Nonspeech Oral Motor Research Articles

Impact of an International Training on Interventionists' Expertise in Cleft Palate Speech: Results From Oaxaca, Mexico.

International cleft lip and palate surgical charities recognize that speech therapy is essential for successful care of individuals after palate repair. The challenge is how to ensure that cleft speech interventionists (i.e., speech-language pathologists and other speech therapy providers) provide quality care. This exploratory study investigated effects of a two-stage cleft training in Oaxaca, Mexico, aimed at preparing speech interventionists to provide research-based services to individuals born with cleft palate. Changes in the interventionists' content knowledge and clinical skills were examined. Twenty-three cleft speech interventionists from Mexico, Guatemala, and Nicaragua participated in a hybrid two-stage training, completing an online Spanish cleft speech course and a 5-day in-person training in Oaxaca. In-person training included a didactic component and supervised clinical practice with 14 individuals with repaired cleft palates. Testing of interventionists' content knowledge and clinical skills via questionnaires occurred before the online course (Test 1), immediately before in-person training (Test 2), and immediately after in-person training (Test 3). Qualitative data on experience/practice were also collected. Significant increases in interventionists' overall content knowledge and clinical skills were found posttraining. Knowledge and clinical skills increased significantly between Tests 1 and 2. Clinical skills, but not knowledge, showed further significant increases between Tests 2 and 3. Posttraining, interventionists demonstrated greater expertise in research-based treatment, and fewer reported they would use nonspeech oral motor exercises (NSOME). Findings provide preliminary support for such two-stage international trainings in preparing local speech interventionists to deliver high-quality speech services to individuals born with cleft palate. While content knowledge appears to be acquired primarily from the online course, the two-stage training incorporating in-person supervised practice working with individuals born with cleft palate may best enhance continued clinical skill development, including replacement of NSOME with evidence-based speech treatment. Such trainings contribute to building capacity for sustainable quality services for this population in underresourced regions.

Treatment Approaches to Speech Sound Disorders: A Scoping Review

Objective: The objective was to highlight and review different therapeutic approaches to cater to speech sound disorders in Pakistan. Methodology: To find the different therapeutic approaches, a literature search for related articles/ publications was conducted using the Keywords “speech sound disorders, phonological disorders, articulation disorder and a combination of words using search engines like Google & and databases like PubMed and other websites. Around 130 publications, reports, and articles were downloaded, of which 25 were used for literature review. Results: There are many treatments used to cater for speech sound disorders including contextual utilisation, phonological contrast, complexity, core vocabulary, cycles phonological pattern, distinctive feature therapy, metaphor therapy, naturalist speech intelligibility, non-speech oral-motor therapy, speech sound perception training and bilingual or cross-lingual approach. However, novel trends like the use of hybrid treatment, speech motor learning- phonetic placement approach, blocked practice versus serial practice schedule & interventions using biofeedback need to be utilized. Conclusion: Treatment approaches in use include contextual utilisation, phonological contrast, complexity, core vocabulary, cycles phonological pattern, distinctive feature therapy, metaphor therapy, naturalist speech intelligibility, non-speech oral-motor therapy, speech sound perception training and bilingual or cross-lingual approach, however, novel treatments need to be utilised. Keywords: Articulation disorders, Phonological disorders, Phonological Representations

The Non-Speech Oral Movement Assessment for Children

Introduction: Examination of oral movements is often part of an assessment undertaken by a speech and language therapist (SLT). Until now, there have been no specific instruments or tests with reference values for typically developing children in Dutch that exclusively evaluate non-speech oral movements in young children. Therefore, a non-speech oral motor observation list was designed to attempt to bridge this gap: the Non-Speech Oral Movement Assessment for Children (NOMAC). The aim of this study was to evaluate the psychometric properties of the NOMAC in terms of inter-rater reliability and its’ construct validity. In addition, we aimed to collect reference values for non-speech oral movements in children. Methods: Data from typically developing Dutch children aged 2–8 years were collected. Inter-rater reliability was studied by estimating the intra-class correlation coefficient (ICC). Construct validity was investigated by assessing the effect of age group and gender on the mean execution score per item (general linear model). To present normative data, the percentage of the children performing a normal oral motor execution was calculated. Results: The study includes a total of 318 children, divided into 9 age groups. The inter-rater reliability shows a moderate to excellent ICC for most items. A significant effect of the factor age group on almost all items was seen, confirming robust construct validity. Normative data are presented with the percentage of the children performing a normal oral movement execution. Conclusion: Non-speech oral movements can be assessed with the NOMAC in children between 2 and 8 years old and can be compared with values obtained from a normative group. It should be used as part of a clinical feeding and speech assessment. Despite the fact that current insights indicate that oral motor training has no value for improving mastication, swallowing, and speech, it is important to know the status of non-speech oral motor capabilities. With this assessment, a complete profile of the child’s oral motor abilities can be achieved, supportive of clinical decision making in SLT.

Speech and language therapists' management practices, perceived effectiveness of current treatments and interest in neuromuscular electrical stimulation for acquired dysarthria rehabilitation: An international perspective.

Research is beginning to shed light on the practices employed by speech-language therapists (SLTs) for the management of acquired dysarthria. However, studies that explore SLTs' satisfaction with the effectiveness of current therapies and their interest in new treatment methods for this population have not been carried out. One potential new method is neuromuscular electrical stimulation (NMES): the pool of evidence for its use in rehabilitation is increasing, yet it has not been widely explored for use with dysarthria. To extend the understanding of acquired dysarthria management practices employed by SLTs across the globe and determine their satisfaction with current therapy options. To explore their interest in using NMES with this population. A cross-sectional international online survey was developed and disseminated to SLTs working with adults with acquired dysarthria through international professional associations. The survey collected information on demographic characteristics, dysarthria management practices, satisfaction with treatment effectiveness and interest in and knowledge of NMES. Survey responses were analysed using descriptive and inferential statistics, and quantitative content analysis. A total of 211 SLTs (North America, 48.8%; Europe, 36%; Asia, 8.1%; Oceania, 5.7%; Africa, 0.9%; South America, 0.5%) completed the survey in full. Management practices varied considerably. There was a clear preference for informal assessments, mainly oral-motor examinations, focusing on body functions and structures. The majority of respondents rejected the use of non-speech oral motor exercises as a clinical or carryover exercise. Variable satisfaction with current speech subsystem treatments was noted; however, overall, there was a general dissatisfaction. Whilst a strong interest in the use of NMES for dysarthria was evidenced, it was noted that most SLTs lacked fundamental knowledge of NMES principles and application. SLTs' management practices and satisfaction with acquired dysarthria treatments differed substantially. Investigations of the potential use of NMES for dysarthria treatment are of interest. What is already known on the subject Recent country-specific surveys have explored speech-language therapists' (SLTs') assessment and intervention practices for acquired dysarthria. These studies indicate that although clinical management for this speech disorder mainly involves informal assessment tools and impairment-focused treatment, communication beyond the impairment, such as the activity and participation domains, is also frequently assessed and treated. What this paper adds to existing knowledge The majority of SLTs are dissatisfied with the overall benefits of current acquired dysarthria treatment. Phonatory, respiration and speech rate therapies are perceived to be more effective than prosody, articulation and resonance treatments. Despite a general lack of theoretical knowledge, most SLTs are interested in neuromuscular electrical stimulation treatment for acquired dysarthria. What are the potential or actual clinical implications of this work? New, evidence-based treatments are needed for SLTs to be confident in the effectiveness of their acquired dysarthria treatment.

Nonspeech Oral Motor Exercises: Use and Knowledge of Speech-Language Pathologists Working with People with Speech Sound Disorders

Previous studies, conducted in different countries (e.g. Australia, Canada, India, Republic of Ireland, USA, UK), have shown that speech-language pathologists (SLPs) use nonspeech oral motor exercises (NSOMEs) to treat speech sound disorders (SSDs), bringing attention to the substantial debate regarding the clinical effectiveness of NSOMEs. The aim of the present study was to investigate and characterize the use of NSOMEs by Portuguese SLPs in the intervention of SSDs, and to analyze the evidence that supports it. To do so, SLPs who provide therapy to children with SSDs were invited to complete an online questionnaire, based on a previous survey conducted in India by Thomas and Kaipa (2015). A total of 184 participants responded to the survey; 93.5% reported knowing about NSOMEs, 78.5% used NSOMEs in their intervention for SSDs, and 80.2% considered them effective in treating SSDs (89% indicated that their knowledge about NSOMEs was acquired through graduate and post-graduate courses; 98.5% reported that they used NSOMEs to improve the motor function of the articulators). This study offers an overview of Portuguese speech-language pathologists’ reported use of NSOMEs as part of the intervention of speech sound disorders in children. Many of the participants in this study reported that they did use NSOMEs in SSD treatments, regardless of the lack of evidence to support their use in this context. Furthermore, the results show that the percentage of SLPs in Portugal using NSOMEs is similar to those found in the USA, UK, Canada, and India, but different from those in Australia and Ireland.

Examining the Prevalence of Intervention Approaches Internationally: The Use of Nonspeech Oral Motor Exercises in Guatemala

Purpose: Little is known about the use of nonspeech oral motor exercises (NSOMEs) to treat Speech Sound Disorders (SSDs) in low- and middle-income countries, such as Guatemala, where the field of speech-language pathology is less well established. The purpose of this study is to examine clinical practices for SSDs in Guatemala. The authors then compare these findings with previous literature on the use of NSOMEs in countries with developed fields of speech-language pathology. Method: Nonmembers and members of the professional association for speech providers, Asociación de Terapistas del Lenguaje de Guatemala (SomosTLgt; n = 65), completed an online survey regarding the use of NSOMEs. Results: Although approximately half of the clinicians in Guatemala reported using NSOMEs in therapy, the time spent in therapy sessions using these exercises was limited to 25% of the time. Very few clinicians (19.8%) reported to use NSOMEs almost always or 50%–75% of the time. NSOMEs were not reportedly used by 33.8% of the clinicians when treating SSDs. A significant positive correlation was found between years of experience and use of NSOME in clinical practice. Nearly all respondents specified learning about NSOMEs at university. Conclusions: Contrary to previous studies from high-income countries that indicate that NSOMEs are commonly used by speech-language pathologists when targeting SSDs, the use of NSOMEs across speech therapists from Guatemala in this current investigation is less. Future studies should explore the rationale behind the use of NSOME across different countries.

Distinguishing Spastic and Dystonic Features in a Patient With a History of Brainstem Encephalitis: A Clinical Case Study

Purpose One role of a speech-language pathologist (SLP) is to differentially diagnose motor speech disorders to aid physicians, typically neurologists, in establishing a medical diagnosis. The present case study describes the clinical problem solving undertaken by the SLP to characterize the nature of neurological deficits to develop an appropriate management plan. Method The patient is a 29-year-old man with a history of brainstem encephalitis who presented for evaluation of dysarthria, dysphagia, and gait difficulties. The neurological exam characterized a spastic dysarthria. The SLP conducted a motor speech examination expressly for the purpose of differential diagnosis. Results The patient exhibited features of spastic dysarthria including strained phonation and hypernasality, equivocally slow rate associated with intermittent interword pauses rather than lengthened segments, and articulatory imprecision in the absence of weakness or slowness of the articulators. Defining features of spastic dysarthria absent from his speech were monopitch and monoloudness, as well as slow alternate motion rates. A diagnosis of hyperkinetic dysarthria associated with dystonia was informed by (a) hypernasality disproportionate to other deviant speech features, with preserved reflexive velar movements and nonspeech movements; (b) adventitious lip pursing; (c) modest improvement in speech with sensory tricks; (d) mild and intermittent phonatory strain; and (e) normal nonspeech oral motor function. Conclusions This case demonstrates the role speech-language pathology can play in the neurological assessment and management process. The recognition by the SLP of hyperkinetic dysarthria led to additional diagnostic tests and to a broader range of options for medical management.

Tutorial: Motor-Based Treatment Strategies for /r/ Distortions.

Purpose This tutorial summarizes current best practices in treating American English /r/ distortions in children with residual speech errors. Method To enhance the effectiveness of clinicians' cueing and feedback, the phonetics of /r/ production is reviewed. Principles of acquisition, which can inform how to practice /r/ in the early stages of therapy, are explained. Elements of therapy that lack scientific support are also mentioned. Results Although there is significant variability in /r/ production, the common articulatory requirements include an oral constriction, a pharyngeal constriction, tongue body lowering, lateral bracing, and slight lip rounding. Examples of phonetic cues and shaping strategies are provided to help clinicians elicit these movements to evoke correct /r/ productions. Principles of acquisition (e.g., blocked practice, frequent knowledge of performance feedback) are reviewed to help clinicians structure the earliest stages of treatment to establish /r/. Examples of approaches that currently lack scientific support include nonspeech oral motor exercises, tactile cues along the mylohyoid muscle, and heterogeneous groupings in group therapy. Conclusion Treatment strategies informed by phonetic science and motor learning theory can be implemented by all clinicians to enhance acquisition of /r/ for children with residual errors. Supplemental Material https://doi.org/10.23641/asha.12771329.

The Use of Nonspeech Oral Motor Exercises in the Treatment of Children With Cleft Palate: A Re-Examination of Available Evidence.

Purpose The purpose of this tutorial is to re-examine the current literature on nonspeech oral motor exercise (NSOME) in general and its use in the treatment of children with cleft palate specifically and provide a best practice recommendation. Method The Population Intervention Comparison Outcome process was used to investigate the clinical question. This systematic framework identifies the clinical population, evaluates the intervention(s) applied to the population, assesses the results of interventions, and delineates the outcome. A literature search, which examined developmental research, applied clinical research, and systematic treatment reviews, was conducted for this purpose. Results The literature reviewed herein suggests that, on a number of different levels, the implementation of NSOMEs does not result in positive communication outcomes for children with cleft palate who present with velopharyngeal dysfunction or compensatory speech errors. Conclusion Based on the current review, there is no empirical support for the use of NSOME as a direct or adjunct treatment for velopharyngeal dysfunction or compensatory speech errors. Appropriate treatments for these communication disorders include surgical, dental, and speech-based interventions.

A survey of speech-language pathology treatment for non-progressive dysarthria in Australia

AbstractAim:To identify management practices of Australian speech-language pathologists (SLPs) in the treatment of non-progressive dysarthria using a subsystem approach, and to explore SLPs’ consideration and implementation of the theoretical underpinnings of non-progressive dysarthria management.Method:A 39-item online survey was distributed to Australian SLPs, with 80 responses suitable for data analysis.Results:Practices of SLPs were variable for the management of the speech subsystems. The Lee Silverman Voice Treatment (LSVT®) was the most commonly used manualised treatment program, and was employed by 63.77% of respondents. Almost all SLPs (>88%) provided strategies to improve functional communication. There was no clear preference for low tech alternative and augmentative communication (AAC) devices. Speech generating devices were the most commonly employed high tech device. Almost two-thirds of respondents used non-speech oral motor exercises (NSOMEs) in treatment. SLPs had varied frequencies and models of service delivery for intervention. SLPs valued interventions targeting the activity and participation domains of the ICF, however this was restricted by the treatment context and resources available. The majority of SLPs (92.06%) were aware of the principles of motor learning, however many were unsure regarding the specifics of implementation.Conclusion:There is a clear need for further research into the efficacy of treatment techniques to guide decision-making.

The Correlation Between Non-Speech Oral Motor Exercises (NSOME) and Speech Production in Childhood Apraxia of Speech Treatment. A Wide Clinical Retrospective Research

Purpose: The use of Non speech Oral Motor Exercises (NSOME) for motor speech sounds disorder treatment has been discussed in the literature in the last three decades, with most of the research presenting poor results for using NSOME. The purpose of this article was to add evidence related to that debate and show the correlations between NSOME and sound production among children diagnosed with Childhood Apraxia of Speech (CAS). Another goal is to clarify the misuse of the term in clinical settings and literature, while presenting solutions to the debate. Method: 256 VML entry evaluations and 89 long term treatment processes were analysed retrospectively. The correlations between Single Sound Pronunciation (SSP) and NSOME variables (i.e. blowing, oral motor imitation and tongue movements) were calculated using the entry evaluation group, as well as the correlations between the changes in SSP and NSOME variables using the long-term group. Results: High correlations were found between NSOME variables and SSP in both groups tested. Conclusions: The results confirmed the relationship between oral motor skills and sound production. Theoretical explanations and practical implications are further discussed.

Nonspeech Oral Motor Exercises

Nonspeech Oral Motor Exercises

Are children with childhood apraxia of speech a subgroup of children with developmental coordination disorders?

Motor development is related to various aspects of human development, from speaking to taking care of oneself and participating in sports. Developmental disorder affecting the motor domain is known as Developmental Coordination Disorder (DCD), which results in a marked impairment in motor skills, which in turn can have a significant impact on activities of everyday living (American Psychiatric Association, 2013). Several studies have shown that the motor deficit in DCD is not restricted to limb control and may be a more general phenomenon that could affect the speech motor system (Ho and Wilmut, 2010). According to Maassen (2002), there is strong evidence that delayed or deviant motor development and perceptual motor learning play a role in many children with childhood apraxia of speech (CAS). Knowing that articulation is a mechanical act executed by the complex speech apparatus, could this potentially mean that children with CAS are a subgroup of children with DCD? Different studies demonstrated that children with CAS had problems with various aspects of nonspeech oral motor function (Tükel, Björelius, Henningsson, McAllister and Eliasson, 2015), as well as balance, aiming and catching (Iuzzini-Siegel, 2019). Further evidences of impaired motor skills could help us understand the underpinnings of CAS.

Does Truth Have a Future?

Does Truth Have a Future?

Interventions for childhood apraxia of speech.

Childhood apraxia of speech (CAS) affects a child's ability to produce sounds and syllables precisely and consistently, and to produce words and sentences with accuracy and correct speech rhythm. It is a rare condition, affecting only 0.1% of the general population. Consensus has been reached that three core features have diagnostic validity: (1) inconsistent error production on both consonants and vowels across repeated productions of syllables or words; (2) lengthened and impaired coarticulatory transitions between sounds and syllables; and (3) inappropriate prosody(ASHA 2007). A deficit in motor programming or planning is thought to underlie the condition. This means that children know what they would like to say but there is a breakdown in the ability to programme or plan the fine and rapid movements required to accurately produce speech. Children with CAS may also have impairments in one or more of the following areas: non-speech oral motor function, dysarthria, language, phonological production impairment, phonemic awareness or metalinguistic skills and literacy, or combinations of these. High-quality evidence from randomised controlled trials (RCTs) is lacking on interventions for CAS. To assess the efficacy of interventions targeting speech and language in children and adolescents with CAS as delivered by speech and language pathologists/therapists. We searched CENTRAL, MEDLINE, Embase, eight other databases and seven trial registers up to April 2017. We searched the reference lists of included reports and requested information on unpublished trials from authors of published studies and other experts as well as information groups in the areas of speech and language therapy/pathology and linguistics. RCTs and quasi-RCTs of children aged 3 to 16 years with CAS diagnosed by a speech and language pathologist/therapist, grouped by treatment types. Two review authors (FL, AM) independently assessed titles and abstracts identified from the searches and obtained full-text reports of all potentially relevant articles and assessed these for eligibility. The same two authors extracted data and conducted the 'Risk of bias' and GRADE assessments. One review author (EM) tabulated findings from excluded observational studies (Table 1). This review includes only one RCT, funded by the Australian Research Council; the University of Sydney International Development Fund; Douglas and Lola Douglas Scholarship on Child and Adolescent Health; Nadia Verrall Memorial Scholarship; and a James Kentley Memorial Fellowship. This study recruited 26 children aged 4 to 12 years, with mild to moderate CAS of unknown cause, and compared two interventions: the Nuffield Dyspraxia Programme-3 (NDP-3); and the Rapid Syllable Transitions Treatment (ReST). Children were allocated randomly to one of the two treatments. Treatments were delivered intensively in one-hour sessions, four days a week for three weeks, in a university clinic in Australia. Speech pathology students delivered the treatments in the English language. Outcomes were assessed before therapy, immediately after therapy, at one month and four months post-therapy. Our review looked at one-month post-therapy outcomes only.We judged all core outcome domains to be low risk of bias. We downgraded the quality of the evidence by one level to moderate due to imprecision, given that only one RCT was identified. Both the NDP-3 and ReST therapies demonstrated improvement at one month post-treatment. A number of cases in each cohort had recommenced usual treatment by their speech and language pathologist between one month and four months post-treatment (NDP-3: 9/13 participants; ReST: 9/13 participants). Hence, maintenance of treatment effects to four months post-treatment could not be analysed without significant potential bias, and thus this time point was not included for further analysis in this review.There is limited evidence that, when delivered intensively, both the NDP-3 and ReST may effect improvement in word accuracy in 4- to 12-year-old children with CAS, measured by the accuracy of production on treated and non-treated words, speech production consistency and the accuracy of connected speech. The study did not measure functional communication. There is limited evidence that, when delivered intensively, both the NDP-3 and ReST may effect improvement in word accuracy in 4- to 12-year-old children with CAS, measured by the accuracy of production on treated and non-treated words, speech production consistency and the accuracy of connected speech. The study did not measure functional communication. No formal analyses were conducted to compare NDP-3 and ReST by the original study authors, hence one treatment cannot be reliably advocated over the other. We are also unable to say whether either treatment is better than no treatment or treatment as usual. No evidence currently exists to support the effectiveness of other treatments for children aged 4 to 12 years with idiopathic CAS without other comorbid neurodevelopmental disorders. Further RCTs replicating this study would strengthen the evidence base. Similarly, further RCTs are needed of other interventions, in other age ranges and populations with CAS and with co-occurring disorders.

Exploring Australian speech-language pathologists’ use and perceptions ofnon-speech oral motor exercises

Purpose: To explore Australian speech-language pathologists’ use of non-speech oral motor exercises, and rationales for using/not using non-speech oral motor exercises in clinical practice.Methods: A total of 124 speech-language pathologists practising in Australia, working with paediatric and/or adult clients with speech sound difficulties, completed an online survey.Results: The majority of speech-language pathologists reported that they did not use non-speech oral motor exercises when working with paediatric or adult clients with speech sound difficulties. However, more than half of the speech-language pathologists working with adult clients who have dysarthria reported using non-speech oral motor exercises with this population. The most frequently reported rationale for using non-speech oral motor exercises in speech sound difficulty management was to improve awareness/placement of articulators. The majority of speech-language pathologists agreed there is no clear clinical or research evidence base to support non-speech oral motor exercise use with clients who have speech sound difficulties.Conclusions: This study provides an overview of Australian speech-language pathologists’ reported use and perceptions of non-speech oral motor exercises’ applicability and efficacy in treating paediatric and adult clients who have speech sound difficulties. The research findings provide speech-language pathologists with insight into how and why non-speech oral motor exercises are currently used, and adds to the knowledge base regarding Australian speech-language pathology practice of non-speech oral motor exercises in the treatment of speech sound difficulties.Implications for RehabilitationNon-speech oral motor exercises refer to oral motor activities which do not involve speech, but involve the manipulation or stimulation of oral structures including the lips, tongue, jaw, and soft palate.Non-speech oral motor exercises are intended to improve the function (e.g., movement, strength) of oral structures.The majority of speech-language pathologists agreed there is no clear clinical or research evidence base to support non-speech oral motor exercise use with clients who have speech sound disorders.Non-speech oral motor exercise use was most frequently reported in the treatment of dysarthria.Non-speech oral motor exercise use when targeting speech sound disorders is not widely endorsed in the literature.

The motor learning approach and strategies in the treatment of children’s articulation disorders

The article presents a theoretical analysis of the concept based on a motor learning approach as well as the possibilities for the application of this approach in speech and language therapy in the treatment of children’s articulation disorders. Motor learning principles have been emphasised as essential elements in speech and language therapy. They explain the importance of speech and language therapy services which are flexible and focused on individual cases. 
 An analysis of theoretical sources focuses on the strategies of speech and language therapy based on the motor learning approach. These therapies differ between non-speech or speech levels. The aims of the application of these strategies and their theoretical presumptions of efficacy reveals the need for changes in the practice of speech and language therapists. An analysis of theoretical sources reveals that speech-based strategies of therapy are more efficient in learning correct sound pronunciation and promoting the intelligible speech of children. The application of non-speech oral motor therapy is purposeful in teaching non-speech movements of the articulatory system. When coping with children’s articulation disorders, it is necessary to differentiate strategies of motor learning with regard to the origin and level of a particular disorder.

Oral Motor Abilities Are Task Dependent: A Factor Analytic Approach to Performance Rate

ABSTRACTMeasures of performance rates in speech-like or volitional nonspeech oral motor tasks are frequently used to draw inferences about articulation rate abnormalities in patients with neurologic movement disorders. The study objective was to investigate the structural relationship between rate measures of speech and of oral motor behaviors different from speech. A total of 130 patients with neurologic movement disorders and 130 healthy subjects participated in the study. Rate data was collected for oral reading (speech), rapid syllable repetition (speech-like), and rapid single articulator movements (nonspeech). The authors used factor analysis to determine whether the different rate variables reflect the same or distinct constructs. The behavioral data were most appropriately captured by a measurement model in which the different task types loaded onto separate latent variables. The data on oral motor performance rates show that speech tasks and oral motor tasks such as rapid syllable repetition or repetitive single articulator movements measure separate traits.

Dissociating oral motor capabilities: Evidence from patients with movement disorders

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

Motor speech skills in children with Down syndrome: A descriptive study

Purpose: Motor speech characteristics of children with Down syndrome (DS) have historically been viewed as either Childhood Dysarthria (CD) or, more infrequently, as Childhood Apraxia of Speech (CAS). The objective of this study was to investigate motor speech deficits in a systematic manner, considering characteristics from both CAS and CD.Method: Motor speech assessments were carried out on seven 3;4–8;11-year old children with DS in comparison with younger, typically-developing children using a Language-Neutral Assessment of Motor Speech for young children (LAMS). Additionally, the motor speech and non-speech oral motor skills of all participants were analysed qualitatively using an investigator checklist of characteristics of CAS, CD and Motor Speech Disorder–Not Otherwise Specified (MSD-NOS).Result: Results indicated that the children with DS exhibited symptoms of CAS, CD and MSD-NOS, with variability within the group and overlapping symptoms of the disorder types. This finding is different from previous assumptions that children with DS have either CD or CAS.Conclusion: The motor speech disorder accompanying DS is complex. The data provide some preliminary descriptions of motor speech disorders in this population and some tools that clinicians would find useful when assessing motor speech skills of young children with DS.