models of speech production and levels of causation, in this review article, we present an in-depth overview of mechanisms and processes, and the dynamics thereof, which are crucial in typical speech development. These basic mechanisms and processes are: (a) neurophysiological motor refinement, that is, the maturational articulatory mechanisms that drive babbling and the more differentiated production of larger speech patterns; (b) sensorimotor integration, which forms the steering function from phonetics to phonology; and (c) motor hierarchy and articulatory phonology describing the gestural organization of syllables, which underlie fluent speech production. These dynamics have consequences for the diagnosis and further analysis of SSD in children. We argue that current diagnostic classification systems do not do justice to the multilevel, multifactorial, and interactive character of the underlying mechanisms and processes. This is illustrated by a recent Dutch study yielding distinct performance profiles among children with SSD, which allows for a dimensional interpretation of underlying processing deficits. Conclusions: Analyses of mainstream treatments with respect to the treatment goals and the speech mechanisms addressed show that treatment programs are quite transparent in their aims and approach and how they contribute to remediating specific deficits or mechanisms. Recent studies into clinical reasoning reveal that the clinical challenge for speech-language pathologists is how to select the most appropriate treatment at the most appropriate time for each individual child with SSD. We argue that a process-oriented approach has merits as compared to categorical diagnostics as a toolbox to aid in the interpretation of the speech profile in terms of underlying deficits and to connect these to a specific intervention approach and treatment target. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to investigate child- and interventionlevel factors that predict improvements in functional communication outcomes in children with motor-based speech sound disorders. Method: Eighty-five preschool-age children with childhood apraxia of speech (n = 37) and speech motor delay (n = 48) participated. Multivariable logistic regression models estimated odds ratios and 95% confidence intervals for the association between minimal clinically important difference in the Focus on the Outcomes of Communication Under Six scores and multiple child-level (e.g., age, sex, speech intelligibility, Kaufman Speech Praxis Test diagnostic rating scale) and intervention-level predictors (dose frequency and home practice duration). Results: Overall, 65% of participants demonstrated minimal clinically important difference changes in the functional communication outcomes. Kaufman Speech Praxis Test rating scale was significantly associated with higher odds of noticeable change in functional communication outcomes in children. There is some evidence that delivering the intervention for 2 times per week for 10 weeks provides benefit. Conclusion: A rating scale based on task complexity has the potential for serving as a screening tool to triage children for intervention from waitlist and/or determining service delivery for this population. [ABSTRACT FROM AUTHOR]

A preface to the special issue of the "Journal of Speech, Language, and Hearing Research," that includes select papers from the Eighth International Conference on Speech Motor Control, is presented.

Purpose: The purpose of this study was to investigate acoustic spatiotemporal variability in children with childhood apraxia of speech (CAS) compared to children with typical development (TD). Increased spatiotemporal variability in children with CAS relative to nonapraxic peers has been documented in multiple kinematic studies. To date, few studies have investigated spatiotemporal variability in CAS using an acoustic signal. Method: Data were drawn from 10 children with CAS and 10 children with TD, ranging in age from 5;0 to 11;2 (years;months), who participated in an online study. All children with CAS had a verified diagnosis and showed at least five CAS features across at least two tasks, independently confirmed by two speech-language pathologists with expertise in CAS. Children repeated the sentences "Buy Bobby a puppy" (BBAP) and "Mom pets the puppy" (MPP) 10 times each. The acoustic spatiotemporal index (STI), calculated from the amplitude envelope, was used to investigate acoustic spatiotemporal variability. Using a regression analysis, we analyzed group differences in STI values while controlling for age and gender. Results: Children with CAS did not produce enough usable tokens of BBAP to analyze. MPP revealed significantly higher acoustic STI values in children with CAS compared to children with TD. No significant effects were observed for age or gender. Acoustic data collected online without the use of specialized equipment yielded high-quality audio data from which amplitude envelope tracing could be reliably accomplished. Conclusions: This study adds to a growing body of empirical data indicating that children with CAS produce speech with more variable spatiotemporal control compared to children with TD. In addition to producing more variable speech, children with CAS were less consistently able to form productions free of phonetic errors. These findings also demonstrate the feasibility of using remote data collection to investigate acoustic spatiotemporal variability, which allows for the recruitment of larger samples of low-incidence populations. [ABSTRACT FROM AUTHOR]

The few studies assessing the affective reactions of different groups of respondents to this disorder reported that their physiological or emotional responses were negative. The purpose of this study was to determine the influence of college students’ gender and major on their feelings and attitudes towards a peer who stutters. The study was conducted with 342 college students aged 19–33 years from different majors. Their attitudes to stuttering peers were evaluated by the Sękowski’s Attitudes Toward Disabled Persons Scale (ATDPS) and feelings by the Positive and Negative Affect Scale (PANAS). The study revealed that some gender-major interactions were associated with less negative feelings and attitudes towards stuttering peers and that different emotions about a stuttering peer led to different attitudes. In male students, the main moderating effect of the major on the relationship between negative feelings and negative attitudes was only established for students of economics. The major of female students also differentiated the relationship between negative feelings and attitudes. Teaching programmes for helping majors (paramedics/nurses) stimulate students’ positive feelings towards persons who stutter. Students in non-helping majors may need special soft skill training to develop positive attitudes towards persons with speech fluency disorders. [ABSTRACT FROM AUTHOR]

Objective: Hoarding disorder is a complex condition that significantly impacts individuals' lives, characterized by excessive acquiring, difficulty discarding, clutter, distress, and impairment. This study aimed to examine the extent to which genetics and environment influence difficulty discarding, excessive acquisition, and clutter through the implementation of a classical twin study. Method: This classical twin study, conducted between April and September 2021, enrolled 194 twins (97 pairs) from Isfahan, recruited through the Isfahan Twins Registry (ITR). A total of 194 twins, consisting of 100 monozygotic (MZ) and 94 dizygotic (DZ) twins, participated in this study. Participants aged 16-50 were invited electronically and completed an online consent form and questionnaire. Hoarding symptoms were assessed using the saving inventory-revised. Zygosity was determined using a self-report method based on Song et al.'s questionnaire. To estimate the heritability of hoarding symptoms, the classical univariate twin model was employed. Results: Based on the univariate analysis, the heritability estimates for difficulty discarding and excessive acquisition were found to be 0.43 and 0.52, respectively. However, the results did not provide support for the role of genetics in clutter. Instead, it was indicated that the common environment accounted for 0.54 of the variance in clutter, while the specific environment contributed 0.46 to this symptom. Conclusion: The difficulty discarding and excessive acquisition were found to be moderately heritable. On the other hand, considering the contribution of genetics and environment to clutter, the results raise doubts about the association of clutter with hoarding. The relatively low genetic influence suggests that this trait may overlap with other behaviors rather than hoarding. [ABSTRACT FROM AUTHOR]

The article focuses on an 11-year-old boy presenting with slurred speech and involuntary movements, later diagnosed with a neurological disorder. Topics include his clinical symptoms such as dysarthria and abnormal involuntary movements, his physical exam findings including hyperreflexia and abnormal gait, and the absence of significant prior medical or family history.

Purpose: National surveys of speech-language pathologists' (SLP) practices play an important role in professional development, and previous research show that many challenges faced by the profession are similar across the globe. This study aims to describe Swedish SLP assessment practices, examine factors that may affect this practice, and discuss the results in the light of international studies. Methods: Data from 584 SLPs were collected through an online questionnaire with multiple choice and open-ended questions. A mixed-method design was deployed where a deductive qualitative analysis of free-text responses complemented quantitative data. Results: In line with previous results from English-speaking countries, both standardized discrete skill tests and contextualized assessments were used by the respondents but fewer used language sample analysis and dynamic assessment procedures, despite international recommendations. There were few differences based on experience, work setting, proportion of multilingual assessments and socio-economic status of the health catchment area. Main challenges reported were lack of time and difficulty prioritizing, and assessment and/or diagnosis of multilingual/L2 children, which is similar to challenges faced by SLPs in other countries. Swedish SLPs also reported lack of national clinical guidelines as a main challenge. Factors contributing to better assessments included experience, and the combination of many sources of information, including professional and interprofessional discussions. Conclusions: The accumulated evidence from this and previous studies show that to address challenges and build on strengths, changes on a systemic level are needed. This includes more time and resources for continuing education and implementation of recommended assessment methods, as well as professional and interprofessional collaborations. [ABSTRACT FROM AUTHOR]

Copyright of Logopedia e Comunicazione is the property of Edizioni Centro Studi Erickson SpA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The purpose of this study was to analyse the relationship between automatic vowel articulation index (aVAI) and direct magnitude estimation (DME) among speakers with Parkinson's disease (PD) and healthy controls. We further analysed the potential of aVAI to serve as an objective measure of speech impairment in the clinical setting. Method: Speech samples from native Finnish speakers were utilised. Expert raters utilised DME to scale the intelligibility of speech samples. aVAI scores for PD speakers and healthy control speakers were analysed in relationship to DME speech intelligibility ratings and, among PD speakers, disease stage utilising nonparametric statistical analysis. Result: Mean DME intelligibility ratings were lower among PD speakers compared to healthy controls. Mean aVAI scores were nearly the same between speaker groups. DME intelligibility ratings and aVAI were strongly correlated within the PD speaker group. aVAI and DME intelligibility ratings were moderately correlated with disease stage as measured by the Hoehn and Yahr scale. Conclusion: aVAI was observed to be a promising tool for analysing vowel articulation in PD speakers. Further research is warranted on the application of aVAI as an objective measure of severity of speech impairment in the clinical setting, with varying patient populations and speech samples. [ABSTRACT FROM AUTHOR]

Research often finds persons with a disability, persons who are transgender non-conforming (TGNC), or who are sexual minorities experience increased victimization risk. Less research has examined how these identities intersect to impact victimization risk. Thus, our study adds to the literature by examining how these identities intersect to influence risk of violent, sexual, and intimate partner violence (IPV) victimization among a national-level sample of college students. In doing so, we explore the interactions between having any disability and being TGNC and being a sexual minority on victimization risk. In addition, specific disability types are explored for their potential interactive effects. Findings show increased risk of sexual victimization and IPV victimization among those who identify as TGNC and have a disability. Specific disability types, speech and mobility, interacted with gender identity to impact risk. Our findings suggest the need for universities to implement inclusive and culturally competent prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

\nIntroduction: The Toolkit to Examine Lifelike Language (TELL) is a web-based application providing speech biomarkers of neurodegeneration. After deployment of TELL v.1.0 in over 20 sites, we now introduce TELL v.2.0. Methods: First, we describe the app’s usability features, including functions for collecting and processing data onsite, offline, and via videoconference. Second, we summarize its clinical survey, tapping on relevant habits (e.g., smoking, sleep) alongside linguistic predictors of performance (language history, use, proficiency, and difficulties). Third, we detail TELL’s speech-based assessments, each combining strategic tasks and features capturing diagnostically relevant domains (motor function, semantic memory, episodic memory, and emotional processing). Fourth, we specify the app’s new data analysis, visualization, and download options. Finally, we list core challenges and opportunities for development. Results: Overall, TELL v.2.0 offers scalable, objective, and multidimensional insights for the field. Conclusion: Through its technical and scientific breakthroughs, this tool can enhance disease detection, phenotyping, and monitoring. Neurodegenerative disorders (NDs), such as Alzheimer’s and Parkinson’s disease, are a leading cause of disability, caregiver stress, and financial strain worldwide. The number of cases, now estimated at 60 million, will triple by 2050. Early detection is crucial to improve treatments, management, and financial planning. Unfortunately, standard diagnostic methods are costly, stressful, and often hard to access due to scheduling delays and availability issues. A promising alternative consists in digital speech analysis. This affordable, noninvasive approach can identify NDs based on individuals’ voice recordings and their transcriptions. In 2023, we launched the Toolkit to Examine Lifelike Language (TELL), an online app providing robust speech biomarkers for clinical and research purposes. This paper introduces TELL v.2.0, a novel version with improved data collection, encryption, processing, storing, download, and visualization features. First, we explain the app’s basic operations and its possibilities for online and offline data collection. Second, we describe its language survey, which covers questions about demographics as well as language history, usage, competence, and difficulties. Third, we describe TELL’s speech tests, which assess key clinical features. Fourth, we outline the app’s functions for analyzing, visualizing, and downloading data. We finish by discussing the main challenges and future opportunities for TELL and the speech biomarker field. With this effort, we hope to boost the use of digital speech markers in medical and research fields. [ABSTRACT FROM AUTHOR]

Aim Method Results Interpretation To evaluate a group of children with epilepsy and motor speech regression, with the aim of characterizing their speech disorders, electrographic features, and outcomes.Children referred to a tertiary developmental epilepsy clinic with epilepsy and motor speech regression were identified retrospectively. A clinical history was taken, and longitudinal speech and cognitive data were recorded. Speech samples were scored for severity and speech features. Seizure frequency and epileptiform discharges in the interictal electroencephalogram were analysed.Eighteen children (10 female) were evaluated, including seven with Landau–Kleffner syndrome and six with Rasmussen syndrome. Speech regression occurred at a mean age of 5 years (SD = 2 years 6 months), which was concurrent with seizure onset or peak seizure burden in eight children. Speech features included dysarthria (n = 13), phonological errors (n = 7), and dyspraxia (n = 6). Electrographic abnormalities occurred most frequently in the left centrotemporal and right frontal regions. Among children who were followed up, intelligibility of speech was affected in 13 at baseline and seven at follow‐up (p = 0.03). Expressive language standardized scores increased from a mean (SD) of 50.0 (11.3) to 91.4 (27.8) in children with Landau–Kleffner syndrome (mean change = 41.4, 95% confidence interval [CI] 0.04–82.8, p = 0.0498) and decreased from 75.2 (15.3) to 59.0 (9.8) in children with Rasmussen syndrome (mean change −16.2, 95% CI −9.0 to −23.4, p = 0.002) over the follow‐up.Motor speech disorders in epilepsy were severe, multifarious, and often fluctuated with seizure burden. Symptoms typically improved, especially in children with Landau–Kleffner syndrome, but rarely fully resolved. [ABSTRACT FROM AUTHOR]