Speech Production Difficulties Research Articles

Self-initiated self-repairs of connected speech and novel vocabulary learning during the first year of recovery from aphasia: four longitudinal case studies

ABSTRACT Background Self-initiated self-repair of problems in speech production has been suggested to be associated with aphasia treatment gains and recovery, but the topic has been little studied. Similarly, the ability to learn novel words has been associated with anomia treatment benefits, although longitudinal data on such learning is lacking. Aims The present study’s aim was to examine whether and how self-initiated self-repairs in connected speech and the ability to learn novel vocabulary reflected recovery from aphasia as measured with cognitive-linguistic tests. Additionally, our aim was to explore whether self-initiated repair and novel word learning changed in parallel during recovery. Methods & Procedures Four people with aphasia (PWA) (2 anomic, 1 Wernicke, and 1 global aphasia) were tested in the subacute (11 to 68 days post stroke) and chronic (12 months post stroke) phases of recovery with cognitive-linguistic tests, connected speech tasks, and a computerized learning task. In the learning task, PWA associated 6 pseudowords with 6 unfamiliar referents. The associations were learned from an ambiguous setup with feedback. At both time points, learning was measured as correct immediate recognition of the items and recognition maintenance one week post-training. The proportion of self-initiated self-repairs and the proportion of unrepaired problems in connected speech were used as measures of self-repair behavior. Outcomes & Results All participants initiated self-repairs both in the subacute and chronic phases, and their self-repairs were most often related to aphasic difficulties in speech production. Between the subacute and chronic phases, self-repairs changed both in quality and quantity. The proportion of self-repair elements decreased in 4/4 participants and the proportion of unrepaired problem segments decreased in 3/4 participants. Of the participants, 3/4 showed significant novel word learning and/or maintenance already in the subacute phase and 4 /4 in the chronic phase. Conclusion Reduction in self-initiated self-repairs of speech reflected recovery from aphasia. Novel word learning improved during aphasia recovery from the subacute to the chronic phase. Novel word learning was possible even in subacute, severe aphasia and even in an ambiguous task set-up with no explicitly provided word-referent connections. Novel word learning and self-initiated self-repairs did not change in a clearly parallel manner; however, these findings need to be tested with a larger sample.

An Exploratory Characterization of Speech- and Fine-Motor Coordination in Verbal Children with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder often associated with difficulties in speech production and fine-motor tasks. Thus, there is a need to develop objective measures to assess and understand speech production and other fine-motor challenges in individuals with ASD. In addition, recent research suggests that difficulties with speech production and fine-motor tasks may contribute to language difficulties in ASD. In this paper, we explore the utility of an off-body recording platform, from which we administer a speech- and fine-motor protocol to verbal children with ASD and neurotypical controls. We utilize a correlation-based analysis technique to develop proxy measures of motor coordination from signals derived from recordings of speech- and fine-motor behaviors. Eigenvalues of the resulting correlation matrix are inputs to Gaussian Mixture Models to discriminate between highly-verbal children with ASD and neurotypical controls. These eigenvalues also characterize the complexity (underlying dimensionality) of representative signals of speech- and fine-motor movement dynamics, and form the feature basis to estimate scores on an expressive vocabulary measure. Based on a pilot dataset (15 ASD and 15 controls), features derived from an oral story reading task are used in discriminating between the two groups with AUCs > 0.80, and highlight lower complexity of coordination in children with ASD. Features derived from handwriting and maze tracing tasks led to AUCs of 0.86 and 0.91, however features derived from ocular tasks did not aid in discrimination between the ASD and neurotypical groups. In addition, features derived from free speech and sustained vowel tasks are strongly correlated with expressive vocabulary scores. These results indicate the promise of a correlation-based analysis in elucidating motor differences between individuals with ASD and neurotypical controls.

Gesture's Role in the Communication of Adults With Different Types of Aphasia.

Adults with aphasia gesture more than adults without aphasia. However, less is known about the role of gesture in different discourse contexts for individuals with different types of aphasia. In this study, we asked whether patterns of speech and gesture production of individuals with aphasia vary by aphasia and discourse type and also differ from the speech and gestures produced by adults without aphasia. We compared the amount, diversity, and complexity of speech and gesture production in adults with anomic or Broca's aphasia and adults with no aphasia (n = 20/group) in their first- versus third-person narratives. Adults with Broca's aphasia showed the lowest performance in their amount, diversity, and complexity of speech production, followed by adults with anomic aphasia and adults without aphasia. This pattern was reversed for gesture production. Speech and gesture production also varied by discourse context. Adults with either type of aphasia used a lower amount of and less diverse speech in third-person than in first-person narratives; this pattern was also reversed for gesture production. Overall, our results provide evidence for a compensatory role of gesture in aphasia communication. Adults with Broca's aphasia, who showed the greatest speech production difficulties, also relied most on gesture, and this pattern was particularly pronounced in the third-person narrative context.

Efficacy of Script Training on Broca’s Aphasia Patients

Background: Broca’s Aphasia is a language disorder characterized by difficulties in speech production and fluency, significantly affecting communication. Script training, a language rehabilitation technique, has shown promise in treating this condition. However, its efficacy in a controlled clinical setting had yet to be fully explored. Objective: The objective of this study was to assess the effectiveness of script training in improving the expressive language abilities of individuals with Broca’s Aphasia. Methods: This case report study was conducted over a period of six months at the University of Lahore Teaching Hospital. Using purposive sampling, patients diagnosed with Broca’s Aphasia were selected. Participants underwent script training sessions, which involved repetitive practice of personalized scripts. The Mississippi Aphasia Screening Test (MAST) was employed for initial assessments and tracking progress. Ethical considerations were strictly adhered to, with informed consent obtained from all participants. The study included both quantitative and qualitative methods for data analysis. Results: The study demonstrated significant improvements in participants' expressive language abilities. Pre-therapy MAST scores averaged at 10/50, which increased to an average of 23/50 post-therapy. Notable areas of improvement included Naming (from 3/10 to 6/10), Automatic Speech (from 1/10 to 6/10), and Verbal Fluency (from 1/10 to 6/10). However, Repetition and Writing/Spelling showed minimal changes. Conclusion: Script training showed a significant positive impact on the expressive language skills of individuals with Broca’s Aphasia. This suggests that script training can be a beneficial therapeutic intervention in the language rehabilitation of Broca’s Aphasia patients, particularly in enhancing Naming, Automatic Speech, and Verbal Fluency. Future studies should investigate long-term effects and the integration of script training with other therapeutic approaches.

A - 101 A Neuropsychological Case Study of Progressive Bulbar Palsy.

There has been limited literature regarding cognitive dysfunction associated with progressive bulbar palsy. This case study presents the neuropsychological profile of a 66-year-old White male diagnosed with progressive bulbar palsy (evolving primary lateral sclerosis) with speech production difficulties. The patient was referred by his neurologist for a neuropsychological evaluation of progressively worsening cognitive changes over the past two years, including difficulties with reading directions, spelling, structuring sentences, thinking of words to write down, and counting. He also described progressively worsening speech production difficulties. During the evaluation, the patient communicated solely through written means. Available MRI results demonstrated subtle evidence of anterior temporal atrophy bilaterally. Additional relevant history includes chronic obstructive pulmonary disease and a remote history of recreational opioid use. Given the patient's speech production difficulties, measures were selected to include those that did not require verbal responses. For the few measures that did require verbal responses, administration was adjusted to allow him to provide written responses. On evaluation, he demonstrated intact orientation, processing speed, receptive language, and visuospatial functioning. In contrast, he demonstrated relative weaknesses on measures of attention, executive functioning (i.e., problem solving and cognitive flexibility), and free recall of information (with intact recognition). Behavioral features were also noted during the evaluation, including impulsivity and disorganization. The case provides preliminary data regarding possible cognitive profiles associated with progressive bulbar palsy, including possible areas of cognitive strengths and weaknesses. This case also highlights the need for further investigation of cognitive profiles of the condition which may assist with treatment planning.

The development of speech output processing skills in Greek-speaking children

ABSTRACT There is a growing body of literature on phonological development in Greek-speaking children, either typically developing (TD) or with speech sound disorders (SSD). In this paper, a cross-sectional longitudinal approach was used to investigate the development of speech output processing skills in TD Greek-speaking preschool-aged children. Moreover, a group of Greek-speaking children with SSD were assessed to identify potential loci of impairment in atypical development. The developmental study involved two groups: group 1 (n = 16) aged 3;0–3;5 years and group 2 (n = 22) aged 4;6–5;0 years, assessed at three assessment points six months apart. Children with SSD (n = 15) aged 5;6–6;0 years were assessed to be compared with performance of group 2 TD children (at the third assessment point). Assessment tasks included (a) a picture naming task, (b) a task of real word repetition and (c) a task of nonword repetition. A strong time effect was found in both groups of TD children in the development of speech output processing abilities. Performance accuracy was higher on tasks including real words than nonwords; children performed more accurately on repetition rather than spontaneous naming of real words; repetition accuracy on 2–3 syllables items was significantly better than on 4–5 syllables items. Children with SSD were outperformed by TD children of the same age in all assessment tasks; lexicality and word length effect were found in the clinical group. Findings from the present study may be used as a starting point to diagnose children with speech production difficulties in Greece.

Tongue strength and endurance among typically developing children and children with idiopathic speech sound disorders in the United Arab Emirates.

Tongue strength and endurance in adults have been extensively studied, but data on these parameters in young children remain largely unavailable. This study aimed to collect normative objective tongue strength and endurance data from a pediatric population in the United Arab Emirates (UAE) and to examine the effects of age and sex on these parameters. This normative study included a total of 65 typically developing (TD; n = 36) children and children with idiopathic speech sound disorders (ISSDs; n = 29). The participants were assigned to four age groups (range: 3-8 years) and stratified by sex. Data on their tongue strength and endurance were collected using the Iowa Oral Performance Instrument. Tongue strength scores and endurance time increased with age in both the TD and ISSD groups. Sex had no statistically significant effects on tongue strength or endurance in either group. Furthermore, tongue strength and endurance time scores were higher in the TD group than in the ISSD group. The data obtained in this study would add important normative data to the database of standardized measurements for maximal strength and endurance scores in the pediatric population of the UAE. Future research is encouraged to collect additional data that can help healthcare professionals objectively evaluate children with feeding, swallowing, and speech sound production difficulties.

Atypical speech production of multisyllabic words and phrases by children with developmental dyslexia.

The prevalent "core phonological deficit" model of dyslexia proposes that the reading and spelling difficulties characterizing affected children stem from prior developmental difficulties in processing speech sound structure, for example, perceiving and identifying syllable stress patterns, syllables, rhymes and phonemes. Yet spoken word production appears normal. This suggests an unexpected disconnect between speech input and speech output processes. Here we investigated the output side of this disconnect from a speech rhythm perspective by measuring the speech amplitude envelope (AE) of multisyllabic spoken phrases. The speech AE contains crucial information regarding stress patterns, speech rate, tonal contrasts and intonational information. We created a novel computerized speech copying task in which participants copied aloud familiar spoken targets like "Aladdin." Seventy-five children with and without dyslexia were tested, some of whom were also receiving an oral intervention designed to enhance multi-syllabic processing. Similarity of the child's productions to the target AE was computed using correlation and mutual information metrics. Similarity of pitch contour, another acoustic cue to speech rhythm, was used for control analyses. Children with dyslexia were significantly worse at producing the multi-syllabic targets as indexed by both similarity metrics for computing the AE. However, children with dyslexia were not different from control children in producing pitch contours. Accordingly, the spoken production of multisyllabic phrases by children with dyslexia is atypical regarding the AE. Children with dyslexia may not appear to listeners to exhibit speech production difficulties because their pitch contours are intact. RESEARCH HIGHLIGHTS: Speech production of syllable stress patterns is atypical in children with dyslexia. Children with dyslexia are significantly worse at producing the amplitude envelope of multi-syllabic targets compared to both age-matched and reading-level-matched control children. No group differences were found for pitch contour production between children with dyslexia and age-matched control children. It may be difficult to detect speech output problems in dyslexia as pitch contours are relatively accurate.

Impact of neurological disorders occurring in neurodegenerative diseases on the conversation process and patients' quality of life

Introduction : Dialogue, or conversation, is the ability to speak as well as listen. It plays a very important role in interpersonal relations.Speech disorders are a group of of disorders that includes various types of speech production difficulties. Speech production depends on the coordination of several motor acts: respiration, phonation, articulation, resonance and prosody. Phonation is the complex activity of producing sound by vibration of the vocal cords. Resonance is the amplification of sounds at specific frequencies through vibration in the chest, throat and sinuses. Prosody includes a set of phonetic features, such as tone, loudness, tempo, and the overall timbre of speech, which are designed to intended to preserve the meaning and character of speech. Disruption of any of these related elements results in motor speech disorders.
 Material and method : An overview is presented of language disorders in diseases neurodegenerative diseases such as Parkinson's disease(PD) and Friedreich's ataxia (FRDA). Their impact on the conversation process and the patient's quality of life assessment was evaluated. The paper was based on scientific publications posted on the PubMed scientific platform.
 Results : Speech and language disorders are the main symptoms of FRDA, which significantly affect the patients' quality of life. Patients often present with dysarthria, resulting from causes of central and peripheral and additional primary language disorders. The classic speech disorder in PD is hypokinetic dysarthria, manifested by hypophonia; monotonous, uneven and strained speech; reduced prosody (melodic voice); crowded articulation; inadequate pauses in speech; freezing of speech, unclear articulation.
 Conclusions : The described disease entities show a significant impact on the deterioration of the process of of conversation by the patient, thus showing a significantly negative impact on the patients' quality of life.
 

An Adjunct to Repair: You Know in Speech Production and Understanding Difficulties

ABSTRACT The English-language particle you know is frequently associated with speech production and understanding difficulties. The present study combines sequential and distributional analyses to explicate the particle’s relationship to the conversational repair system. It demonstrates that you know functions as an adjunct to repair, addressing secondary difficulties associated with implementing self-repair in practice, while also promoting the avoidance of transformative repair operations. This repair adjunct viewpoint trades off the particle’s general import as an alignment token and is supported by examining its specialized role in: (a) self-repair operations, (b) suboptimal formulations, and (c) understanding pursuits. This article elaborates our understanding of the repair system by identifying an ancillary practice that smooths over recurrent shortcomings of natural speech. Data in American English.

Current Aspects of Speech Disfluency Research: Scientific Review of the International Workshop DiSS 19 (Budapest) Issues

Disfluency in spontaneous speech is currently a subject of study of specialists working in different fields of knowledge. Different external manifestations of disfluency (hesitation pauses, sound prolongations, pause fillers, articulatory perseverations and lexico-grammatical repetitions, self-corrections, breaks, nonverbal means of information transfer, etc.) are being investigated. They turn out to be a convenient tool for revealing and monitoring the peculiarities of cognitive processes with the help of explicit clearly registered signals occurring in speech under the influence of a number of extralinguistic factors such as the communicative situation, the type of speech (monologic or dialogic), the language of communication (L1 or L2), the emotional state of the speaker, the age, the social status, the diseases impairing speech and mental activity, and others. Further investigation of disfluency makes it possible to solve both a number of fundamental problems connected with modeling of cognitive coding and decoding speech processes and applied tasks connected with adoption of research findings in such fields as developmental pedagogy, psychology, medicine, foreign language training, translation, automatic recognition of speech signal, etc. Up to now, a sufficient number of empirical investigations have been carried out providing a basis for working out particular models which will make it possible, in the long run, to create the overall model of disfluency in spontaneous speech. Conferences and workshops undoubtedly play an important role in uniting the efforts of specialists in this sphere. One of them is the international workshop “Disfluency in Spontaneous Speech (DiSS)” that was first held in 1999. The current problems that were discussed by the participants of the workshop (production and perception speech models, age and clinical factors of disfluency, special difficulties in foreign speech production, including translation, speech technology) may be a useful reference point for researchers working on the issue.

Brak bezpośredniego wpływu umiejętności percepcyjnych na umiejętności narracyjne dzieci z niedokształceniem mowy pochodzenia korowego

In the paper, an analysis of information gathered during examinations of children with speech development disorder of cortical origin is presented. The study group consisted of 4 individuals (two girls and two boys), aged 5–10. The results of the examination of phonemic awareness and understanding of a few sentences-long spoken texts as well as articulating a few sentences-long texts suggested a possible correlation between these two types of skills (phonemic awareness, spoken text understanding and production). However, a thorough analysis of the results does not allow one to conclude that the specific phonemic awareness deficits and/or speech perception difficulties have a predominant influence on the narrative skills of children with speech development disorder of cortical origin. Although the main hypothesis was disproved, the results of the analysis shed light on another possible explanation of speech production difficulties in the abovementioned speech and language disorder: deficient/insufficient auditory attention and/or verbal working memory. Such explanation has not yet been taken into consideration in the research on speech and language development disorder of cortical origin.

Changes in temporal features of speech in secondary progressive multiple sclerosis (SPMS) – case studies

ABSTRACTMultiple sclerosis (MS) is a chronic inflammatory disease which, in addition to affecting motor and cognitive functions, may involve language disorders. Despite the importance of speech and language disorders in the quality of life of patients, there are only a few studies about language and speech production difficulties in MS. The aim of this research is to describe the limitation patterns of speech and temporal characteristics of the suprasegmental level in two SPMS cases related to various types of spontaneous speech tasks. We assumed the change of the cognitive load has a greater effect on spontaneous speech in MS patients than in controls. Two SPMS patients, and two sex-, age- and education matched healthy controls were studied. We applied verbal fluency tests (phonemic, episodic, semantic, verb), digit span test, non-word repetition test, Corsi Block Tapping Test, Stroop Colour and Word Test, and Trail Making Test. Token Test was used to measure speech comprehension. The four speech tasks required relatively different degrees of cognitive effort: (a) spontaneous narrative about own life; (b) event description; (c) picture description; (d) narrative recall. Our results show that there are differences between MS patients and controls: MS patients produced slower speech and articulation rate, and they had more and longer pauses in every speech task. Speech tasks and the degree of the cognitive load had a greater effect on MS patients than on control speakers.

Filled Pauses as a Special Case of Automatic Speech Behaviors and the Effect of Parkinson's Disease

Purpose In Parkinson's disease (PD), there are significant changes in the basal ganglia, a structure known to be important for controlling automatic responses to cues. Changes to the basal ganglia in PD impair an individual's ability to trigger a behavior in response to cues, but more so in response to internal cues more than external ones. Filled pauses are considered a subconscious or automatic speech response to an internal cue that there are difficulties with ongoing communication. Typical speakers use filled pauses (such as uh or um) to mark silent pauses. The purpose of this study was to examine how automatic speech responses are impacted in PD by looking at filled and silent pausing behaviors, extending our understanding of the role of the basal ganglia in automatic behaviors. We hypothesized that individuals with PD would use fewer filled pauses and longer silent pauses. We also hypothesized that longer pauses would be more likely to be marked with filled pauses and that this relationship would be weaker in speakers with PD. Method Speech samples were collected via a story-retelling task from 15 individuals with PD and 18 age-matched controls. Duration and frequency of filled and silent pauses were measured using spectrographic analysis. Number and duration of marked silent pauses (those consecutive with 1 or more filled pauses) were measured. The t tests and analyses of variance were used to test our hypotheses. Results There was no significant difference in the number of silent pauses between groups, but the duration of silent pauses was significantly greater for individuals with PD. Despite this, individuals with PD produced significantly fewer filled pauses and fewer marked silent pauses. For both groups, longer silent pauses were more likely to be marked by filled pauses, but individuals with PD marked a smaller percentage of silent pauses at longer durations than controls. Conclusions Producing fewer marked silent pauses, coupled with longer silent pauses, reduces natural cues to discourse and puts people with PD at greater risk of sounding unnatural and losing their communicative turn. These results suggest that automatic responses regarding speech production difficulties are impaired by PD. This interpretation fits with nonspeech literature where automatic responses have been demonstrated to be impaired in PD.

Use of electropalatography in the treatment of speech disorders in children with Down syndrome: a randomized controlled trial.

Electropalatography (EPG) records details of the location and timing of tongue contacts with the hard palate during speech. It has been effective in treating articulation disorders that have failed to respond to conventional therapy approaches but, until now, its use with children and adolescents with intellectual/learning disabilities and speech disorders has been limited. To evaluate the usefulness of EPG in the treatment of speech production difficulties in children and adolescents with Down syndrome (DS) aged 8-18 years. A total of 27 children with DS were assessed on a range of cognitive and speech and language measures and underwent additional EPG assessment. Participants were randomly allocated to one of three age-matched groups receiving either EPG therapy, EPG-informed conventional therapy or 'treatment as usual' over a 12-week period. The speech of all children was assessed before therapy using the Diagnostic Evaluation of Articulation and Phonology (DEAP) and reassessed immediately post- and 3 and 6 months post-intervention to measure percentage consonants correct (PCC). EPG recordings were made of the DEAP assessment items at all time points. Per cent intelligibility was also calculated using the Children's Speech Intelligibility Measure (CSIM). Gains in accuracy of production immediately post-therapy, as measured by PCC, were seen for all groups. Reassessment at 3 and 6 months post-therapy revealed that those who had received therapy based directly on EPG visual feedback were more likely to maintain and improve on these gains compared with the other groups. Statistical testing showed significant differences between groups in DEAP scores across time points, although the majority did not survive post-hoc evaluation. Intelligibility across time points, as measured by CSIM, was also highly variable within and between the three groups, but despite significant correlations between DEAP and CSIM at all time points, no statistically significant group differences emerged. EPG was an effective intervention tool for improving speech production in many participants. This may be because it capitalizes on the relative strength of visual over auditory processing in this client group. The findings would seem to warrant an increased focus on addressing speech production difficulties in current therapy.

ROLE OF CEREBELLUM IN FORMATION OF POSTURAL AND COGNITIVE FUNCTIONS: CLINICAL EXAMPLE WITH SCHMAHMANN SYNDROME

The data on the etiology and pathogenesis of cerebellar cognitive affective syndrome (CCAS) as well as clinical observations are presented in the paper. Schmahmann J.D. and Sherman J.C. described the spectrum of behavioral and cognitive disorders, which are the results of cerebellum stroke and are called CCAS. This syndrome includes disturbances of executive functions and is characterized by perseverations, absent-mindedness or disatractibility, visual-spatial disorders, speech production difficulties and personality changes. The authors considered the historical description of this syndrome, its etiology, pathogenesis and presented their own clinical observation of CCAS in a 70-year-old woman.

Realisation of voicing by French-speaking CI children after long-term implant use: An acoustic study

ABSTRACTStudies of speech production in French-speaking cochlear-implanted (CI) children are very scarce. Yet, difficulties in speech production have been shown to impact the intelligibility of these children. The goal of this study is to understand the effect of long-term use of cochlear implant on speech production, and more precisely on the coordination of laryngeal-oral gestures in stop production. The participants were all monolingual French children: 13 6;6- to 10;7-year-old CI children and 20 age-matched normally hearing (NH) children. We compared /p/, /t/, /k/, /b/, /d/ and /g/ in word-initial consonant-vowel sequences, produced in isolation in two different tasks, and we studied the effects of CI use, vowel context, task and age factors (i.e. chronological age, age at implantation and duration of implant use). Statistical analyses show a difference in voicing production between groups for voiceless consonants (shorter Voice Onset Times for CI children), with significance reached only for /k/, but no difference for voiced consonants. Our study indicates that in the long run, use of CI seems to have limited effects on the acquisition of oro-laryngeal coordination needed to produce voicing, except for specific difficulties located on velars. In a follow-up study, further acoustic analyses on vowel and fricative production by the same children reveal more difficulties, which suggest that cochlear implantation impacts frequency-based features (second formant of vowels and spectral moments of fricatives) more than durational cues (voicing).

The production effect in adults with dysarthria: improving long-term verbal memory by vocal production

ABSTRACTPeople show better memory for words read aloud relative to words read silently, the Production Effect (PE). Vocalisation at study makes the produced (aloud) words more distinct than the non-produced (silent) words, hence more memorable. Such encoding distinctiveness is related to the additional processing of aloud words that is later used during retrieval. This study investigated the PE in dysarthric adults, characterised by speech production difficulties. Their memory performance (recognition) was compared to a group of healthy adults. Results showed a PE for both groups. The production benefit was significantly larger for the dysarthric adults, despite their overall memory performance being reduced relative to controls. The results demonstrate long-term verbal memory deficits in dysarthria, and suggest that vocalisation (although impaired) may assist in remembering. Hence, vocalisation may be used in intervention contexts with this population, to compensate for memory decrease.

Relationship between Speech Production and Perception in People Who Stutter.

Speech production difficulties are apparent in people who stutter (PWS). PWS also have difficulties in speech perception compared to controls. It is unclear whether the speech perception difficulties in PWS are independent of, or related to, their speech production difficulties. To investigate this issue, functional MRI data were collected on 13 PWS and 13 controls whilst the participants performed a speech production task and a speech perception task. PWS performed poorer than controls in the perception task and the poorer performance was associated with a functional activity difference in the left anterior insula (part of the speech motor area) compared to controls. PWS also showed a functional activity difference in this and the surrounding area [left inferior frontal cortex (IFC)/anterior insula] in the production task compared to controls. Conjunction analysis showed that the functional activity differences between PWS and controls in the left IFC/anterior insula coincided across the perception and production tasks. Furthermore, Granger Causality Analysis on the resting-state fMRI data of the participants showed that the causal connection from the left IFC/anterior insula to an area in the left primary auditory cortex (Heschl’s gyrus) differed significantly between PWS and controls. The strength of this connection correlated significantly with performance in the perception task. These results suggest that speech perception difficulties in PWS are associated with anomalous functional activity in the speech motor area, and the altered functional connectivity from this area to the auditory area plays a role in the speech perception difficulties of PWS.

Phonological difficulties in children with autism: An overview

The purpose of this paper is to provide an overview and update of speech sound production difficulties in children with autism. Historically, relatively little attention has been given to speech sound production abilities in these children. Several possible reasons for the paucity of research on this topic are offered in this paper, including methodological issues. Results of earlier research showed articulatory behavior to be delayed, resembling sound production of younger typically developing children. Findings of more recent studies have shown specific phonological patterns, including typical and atypical phonological processes in some of these children. Other findings suggest that the articulatory/phonological skills in these children are relatively intact. Thus, there are conflicting results in the literature, and at this time, the fundamental speech sound behavior in these children is still not fully understood. Recent preliminary findings suggest that some children with autism who present with more severe global language impairment may also exhibit more severe phonological difficulties. Current research overall suggests that at least a subgroup of children with autism may exhibit both typical as well as atypical phonological processes, disturbances in prosody, and limited consonant inventories. Clinical implications are provided, including assessment and treatment suggestions, particularly with regards to the influence of speech sound production difficulties on overall intelligibility. Suggestions for future research are also offered.