Single-Word Speech Intelligibility in Children and Adults With Down Syndrome

Purpose

A single-word identification test was used to study speech production in children and adults with Down syndrome (DS) to determine the developmental pattern of speech intelligibility with an emphasis on vowels.

Method

Speech recordings were collected from 62 participants with DS aged 4–40 years and 25 typically developing participants aged 4–7 years. Panels of 5 adult lay listeners transcribed the speech recordings orthographically, and their responses were scored in comparison with the speakers’ target words.

Results

Speech intelligibility in persons with DS improved with age, especially between the ages of 4 and 16 years. Whereas consonants contribute to intelligibility, vowels also played an important role in reduced intelligibility with an apparent developmental difference in low versus high vowels, where the vowels /æ/ and/ɑ/ developed at a later age than /i/ and /u/. Interspeaker variability was large, with male individuals being generally less intelligible than female individuals and some adult men having very low intelligibility.

Conclusion

Results show age-related patterns in speech intelligibility in persons with DS and identify the contribution of dimensions of vowel production to intelligibility. The methods used clarify the phonetic basis of reduced intelligibility, with implications for assessment and treatment.

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Single-Word Speech Intelligibility in Children and Adults With Down Syndrome

Model-Driven Treatment of Childhood Apraxia of Speech: Positive Effects of the Speech Motor Learning Approach

Purpose

The aim of the study was to propose the speech motor learning approach (Van der Merwe, 2011) as a treatment for childhood apraxia of speech and to determine if it will effect positive change in the ability of a 33-month-old child to produce untreated nonwords and words containing treated age-appropriate consonants (Set 1 sounds), untreated age-appropriate consonants (Set 2), and untreated age-inappropriate consonants (Set 3) and also to determine the nature and number of segmental speech errors before and after treatment.

Method

An A-B design with multiple target measures and follow-up was implemented to assess the effects of treatment of Set 1. Effect sizes for whole-word accuracy were determined, and two criterion lines were generated following the conservative dual criterion method. Speech errors were judged perceptually.

Results

Conservative dual criterion analyses indicated no reliable treatment effect due to rising baseline scores. Effect sizes showed significant improvement in whole-word accuracy of untreated nonwords and real words containing age-appropriate treated sounds and real words containing age-appropriate untreated sounds. The number of errors for all three sound sets declined. Sound distortion was the most frequent error type.

Conclusions

Preliminary evidence suggests potentially positive treatment effects. However, rising baseline scores limit causal inference. Replication with more children of different ages is necessary.

Supplemental Materials

https://doi.org/10.23641/asha.5596708

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Model-Driven Treatment of Childhood Apraxia of Speech: Positive Effects of the Speech Motor Learning Approach

Comparing Traditional Service Delivery and Telepractice for Speech Sound Production Using a Functional Outcome Measure

Purpose

Using American Speech-Language-Hearing Association’s (ASHA’s) National Outcomes Measurement System (NOMS) Functional Communication Measure (FCM) as a common metric, this investigation compared traditional service delivery and telepractice service delivery for children receiving therapy for the NOMS diagnostic category of “speech sound production.”

Method

De-identified cases were secured from ASHA’s NOMS database and a proprietary database from a private e-learning provider. Cases were included if they met 3 criteria: (a) children received treatment exclusively for speech sound production, (b) they were between 6.0 and 9.5 years old, and (c) they received therapy lasting between 4 and 9 months. A total of 1,331 ASHA NOMS cases and 428 telepractice cases were included. The 2 groups were matched by initial FCM scores. Mann–Whitney U tests were completed to compare differences in the median change scores (the difference between the initial and final FCM scores) between the 2 groups.

Results

There were no significant differences in the median change scores between the traditional group and the telepractice group.

Conclusions

These results suggest comparable treatment outcomes between traditional service delivery and telepractice for treatment of children exhibiting speech sound disorders. The findings provide support for the use of telepractice for school-age children.

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Comparing Traditional Service Delivery and Telepractice for Speech Sound Production Using a Functional Outcome Measure

Delivering Bad News: Attitudes, Feelings, and Practice Characteristics Among Speech-Language Pathologists

Purpose

The purpose of this study was to examine the attitudes, feelings, and practice characteristics of speech-language pathologists (SLPs) in Israel regarding the subject of delivering bad news.

Method

One hundred and seventy-three Israeli SLPs answered an online survey. Respondents represented SLPs in Israel in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed emotions involved in the process of delivering bad news, training on this subject, and background information of the respondents. Frequency distributions of the responses of the participants were determined, and Pearson correlations were computed to determine the relation between years of occupational experience and the following variables: frequency of delivering bad news, opinions regarding training, and emotions experienced during the process of bad news delivery.

Results

Our survey showed that bad news delivery is a task that most participants are confronted with from the very beginning of their careers. Participants regarded training in the subject of delivering bad news as important but, at the same time, reported receiving relatively little training on this subject. In addition, our survey showed that negative emotions are involved in the process of delivering bad news.

Conclusions

Training SLPs on specific techniques is required for successfully delivering bad news. The emotional burden associated with breaking bad news in the field of speech-language pathology should be noticed and addressed.

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Delivering Bad News: Attitudes, Feelings, and Practice Characteristics Among Speech-Language Pathologists

Articulatory Kinematic Characteristics Across the Dysarthria Severity Spectrum in Individuals With Amyotrophic Lateral Sclerosis

Purpose

The current study investigated whether articulatory kinematic patterns can be extrapolated across the spectrum of dysarthria severity in individuals with amyotrophic lateral sclerosis (ALS).

Method

Temporal and spatial articulatory kinematic data were collected using electromagnetic articulography from 14 individuals with dysarthria secondary to ALS and 6 typically aging speakers. Speech intelligibility and speaking rate were used as indices of severity.

Results

Temporal measures (duration, speed of articulators) were significantly correlated with both indices of severity. In speakers with dysarthria, spatial measures were not correlated with severity except in 3 measures: tongue movement displacement was more reduced in the anterior–posterior dimension; jaw movement distance was greater in the inferior–superior dimension; jaw convex hull area was larger in speakers with slower speaking rates. Visual inspection of movement trajectories revealed that overall spatial kinematic characteristics in speakers with severe dysarthria differed qualitatively from those in speakers with mild or moderate dysarthria. Unlike speakers with dysarthria, typically aging speakers displayed variable tongue movement and minimal jaw movement.

Conclusions

The current study revealed that spatial articulatory characteristics, unlike temporal characteristics, showed a complicated pattern across the severity spectrum. The findings suggest that articulatory characteristics in speakers with severe dysarthria cannot simply be extrapolated from those in speakers with mild-to-moderate dysarthria secondary to ALS.

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Articulatory Kinematic Characteristics Across the Dysarthria Severity Spectrum in Individuals With Amyotrophic Lateral Sclerosis

Narrative Language Sampling in Typical Development: Implications for Clinical Trials

Purpose

This study examined cross-sectional age-related trajectories of expressive language variables (syntactic complexity, lexical diversity, unintelligibility, dysfluency, and talkativeness) derived from a narrative language sampling procedure.

Method

Narrative samples were analyzed from 103 typically developing individuals, ages 4–21 years.

Results

Results showed that this procedure was effective for the entire age range, with participants producing an utterance on virtually every page of the wordless picture books used to prompt the narrative. Importantly, the cross-sectional trajectories for syntactic complexity and lexical diversity showed age-related increases through the age of 18 years, although measures of other dimensions of language showed different relationships with age.

Conclusions

These data inform developmental work and document the extent to which the narrative procedure can be used to characterize expressive language over a wide age range. This procedure has been proposed as an outcome measure for clinical trials and interventions involving individuals with intellectual and developmental disabilities. The present data document the developmental levels for which the procedure and metrics derived are appropriate.

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Narrative Language Sampling in Typical Development: Implications for Clinical Trials

Brain–Computer Interfaces for Augmentative and Alternative Communication: A Tutorial

Purpose

Brain–computer interfaces (BCIs) have the potential to improve communication for people who require but are unable to use traditional augmentative and alternative communication (AAC) devices. As BCIs move toward clinical practice, speech-language pathologists (SLPs) will need to consider their appropriateness for AAC intervention.

Method

This tutorial provides a background on BCI approaches to provide AAC specialists foundational knowledge necessary for clinical application of BCI. Tutorial descriptions were generated based on a literature review of BCIs for restoring communication.

Results

The tutorial responses directly address 4 major areas of interest for SLPs who specialize in AAC: (a) the current state of BCI with emphasis on SLP scope of practice (including the subareas: the way in which individuals access AAC with BCI, the efficacy of BCI for AAC, and the effects of fatigue), (b) populations for whom BCI is best suited, (c) the future of BCI as an addition to AAC access strategies, and (d) limitations of BCI.

Conclusion

Current BCIs have been designed as access methods for AAC rather than a replacement; therefore, SLPs can use existing knowledge in AAC as a starting point for clinical application. Additional training is recommended to stay updated with rapid advances in BCI.

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Brain–Computer Interfaces for Augmentative and Alternative Communication: A Tutorial