Articulation Errors Research Articles

'Suspension Palatoplasty' - A new Method of Primary Palate Repair for Speaking Un-Repaired Clefts.

To design a technique of palate repair with predictable Velo Pharyngeal (VP) closure and normal speech - 'Suspension Palatoplasty' in speaking unrepaired Cleft Palate (CP) patients. To evaluate the results of patients with CP operated using the technique of 'Suspension palatoplasty' from 2014 -2018 in terms of surgical complications and speech outcomes. An ambi-spective longitudinal clinical study. Comprehensive cleft care clinic in a private trust hospital. Patients above 6 years of age with isolated CP, cleft lip and palate (CLP), operated using 'Suspension Palatoplasty' technique between 2014 and 2018 were included with minimum follow up period of 5 years. Subjective speech evaluation was done by two speech therapists and analysed. Author designed the technique of 'Suspension Palatoplasty' which aims to suspend the soft palate repaired by 'Hybrid Palatoplasty' technique, close to the nasopharynx using narrow pharyngeal flap with the pedicle based superiorly at adenoids, for an acceptable VP closure. Speech outcome and surgical complications were assessed. Out of 94 cases operated with age ranging from 6 to 45 years, 59 (62.8%) had normal speech, 12 (12.8%) had articulation errors but with no Velo-Pharyngeal Insufficiency (VPI) and 23 patients (24.4%) had hypernasality/ nasal emission (Suspected VPI). None of them had difficulty in breathing but one patient had snoring. 'Suspension Palatoplasty' is a simple primary operation with excellent speech outcomes with no obstructive sequelae in patients with speaking unrepaired cleft palate.

Effect of Voice and Articulation Parameters of a Home-Based Serious Game for Speech Therapy in Children With Articulation Disorder: Prospective Single-Arm Clinical Trial.

Articulation disorder decreases the clarity of language and causes a decrease in children's learning and social ability. The demand for non-face-to-face treatment is increasing owing to the limited number of therapists and geographical or economic constraints. Non-face-to-face speech therapy programs using serious games have been proposed as an alternative. The aim of this study is to investigate the efficacy of home therapy on logopedic and phoniatric abilities in children with articulation disorder using the Smart Speech game interface. This study is a prospective single-arm clinical trial. Children with articulation disorders, whose Urimal Test of Articulation and Phonology (U-TAP) was -2 SDs or less and the Receptive and Expressive Vocabulary Test score was -1 SD or more, were enrolled. A preliminary evaluation (E0) was conducted to check whether the children had articulation disorders, and for the next 4 weeks, they lived their usual lifestyle without other treatments. Prior to the beginning of the training, a pre-evaluation (E1) was performed, and the children trained at home for ≥30 minutes per day, ≥5 times a week, over 4 weeks (a total of 20 sessions). The Smart Speech program comprised oral exercise training, breathing training, and speech training; the difficulty and type of the training were configured differently according to the participants' articulation error, exercise, and vocal ability. After the training, postevaluation (E2) was performed using the same method. Finally, 8 weeks later, postevaluation (E3) was performed as a follow-up. A voice evaluation included parameters such as maximum phonation time (MPT), fundamental frequency (F0), jitter, peak air pressure (relative average perturbation), pitch, intensity, and voice onset time. Articulation parameters included a percentage of correct consonants (PCC; U-TAP word-unit PCC, U-TAP sentence-unit PCC, and three-position articulation test) and alternate motion evaluation (diadochokinesis, DDK). Data obtained during each evaluation (E1-E2-E3) were compared. A total of 13 children with articulation disorders aged 4-10 years were enrolled in the study. In voice parameters, MPT, jitter, and pitch showed significant changes in repeated-measures ANOVA. However, only MPT showed significant changes during E1-E2 (P=.007) and E1-E3 (P=.004) in post hoc tests. Other voice parameters did not show significant changes. In articulation parameters, U-TAP, three-position articulation test (TA), and DDK showed significant changes in repeated-measures ANOVA. In post hoc tests, U-TAP (word, sentence) and TA showed significant changes during E1-E2 (P=.003, .04, and .01) and E1-E3 (P=.001, .03, and .003), and DDK showed significant changes during E1-E2 only (P=.03). Home-based serious games can be considered an alternative treatment method to improve language function. Clinical Research Information Service KCT0006448; https://cris.nih.go.kr/cris/search/detailSearch.do/20119.

Long-Term Patient-Reported Outcomes in Internationally Adopted Children with Cleft Lip and Palate.

To compare patient-reported outcomes (PROs) in internationally adopted patients with cleft lip and palate to those in non-adopted peers. Cross-sectional study. Multidisciplinary cleft team at tertiary care hospital. Patients aged ≥ 8 with cleft lip and palate attending routine cleft team evaluations September 2021 - September 2022. CLEFT-Q PRO scores. Sixty-four internationally adopted patients and 113 non-adopted patients with a mean age of 13 years were included. Compared to non-adopted peers, adopted patients demonstrated worse satisfaction with face appearance (mean 59 vs. 66, p = .044), speech function (mean 69 vs. 78, p = .005), and speech distress (mean 80 vs. 84, p = .032). No significant differences were observed on the nose, nostrils, teeth, lips, lip scar, jaws, psychological function, or social function scales (p > .05). Objective clinical evaluation corroborated these findings, with adopted patients demonstrating worse Pittsburgh Weighted Speech scores (mean 3.0 vs 1.9, p = .027) and greater incidence of articulation errors (64% vs 46%, p = .021). No significant differences were observed in rates of mood, anxiety, or behavior concerns identified on psychosocial assessment (p = .764). Among adopted patients, undergoing palatoplasty prior to adoption was associated with worse satisfaction with speech, appearance, school, and social function (p < .05). Patient-reported outcomes among internationally adopted adolescents and young adults with cleft lip and palate show slightly lower satisfaction with facial appearance and speech but otherwise demonstrate similar results to non-adopted peers on most appearance and psychosocial measures. PRO data correlated well with objective speech assessment and did not portend worse psychosocial function.

Impact of orthognathic surgery on voice and speech: a systematic review and meta-analysis.

Orthognathic surgical procedures, whether in one or both jaws, can affect structures regarding the articulation and resonance of voice and speech. Evaluating the impact of orthognathic surgery on voice and speech performance in individuals with skeletal dentofacial disharmony. Word combinations and truncations were adapted for the following electronic databases: EMBASE, PubMed/Medline, Scopus, Web of Science, Cochrane Library, and Latin American and Caribbean Literature in Health Sciences (LILACS), and grey literature. The research included studies on nonsyndromic adults with skeletal dentofacial disharmony undergoing orthognathic surgery. These studies assessed patients before and after surgery or compared them with individuals with good facial harmony using voice and speech parameters through validated protocols. Two independent reviewers performed all stages of the review. The Joanna Briggs Institute tool was used to assess risk of bias in the cohort studies, and ROBINS-I was used for nonrandomized clinical trials. The authors also performed a meta-analysis of random effects. A total of 1163 articles were retrieved after the last search, of which 23 were read in full. Of these, four were excluded, totalling 19 articles for quantitative synthesis. When comparing the pre- and postoperative periods, both for fundamental frequency, formants, and jitter and shimmer perturbation measures, orthognathic surgery did not affect vowel production. According to the articles, the main articulatory errors associated with skeletal dentofacial disharmonies prior to surgery were distortions of fricative sounds, mainly/s/ and/z/. Orthognathic surgery may have little or no impact on vocal characteristics during vowel production. However, due to the confounding factors involved, estimates are inconclusive. The most prevalent articulatory disorders in the preoperative period were distortion of the fricative phonemes/s/ and/z/. However, further studies must be carried out to ensure greater robustness to these findings. PROSPERO (CRD42022291113).

Analysis of Errors in Sentence Repetition by Subgroups of Children with Speech Sound Disorders

Objectives: Sentence repetition tasks (SRTs) are clinically useful tasks for examining working memory ability and discriminating residual language delay. This study aims to examine sentence repetition skills by groups of children with SSDs and analyze error types and morphosyntactic strengths and weaknesses in SRTs. Methods: Thirty-four children aged 5-7 years with SSDs were classified into groups with articulation disorders, phonological delays, and phonological disorders. SRTs were conducted, and errors in SRTs were analyzed in terms of lexical and grammatical morphemes and children’s sentence repetition (SR) skills were examined by two scoring systems including or excluding articulation errors. Results: In SRTs, children with phonological disorders showed more omission errors; in particular, omission of grammatical morphemes, and sentence paraphrase errors were more frequent. Children with phonological disorders showed more lexical grammatical morpheme errors than the other subgroups. Even in the scoring system that reflects both language and articulation errors, children with phonological disorders showed a lower performance than children with articulation disorders. Conclusion: Children with phonological disorders exhibited morphosyntactic weakness by showing greater difficulties in repeating grammatical morphemes accurately in SRTs. This finding suggests that systematic grammar intervention should be addressed for children with phonological disorders.

Reeducarea tulburărilor specifice de articulare a vorbirii determinate de dezechilibru muscular orofacial cu ajutorul terapiei logopedice miofuncționale

Phonetic disorders are errors of articulation and resonance of phonemes, which, in the presence or absence of organic changes in the phonoarticulatory organs, persist beyond the acquisition of perceptual and articulatory skills. For the correct production of each vowel/consonant, the structures of the articulatory apparatus come into contact in a variable way, following finely coordinated movements, and adopt a certain position to allow the correct emission of the sound. Orofacial muscle imbalances and disorders are disorders of the muscles and functions of the face and mouth. These can directly and/or indirectly affect breastfeeding, growth and development of the facial skeleton, mastication, swallowing, resting position of the tongue, speech- phonemic articulation, occlusion, temporomandibular joint (TMJ) movements, oral hygiene, stability of orthodontic treatment, facial aesthetics and others. The correct swallowing mechanism depends on the correct relationship between the muscles of the face, mouth and pharyngo-laryngeal region, but also on a balance of the entire body system. Another important element that must be taken into account, in particular, is the resting position of the tongue. Dysfunctional swallowing - refers to a condition in which there is an alteration of the mouth-lingual movements in the act of swallowing. Balancing the oro-facial musculature through education - re-education of deviant swallowing, breathing and mastication difficulties, phonatory verbal articulation alterations, malocclusion and painful symptoms of the temporomandibular joint, in different age groups is done through TMF (Myofunctional Therapy). Myofunctional therapy can lead to stable correction of swallowing abnormalities, with positive effects for correcting speech articulation disorders.

Treating a Young Child Who Stutters' Lateral Lisp: A Case Study

Purpose: This case study describes treatment recommendations for young children who stutter who present with articulation (i.e., motor-based) errors impacting the child's ability or desire to communicate. Recommendations for children who stutter with speech sound disorders have previously focused on phonological (e.g., language-based) errors; however, remediation of motor-based errors require a more direct treatment approach. Method: The case is a 3-year-old female who stutters with concomitant lateralized productions of sibilants, including /s/ and /z/. A literature review was conducted when developing the treatment plan to identify treatment elements that might best support the child's development of her speech sound skills and overall communication. Evaluation results and treatment progress data are reported across 8 months of treatment. Results: As a result of the provided motor-based approach with modifications to facilitate a positive speaking environment, the child improved her production of sibilants at the word level from 69% occurrence of lateralizations to 9%, her attitudes about her communication improved, and her stuttering severity remained the same. Conclusion: A motor-based treatment plan to improve speech sound accuracy is appropriate when working with a child who stutters with articulation errors. Individualized treatment plans should consider the motoric and emotional demands on the child during the sessions to limit the potential interaction between the speech sound treatment and stuttering. Several treatment options are discussed to help clinicians tailor treatment plans to the needs of individual children.

THE MOST TYPES OF ARTICULATION DISORDERS OCCURRING IN MENTAL RETARDED DYSLOGIA CHILDREN

When speaking, we interpret sound symbols or symbols spoken through the mouth, which is called articulation, whether the spoken word is produced clearly or not. This ability is influenced by the use of articulation organ movements. Good articulation if the speaker (communicant) when conveying what is said is heard or captured clearly by the other person (communicator), the speech does not sound good and does not experience failure or articulation errors, whether in the form of sound impressions (substitution), omission of sound (omission), sound disruption (distortion), and sound addition (addition). Dyslogia is a disorder of the mind caused by mental retardation, or intellectual disabilities whose intelligence is below average, which limits the normal IQ of 90. Children who have abnormalities or failure to produce articulations can be caused by abnormalities in the form of mental retardation, meaning that they are mentally retarded. Those with speech impairments are known as dyslogia. Mental retardation difficulties which are mainly in theform of difficulties in thinking and understanding. Life skills that can influence are certain conceptual, social and practical skills. The purpose of this research is to find out whether the most visible form of articulation failure is owned by clients with mental retardation dyslogia The research analyzed consisted of 10 (ten) samples which were secondary data, with forms of articulation failure in the form of substitution, omission, distortion and addition, also known as (SODA).

Longitudinal data on speech outcomes in internationally adopted children compared with non-adopted children with cleft lip and palate.

At the beginning of the 21st century, international adoptions of children with cleft lip and/or palate increased dramatically in Sweden. Many children arrived partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. To date, the speech development of internationally adopted (IA) children has been described up to age 7-8 years, but later development remains unstudied. To investigate speech development between ages 5 and 10 years in children born with cleft lip and palate (CLP) adopted from China and to compare them with non-adopted (NA) children with CLP. A secondary aim was to compare the frequencies of secondary palatal surgery and number of visits to a speech and language pathologist (SLP) between the groups. In a longitudinal study, 23 IA children from China were included and matched with 23 NA children born in Sweden. Experienced SLPs blindly reassessed audio recordings from routine follow-ups at ages 5 and 10 years. Velopharyngeal function (VPF) was assessed with the composite score for velopharyngeal competence (VPC-Sum) for single words and rated on a three-point scale (VPC-Rate) in sentence repetition. Target sounds in words and sentences were phonetically transcribed. Per cent correct consonants (PCC) were calculated at word and sentence levels. For in-depth analyses, articulation errors were divided into cleft speech characteristics (CSCs), developmental speech characteristics (DSCs) and s-errors. Information on secondary palatal surgery and number of visits to an SLP was collected. VPF differed significantly between the groups at both ages when assessed with VPC-Sum, but not with VPC-Rate. Regardless of the method for assessing VPF, a similar proportion in both groups had incompetent VPF but fewer IA than NA children had competent VPF at both ages. IA children had lower PCC at both ages at both word and sentence levels. More IA children had CSCs, DSCs and s-errors at age 5 years, and CSCs and s-errors at age 10. The development of PCC was significant in both groups between ages 5 and 10 years. The proportion of children receiving secondary palatal surgery did not differ significantly between the groups, nor did number of SLP visits. CSCs were more persistent in IA children than in NA children at age 10 years. Interventions should target both cleft and DSCs, be comprehensive and continue past the pre-school years. What is already known on this subject At the beginning of the 21st century, IA children with cleft lip and/or palate arrived in Sweden partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. Studies up to age 7-8 years show that adopted children, compared with NA peers, have poorer articulation skills, demonstrate both cleft-related and developmental articulation errors, and are more likely to have velopharyngeal incompetence. Several studies also report that adopted children more often require secondary palatal surgery due to fistulas, dehiscence or velopharyngeal incompetence compared with NA peers. What this paper adds to existing knowledge This longitudinal study provides additional knowledge based on longer follow-ups than previous studies. It shows that the proportion of children assessed to have incompetent VPF was similar among IA and NA children. It was no significant difference between the groups regarding the proportion that received secondary palatal surgery. However, fewer IA children were assessed to have a competent VPF. Developmental articulation errors have ceased in most IA and all NA children at age 10 years, but significantly more adopted children than NA children still have cleft-related articulation errors. What are the potential or actual clinical implications of this work? Speech and language therapy should target both cleft-related and developmental articulation errors. When needed, treatment must be initiated early, comprehensive, and continued past the pre-school years, not least for adopted children.

Speech error rates after a sports-related concussion.

Alterations in speech have long been identified as indicators of various neurologic conditions including traumatic brain injury, neurodegenerative diseases, and stroke. The extent to which speech errors occur in milder brain injuries, such as sports-related concussions, is unknown. The present study examined speech error rates in student athletes after a sports-related concussion compared to pre-injury speech performance in order to determine the presence and relevant characteristics of changes in speech production in this less easily detected neurologic condition. A within-subjects pre/post-injury design was used. A total of 359 Division I student athletes participated in pre-season baseline speech testing. Of these, 27 athletes (18-22 years) who sustained a concussion also participated in speech testing in the days immediately following diagnosis of concussion. Picture description tasks were utilized to prompt connected speech samples. These samples were recorded and then transcribed for identification of errors and disfluencies. These were coded by two trained raters using a 6-category system that included 14 types of error metrics. Repeated measures analysis of variance was used to compare the difference in error rates at baseline and post-concussion. Results revealed significant increases in the speech error categories of pauses and time fillers (interjections/fillers). Additionally, regression analysis showed that a different pattern of errors and disfluencies occur after a sports-related concussion (primarily time fillers) compared to pre-injury (primarily pauses). Results demonstrate that speech error rates increase following even mild head injuries, in particular, sports-related concussion. Furthermore, the speech error patterns driving this increase in speech errors, rate of pauses and interjections, are distinct features of this neurological injury, which is in contrast with more severe injuries that are marked by articulation errors and an overall reduction in verbal output. Future studies should consider speech as a diagnostic tool for concussion.

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.

Long-term speech outcome in patients with Robin sequence after cleft palate repair and tongue-lip adhesion: A 21-year retrospective analysis

The purpose of this study was to assess the effect of tongue−lip adhesion (TLA) on the long-term speech and articulation outcomes of patients with Robin sequence (RS) after cleft palate repair. Outcomes were compared to those in patients with RS who required positioning alone and to patients with isolated cleft palate (ICP).All consecutive patients with RS (with or without TLA) versus isolated cleft palate (ICP) who underwent cleft palate repair were retrospectively reviewed. Speech and articulation included all assessments between the age of 3–6 years. Secondary speech operations, velopharyngeal insufficiency (VPI), hypernasality, and articulation errors by cleft-type characteristics (CTC), including 4 categories (passive), non-oral, anterior-oral, and posterior-oral. A total of 41 RS patients and 61 ICP patients underwent repair with sufficient follow-up. Of them, 23 patients underwent a TLA at median age of 12 days. Rates of hypernasality (p = 0.004), secondary speech operations (p = 0.004), and posterior oral CTC (p = 0.042) were higher in RS compared to ICP. Isolated RS had speech outcomes similar to those of ICP; however, syndromic RS patients needed more secondary speech operations compared to isolated RS (p = 0.043). TLA-RS patients did not demonstrate differences in speech outcomes or any CTCs (all p > 0.05) compared to non−TLA-RS patients, except for the anterior oral CTC (74% TLA-RS vs 28% non−TLA-RS, p = 0.005).Within the limitations of the study, it seem that TLA does not affect long-term velopharyngeal function in patients with RS. However, TLA-RS patients demonstrated higher rates of anterior-oral CTC, which might be related to a different positioning of the tongue after TLA. Every effort should be taken to treat patients with RS conservatively instead of with TLA because of this demonstrated a negative effect on one type of articulation error. However, if conservative therapy fails, a TLA is still a valuable adjunct in the treatment of RS, and cleft speech pathologists who treat such patients should be more aware of this phenomenon in order to improve long-term articulation outcomes.

The Apraxia of Speech Rating Scale: Reliability, Validity, and Utility.

The purpose of this study was to examine the interrater reliability and validity of the Apraxia of Speech Rating Scale (ASRS-3.5) as an index of the presence and severity of apraxia of speech (AOS) and the prominence of several of its important features. Interrater reliability was assessed for 27 participants. Validity was examined in a cohort of 308 participants (120 with and 188 without progressive AOS) through item analysis; item-Total score correlations; correlations among ASRS Total score and component subscores and independent clinical ratings of AOS, dysarthria and aphasia severity, intelligibility, and articulatory errors, as well as years postonset and age; and regression models assessing item and Total score prediction of AOS presence. Interrater reliability was good or excellent for most items and excellent for the Total score. Item and Total score analyses revealed good separation of participants with versus without AOS. Inter-item and item-Total score correlations were generally moderately high as were correlations between the ASRS Total score and independent ratings of AOS severity, intelligibility, and articulatory errors. The Total score was not meaningfully correlated with ratings of aphasia and dysarthria severity, years postonset, or age. Total scores below 7 and above 10 revealed excellent diagnostic sensitivity and specificity for AOS. The presence of eight or more abnormal features was also highly predictive of AOS presence. The ASRS-3.5 is a reliable and valid scale for identifying the presence and severity of AOS and its predominant features. It has excellent sensitivity to AOS presence and excellent specificity relative to aphasia and dysarthria in patients with neurodegenerative disease. https://doi.org/10.23641/asha.21817584.

A Comparison of Speech Dysfluencies Before and After Sports-Related Concussion

<h3>Research Objectives</h3> The purpose of this study is to compare the number and type of speech disfluencies that occur in college-aged athletes at baseline compared to after a sports-related concussion. <h3>Design</h3> Pre-post (repeated measures). <h3>Setting</h3> University. <h3>Participants</h3> A total of 230 Division I student athletes participated in pre-season speech testing. Twelve students (18-22 years) who sustained a concussion participated in speech testing in the days following concussion. Picture description speech samples were independently coded by three trained raters for 17 error types in the traditional categories of errors defined in fluency analysis. <h3>Interventions</h3> Not Applicable. <h3>Main Outcome Measures</h3> Error types were sorted into three categories: stuttering-like dysfluencies (part-word repetition, single-syllable whole-word repetition, prolongation, block), articulation errors (substitution, distortion, addition, omission), and other dysfluencies (multisyllable whole-word repetition, revision, abandoned or incomplete segment, interjection, filler, phrase repetition, pauses). <h3>Results</h3> Within-subjects analysis comparing the difference in percent error scores at baseline and post-concussion revealed significant differences for interjections (t(11)=-2.678, p< .05). The Other Disfluency category was also significantly different (t(11)= -2.735, p< .05), with more errors occurring after a concussion. No change in the Stuttering-Like Disfluency (t(11)= -0.799, p>.05) or Articulation Error category (t(11)=-0.045, p>.05) was found. <h3>Conclusions</h3> As predicted, pre-post comparisons demonstrated an overall increase in total number of speech errors after a concussion (Mean Baseline = 11.5 errors; Mean Concussion = 15.9 errors). Results demonstrate that specific speech fluency changes occur following mild sports-related concussions. Future studies should consider speech as a diagnostic tool for concussion. <h3>Author(s) Disclosures</h3> Funding for this work is through an internal grant by Seton Hall University. No other relevant disclosures.

Examining the Relationship Between Task-Switching and Speech Errors in Parkinson's Disease

<h3>Research Objectives</h3> To establish the link between cognitive flexibility deficits and errors in speech production in Parkinson's disease (PD). A secondary goal is to show that this relationship exists despite the presentation of "normal" overall cognitive functioning on a standard screening test (Montreal Cognitive Battery; MoCA). <h3>Design</h3> Regression (between-subjects). <h3>Setting</h3> University. <h3>Participants</h3> Fifteen people with PD and 15 adult controls participated in this study. All were native speakers of American English, had no upper respiratory tract infections, and passed depression and hearing screenings. People with PD varied on a continuum of overall disease and speech severity. Controls had no history of hearing, speech-language, or neurological disorders. All study procedures were approved by the Institutional Review Board. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> 1) Metrics of cognitive flexibility (reaction times, error rates) 2) MoCA scores, speech errors (articulation errors, stuttering-like disfluencies, and other disfluencies) and 3) Speech rate. <h3>Results</h3> Results show that people with PD would present with impaired cognitive flexibility (slower reaction times to switch demands compared to controls) despite falling within normal range on standard clinical screenings of cognition (MoCA) and that people with PD and controls show an inverse relationship between cognitive flexibility and the number of errors during speech production with group differences in both flexibility and speech error rates occurring. <h3>Conclusions</h3> Our findings suggest that impairments in cognition in PD may occur earlier than previously thought and may only be apparent on more sensitive tests of cognitive flexibility that are typically not performed as standard-of-care. A relationship between cognitive flexibility and speech errors suggests a role of cognitive flexibility during speech-motor control. These deficits should be considered when recommending therapy and designing interventions. <h3>Author(s) Disclosures</h3> Funding for this work is through an internal grant by Seton Hall University. No other relevant disclosures.

An Investigation of the Relationship between Oral Sucking Habits and Types of Articulation Errors in Preschool Children with Phonological Impairment

An Investigation of the Relationship between Oral Sucking Habits and Types of Articulation Errors in Preschool Children with Phonological Impairment

How Early Can We Predict the Need for VPI Surgery?

This retrospective study reviewed documentation of children with moderate-to-severe VPI at age 3 years who did not undergo VPI surgery until age 5 years. Based on the national cleft register, 959 patients with syndromic and nonsyndromic CP were treated by the craniofacial team at Helsinki University Hospital, Finland between 2000 and 2014. Eighty-six patients fulfilled the study inclusion criteria. The speech pathologist evaluated velopharyngeal function at age 3, 5, and 8 years. Of the 86 children presenting with moderate-to-severe VPI at age 3 years, 94% still had moderate-to-severe VPI at age 5 years, even though speech therapy was offered to 77%. Of those whose velopharyngeal function improved by age 5 years, function regressed to incompetent over time. Overall, 93% underwent VPI surgery and 82% underwent VPI surgery between ages 5 and 8 years. Only 23% at age 8 years still had moderate-to-severe VPI. Speech therapy alone did not improve VPI speech characteristics. Moderate-to-severe VPI did not improve from 3 to 5 years or improved but subsequently relapsed. This suggests that the decision for VPI surgery can be made for children aged 3 years with moderate-to-severe VPI.

Leveraging audible and inaudible signals for pronunciation training by sensing articulation through a smartphone

• Under pronunciation principles, this paper presents a smartphone-based pronunciation training system for practicing monophthong regarding vowel articulation. • Speech and ultrasonic signals are captured and analyzed simultaneously to determine the tongue position and shape of the lips respecting uttering vowels. • The proposed system implementing a commercial smartphone is robust with high accuracy for practical scenarios. • The evaluation for its impact on user experience shows that the proposed system has raised learning engagement and enjoyment. Learning a foreign language pronunciation is the most challenging task for non-native speakers. Improving pronunciation based on feedback on pronunciation error scores is also not easy for learners. Our goal is to develop an alternative approach to pronunciation training that can point out articulation errors at the phoneme level to users through a smartphone-based system. Using self-correction as a means of ensuring learners' engagement, we focus on self-correction of pronunciation by adjusting articulation. In order to identify articulation concerning pronunciation, the system evaluates both audible and inaudible acoustic signals to examine fine-grained frequency-shifting direction of mouth movements and tongue position simultaneously. The result shows that the system can reach an average accuracy of 99.09% and is robust in different scenarios and genders. Additionally, the evaluation of the user study reveals that the proposed system provides positive user experiences and allows learners to improve their pronunciation more efficiently.

Audio-video database from subacute stroke patients for dysarthric speech intelligence assessment and preliminary analysis

Early, objective, and accurate assessment and identification of dysarthria caused by neurological diseases are essential in neurorehabilitation. This could be achieved by a robust smart system. However, developing such a system requires a standard training database that is properly labelled, which unfortunately is currently lacking. The present study aimed to establish a standardized, audio-visual integrated speech database of subacute stroke patients with dysarthria, named “The Mandarin Subacute Stroke Dysarthria Multimodal (MSDM) Database”, which included audio-visual data from 25 subacute stroke patients and 25 healthy participants. In addition, comprehensive subjective clinical assessment information of speech-motor function and ecological psychology of each patient was also provided. Based on this database, a pilot study was conducted to detect the significant acoustic and visual characteristics that revealed the severity of dysarthria related to subacute stroke. The present study offered a novel perspective to objectively quantify and identify the pathological differences in speech production. It can serve as a baseline for the development of an automatic intelligent system for assessing severity of dysarthria. In conclusion, the establishment and analysis of high-quality database on articulation errors associated with dysarthria will benefit clinical treatments and contribute to the realization of automatic diagnostic tools that can be implemented for clinical telehealth services.

LINGUISTIC AND NEUROPSYCHOLOGICAL ANALYSIS OF LANGUAGE PRODUCTION IN 4-6-YEAR-OLD GEORGIAN-SPEAKING CHILDREN WITH TYPICAL LANGUAGE DEVELOPMENT AND SPECIFIC LANGUAGE DISORDER

The present study aimed at conducting the neuropsychological and linguistic analysis of expressive lan- guage disorder in the population of Georgian-speaking children. 4-6-year-old children with expressive&nbsp; language disorder and typical language development participated in the study (40 participants in total). &nbsp;&nbsp;The child’s speech was assessed through formal testing and free play in informal situations.&nbsp; The comparison of the two groups showed that the children with typical language development signifi- cantly differ from the group with language disorder by articulation (t (38) = - 4,65, p&lt;0,001), phono- logical (t (38) = - 2,48, p&lt;0,05), and syntactic errors (t (38) = - 3,67), length of utterance (t (38) = 3,62,&nbsp; p=0,001), and the total number of errors (t (38) =- 5,36, p&lt;0,001). The above data lead to the following&nbsp; conclusion: Georgian-speaking children with expressive language disorder mostly make phonological,&nbsp; syntactic and articulation errors. They also find difficult to construct complex sentences. The comparison&nbsp; of the two groups did not reveal qualitative differences.&nbsp; Both groups made the same type of mistakes.&nbsp; The only difference was the total number of errors. &nbsp;Regression analysis showed that the length of utterance and the total production can only predict the type&nbsp; of errors in average population.The interpretation of&nbsp; the&nbsp; research results&nbsp; leads to four&nbsp; general conclusions: 1. Expressive language&nbsp; disorder&nbsp; is not&nbsp; atypical&nbsp; language&nbsp; development&nbsp; disorder and only implies prolonged&nbsp; language acqui- sition; 2. The deficiency profile manifested in the case of expressive language disorder depends on a&nbsp; concrete language&nbsp; and the requirements imposed on the child by this language; 3. Phonetic,&nbsp; articulation,&nbsp; syntactic errors and short sentences are mostly typical of Georgian-speaking children with expressive&nbsp; language disorder; 4. &nbsp;According to Levelt’s&nbsp; cognitive model, the stage of grammatical and phonological&nbsp; encoding and the stage of articulation of phonetic plan are the deficient links in the population of Geor- gian-speaking children.