DDK Rate Research Articles

The effect of real word stimuli versus non-word stimuli on oral diadochokinetic rates across the life span: An item discrimination analysis.

Diadochokinetic (DDK) rate tasks are extensively used in the evaluation of speech disorders; however, it is unclear how the different types of speech stimuli affect DDK rate performance. To investigate the effect of age, gender and type of stimuli (non-words versus real words) on the DDK rates in individuals across the lifespan and to provide normative data for Greek. Also to examine the discrimination ability of the speech DDK stimuli administered (non-words and real words) based on a dual DDK assessment protocol using a polytomous item response theory (IRT) model. The participants were 1747 monolingual Greek speakers (376 children, aged 4-17 years; and 1371 adults, aged 18-90+ years). All participants had normal hearing acuity which allowed them to understand and follow instructions. Participants with a medical condition or a language disorder which would affect DDK rate performance were excluded from the study. The time-by-count method was used, and all participants had to repeat as accurately and fast as possible: (1) four disyllabic non-words (/'gaba/, /'taka/, /'kata/, /'baga/), (2) four disyllabic real words (/'kapa/, /'tapa/, /ka'la/, /'paka/) and (3) two trisyllabic non-words (/'pataka/, /'badaga/). All responses were recorded and the speech samples that did not include at least 5 s of correct repetitions were excluded from the analysis. Age affected significantly DDK rates with performance increasing gradually until approximately the age of 40 and then gradually decreasing. Gender had no effect. Overall, there was a significant advantage of disyllabic real word stimuli over disyllabic non-word stimuli and of trisyllabic non-word stimuli over disyllabic non-word stimuli on DDK rates performance. IRT analysis suggested that the data fit the polytomous model reasonably well and all DDK stimuli (real words and non-words) showed a strong relationship (loadings > 0.50) with the latent trait. The current study complements prior research which supports that age and type of stimuli significantly affect DDK rates performance. It is the first study, that testifies to the benefit of real-word stimuli over non-word stimuli on DDK rates across the lifespan in a large representative sample. The implementation of IRT analysis provides empirical evidence about the discrimination ability of the DDK stimuli administered and confirms the reliability of this dual DDK assessment protocol. These findings are valuable for clinicians who work with motor speech disorders. What is already known on this subject Age, type of stimuli (real words versus non-words) and language significantly affect DDK rates performance. Current research strongly suggests the administration of language-specific norms since language-dependent features seem to have a noteworthy effect on the DDK rates, but scarce evidence exists about the discriminatory ability of the DDK speech stimuli commonly administered. What this study adds to the existing knowledge Conflicting findings have been reported about the effect of different types of DDK speech stimuli (real words and non-words) but no study to date has evaluated their discriminatory abilities. The current study is the first to implement a polytomous IRT model to examine this issue. This is also the first study to attempt an investigation of the effect of types of stimuli (real words versus non-words) on a large representative sample across the lifespan (4-90+ years) and to provide normative data for Greek. What are the practical and clinical implications of this work? The present study offers concrete evidence about the advantage of real-word stimuli over non-word stimuli in Greek, as well as normative data for the Greek-speaking populations. Moreover, the IRT analysis testifies to the discriminatory ability of real-word and non-word stimuli affirming the reliability of the present dual DDK assessment protocol as a psychometrically sound measure of DDK ability. The above has significant value for clinicians who work with individuals with motor speech disorders as the protocol can help them with the diagnosis and differential diagnosis of motor speech disorders.

Wav2DDK: Analytical and Clinical Validation of an Automated Diadochokinetic Rate Estimation Algorithm on Remotely Collected Speech.

Oral diadochokinesis is a useful task in assessment of speech motor function in the context of neurological disease. Remote collection of speech tasks provides a convenient alternative to in-clinic visits, but scoring these assessments can be a laborious process for clinicians. This work describes Wav2DDK, an automated algorithm for estimating the diadochokinetic (DDK) rate on remotely collected audio from healthy participants and participants with amyotrophic lateral sclerosis (ALS). Wav2DDK was developed using a corpus of 970 DDK assessments from healthy and ALS speakers where ground truth DDK rates were provided manually by trained annotators. The clinical utility of the algorithm was demonstrated on a corpus of 7,919 assessments collected longitudinally from 26 healthy controls and 82 ALS speakers. Corpora were collected via the participants' own mobile device, and instructions for speech elicitation were provided via a mobile app. DDK rate was estimated by parsing the character transcript from a deep neural network transformer acoustic model trained on healthy and ALS speech. Algorithm estimated DDK rates are highly accurate, achieving .98 correlation with manual annotation, and an average error of only 0.071 syllables per second. The rate exactly matched ground truth for 83% of files and was within 0.5 syllables per second for 95% of files. Estimated rates achieve a high test-retest reliability (r = .95) and show good correlation with the revised ALS functional rating scale speech subscore (r = .67). We demonstrate a system for automated DDK estimation that increases efficiency of calculation beyond manual annotation. Thorough analytical and clinical validation demonstrates that the algorithm is not only highly accurate, but also provides a convenient, clinically relevant metric for tracking longitudinal decline in ALS, serving to promote participation and diversity of participants in clinical research. https://doi.org/10.23641/asha.23787033.

Diadochokinesis Performance and Its Link to Cognitive Control: Alternating Versus Non-Alternating Diadochokinesis.

In a previous publication, we observed that maximum speech performance in a nonclinical sample of young adult speakers producing alternating diadochokinesis (DDK) sequences (e.g., rapidly repeating "pataka") was associated with cognitive control: Those with better cognitive switching abilities (i.e., switching flexibly between tasks or mental sets) showed higher DDK accuracy. To follow up on these results, we investigated whether this previously observed association is specific to the rapid production of alternating sequences or also holds for non-alternating sequences (e.g., "tatata"). For the same sample of 78 young adults as in our previous study, we additionally analyzed their accuracy and rate performance on non-alternating sequences to investigate whether executive control abilities (i.e., indices of speakers' updating, inhibition, and switching abilities) were more strongly associated with production of alternating, as compared with non-alternating, sequences. Of the three executive control abilities, only switching predicted both DDK accuracy and rate. The association between cognitive switching (and updating ability) and DDK accuracy was only observed for alternating sequences. The DDK rate model included a simple effect of cognitive switching, such that those with better switching ability showed slower diadochokinetic rates across the board. Thus, those with better cognitive ability showed more accurate (alternating) diadochokinetic production and slower maximum rates for both alternating and non-alternating sequences. These combined results suggest that those with better executive control have better control over their maximum speech performance and show that the link between cognitive control and maximum speech performance also holds for non-alternating sequences.

Speech timing and monosyllabic diadochokinesis measures in the assessment of amyotrophic lateral sclerosis in Canadian French

Purpose The primary objective of this study was to determine if speech and pause measures obtained using a passage reading task and timing measures from a monosyllabic diadochokinesis (DDK) task differ across speakers of Canadian French diagnosed with amyotrophic lateral sclerosis (ALS) presenting with and without bulbar symptoms, and healthy controls. The secondary objective was to determine if these measures can reflect the severity of bulbar symptoms. Method A total of 29 Canadian French speakers with ALS (classified as bulbar symptomatic [n = 14] or pre-symptomatic [n = 15]) and 17 age-matched healthy controls completed a passage reading task and a monosyllabic DDK task (/pa/ and /ta/), for up to three follow-up visits. Measures of speaking rate, total duration, speech duration, and pause events were extracted from the passage reading recordings using a semi-automated speech and pause analysis procedure. Manual analysis of DDK recordings provided measures of DDK rate and variability. Result Group comparisons revealed significant differences (p = < .05) between the symptomatic group and the pre-symptomatic and control groups for all passage measures and DDK rates. Only the DDK rate in /ta/ differentiated the pre-symptomatic and control groups. Repeated measures correlations revealed moderate correlations (rrm = > 0.40; p = < 0.05) between passage measures of total duration, speaking rate, speech duration, and number of pauses, and ALSFRS-R total and bulbar scores, as well as between DDK rate and ALSFRS-R total score. Conclusion Speech and pause measures in passage and timing measures in monosyllabic DDK tasks might be suitable for monitoring bulbar functional symptoms in French speakers with ALS, but more work is required to identify which measures are sensitive to the earliest stages of the disease.

The automated screening of speech motor development in children based on the sequential motion rate

BackgroundMotor skills in children have traditionally been examined via challenging speech tasks such as syllable repetition, and calculating the syllabic rate using a stopwatch or by inspecting the oscillogram followed by a laborious comparison of the scores on a look-up table representing the typical performances of children of the given age and sex. As the commonly used performance tables are over-simplified to allow for manual scoring, we raise the question of whether a computational model of motor skills development could be more informative, and could allow for the automated screening of children to detect underdeveloped motor skills. MethodsWe recruited a total of 275 children aged four to 15 years. All the participants were native Czech speakers with no history of hearing or neurological impairments. We recorded each child's performance of/pa/-/ta/-/ka/syllable repetition. Various parameters of diadochokinesis (DDK; DDK rate, DDK regularity, voice onset time [VOT] ratio, syllable, vowel and VOT duration) were investigated in the acoustic signals using supervised reference labels. Female and male participants were analyzed separately by comparing younger, middle, and older age groups of children via ANOVA. Finally, we implemented a fully automated model that estimated the developmental age of a child based on the acoustic signal, and evaluated its accuracy using Pearson's correlation coefficient and normalized root-mean-squared errors (RMSEs). ResultsThe DDK rate reflected the ages of the children proportionally (p < 0.001). Other DDK parameters also showed strong sensitivity to age (p < 0.001), with the exception of VOT duration, which had a smaller effect (p = 0.091). The effect of age was found to be sex specific for the syllable length (p < 0.001) and DDK rate (p = 0.003). We observed that females spoke more slowly and had a longer VOT at preschool age (p < 0.001). The DDK rate obtained via the automated algorithm was strongly correlated with the reference (p < 0.001, Pearson's correlation coefficient of 0.97), with a low normalized RMSE of 3.77%. ConclusionsAs children develop their motor skills, they are capable of shortening the vowels to increase the rate of syllabic repetitions. The nonlinear development in childhood and adolescence, with a steady state in adulthood, follows a logistic function for the DDK rate. This study demonstrates that the development of motor skills can be examined sensitively and more appropriately by a fully automated noninvasive procedure that also accounts for the dispersion of values within age brackets.

Oral diadochokinetic production in children with typical speech development and speech-sound disorders.

AIMS: To investigate the developmental trajectory of the rate and perceptual assessment of oral diadochokinesis (DDK) in typically developing children compared with adults. Also to examine the characteristics of DDK productions in children with speech sound disorders (SSD) and the relationship between DDK production and percentage of consonants correct (PCC). Participants were 316 typically developing children and 90 children with SSD from 3 to 9 years old, as well as 20 adults with normal speech. The mono-, bi- and trisyllabic nonsense strings containing Korean tense consonants and the vowel [a] were used for DDK tasks. The number of iterations per s was measured as the DDK rate for each stimulus. The perceptual assessment of DDK productions was also performed for regularity, accuracy and rate. The DDK rates increased throughout childhood, but the oldest children, 9-year-olds in the current study, did not achieve adult-like rates for all mono- and trisyllabic strings. Children with SSD also did not show significant differences from typically developing children when the DDK productions were analysed using only accurate tokens. The PCC of children with SSD showed higher correlations with regularity, accuracy and rate of perceptual ratings than the timed DDK rate. This study highlighted the fact that the comprehensive evaluation of DDK productions may provide even more useful information about children's oral motor skills. What is already known on the subject Rates of DDK reflect the motor skills of the articulatory systems independently of phonological skills; therefore, the tasks are widely used in the diagnostic evaluations of speech disorders in both children and adult populations. However, a substantial number of studies have questioned the validity and usefulness of DDK rates for evaluating speech abilities. Also, the literature suggested that the measure of DDK rate alone does not provide a clear and useful indication of children's oral motor skills. DDK tasks should be analysed in terms of accuracy and consistency as well as rate. What this paper adds to the existing knowledge The literature reporting normative DDK performance has mainly been based on English speakers. As different consonants have different temporal characteristics, the linguistic and segmental features of DDK tasks can impact the DDK rate. This study established a norm for DDK rate for Korean-speaking children and investigated the developmental trajectory of DDK performance in typically developing children compared with adults. This study suggested that the comprehensive evaluation of DDK productions may provide even more useful information about children's oral motor skills by examining the characteristics of DDK productions in children with SSD. What are the potential or actual clinical implications of this work? This study provided normative data of young Korean-speaking children aged 3-9 years. Normative data in children under 5 years of age are valuable given that the majority of children referred for speech difficulty assessments are between 3 and 5 years of age, but only a few studies have provided the normative data in young children. This study showed that many children could not complete DDK tasks correctly and provided additional support for the notion that other aspects of DDK performance, including accuracy and regularity, may yield more useful diagnostic indications than timed DDK rates alone.

Automated Analysis of Phonoarticulatory Diadochokinesis in Tamil Speakers

Diadochokinetic rate (DDK) quantifies the laryngeal and oral muscle coordination, but there are insufficient baseline evidence exist, that limits the effectiveness of computerized DDK evaluation in assessing motor speech control. In the end, this study will give normative data on age and gender effects on both oral and laryngeal DDK in Tamil speakers. Cross sectional Study. A total of 150 participants in the age range of 17-25;11 years were divided into three groups- Group I (17-19;11 years), Group II (20-22;11 years) and Group III (23-25;11 years) with equal number of male and female. The participants were asked to produce /pʌ/, /tʌ/, /kʌ/, /pʌtʌkʌ/, /a/& /i/ for 5 seconds in Motor Speech Profile (MSP), at Computerized Speech Lab (CSL). The parameters such as Average DDK period (DDKavp), average DDK rate (DDKavr), Standard deviation(SD) of DDK period (DDKsdp), Coefficient of Variation of DDK period (DDKcdp), Perturbations of DDK period (DDKJit) and Coefficient of variation of the DDK peak intensity (DDKcvi) were selected for analysis. The effect of age was noted for Laryngeal DDK, the DDKavr of /a/ (P=0.008) and /i/ (P=0.04) and DDKcdp for /a/ (P=0.01), the mean values of those parameters are higher for the individuals within the age of 23-25;11 years but no difference was observed across the age for Oral DDK. The effect of gender was noted for Laryngeal DDK, DDKsdp (P=0.007) and DDKJit (P=0.04) for /i/, the mean values are higher for females. For Oral DDK, DDKJit (P=0.006) for /kʌ/ the mean values are higher for females. The normative data has been established for the Tamil speakers. Age specific normative should be used during the DDK evaluation of speech disorders in MSP, CSL.

Vocal and articulatory performance fluctuates across the menstrual cycle: Acoustic analysis of daily single participant speech data over three months

The impact of sex hormones on voice and speech has been observed across the menstrual cycle; however, the evidence remains mixed. Here, we investigated voice and articulatory performance as a function of the menstrual cycle over three months via an intensive longterm single case experimental design. A 17-yearold naturally cycling female who did not use oral/hormonal contraceptives gave a written consent to participate in the study over a period of three cycles (i.e., 90 days). Daily urine sample test strips were utilized to identify the onset of ovulation (via luteinizing hormone, LH). Daily voice and articulation tasks including a Maximum Phonation Time (MPT) task, a diadochokinesis (DDK) task were completed. A harmonic regression analysis showed a linear learning effect for DDK rate (p&amp;lt;.00001) with a fluctuation of values as a function of the menstrual cycle (p = 0.024). MPT showed a cyclic fluctuation (p = 0.028) but no linear learning effect. Linear and harmonic terms for fundamental frequency (measured from MPT recordings) showed no significant patterns. Understanding hormone driven variability in speech and voice helps to inform remediation strategies that aim to minimize the impact of speech motor and voice disorders across the lifespan.

Impact of oral motor task training on corticomotor pathways and diadochokinetic rates in young healthy participants.

BackgroundStudies addressing the training‐induced neuroplasticity and interrelationships of the lip, masseter, and tongue motor representations in the human motor cortex using single syllable repetition are lacking.ObjectiveThis study investigated the impact of a repeated training in a novel PaTaKa diadochokinetic (DDK) orofacial motor task (OMT) on corticomotor control of the lips, masseter, and tongue muscles in young healthy participants.MethodsA total of 22 young healthy volunteers performed 3 consecutive days of training in an OMT. Transcranial magnetic stimulation was applied to elicit motor evoked potentials (MEPs) from the lip, masseter, tongue, and first dorsal interosseous (FDI, internal control) muscles. MEPs were assessed by stimulus–response curves and corticomotor mapping at baseline and after OMT. The DDK rate from PaTaKa single syllable repetition and numeric rating scale (NRS) scores were also obtained at baseline and immediately after each OMT. Repeated‐measures analysis of variance was used to detect differences at a significance level of 5%.ResultsThere was a significant effect of OMT and stimulus intensity on the lips, masseter, and tongue MEPs compared to baseline (p < .001), but not FDI MEPs (p > .05). OMT increased corticomotor topographic maps area (p < .001), and DDK rates (p < .01).ConclusionOur findings suggest that 3 consecutive days of a repeated PaTaKa training in an OMT can induce neuroplastic changes in the corticomotor pathways of orofacial muscles, and it may be related to mechanisms underlying the improvement of orofacial fine motor skills due to short‐term training. The clinical utility should now be investigated.

Validating Automatic Diadochokinesis Analysis Methods Across Dysarthria Severity and Syllable Task in Amyotrophic Lateral Sclerosis.

Oral diadochokinesis (DDK) is a standard dysarthria assessment task. To extract automatic and semi-automatic DDK measurements, numerous DDK analysis algorithms based on acoustic signal processing are available, including amplitude based, spectral based, and hybrid. However, these algorithms have been predominantly validated in individuals with no perceptible to mild dysarthria. The behavior of these algorithms across dysarthria severity is largely unknown. Likewise, these algorithms have not been tested equally for various syllable types. The goal of this study was to evaluate the performance of five common DDK algorithms as a function of dysarthria severity, considering syllable types. We analyzed 282 DDK recordings of /ba/, /pa/, and /ta/ from 145 participants with amyotrophic lateral sclerosis. Recordings were stratified into mild, moderate, or severe dysarthria groups based on individual performance on the Speech Intelligibility Test. Analysis included manual and automatic estimation of the number of syllables, DDK rate, and cycle-to-cycle temporal variability (cTV). Validation metrics included Bland-Altman mixed-effects limits of agreement between manual and automatic syllable counts, recall and precision between manual and automatic syllable boundary detection, and Kendall's tau-b correlations between manual and algorithm-detected DDK rate and cTV. The amplitude-based algorithm (absolute energy) yielded the strongest correlations with manual analysis across all severity groups for DDK rate (τ b = 0.7-0.84) and cTV (τ b = 0.7-0.84) and the narrowest limits of agreement (-5.92 to 7.12 syllable difference). Moreover, this algorithm also provided the highest mean recall and precision across severity groups for /ba/ and /pa/, but with significantly more variation for/ta/. Algorithms based on signal energy analysis appeared to be the most robust for DDK analysis across dysarthria severity and syllable types; however, it remains prone to error against severe dysarthria and alveolar syllable context. Further development is needed to address this important issue.

Articulatory network reorganization in Parkinson's disease as assessed by multimodal MRI and acoustic measures

IntroductionHypokinetic dysarthria (HD) is common in Parkinson's disease (PD). Our objective was to evaluate articulatory networks and their reorganization due to PD pathology in individuals without overt speech impairment using a multimodal MRI protocol and acoustic analysis of speech. MethodsA total of 34 PD patients with no subjective HD complaints and 25 age-matched healthy controls (HC) underwent speech task recordings, structural MRI, and reading task-induced and resting-state fMRI. Grey matter probability maps, task-induced activations, and resting-state functional connectivity within the regions engaged in speech production (ROIs) were assessed and compared between groups. Correlation with acoustic parameters was also performed. ResultsPD patients as compared Tto HC displayed temporal decreases in speech loudness which were related to BOLD signal increases in the right-sided regions of the dorsal language pathway/articulatory network. Among those regions, activation of the right anterior cingulate was increased in PD as compared to HC. We also found bilateral posterior superior temporal gyrus (STG) GM loss in PD as compared to HC that was strongly associated with diadochokinetic (DDK) irregularity in the PD group. Task-induced activations of the left STG were increased in PD as compared to HC and were related to the DDK rate control. ConclusionsThe results provide insight into the neural correlates of speech production control and distinct articulatory network reorganization in PD apparent already in patients without subjective speech impairment.

Characteristics of Diadochokinesis in Typically Developing Children and Adults

Purpose: The purpose of this study was to examine the characteristics of the rate and perceptual judgment of diadochokinesis (DDK) in typically developing children and adults.Methods: Participants were typically developing children aged 2;6 to 9;11 and normal adults. For DDK tasks, they were asked to repeat [p*a], [t*a], [k*a], [p*at*a], and [p*at*ak*a] accurately and quickly with one breath. The number of repetitions per second was measured as DDK rate for each stimuli. The perceptual judgment of DDK were also performed in terms of regularity, rate, and accuracy using a three-point scale.Results: Children showed increases in the number of repetitions per second for all the DDK tasks with age. However, all the children groups between ages 2;6 and 9:11 exhibited significantly slower DDK rates than adults. In the perceptual judgment of DDK tasks, accuracy, rate, and consistency of sequential motion rates using [p*at*a] and [p*at*ak*a] showed statistically significant differences across age groups. Children demonstrated similar accuracy of SMR tasks with adults after age 6;0.Conclusion: This study showed developmental patterns of speech motor skills based on rate, accuracy, and consistency of DDK tasks. This study provides references for assessing speech motor skills related to children with speech difficulties.

Tongue function and swallowing in individuals with temporomandibular disorders.

The tongue participates in the oral phase of swallowing by pushing the food bolus toward the oropharynx. This relationship between tongue function and swallowing is little addressed addressed in individuals with temporomandibular dysfunction (TMD).Objective:To analyze the association of functional tongue conditions on swallowing in individuals with TMD.Methodology:After approval by the Institutional Review Board, the study was conducted on 30 individuals of both sexes, aged 18 to 28 years, with TMD, and not treated for the disorder. Tongue function was assessed as to the mobility, pressure, and oral motor control. Swallowing was analyzed by clinical assessment during ingestion of solid (wafer biscuit) and liquid (water). Data regarding mobility and swallowing were collected using the orofacial myofunctional evaluation protocol. Tongue pressure was measured by the Iowa Oral Performance Instrument, during elevation, protrusion, swallowing, and resistance test. The oral motor control was assessed by the oral diadochokinesis (DDK) test by rapid and repeated emissions of syllables “ta” and “ka”. Data were statistically analyzed by the Spearman correlation coefficient, at a significance level of 5%.Results:Relationships were found between tongue function and swallowing for the following aspects: mobility (r=0.741), pressure in protrusion (r=-0.366), swallowing of saliva (r=-0.499), mean DDK rate in emissions “ta” (r=-0.424) and “ka” (r=-0.446), and mean DDK period in emissions “ta” (r=0.424) and “ka” (r=0.446). Thus, the greater the change in tongue mobility, the lower the tongue pressure in protrusion and swallowing of saliva, the lower the emissions per second, the longer the mean time between vocalizations, and the worse the swallowing of individuals with TMD.Conclusion:The functional conditions of the tongue regarding mobility, pressure, and oral DDK were associated with swallowing in individuals with TMD.

Diadochokinetic rate in Saudi and Bahraini Arabic speakers: Dialect and the influence of syllable type.

Arabic is spoken by more than 420 million people worldwide and still there are a limited number of studies on dialects of the Gulf Arabic regions where most selected respondents are male speakers. This study aimed to explore and establish normative data for the Diadochokinetic Rate (DDK) for two dialects (Saudi Arabia’s Najdi and Bahrain’s Bahraini) speakers. Furthermore, it aimed to investigate whether there are differences between the two dialects and whether sex differences are evident. In addition, it investigated syllable type differences. The study used the monosyllables /ba, da, ga/ and the multisyllabic sequence /badaga/ to analyse the DDK rates. Acoustic analysis was carried out to obtain DDK rates for the syllables. A mixed model ANOVA was performed to investigate dialect and sex differences, in addition, to syllable type. The study included 40 males and 40 female speakers from each of the two dialects. Results showed that for DDK, Saudi speakers had faster DDK rates for the monosyllables /ba/, /da/, /ga/, than Bahrainis, while, no significant differences were observed for the multisyllabic sequences. However, there were no differences between male and female speakers with regard to the DDK rates. The syllable /ga/ showed the slowest DDK rate among the monosyllables while the multisyllabic sequences displayed the slowest DDK rates. In brief, normative data for DDK rates for clinic were determined for the Arabic Nadji and Bahrain’s Bahraini dialects. DDK rate was shown to be more sensitive to dialect differences for the monosyllable tasks. However, no sex differences were observed for the Arabic dialects in this study across all DDK tasks.

Oral and Laryngeal Diadochokinetic Rate in Multiple Sclerosis: Relationship to Disease Progression

Background: The first purpose of this study was to investigate the rate of oral and laryngeal Diadochokinesis (DDK) in Multiple Sclerosis (MS) patients in comparison with healthy people. The second goal was to determine if DDK rate has any relationship with the disease progression. Methods: In this cross-sectional study, two groups were enrolled: MS patients (n=31) and healthy subjects (n=14) . The samples of DDK tasks were collected. The scores of Expanded Disability Status Scale (EDSS) and duration of disease were considered as the indices of disease progression. Results: There were significant differences between the two groups in the rates of all DDK tasks (P≤0.001). Significant correlations were found between laryngeal DDK tasks and disease progression (r = - 0.488, r = -0.396, r = -0.444, r = - 0.667, P ≤ 0.027). Two oral DDK tasks were in correlation with EDSS and the disease duration (r = -0.403, r = -0.446, r =-0.521, r = -0.465, p≤0.025). There were high correlations between functional systems of EDSS (pyramidal, cerebellar and brainstem) and DDK tasks (r = - 0.448, r = -452, r = -0.458, r =-0.379, P ≤ 0.036). Conclusions: In the present study, poor performance in DDK tasks provided evidence for insufficient motor control over related speech subsystems in MS. These findings suggest that DDK rate is a sensitive beneficial speech motor control assessment in MS. Moreover, DDK tasks might be introduced as additional prognostic parameters for detecting disease progression and evaluating treatment achievements.

Analysis of diadochokinesis in persons with Parkinson's disease

Background: Parkinson's disease (PD) is a chronic and progressive disorder of movements of body parts which affect muscles of face, mouth, and throat. This can lead to affect the speech production in various aspects such as changes in voice, difficulty in forming sounds, and slow speech rate. Diadochokinetic (DDK) rate is the most common measures to see the speech production in persons with PD. Methods: This study was carried out on seven persons with PD with the control of medications and compared with the age- and gender-matched control group. Speech sample of DDK (alternating motion rate and sequential motion rate) was recorded in quiet environment. All the participants were instructed to produce syllable with rapid rate in a single breath. PRAAT software was used for the analysis of speech rate. Result and Conclusion: DDK rate was lower in PD group compared to control group. This could be due to limited muscle control and movements of lips and tongue.

취학 전 정상구어발달 아동의 조음교대운동 특성

본 논문은 자연스럽고 빠르게 모델링했을 때 4~6세 37명이 산출한 조음교대운동(DDK) 결과를 통해 모음구조의 DDK도 임상적 가치가 있음을 확인했고, DDK속도와 함께 조음오류 빈도와 유형 및 규칙성도 분석해야 말장애 아동의 조음능력에 대한 더 정확한 정보를 얻을 수 있음을 제안하고 있다. 자모음(예: '퍼')과 모음(예: '아이')의 음운구조를 반복 산출한 자료에서 각 검사음을 반복한 횟수, 오류 빈도, 오류 유형 및 규칙성(DDKsdp)을 측정했다. 그 결과, 조음교대운동 평균 속도는 연령과 함께 증가했으나, 음운 구조나 연령에 따른 유의한 차이는 없었다. DDK 수행시 나타난 실수를 분석한 결과, 4세의 오류빈도는 5세 및 6세에 비해 유의하게 높았다. DDKsdp에서 표준화된 발음검사 점수와 연령에 따른 차이는 없었다. This paper aimed to find out the differences of DDK performances of 37 normally developing children in the range of 4-6 years. DDK tasks included with the Consonant-Vowel(CV) syllables and with the Vowel-Vowel(VV) syllables. For DDK rate, all spoken AMR and SMR in one second were measured by Multi-Speech, and analyzed with Motor Speech Profile for DDK regularity. Error frequency and type in DDK performance were transcribed and auditorily judged by two professional speech pathologists. The findings in this study were follow as: First, DDK rate became faster as the age of children were increased. But there were no statistical differences between the groups for age. Second, there was no significant differences the CV and VV syllables of DDK tasks. Third, the frequency of articulatory error in DDK performance was significantly higher in the age of 4 than other two groups.

Pediatric Diadochokinetic Rates: Establishing a Normative Database

Objective: 1) Establish the first comprehensive pediatric normative database for diadochokinetic rates (DDK) using the Voice Evaluation Suite, a computerized voice analysis program. 2) Analyze normal DDK rates for age and gender differences. Method: Observational design analyzing DDK rates on 335 children ages 4 to 18 years with normal voices. Data was collected over a 6-month period from July to December 2010 in a pediatric otolaryngology clinic. Main outcome measures included age, gender, Pediatric Voice Related Quality of Life screening, and DDK rates. Results: The mean DDK rates of each age and gender are presented. There was no statistically significant difference between boys and girls of the same age ( P &lt; .05). There was a statistically significant difference in children ages 4 to 11 years when compared with children ages 12 to 18 years ( P &lt; .001). Conclusion: Pediatric DDK rate is similar between boys and girls of the same age. Faster DDK rates are seen in children over 12 years of age, regardless of gender, when compared with those children younger than 12 years. The normative data presented represents the most comprehensive DDK database in the English language.

학령전기 정상발달 아동의 자모음 교대운동특성 : 예비연구

본 논문의 목적은 학령전기 정상발달 아동을 대상으로 연령대 증가에 따른 조음 교대운동속도 차이의 경향을 알아보는 데 있다. 조사대상은 생활연령이 4세에서 6세 사이에 해당하는 총 12명의 아동이었고 샘플링 기간은 5월 첫 주, 일주일동안 이었다. 조음교대운동 속도 측정에 사용한 검사 음의 구성은 모음 구조에서 /ai/, /ɔi/, /ɑɔi/ 이며, 자모음 구조에서는 /pʰə/, /tʰə/, /kʰə/, /pʰətʰə/, /tʰəkʰə?/, /pʰətʰəkʰə/이다. 속도 측정은 연령대별로 초당 각 검사음을 반복한 횟수를 기준으로 하였고, PC-quirer의 음성파형을 통해 측정하였다. 연구결과는 다음과 같다. 첫째, 연령이 증가할수록 조음교대운동 속도가 빠른 것으로 나타났다. 둘째, 모음과 자모음 구조의 음성 특성에 따라 조음교대운동 속도에는 차이가 없었다. 그러나 연령대 증가에 따른 자음의 구조에서의 조음 교대운동 속도 증가 기울기 변화가 모음구조와 유사하게 나타났다. 셋째, DDK 과업수행에서 나타난 아동들의 반응태도를 분석한 결과 3세 연령에서 DDK 수행시 조음오류 빈도가 가장 높았으며, 4세에서 6세 사이에서 나타난 조음오류빈도수는 다양하였다. 이 연구결과는 자음뿐만 아니라 모음구조의 교대운동과업이 임상적인 평가로써 가치가 있음을 시사하며, 더불어 DDK 속도 평가뿐만 아니라 DDK 수행시 조음오류에 대한 빈도수와 조음유창성이 동시적으로 평가되어야 보다 신뢰롭게 정보를 얻을 수 있음을 제안하고 있다. The purpose of this study was to know the characteristics of DDK performance between CV(e.g. 'pa') and VV(e.g., 'ai') syllables in typically developing children aged 4 to 6 years old. 12 TD children performed DDK with CV structure(/pʰə/, /tʰə/, /kʰə/, /pʰətʰə/, /tʰəkʰə?/, /pʰətʰəkʰə/) and with VV structure(/ai/, /ɔi/, /ɑɔi/). Spoken syllables were counted in one second, and all spoken DDK were measured by PC-quirer. The results showed that all spoken DDK became faster as the age of children were increased. This trend was also appeared in both CV and VV syllables repetition. In addition, there was no differences in DDK rate with CV and VV syllables. The frequency of articulatory error during DDK performance was very high in the age of 3, and there was no pattern in the frequency of articulatory error according to the developmental age.

The effects of verbal reaction time in Alzheimer's disease

Verbal fluency deteriorates with normal aging, but is much more severe in Alzheimer's Disease (AD). Verbal functions were analyzed to find differences between normal aging subjects in patients with mild cognitive impairment (MCI), and in patients with early and moderate stages of AD. This study measured the verbal response time in patients with AD, MCI, and in control subjects This study measured the verbal response time in patients with AD, MCI, and in control subjects Fifteen patients with MCI, 15 patients with early AD, 8 patients with moderate AD, and 15 subjects for controls were included in the study. Word length in milliseconds, reaction time to a phoneme, word, or sentence and acoustic analysis of voice quality and speech diadochokinetic rate (DDK) were measured. Reaction time for a phoneme, word, or sentence especially the initiation period for them were longer in patients with early AD compared to patients with MCI (P < .001). The mean DDK rate was lower with increased severity of the disease, and was much more severe in patients with moderate AD. Clinical discrimination of the early stages of AD and MCI is challenging. Unfortunately, there are no laboratory markers present for the diagnosis of preclinical cases of AD. With the results of this study, the assessments of verbal reaction time may helpful for diagnosis of early AD.