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BMJ (Clinical Research Ed.) May 2015
Review
Topics: Child; Child Development; Child, Preschool; Developmental Disabilities; Humans; Language Development Disorders; Language Therapy; Prevalence; Referral and Consultation; Self Concept; Social Behavior; Speech Disorders; Speech Therapy
PubMed: 25976972
DOI: 10.1136/bmj.h2318 -
Journal of Speech, Language, and... Apr 2021Purpose The aim of this study was to determine how the speech disorder profiles in Down syndrome (DS) relate to reduced intelligibility, atypical overall quality, and...
Purpose The aim of this study was to determine how the speech disorder profiles in Down syndrome (DS) relate to reduced intelligibility, atypical overall quality, and impairments in the subsystems of speech production (phonation, articulation, resonance, and prosody). Method Auditory-perceptual ratings of intelligibility, overall quality, and features associated with the subsystems of speech production were obtained from recordings of 79 children and adults with DS. Ratings were made for sustained vowels (62 of 79 speakers) and short sentences (79 speakers). The data were analyzed to determine the severity of the affected features in each speaking task and to detect patterns in the group data by means of principal components analysis. Results Reduced intelligibility was noted in 90% of the speakers, and atypical overall speech quality was noted in 100%. Affected speech features were distributed across the speech production subsystems. Principal components analysis revealed four components each for the vowel and sentence tasks, showing that individuals with DS are not homogeneous in the features of their speech disorder. Discussion The speech disorder in DS is complex in its perceptual features and reflects impairments across the subsystems of speech production, but the pattern is not uniform across individuals, indicating that attention must be given to individual variation in designing treatments.
Topics: Adult; Child; Down Syndrome; Humans; Phonation; Speech; Speech Acoustics; Speech Disorders; Speech Intelligibility; Speech Production Measurement
PubMed: 33789057
DOI: 10.1044/2021_JSLHR-20-00617 -
Journal of Speech, Language, and... Feb 2013This review summarizes research on disorders of speech production in Down syndrome (DS) for the purposes of informing clinical services and guiding future research. (Review)
Review
PURPOSE
This review summarizes research on disorders of speech production in Down syndrome (DS) for the purposes of informing clinical services and guiding future research.
METHOD
Review of the literature was based on searches using MEDLINE, Google Scholar, PsycINFO, and HighWire Press, as well as consideration of reference lists in retrieved documents (including online sources). Search terms emphasized functions related to voice, articulation, phonology, prosody, fluency, and intelligibility.
CONCLUSIONS
The following conclusions pertain to four major areas of review: voice, speech sounds, fluency and prosody, and intelligibility. The first major area is voice. Although a number of studies have reported on vocal abnormalities in DS, major questions remain about the nature and frequency of the phonatory disorder. Results of perceptual and acoustic studies have been mixed, making it difficult to draw firm conclusions or even to identify sensitive measures for future study. The second major area is speech sounds. Articulatory and phonological studies show that speech patterns in DS are a combination of delayed development and errors not seen in typical development. Delayed (i.e., developmental) and disordered (i.e., nondevelopmental) patterns are evident by the age of about 3 years, although DS-related abnormalities possibly appear earlier, even in infant babbling. The third major area is fluency and prosody. Stuttering and/or cluttering occur in DS at rates of 10%-45%, compared with about 1% in the general population. Research also points to significant disturbances in prosody. The fourth major area is intelligibility. Studies consistently show marked limitations in this area, but only recently has the research gone beyond simple rating scales.
Topics: Down Syndrome; Humans; Speech; Speech Disorders; Speech Production Measurement
PubMed: 23275397
DOI: 10.1044/1092-4388(2012/12-0148) -
Deutsches Arzteblatt International Jun 2017Approximately 1% of children and adolescents, 0.2% of women, and 0.8% of men suffer from stuttering, and lesser numbers from cluttering. Persistent speech fluency...
BACKGROUND
Approximately 1% of children and adolescents, 0.2% of women, and 0.8% of men suffer from stuttering, and lesser numbers from cluttering. Persistent speech fluency disorders often cause lifelong problems in communication and social participation.
METHODS
In an interdisciplinary, evidence and consensus based clinical practice guideline, the current understanding of the nature, identification, diagnosis, and treatment of stuttering and cluttering was summarized. A systematic review of the literature was carried out to assess the efficacy and effectiveness of treatments for stuttering. Evidence is lacking on the etiology, pathogenesis, evaluation, and treatment of cluttering.
RESULTS
In view of the fact that common (developmental, idiopathic) stuttering is associated with structural and functional changes of the brain, the guideline recommends that it should be called "originary neurogenic non-syndromic stuttering." Heritability estimates for this disorder range from 70% to over 80%. For preschool children, the Lidcombe therapy has the best evidence of efficacy (Cohen's d = 0.72-1.00). There is also strong evidence for an indirect treatment approach. For children aged 6 to 12, there is no solid evidence for the efficacy of any treatment. For adolescents and adults, there is good evidence with high effect sizes (Cohen's d = 0.75-1.63) for speech restructuring methods such as fluency shaping; weak evidence with intermediate effect sizes for stuttering modification (Cohen's d = 0.56-0.65); and weak evidence for combined speech restructuring and stuttering modification. The evidence does not support the efficacy of pharmacotherapy, rhythmic speaking, or breathing regulation as the sole or main form of treatment, or that of hypnosis or eclectic, unspecified stuttering therapies.
CONCLUSION
Stuttering is often treated in Germany with therapies for which there is inadequate evidence, and the initiation of treatment is often unnecessarily delayed. The guideline presents treatment methods whose efficacy is supported by the current evidence.
Topics: Adolescent; Adult; Child; Child, Preschool; Female; Germany; Humans; Male; Quality of Life; Retrospective Studies; Speech; Speech Disorders; Stuttering
PubMed: 28655373
DOI: 10.3238/arztebl.2017.0383 -
Medicine Dec 2023To examine the impact of stepwise speech rehabilitation exercise therapy in the treatment of patients with Parkinson speech problems under psychological intervention on...
To examine the impact of stepwise speech rehabilitation exercise therapy in the treatment of patients with Parkinson speech problems under psychological intervention on clinical results and cognitive functioning. Parkinson speech disorder patients who met the inclusion criteria were selected and divided into a control group and an observation group for training respectively. The control group used conventional nursing methods, including training in orofacial movement, vocalization, pitch, volume and breath control. The observation group used stepwise speech rehabilitation exercise intervention combined with psychotherapy nursing programme. In the statistical analysis, independent sample t-test and chi-square test were used to test the significance of the data processing methods. In the statistical analysis of baseline functional level (P > .05). The difference was not statistically significant. After 7 weeks of training, the mFDA level and speech intelligibility increased in both the observation and control groups. From the situation analysis of "modified drinking test" and the comparison of UPDRS-I scores, it can be seen that dysphagia and Parkinson dysphasia were reduced in both groups after training. The observation group spontaneous speech dimension was greater than the control group by around 0.07 in the aphasia comparison. Both groups displayed an upward trend in their MMSE and Montreal Cognitive Assessment (MoCA) when measuring cognitive function; the evaluation of P300, constructive function, and quality of life revealed this. The observation group P300 potential score was 0.13 points higher than that of the control group. The therapeutic training of stepped speech rehabilitation exercise care combined with psychological intervention has significant nursing effects on patients with Parkinson disease speech disorders, and the patients' cognitive functions have been effectively improved.
Topics: Humans; Parkinson Disease; Speech; Quality of Life; Psychosocial Intervention; Speech Disorders; Cognition
PubMed: 38206724
DOI: 10.1097/MD.0000000000036420 -
IEEE Transactions on Bio-medical... Nov 2017Speech-language pathologists (SLPs) are trained to correct articulation of people diagnosed with motor speech disorders by analyzing articulators' motion and assessing...
Speech-language pathologists (SLPs) are trained to correct articulation of people diagnosed with motor speech disorders by analyzing articulators' motion and assessing speech outcome while patients speak. To assist SLPs in this task, we are presenting the multimodal speech capture system (MSCS) that records and displays kinematics of key speech articulators, the tongue and lips, along with voice, using unobtrusive methods. Collected speech modalities, tongue motion, lips gestures, and voice are visualized not only in real-time to provide patients with instant feedback but also offline to allow SLPs to perform post-analysis of articulators' motion, particularly the tongue, with its prominent but hardly visible role in articulation. We describe the MSCS hardware and software components, and demonstrate its basic visualization capabilities by a healthy individual repeating the words "Hello World." A proof-of-concept prototype has been successfully developed for this purpose, and will be used in future clinical studies to evaluate its potential impact on accelerating speech rehabilitation by enabling patients to speak naturally. Pattern matching algorithms to be applied to the collected data can provide patients with quantitative and objective feedback on their speech performance, unlike current methods that are mostly subjective, and may vary from one SLP to another.
Topics: Adult; Algorithms; Humans; Imaging, Three-Dimensional; Lipreading; Male; Speech; Speech Disorders; Speech-Language Pathology; Tongue
PubMed: 28103545
DOI: 10.1109/TBME.2017.2654361 -
Acta Medica Portuguesa Jun 2023Stuttering is a speech fluency disorder, in which people know perfectly well the message they want to convey, even though their speech is characterized by changes in... (Review)
Review
Stuttering is a speech fluency disorder, in which people know perfectly well the message they want to convey, even though their speech is characterized by changes in rhythm, repetitions, prolongations, pauses and blocks, and may also be associated with states of anxiety or emotional tension. Up to one in every six children, typically between two and five years old, experience a period of transitory speech disfluency, with usual spontaneous recovery before reaching school age, with a prevalence rate of stuttering of up to 1% of the adult population, and a higher incidence rate in males (4:1). In Portugal, it is estimated that stuttering affects around 100 thousand people, acquiring importance due to its frequency and association with lower self-esteem, anxiety and social isolation, with negative impact on people's ability to communicate and on their well-being and social interactions. The aim of this article is to highlight the complexity of the diagnostic and therapeutic approach of stuttering in pediatrics, with a particular focus on differentiating between normal speech disfluencies and childhood-onset fluency disorder (stuttering) and referral criteria, in order to raise awareness and facilitate early detection of these cases.
Topics: Child, Preschool; Humans; Male; Anxiety; Emotions; Portugal; Speech; Stuttering; Female
PubMed: 37261913
DOI: 10.20344/amp.18909 -
International Journal of... Feb 2015A number of variables—word frequency, word length—have long been known to influence language processing. This study briefly reviews the effects in speech perception... (Review)
Review
A number of variables—word frequency, word length—have long been known to influence language processing. This study briefly reviews the effects in speech perception and production of two more recently examined variables: phonotactic probability and neighbourhood density. It then describes a new approach to study language, network science, which is an interdisciplinary field drawing from mathematics, computer science, physics and other disciplines. In this approach, nodes represent individual entities in a system (i.e. phonological word-forms in the lexicon), links between nodes represent relationships between nodes (i.e. phonological neighbours) and various measures enable researchers to assess the micro-level (i.e. the individual word), the macro-level (i.e. characteristics about the whole system) and the meso-level (i.e. how an individual fits into smaller sub-groups in the larger system). Although research on individual lexical characteristics such as word-frequency has increased understanding of language processing, these measures only assess the "micro-level". Using network science, researchers can examine words at various levels in the system and how each word relates to the many other words stored in the lexicon. Several new findings using the network science approach are summarized to illustrate how this approach can be used to advance basic research as well as clinical practice.
Topics: Adult; Age Factors; Auditory Pathways; Child; Humans; Language Development; Language Disorders; Neural Networks, Computer; Phonetics; Psycholinguistics; Speech; Speech Acoustics; Speech Disorders; Speech Perception; Systems Integration; Systems Theory
PubMed: 25539473
DOI: 10.3109/17549507.2014.987819 -
Journal of Neurology, Neurosurgery, and... Sep 1981Study of the speech disorders of Parkinsonism provides a paradigm of the integration of phonation, articulation and language in the production of speech. The initial... (Review)
Review
Study of the speech disorders of Parkinsonism provides a paradigm of the integration of phonation, articulation and language in the production of speech. The initial defect in the untreated patient is a failure to control respiration for the purpose of speech and there follows a forward progression of articulatory symptoms involving larynx, pharynx, tongue and finally lips. There is evidence that the integration of speech production is organised asymmetrically at thalamic level. Experimental or therapeutic lesions in the region of the inferior medial portion of ventro-lateral thalamus may influence the initiation, respiratory control, rate and prosody of speech. Higher language functions may also be involved in thalamic integration: different forms of anomia are reported with pulvinar and ventrolateral thalamic lesions and transient aphasia may follow stereotaxis. The results of treatment with levodopa indicates that neurotransmitter substances enhance the clarity, volume and persistence of phonation and the latency and smoothness of articulation. The improvement of speech performance is not necessarily in phase with locomotor changes. The dose-related dyskinetic effects of levodopa, which appear to have a physiological basis in observations previously made in post-encephalitic Parkinsonism, not only influence the prosody of speech with near-mutism, hesitancy and dysfluency but may affect work-finding ability and in instances of excitement (erethism) even involve the association of long-term memory with speech. In future, neurologists will need to examine more closely the role of neurotransmitters in speech production and formulation.
Topics: Humans; Levodopa; Parkinson Disease; Respiration; Speech; Speech Disorders; Stereotaxic Techniques; Thalamus
PubMed: 7031185
DOI: 10.1136/jnnp.44.9.751 -
Seminars in Speech and Language Sep 2017The ability to read has implications for communication development for individuals who use augmentative and alternative communication (AAC) systems. Access to print for... (Review)
Review
The ability to read has implications for communication development for individuals who use augmentative and alternative communication (AAC) systems. Access to print for generative language provides a flexible system in which an individual can create novel messages and interact with his or her family, friends, and peers. Several challenges in reading instruction inherently exist for individuals who have limitations in speech ability. Reading instruction is becoming increasingly more accessible with current advances in technology; however, several challenges remain regarding the creation of accessible learning environments, assessment tools, and reading intervention strategies for children with limited speech. The current article provides an overview of the role of the speech-language pathologist in reading instruction and particularly addresses children’s need for more experience with instruction in phonological awareness and decoding, an area that has presented the greatest challenge in access to reading instruction for individuals who use AAC. Several considerations are presented to increase access to instruction with directions for future research highlighted.
Topics: Child; Communication Aids for Disabled; Humans; Phonetics; Reading; Speech Disorders; Speech-Language Pathology
PubMed: 28892832
DOI: 10.1055/s-0037-1604273