Abnormal Articulation Research Articles

New type of lacunar stroke presenting in brain perfusion images: A case report

BACKGROUND A stroke is a significant brain event that impinges on individual motor or cognitive functions. In the lacunar stroke subtype of ischemic stroke, which results from blocked blood flow in certain brain areas, cases of dysarthria due to impaired blood flow are not uncommon. However, limited literature and research on the relevant pathophysiology and neural pathways exist. CASE SUMMARY We focus on a 60-year-old female with subacute stroke presenting symptoms including tongue deviation to the right, speech difficulty, choking on water, and biting the oral mucosa. She did not exhibit abnormalities in limb movement or sensation except for numbness in the tongue. We use single-photon emission computed tomography to reveal reduced blood flow in the left parietal lobe and bilateral temporal lobes. This report presents an atypical case of dysarthria, who exhibits abnormal articulation along with abnormal sensation and numbness in the tongue, prompting further investigation into the association between lacunar stroke subtypes, altered blood perfusion in affected brain regions, and neurological clinical status. CONCLUSION Dysarthria-plus syndrome in lacunar stroke isn’t solely related to motor function but also affects sensory function such as oral numbness.

Disordered speech recognition considering low resources and abnormal articulation

The success of automatic speech recognition (ASR) benefits a great number of healthy people, but not people with disorders. The speech disordered may truly need support from technology, while they actually gain little. The difficulties of disordered ASR arise from the limited availability of data and the abnormal nature of speech, e.g, unclear, unstable, and incorrect pronunciations. To realize the ASR of disordered speech, this study addresses the problems of disordered speech in two respects, low resources, and articulatory abnormality. In order to solve the problem of low resources, this study proposes staged knowledge distillation (KD), which provides different references to the student models according to their mastery of knowledge, so as to avoid feature overfitting. To tackle the articulatory abnormalities in dysarthria, we propose an intended phonological perception method (IPPM) by applying the motor theory of speech perception to ASR, in which pieces of intended phonological features are estimated and provided to ASR. And further, we solve the challenges of disordered ASR by combining the staged KD and the IPPM. TORGO database and UASEECH corpus are two commonly used datasets of dysarthria which is the main cause of speech disorders. Experiments on the two datasets validated the effectiveness of the proposed methods. Compared with the baseline, the proposed method achieves 35.14%∼38.12% relative phoneme error rate reductions (PERRs) for speakers with varying degrees of dysarthria on the TORGO database and relative 8.17%∼13.00% PERRs on the UASPEECH corpus. The experiments demonstrated that addressing disordered speech from both low resources and speech abnormality is an effective way to solve the problems, and the proposed methods significantly improved the performance of ASR for disordered speech.

Abnormal Articulation Detecting Model with Fluctuation Measurements Using Acoustic Analysis

Articulation disorder is a condition in which the mouth, tongue, vocal cords, and other parts of the body that play an important role in producing voice are damaged, resulting in the inability to produce sound. To diagnose articulation disorders, the movement and shape of each organ concerned with pronunciation are examined. If necessary, the underlying disease or disorder should be managed properly. In it, a speech therapist tests your pronunciation. The observation of conversation and the examination of the pronunciation of each syllable are used to distinguish between mistakes and the degree of articulation disorder. However, these processes are time consuming and labor intensive and are subjective judgments by experts. Therefore, it is important to investigate the characteristics of vocal signals by acoustic analysis of speech objectively. In this study, we focused on fluctuations in the period and amplitude of speech signals and predicted a model for detecting abnormal articulations using fluctuation measurement of the voice data in six healthy subjects and nine patients with an articulation disorder. We used inverse probability of treatment weighting to match the variability for the two groups using the inverse of propensity scores. As the results, the classification performance area under the curve was 0.781 (sensitivity: 0.781, specificity: 0.680) for healthy subjects and patients. We conclude that acoustic analyzing techniques are useful for diagnosing and treating articulation disorders.

Diagnosis and treatment of speech disorders in children with Moebius syndrome

BackgroundMoebius syndrome (MS) is characterized by congenital bilateral paralysis of the facial and abducens nerves. Clinical features include feeding problems, dysarthria, dysphagia, sialorrhea, strabismus, and lack of facial expression. Patients with MS frequently present with dysphagia during infancy. Further on during childhood a severe speech disorder is a common feature. However, articulation deficits in patients with MS are scarcely reported in the related scientific literature. ObjectiveThe aim of this study is to describe speech deviations, intelligibility and sialorrhea in patients with MS. Material and methodsEighty-seven patients with MS were prospectively studied. Age ranged from 4 to 18 years. A complete Speech and Language Pathology (SLP) evaluation was performed in all cases. The evaluation focused on articulation placement, sialorrhea and intelligibility of speech. ResultsSialorrhea was detected in 23% of the patients. Abnormal articulation placement of bilabial phonemes was observed in 68% of the patients. Another 50% of the patients presented with articulation placement errors in other phonemes. Intelligibility was classified as adequate in 18% of the cases. Mildly affected intelligibility was found in 51% of the patients. Speech was considered moderately unintelligible in 20% of the cases. Unintelligible speech was found in 11% of the patients. ConclusionsFrom the results of this prospective study it can be concluded that a high percentage of patients with MS are at high risk of presenting with moderate to severe speech disorders. Thus, an early SLP intervention should be provided for this population in order to enhance speech development and reducing the risk of severe oral communication impairments.

Understanding Nasal Emission During Speech Production: A Review of Types, Terminology, and Causality.

There are several different types of nasal emission that can occur during speech due to either velopharyngeal dysfunction or abnormal articulation in the pharynx. Nasal emission can be inaudible or very loud and distracting, depending on the size of the velopharyngeal opening and the physics of the flow. Nasal emission can be obligatory and/or compensatory (due to abnormal structure) or it can be caused by a misarticulation that results in a substitution of a pharyngeal sound for an oral sound, despite normal velopharyngeal structure. Nasal emission can occur on all pressure-sensitive phonemes or it can be phoneme-specific. Although it is generally recognized that the loud and distracting form of nasal emission (called nasal turbulence or nasal rustle) is due to a small velopharyngeal opening, the causality of the distracted sound is debated. This article provides a brief review of the types of nasal emission, the terms used to describe it, and the potential causes. This article also stresses the need for further research to clarify the causality of the sound generated by a small velopharyngeal opening.

Audit risk and articulation errors from different cash flow disclosures: evidence from China

We investigate the effects of articulation errors on audit opinions and fees, and moderating effects of the auditor size and different litigation regimes on the relationships between articulation errors on audit opinions and fees in China. We find that auditors are more likely to issue modified audit opinions (MAOs) and charge higher audit fees from their clients with higher absolute articulation errors, especially for big auditors and in high litigation risk regime. We also find that auditors who do not issue MAOs to clients with abnormal articulation errors receive higher fees than auditors who do issue MAOs.

Dissociating oral motor capabilities: Evidence from patients with movement disorders

Abnormal articulation rate is a frequent symptom in neurogenic speech disorders. Performance rates in speech-like or nonspeech tasks involving the vocal motor apparatus are commonly accepted predictors of speech motor function in general and of articulation rate in particular. However, theoretical arguments and behavioral observations in populations with disordered speech indicate that different oral motor behaviors may be governed by distinct mechanisms. The objective of the present study was to expand our knowledge of the relationship between speech movements, on the one hand, and speech-like and nonspeech oral motor behaviors, on the other, by using a rate paradigm. 130 patients with neurological movement disorders of different origins and 130 neurologically healthy subjects participated in the study. Rate data was collected in a speech task (oral reading/repetition), in speech-like tasks (rapid syllable repetitions), and in nonspeech tasks (rapid single articulator movements of the tongue/lips). The main analyses involved a multiple single-case method, by which we tested for differences among each patient's performance rates on the three task types. The results disclosed statistically significant (classical and strong) dissociations between movement rates obtained from the speech task and those obtained from speech-like and nonspeech oral motor tasks in a number of patients. The findings can be interpreted as reflecting major differences in task demands and underlying control mechanisms. The validity of diagnostic indices for speech obtained from speech-like or nonspeech tasks must thus be called into question.

The rare cuboid-navicular coalition presenting as chronic foot pain.

Tarsal coalitions are relatively rare diagnoses affecting adolescent patients that typically present with progressive foot pain. Cuboid-navicular coalition, a type of tarsal coalition, is extremely rare with less than 10 reported cases to date. Most prevailing theories reported have described this specific type of coalition as asymptomatic except at specific moments of stress and exercise. The purpose in presenting this case is to demonstrate that cuboid-navicular coalition can be associated with chronic unremitting pain, as in our patient. We present a case of cuboid-navicular fibrocartilaginous coalition in an adolescent patient presenting with chronic foot pain. Furthermore, from an imaging standpoint, radiographic findings are often subtle and radiologists cannot rely on indirect signs such as talar beak in clinching the diagnosis of cuboid-navicular coalition. Instead, abnormal articulation between the cuboid and navicular must be sought.

Il piede piatto sinostosico

Tarsal coalitions are aberrant unions of two or more tarsal bones. The most common sites of tarsal coalition are the calcaneonavicular and the talocalcaneal. The resulting abnormal articulation presents as a noncorrectable flat foot, usually during adolescence, leading to accelerated degeneration within adjacent joints. This article focuses on the clinical examination and findings of specific imaging studies to assist in an accurate diagnosis of these patients. Surgical options are resection of the bar or tarsal arthrodesis depending of the age, morphology of the coalitions and arthritis of adjacent joints.

Atlas Occipitalization in a Supersonic Fighter Pilot Involved in a Midair Collision: A Case Report

We report a case of a midair collision between two F16 fighter aircraft, in which one pilot survived and the other was ejected upon impact and his remains recovered from sea. In autopsy, no patholgy was detected, other than the expected evidence of mechanical trauma. No defects in the aircraft or faults in the parachute or ejection mechanism were found. Reconstruction of the shattered skull base and the cervical vertebrae revealed fusion of the atlanto-occipital joint (occipitalization) and a left paracondylar process. The effective diameter of the spinal canal was decreased by the abnormal articulation. Such malformations can cause a wide range of neurologic deficits. Considering the skill and alertness needed to operate a supersonic fighter aircraft, with the pressure applied by the heavy protective head gear and various G forces endured by the spinal column during flight, we postulate that the collision was related to the pilot's sudden incapacitation.

A Study of Speech Discrimination Ability of Cleft Palate Patients with Abnormal Articulation

A Study of Speech Discrimination Ability of Cleft Palate Patients with Abnormal Articulation

Caudal regression syndrome and popliteal webbing in connection with maternal diabetes mellitus: a case report and literature review

IntroductionMost cases of caudal regression are sporadic or associated with gestational/maternal diabetes. The condition is thought to be part of a spectrum including imperforate anus, sacral agenesis and sirenomelia. Infants of diabetic mothers have two to three times the average incidence of congenital anomalies.Case PresentationWe report on a 7-year-old boy from non-consanguineous family in Austria was born with features of caudal regression syndrome. A constellation of malformation complex such as caudal regression syndrome and anorectal malformation complex were evident at birth. Of great interest was the abnormal articulation between the pelvis and the remaining abnormal spine. Spinal-pelvic instability, dislocation of the hip, and knee-flexion contracture associated with popliteal webbing were the major orthopaedic abnormalities.ConclusionWe showed that an offspring of a diabetic mother was at significant risk of developing caudal regression syndrome. Our present patient demonstrated type1 of Welch and Aterman classification. There was total sacral agenesis associated with subtotal lumbar agenesis. The lowest vertebrae were resting above an iliac amphiathrosis. We strongly encourage primary care providers to discuss the consequences of maternal diabetes mellitus as part of routine anticipatory guidance for antenatal/prenatal management. Careful diabetic control in the preconceptional period and the first eight weeks of pregnancy may lower the chances of congenital anomalies.

Tongue-Palate Contact during Bilabials in Normal Speech

Previous research using electropalatography (EPG) identified a compensatory articulation called bilabial-lingual double articulations. These double articulations were produced for bilabials by some speakers with cleft palate and involved closure at the lips occurring simultaneously with complete tongue-palate constriction. However, no normative English EPG data exist to confirm the abnormal status of these double articulations. This study reports normative data for EPG contact during bilabial closure. Acoustic and EPG data were recorded for bilabials in different vowel contexts. Eight normal English-speaking adults. One measure identified complete tongue-palate constriction, and a second measure calculated percent contact. There were no instances of complete tongue-palate constriction, though some EPG contact occurred in the lateral regions of the palate. The vowel context significantly affected the amount of contact present, with /i/ having the most and /a/ having the least amount of contact. Complete tongue-palate constriction during bilabials of the type found in bilabial-lingual double articulations is not a feature of normal English speech and can therefore be considered an abnormal articulation pattern. Speech-language pathologists who use EPG in their clinical work should be aware that some lateral contact during bilabial closure is normal.

Comparison of Speaking Rate, Articulation Rate and Alternating Motion Rate in Dysarthric Speakers

Despite recent indications that speaking rate, articulation rate and alternating motion rate (AMR) are sensitive to the influence of neurological disease on speech production in dysarthric speakers, the relationship among these parameters remains largely questionable. In the current study, speech samples were collected from 62 dysarthric speakers and 34 controls while reading a passage. Acoustic analysis investigated speaking rate, articulation rate and AMR and compared these parameters between the dysarthric and control groups and within the control and dysarthric group. The major findings were: (1) Speaking rate, articulation rate and AMR were all markedly lower in dysarthric speakers than in controls. (2) Marked correlations were recognized between speaking rate, articulation rate and AMR in the dysarthric group. (3) Compared with the speaking rate and articulation rate, AMR is characterized as follows: (i) variation was more limited in controls, and (ii) the control group was clearly distinguishable from the dysarthric group. (4) Unlike in controls, AMR in the dysarthric speakers was notably lower than their articulation rate. We therefore conclude that AMR is a more easily detected sign of abnormal articulation than speaking rate and articulation rate.

Congenital tarsal coalition: multimodality evaluation with emphasis on CT and MR imaging.

Congenital tarsal coalition is a diagnosis that is often overlooked in young patients who first present with foot and ankle pain. Calcaneonavicular and talocalcaneal coalitions are encountered most frequently; fusion at other sites is much less common. Tarsal coalitions may be osseous, cartilaginous, or fibrous. Calcaneonavicular coalitions are readily detected on oblique radiographs. Radiographic confirmation of talocalcaneal coalition is more difficult than for fusion at other locations, although several secondary radiographic signs may indirectly suggest the diagnosis. Computed tomography (CT) and magnetic resonance (MR) imaging are invaluable for assessment of tarsal coalitions because they allow differentiation of osseous from nonosseous coalitions and because they depict the extent of joint involvement as well as secondary degenerative changes, features of vital importance in surgical planning. Short-inversion-time inversion recovery MR images may reveal bone marrow edema along the margins of the abnormal articulation, an important clue to the diagnosis. Moreover, CT or MR imaging may be required to confirm the diagnosis of talocalcaneal coalition when radiographic findings are equivocal. Because the diagnosis of tarsal coalition is often not entertained by the clinician ordering a CT or MR imaging examination, multiplanar imaging of the ankle and hindfoot is required.

Listeners’ Reactions to Misarticulation: A Methodological Investigation

It has been shown that listeners react negatively to speakers with abnormal articulation. There is no evidence indicating whether the actual placement of the occurrence of a misarticulation in a passage influences listeners' reactions. Subjects in this study heard a 98-word recording of a speaker feigning a misarticulation of /1/. One group of 20 subjects heard the misarticulation within the first five words of the recording. A second group heard the misarticulation within the first five words of the recording. All subjects rated the speaker on 13 bipolar scales, representing three dimensions of judgment. Findings indicate that the recorded samples were not rated differently. This placement of the token error did not influence subjects' judgments of the speaker.

LISTENERS' REACTIONS TO MISARTICULATION: A METHODOLOGICAL INVESTIGATION

It has been shown that listeners react negatively to speakers with abnormal articulation. There is no evidence indicating whether the actual placement of the occurrence of a misarticulation in a passage influences listeners' reactions. Subjects in this study heard a 98-word recording of a speaker feigning a misarticulation of /1/. One group of 20 subjects heard the misarticulation within the first five words of the recording. A second group heard the misarticulation within the first five words of the recording. All subjects rated the speaker on 13 bipolar scales, representing three dimensions of judgment. Findings indicate that the recorded samples were not rated differently. This placement of the token error did not influence subjects' judgments of the speaker.

Speech disorders in systemic amyloidosis

The purpose of this study was to define more completely the speech disorders that can occur in systemic amyloidosis. Fifty-nine patients with histologically established primary systemic amyloidosis were studied. Of this group, 81% had abnormal voice quality, 43% had abnormal pitch, 7% had abnormal resonation and 15% had abnormal articulation. Twenty-two patients also had abnormal findings at laryngeal examination, consisting of bowing, oedema, thickening, dry irritation and polypoid changes of the vocal folds. Macroglossia was found in 17% of the patients and submandibular swelling in 10%. These results support previous studies which showed that abnormal phonation is a sign of systemic amyloidosis and that abnormal voice is by far the most common abnormal speech sign. The relationship between amyloid deposit and dysphonia was not clear. In 23 patients who had laryngeal examinations, no evidence of actual amyloid deposits was documented.

Listeners' Reactions to Misarticulations of /1, r, s/

This study determined whether certain articulations are perceived as more negative than others. Adult listeners heard a recording of a speaker feigning a misarticulation of /1/, /r/ or /s/ and rated him on 20 bipolar scales. Factor analysis of these ratings yielded three dimensions of judgment. Findings suggest abnormal articulation generates a negative impression on factors of activity, evaluation, and potency; however, listeners do not appear, in general, to react differentially to these six misarticulations.

LANGUAGE AND DEVELOPMENT IN THE “FG” SYNDROME

The “FG” Syndrome is an X-linked syndrome characterized by unusual facial features, cardiac defects, mental retardation and gastrointestinal anomalies. Agenesis of the corpus callosum has also been noted in this syndrome. We report sequential language and developmental testing in a patient with “FG” syndrome, including callosal agenesis. J.B. is a 4 year 6 month old white male who has shown progressive delay in language and development. When first tested at 25 months of age, he had a 7 month receptive delay and an 11 month expressive delay. By 34 months of age, both were delayed by 14 months. At 54 months, his receptive skills were 21 months delayed and expressive skills were 24 months delayed and neither had shown measurable progression over the preceeding 10 months. He has abnormal articulation, word finding difficulty, and disordered syntax. This pattern of speech development is consistent with the language function defects reported in adults with callosal agenesis. His motor skills have been similarly delayed, and he has been consistently unable to anticipate his own manual adjustments. His skills on the Bayley and selected McCarthy subtests place him in the mildly mentally retarded range. Some of the deficits noted are consistent with a defect in interhemispheric communication. This pattern of progressive developmental and language delay has not been previously reported in the “FG” syndrome.