Articulation Accuracy Research Articles

Effectiveness of the Kaufman Speech to Language Protocol for Children With Childhood Apraxia of Speech and Comorbidities When Delivered in a Dyadic and Group Format.

The current study is a Phase I clinical study with the goal of determining feasibility and the effectiveness of the Kaufman Speech to Language Protocol (K-SLP) for children with childhood apraxia of speech (CAS) and comorbidities. We hypothesized that K-SLP intervention would result in improved outcomes and maintenance of treatment effect at 3-4 months postintervention. Single-subject experimental design with multiple baselines across behaviors was replicated across a group of six children. Five out of six participants completed the study. The K-SLP intervention was administered in dyads four times a week for three consecutive weeks. Outcomes included assessment of word/syllable shapes, articulation accuracy, speech intelligibility, and functional communication. Treatment progress was measured through: (a) the administration of custom probe word lists and (b) assessments carried out at pretreatment, immediately following intervention and approximately 3-4 months after the study period. Four out of five participants demonstrated significant improvements to words targeted in treatment and three out of five generalized these to untreated words. Furthermore, three out of five participants showed immediate and clinically significant posttreatment improvements in speech intelligibility and functional outcomes, and this increased to four out of five participants at 3-4 months follow-up. The study provides preliminary support for the effectiveness of the K-SLP program when delivered in dyads to children with CAS with comorbidities. The study replicates earlier findings and reaffirms the positive outcomes of K-SLP for children with CAS.

Articulation Assessment for Tongue Cancer Patients: Using Consonant Production Performance to Capture Speech Deficits.

The purpose of this study was to thoroughly analyze postoperative consonant errors by tongue cancer (TC) patients with speech disorders and also to investigate the correlation between the pathological factors and the speech performance using our Consonant-based Articulation Assessment Battery (CAAB). The participants were 57 monolingual Mandarin TC patients (26 women, 31 men) after surgery (aged 20-80 years). All participants were literate and had normal vision and hearing, enabling them to comprehend and comply with our instructions. In order to quickly evaluate their articulation performance based on the place and manner of articulation, they were instructed to pronounce the characters in CAAB. The analysis removed speech samples impacted by speakers' dialects, while recording and documenting all other responses. The study uncovered a significant correlation between pathological factors (e.g., size of tongue resection, specific resection site, and tumor size) and the accuracy of consonant articulation. Furthermore, tongue damage predominantly impacts the place of articulation (63.85%) than the manner of articulation (20.78%). The damage in the anterior part of the tongue has the most prominent influence on consonant production. CAAB can fast capture the idiosyncratic characteristics of speech production by TC patients, and the articulation deficits are quite different from other types of organic or nonorganic speech disorders, for example, cleft lip and cleft palate. Hence, CAAB can be designated as an assessment tool for articulation disorders caused by stomatognathic damages. Our findings also shed light on the possible oral cancer surgery plan and the postoperative speech rehabilitation training.

SR-TTS: a rhyme-based end-to-end speech synthesis system.

Deep learning has significantly advanced text-to-speech (TTS) systems. These neural network-based systems have enhanced speech synthesis quality and are increasingly vital in applications like human-computer interaction. However, conventional TTS models still face challenges, as the synthesized speeches often lack naturalness and expressiveness. Additionally, the slow inference speed, reflecting low efficiency, contributes to the reduced voice quality. This paper introduces SynthRhythm-TTS (SR-TTS), an optimized Transformer-based structure designed to enhance synthesized speech. SR-TTS not only improves phonological quality and naturalness but also accelerates the speech generation process, thereby increasing inference efficiency. SR-TTS contains an encoder, a rhythm coordinator, and a decoder. In particular, a pre-duration predictor within the cadence coordinator and a self-attention-based feature predictor work together to enhance the naturalness and articulatory accuracy of speech. In addition, the introduction of causal convolution enhances the consistency of the time series. The cross-linguistic capability of SR-TTS is validated by training it on both English and Chinese corpora. Human evaluation shows that SR-TTS outperforms existing techniques in terms of speech quality and naturalness of expression. This technology is particularly suitable for applications that require high-quality natural speech, such as intelligent assistants, speech synthesized podcasts, and human-computer interaction.

The effects of a therapeutic program based on motor learning in the recovery of apraxia of speech in children

The purpose of the present study is to analyze comparatively the effects of some therapeutic interventions to improve the symptoms of apraxia of speech in children (CAS). In this sense, three different therapeutic programs were implemented, each lasting 12 months, in three groups of children. Two measurements were made, before and after the children's participation in the programs. P1 included therapy based on augmentative and alternative communication, P2 included therapy based on the classic speech therapy model and therapeutic speech massage, P3 included therapy based on verbal motor learning, VML. 106 children diagnosed with CAS participated in the study, aged between 5 and 7 years, M = 5.75, SD = .75, of which 81 boys (76%) and 25 girls (24%), were randomly divided into three groups. CAS severity was measured using a grid from the Dynamic Assessment of Motor Speech Skills, measuring articulatory accuracy, vowel scoring, and prosody. Visuomotor accuracy, visuospatial processing, phonemic hearing, narrative memory, and attention were measured with a series of tests from the PEDb and PEDa packages (Cognitrom, 2012). Although all three therapeutic programs registered significant effects on the improvement of CAS symptomatology, the most notable effects were obtained by the VML method. The practical implications of the study are discussed, as well as future research directions.

Speech Production in Healthy Older Adults With or Without Amateur Singing Experience.

Amateur singing is a universal, accessible, and enjoyable musical activity that may have positive impacts on human communication. However, evidence of an impact of singing on speech articulation is still scarce, yet understanding the effects of vocal training on speech production could provide a model for treating people with speech deficits. The aim of this study was to examine speech production in younger and older adults with or without amateur singing experience. Thirty-eight amateur singers (aged 20-87 years, 23 women and 15 men) and 40 nonmusician active controls (aged 23-88 years, 19 women and 21 men) were recruited. A set of tasks were used to evaluate the oral motor sphere: two voice production tasks, a passage reading task, and a modified diadochokinetic (DDK) rates task performed at a natural rhythm and as quickly as possible. Our results show that older age was associated with lower reading rate, lower articulation rate, and articulation rate variability in the DDK task, as well as reduced accuracy for the phonologically complex stimuli. Most importantly, our results show an advantage for singers over cognitively active nonsingers in terms of articulatory accuracy in the most challenging situations. This result suggests extended maximal performance capacities in amateur singers perhaps resulting from the articulatory efforts required during singing. https://doi.org/10.23641/asha.24274813.

A single case experimental design study using an operationalised version of the Kaufman Speech to Language Protocol for children with childhood apraxia of speech

Purpose A Phase I study was conducted to examine the treatment effectiveness of the Kaufman Speech to Language Protocol using a research-operationalised protocol. It was hypothesised that articulatory accuracy would improve as a result of the treatment and that these improvements would be maintained after treatment was discontinued. Method A single case experimental design was used to evaluate the effectiveness of the Kaufman Speech to Language Protocol. Four children with a confirmed childhood apraxia of speech diagnosis were included in this study. Each child received 12 individual 1 hr treatment sessions that each consisted of an approximation setting phase and a practice phase. Probe data was collected during treatment and at post-treatment time points to measure treatment effectiveness and to measure changes in the untreated words. Untreated (control) sounds were included to test whether recorded improvements in articulatory accuracy could be attributed to the Kaufman Speech to Language Protocol. Result Two of the four children demonstrated a response to the intervention and maintenance of these changes, while the two remaining children demonstrated some generalisation in the absence of improved target (treatment) words. No specific child factors were clearly associated with positive treatment outcomes. Conclusion This study replicated the findings of an earlier pilot study and found that the operationalised protocol for the Kaufman Speech to Language Protocol is effective in improving articulatory accuracy for some children with childhood apraxia of speech. Additional replication with a further refined treatment protocol and a larger sample size is needed to support a recommendation of clinical use of the Kaufman Speech to Language Protocol.

Using "Real-World Data" to Study Cleft Lip/Palate Care: An Exploration of Speech Outcomes from a Multi-Center US Learning Health Network.

To assess the ability of a cleft-specific multi-site learning health network registry to describe variations in cleft outcomes by cleft phenotypes, ages, and treatment centers. Observed variations were assessed for coherence with prior study findings. Cross-sectional analysis of prospectively collected data from 2019-2022. Six cleft treatment centers collected data systematically during routine clinic appointments according to a standardized protocol. 714 English-speaking children and adolescents with non-syndromic cleft lip/palate. Routine multidisciplinary care and systematic outcomes measurement by cleft teams. Speech outcomes included articulatory accuracy measured by Percent Consonants Correct (PCC), velopharyngeal function measured by Velopharyngeal Competence (VPC) Rating Scale (VPC-R), intelligibility measured by caregiver-reported Intelligibility in Context Scale (ICS), and two CLEFT-Q™ surveys, in which patients rate their own speech function and level of speech distress. 12year-olds exhibited high median PCC scores (91-100%), high frequency of velopharyngeal competency (62.50-100%), and high median Speech Function (80-91) relative to younger peers parsed by phenotype. Patients with bilateral cleft lip, alveolus, and palate reported low PCC scores (51-91%) relative to peers at some ages and low frequency of velopharyngeal competency (26.67%) at 5 years. ICS scores ranged from 3.93-5.0 for all ages and phenotypes. Speech Function and Speech Distress were similar across phenotypes. This exploration of speech outcomes demonstrates the current ability of the cleft-specific registry to support cleft research efforts as a source of "real-world" data. Further work is focused on developing robust methodology for hypothesis-driven research and causal inference.

APPLICATION OF THE PHONETIC PLACEMENT METHOD FOR ARTICULATION DISORDERS IN CHILDREN WITH INTELLECTUAL DISABILITIES

Speech intelligibility is an important factor in verbal communication. Children with intellectual disabilities with intellectual disabilities will face difficulties in communicating due to reduced speech intelligibility. This condition will affect social skills, mental mental state, and academics. Articulatory misplacement is one of the factor that makes difficulties in articulation accuracy. Method: Using a single subject experiment, with a one group pretest-posttest design. The participant was a 7-year-old girl with articulation disorder /m/ in the initial position of the word and had never received speech therapy. Data collection was conducted through interviews with the client's parents, direct observation of the client, tests, and document studies. Speech therapy was conducted for 10 sessions with an emphasis on bilabial phonetic placement exercises. Perceptual assessment by comparing the ability to produce /m/ in the initial position of the word before and after therapy. Results: In the evaluation assessment, there has been no improvement in the client's ability to produce /m/ in the initial position of the word. Conclusion: The use of the phonetic placement method to improve the ability to produce /m/ in the initial position of words has not been effective for children with intellectual disabilities in this case. Suggestion: It may be possible to increase the frequency of therapy to see more significant improvement, and adjust the therapy materials.

The Outcomes of Remote Administration of Combined Aphasia and Apraxia of Speech Treatment: A Single-Subject Experimental Design Study.

This study was designed to examine the outcomes of Combined Aphasia and Apraxia of Speech Treatment (CAAST) administered remotely in terms of acquisition and generalization effects and to compare these effects to previous in-person CAAST studies and Response Elaboration Training (RET)/Modified-Response Elaboration Training (M-RET) benchmarks. Multiple probe designs across participants and behaviors were employed with three speakers with chronic aphasia and apraxia of speech. Correct information units (CIUs) were the primary outcome measure to measure changes in language production. Percent consonants correct (PCC) was used as the secondary outcome measure to evaluate changes in speech sound accuracy. Production of CIUs was compared with existing benchmarks from Bunker et al.'s (2019) meta-analysis of previous RET/M-RET studies. In addition, both CIUs and PCC were compared with the most recent CAAST in-person studies. All participants demonstrated substantial increases in CIUs for treated and untreated picture sets, comparable to outcomes of in-person CAAST administration. These language changes were maintained at posttreatment intervals for all participants. PCC also improved for all participants, with gains in articulatory accuracy being maintained posttreatment. Improvements in CIU production and PCC for all three participants were in keeping with results from Wambaugh et al. (2017). These findings provide additional support for the efficacy of CAAST and indicate that remote administration may be a viable alternative to in-person application. https://doi.org/10.23641/asha.23418635.

Effects of multitasker babble noise on speech intelligibility in children with velopharyngeal insufficiency (VPI).

Intelligibility measurement is influenced by the characteristics of a speaker, listener and contextual factors. This study addresses the clinical problem of measuring speech intelligibility in children with velopharyngeal insufficiency (VPI) in real-world conditions. The purpose of the study was to investigate the effects of background noise on speech intelligibility in speakers with velopharyngeal insufficiency (VPI) compared to typical speech. The study further determined the contribution of nasalance and articulation accuracy in judgments of intelligibility. Fifteen speakers diagnosed with VPI and their typical peers provided audio recordings of 20 sentences from the Hearing in Noise Test. Speech samples were presented over quiet and noise (+5dB signal-to-noise ratio) conditions to 70 naïve listeners. Intelligibility scores from naïve listeners' orthographic transcriptions were obtained as the percentage of correctly identified words. A repeated-measures analysis of variance showed diagnosis of VPI (F(1, 28) = 13.44, p = 0.001, and presence of noise (F(1, 28) = 39.18, p < 0.001) significantly affected the intelligibility scores. There was no interaction between the diagnosis of VPI and noise (F(1, 28) = 0.06, p = 0.80). The multivariate regression analysis indicated that nasalance and articulation accuracy explain a significant amount of variance in the intelligibility scores of VPI speakers in quiet (F(2, 12) = 7.11, p < 0.05, R2 = 0.55, R2 Adjusted = 0.47) and noise (F(2, 12) = 6.32, p < 0.05, R2 = 0.51, R2 Adjusted = 0.43), but the significance mainly came from the effect of percentage of consonants correct (β = 0.97, t(12) = 2.90, p = 0.01). Percentage of consonants correct significantly increased the speech intelligibility in either with or without noise conditions. The current work suggests that background noise will significantly affect reductions in intelligibility in both groups; the effect is more prominent in VPI speech. It was also further noted that articulation accuracy significantly affected intelligibility in quiet and noise rather than nasalance scores. What is already known on the subject Intelligibility measurement is influenced by the characteristics of a speaker, listener and contextual factors. Accordingly, it is essential to determine the degree to which speech assessments in the clinic can predict communication difficulties in the presence of background noise in real life. Background noise can adversely cause speech intelligibility degradation in individuals with speech disorders. What this study adds The study examined the effects of background noise on speech intelligibility in speakers with velopharyngeal insufficiency (VPI) secondary to cleft palate compared to typical speech. The study results suggested that the presence of background noise will significantly affect reductions in intelligibility in both groups; however, the effect is more prominent in VPI speech. What are the clinical implications of this work? We found out that the intelligibility of VPI speech is lower in the presence of background noise, and therefore, assessments of speech intelligibility in clinical settings should take this into account. To ensure effective communication in noisy environments, recommended strategies include selecting quiet locations, eliminating potential distractions and supplementing communication with nonverbal cues. It is important to recognize that the effectiveness of these strategies may vary depending on the individual and the specific communication context.

STYLISTIC FEATURES OF SOUND PRODUCTION IN PIANOFORTE MUSIC OF WOLFGANG AMADEUS MOZART

The article deals with the basic stylistic features of the sound production technique in the interpretation of piano opuses of the brilliant Austrian composer Wolfgang Amadeus Mozart. Its specific features are outlined in the context of the basic stylistic features of the artist’s piano heritage and typical performance tradition. The main features of sound production technique are related to the following basic stylistic elements of Mozart’s piano works: the laconicism of expressive means, the accuracy of all records of performance instructions, the transparency of the substance and at the same time the super-rich sense, the extraordinary expressiveness of the melody line in its slightest pitches; balance of emotions and logic and inexhaustible variability of images; logic of the chosen tempo-character of the work, accuracy of articulation, adequacy of the dynamics, quality and tonal beauty; clavier polytimbral. The character of sound production technique is also revealed on the basis of an analysis of Mozart’s performance style, which was characterized by perfect technical competence, accuracy of detailed nuances, exemplary highly artistic performance in the absence of any exaggerations, transparency of “grainy” sound, cantilenity and extent of the dynamics of the piano of the XVIII century. The sound production work in the play of Mozart’s works is determined by the specific tasks caused by specific musical and artistic content of each particular work. In general, the nature of pianistic techniques is associated with at excellent, brilliant finger technique, which excludes the excessive use of large arm levers, its excessive weighting. Under common kind of articulation, the finger rises from the key just before pressing the next one. The article provides exercises for the formation of this basic key touch, which is necessary for the gentle sound of “demilegato” play, the production of grainy sounds; emphasizes the need for rational organization of movements of the sensitive fingers for a detailed performance nuance, delicate “messa di voce” of the dynamics of the volume due to the recitative-declamatory nature of vocal plastic art in Mozart’s piano works. The development of Mozartianism will motivate researchers to analyze the wealthy palette of music styles of Austrian genius. At the same time, a deep understanding and, above all, mastering the art of interpreting a musical piece should also take into account the nature of a deliberate and appropriate pianistic embodiment of the performer’s artistic intentions.

Reproducibility and reliability of digital occlusal planning for orthognathic surgery

The digital articulation of dental models is gradually replacing the conventional physical approach for occlusal prediction planning. This study was performed to compare the accuracy and reproducibility of free-hand articulation of two groups of digital and physical dental models, 12 Class I (group 1) and 12 Class III (group 2). The models were scanned using an intraoral scanner. The physical and digital models were independently articulated 2 weeks apart by three orthodontists to achieve the maximum inter-digitation, with coincident midlines and a positive overjet and overbite. The occlusal contacts provided by the software color-coded maps were assessed and the differences in the pitch, roll, and yaw were measured. The reproducibility of the achieved occlusion of both the physical and digital articulation was excellent. The z-axis displayed the smallest absolute mean differences of 0.10 ± 0.08 mm and 0.27 ± 0.24 mm in the repeated physical and repeated digital articulations, respectively, both in group 2. The largest discrepancies between the two methods of articulation were in the y-axis (0.76 ± 0.60 mm, P = 0.010) and in roll (1.83° ± 1.72°, P = 0.005). The overall measured differences were< 0.8 mm and< 2°. Despite the steep learning curve, digital occlusal planning is accurate enough for clinical applications.

Rate Modulation Abilities in Acquired Motor Speech Disorders.

The purpose of this study was to describe, compare, and understand speech modulation capabilities of patients with varying motor speech disorders (MSDs) in a paradigm in which patients made highly cued attempts to speak faster or slower. Twenty-nine patients, 12 with apraxia of speech (AOS; four phonetic and eight prosodic subtype), eight with dysarthria (six hypokinetic and two spastic subtype), and nine patients without any neurogenic MSD completed a standard motor speech evaluation where they were asked to repeat words and sentences, which served as their "natural" speaking rate. They were then asked to repeat lower complexity (counting 1-5; repeating "cat" and "catnip" 3 times each) and higher complexity stimuli (repeating "catastrophe" and "stethoscope" 3 times each and "My physician wrote out a prescription" once) as fast/slow as possible. Word durations and interword intervals were measured. Linear mixed-effects models were used to assess differences related to MSD subtype and stimuli complexity on bidirectional rate modulation capacity as indexed by word duration and interword interval. Articulatory accuracy was also judged and compared. Patients with prosodic AOS demonstrated a reduced ability to go faster; while they performed similarly to patients with spastic dysarthria when counting, patients with spastic dysarthria were able to increase rate similar to controls during sentence repetition; patients with prosodic AOS could not and made increased articulatory errors attempting to increase rate. AOS patients made more articulatory errors relative to other groups, regardless of condition; however, their percentage of errors reduced with an intentionally slowed speaking rate. The findings suggest comparative rate modulation abilities in conjunction with their impact on articulatory accuracy may support differential diagnosis between healthy and abnormal speech and among subtypes of MSDs (i.e., type of dysarthria or AOS). Findings need to be validated in a larger, more representative cohort encompassing several types of MSDs. https://doi.org/10.23641/asha.22044632.

Accuracy comparison of bilateral versus complete arch interocclusal registration scans for virtual articulation

Statement of problemAlternatives to the bilateral interocclusal registration scanning technique to improve virtual articulation have not been fully investigated. PurposeThe purpose of this in vitro study was to compare the accuracy of virtually articulating digital casts by using bilateral interocclusal registration scans versus a complete arch interocclusal scan. Material and methodsA set of maxillary and mandibular reference casts were hand-articulated and mounted on an articulator. The mounted reference casts were scanned, and the maxillomandibular relationship record was scanned 15 times using 2 different scanning techniques, the bilateral interocclusal registration scan (BIRS) and complete arch interocclusal registration scan (CIRS), with an intraoral scanner. The generated files were transferred to a virtual articulator, and each set of scanned casts was articulated using BIRS and CIRS. The virtually articulated casts were saved as a set and transferred to a 3-dimensional (3D) analysis program. The scanned casts were set in the same coordinate system as the reference cast and overlaid on top of the reference cast for analysis. Two anterior and 2 posterior points were selected to determine points of comparison between the reference cast and test casts virtually articulated with BIRS and CIRS. The mean discrepancy between the 2 test groups and the anterior and posterior mean discrepancy within each group were tested for significance by using the Mann-Whitney U test (α=.05). ResultsA significant difference was found between the virtual articulation accuracy of BIRS and CIRS (P<.001). The mean deviation for BIRS was 0.053 ±0.051 mm and that for CIRS was 0.265 ±0.241 mm. Furthermore, significant differences were found between the anterior and posterior deviations in both BIRS (P=.020) and CIRS (P<.001). The mean deviation for BIRS was 0.034 ±0.026 mm in the anterior and 0.073 ±0.062 mm in the posterior. The mean deviation for CIRS was 0.146 ±0.108 mm anteriorly and 0.385 ±0.277 mm posteriorly. ConclusionsBIRS was more accurate than CIRS for virtual articulation. Moreover, the alignment accuracy of anterior and posterior sites for both BIRS and CIRS exhibited significant differences, with the anterior alignment exhibiting better accuracy in relation to the reference cast.

A Case of Sphincter Pharyngoplasty for Persistent Velopharyngeal Insufficiency After Submucosal Cleft Palate Surgery

Velopharyngeal insufficiency (VPI) is a phenomenon that can occur due to anatomical or neurological causes of the soft palate. VPI can make the patient difficult to articulate through hypernasality and nasal emission. There has been needed the customized treatment, as VPI can occur for many causes. We present the case of 21-year-old male who took palate plastic surgery 20 years ago for congenital submucosal cleft palate. As he had poor contraction of both lateral side of velopharynx, he was diagnosed with coronal type VPI. Through sphincter pharyngoplasty, he can obtain improvement of articulation accuracy. We would like to share this challenged case.

The impact on speech with different deep brain stimulation settings in Parkinson's disease

Parkinson’s disease (PD) is a progressive neurodegenerative disorder, characterized by the progressive degeneration of the nigrostriatal dopaminergic pathway which affects movement initiation and maintenance, causing hypokinetic dysarthria in PD. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been widely used to manage rigidity, bradykinesias and drug-induced dyskinesias. While STN DBS successfully manages many symptoms of PD, speech response has been widely reported as “no or negative impact”. The High-Frequency Setting (HFS) is more focused within the STN which is known to control appendicular symptoms. However, the unintentional HFS current spreading to adjacent brain areas, such as the corticospinal and corticobulbar tracts, was thought to contribute to the deterioration of axial symptoms, including speech. The Low-Frequency Setting (LFS) extends more dorsally and ventrally towards surrounding structures, hence does not show the same negative impact and may reduce the negative impact on the axial functions including speech. This double-blind, randomized perception study assesses the impact of two deep brain stimulation (DBS) settings (high-frequency stimulation and interleave-interlink dual-frequency paradigm) on speech produced by 20 patients with PD. The impact of the two testing conditions was different for different Syllable Types with significant negative correlation between the articulatory rate and articulatory accuracy.

Speech treatment for Hebrew-speaking adolescents and young adults with developmental dysarthria: A comparison of mSIT and Beatalk.

Individuals with developmental dysarthria typically demonstrate reduced functioning of one or more of the speech subsystems, which negatively impacts speech intelligibility and communication within social contexts. A few treatment approaches are available for improving speech production and intelligibility among individuals with developmental dysarthria. However, these approaches have only limited application and research findings among adolescents and young adults. To determine and compare the effectiveness of two treatment approaches, the modified Speech Intelligibility Treatment (mSIT) and the Beatalk technique, on speech production and intelligibility among Hebrew-speaking adolescents and young adults with developmental dysarthria. Two matched groups of adolescents and young adults with developmental dysarthria participated in the study. Each received one of the two treatments, mSIT or Beatalk, over the course of 9 weeks. Measures of speech intelligibility, articulatory accuracy, voice and vowel acoustics were assessed both pre- and post-treatment. Both the mSIT and Beatalk groups demonstrated gains in at least some of the outcome measures. Participants in the mSIT group exhibited improvement in speech intelligibility and voice measures, while participants in the Beatalk group demonstrated increased articulatory accuracy and gains in voice measures from pre- to post-treatment. Significant increases were noted post-treatment for first formant values for select vowels. Results of this preliminary study are promising for both treatment approaches. The differentiated results indicate their distinct application to speech intelligibility deficits. The current findings also hold clinical significance for treatment among adolescents and young adults with motor speech disorders and application for a language other than English. What is already known on the subject Developmental dysarthria (e.g., secondary to cerebral palsy) is a motor speech disorder that negatively impacts speech intelligibility, and thus communication participation. Select treatment approaches are available with the aim of improving speech intelligibility in individuals with developmental dysarthria; however, these approaches are limited in number and have only seldomly been applied specifically to adolescents and young adults. What this paper adds to existing knowledge The current study presents preliminary data regarding two treatment approaches, the mSIT and Beatalk technique, administered to Hebrew-speaking adolescents and young adults with developmental dysarthria in a group setting. Results demonstrate the initial effectiveness of the treatment approaches, with different gains noted for each approach across speech and voice domains. What are the potential or actual clinical implications of this work? The findings add to the existing literature on potential treatment approaches aiming to improve speech production and intelligibility among individuals with developmental dysarthria. The presented approaches also show promise for group-based treatments as well as the potential for improvement among adolescents and young adults with motor speech disorders.

Effects of Word Length on Articulatory Accuracy in Children with Speech Sound Disorders

Objectives: The purpose of this study was to investigate the word length effects in a 1-2-3 syllable string test in children with speech sound disorders (SSDs) and to examine whether the accuracy in the 1-2-3 syllable string test could differentiate subgroups of SSDs classified by linguistic symptomatology.Methods: The 1-2-3 syllable string test was administrated to a total of 161 children with SSDs from 3 years to 9 years 11 months of age. The children with SSDs were classified into four subgroups, articulatory disorders, phonological delay, consistent phonological disorder, and inconsistent phonological disorder. Accuracy in the 1-2-3 syllable string test was measured at word, phoneme, vowel, consonant, and target syllables; and compared among SSD subgroups.Results: The main effects of SSD subgroups and word length exhibited significances at word, phoneme, consonant, and target syllables levels. The interaction effect between subgroups and word length was also significant. Phonological delay and inconsistent phonological disorder revealed significant effects of word length; and in particular, children with inconsistent phonological disorders showed a significant increase of errors as the number of syllable in the test words increased.Conclusion: The results support the possibility that subgroups of SSDs can be differentiated based on accuracy and word length effect in a 1-2-3 syllable string test, which can be useful in identifying children showing inconsistent productions and sequencing difficulties.

An In-Vitro Evaluation of Articulation Accuracy for Digitally Milled Models vs. Conventional Gypsum Casts.

With the advent of a digital workflow in dentistry, the inter-occlusal articulation of digital models is now possible through various means. The Cadent iTero intraoral scanner uses a buccal scan in maximum intercuspation to record the maxillomandibular relationship. This in-vitro study compares the occlusion derived from conventionally articulated stone casts versus that of digitally articulated quadrant milled models. Thirty sets of stone casts poured from full arch polyvinyl siloxane impressions (Group A) and thirty sets of polyurethane quadrant models milled from digital impressions (Group B) were used for this study. The full arch stone casts were hand-articulated and mounted on semi-adjustable articulators, while the digitally derived models were pre-mounted from the milling center based on the data obtained from the buccal scanning procedure. A T-scan sensor was used to obtain a bite registration from each set of models in both groups. The T-scan data derived from groups A and B were compared to that from the master model to evaluate the reproducibility of the occlusion in the two groups. A statistically significant difference of the contact region surface area was found on #11 of the digitally articulated models compared to the master. An analysis of the force distribution also showed a tendency for a heavier distribution on the more anterior #11 tooth for the digitally articulated models. Within the limitations of this study, the use of a digitally articulated quadrant model system may result in a loss of accuracy, in terms of occlusion, the further anteriorly the tooth to be restored is located. Care must be taken to consider the sources of inaccuracies in the digital workflow to minimize them for a more efficient and effective restorative process.

Improving speech characteristics of young adults with congenital dysarthria: An exploratory study comparing articulation training and the Beatalk method

IntroductionThis exploratory study compared the effects of two speech therapy approaches on speech characteristics of young adults with congenital dysarthria resulting from various etiologies: a) articulation training focusing on consonant articulation exercises at various levels (isolation, syllables, and words), and b) the Beatalk method, based on human beatboxing, i.e., producing various instrumental sounds in an a-cappella musical context. Both interventions were designed to increase participants’ speech intelligibility. MethodsTwelve adults with congenital dysarthria and reduced speech intelligibility participated in treatment groups for eight weeks. Six participants were assigned to the articulation training group, and six to the Beatalk group. Intelligibility of single words and continuous speech, voice measures, and oral-diadochokinesis rates were measured before and after the treatment. ResultsThe results showed that the Beatalk intervention yielded a significant overall pre- to post-treatment effect. Specifically, it resulted in gains in articulatory accuracy and intelligibility for single words. Improvements were not noted following articulation training. ConclusionsThe results present initial evidence of the positive effect of the Beatalk method as an intervention tool for adults with congenital dysarthria. This relatively easy-to-learn technique shows promise, as it involves intense and repetitive production of speech sounds while controlling rhythm and breathing in an enjoyable context.