Speech Deficits Research Articles

Speech perception differences in children with dyslexia and persistent speech delay

PurposeDeficits in phonology, which are related to the organization and retrieval of speech sounds in the mental lexicon, are associated with two distinct clinical disorders, dyslexia and persistent speech delay. Research has shown associated speech perception deficits in individuals with these disorders, but the degree to which the underlying perceptual deficits overlap is unclear. In this study, we investigated how children with dyslexia, children with persistent speech delay and their typically-developing peers differed in speech perception when listening to speech stimuli that varied in non-linguistic temporal fine structure acoustic characteristics. MethodThirty-six children were classified into three groups (dyslexia, speech sound disorder, typically-developing; n=12 in each group) based on their reading and speech articulation skills. Novel single-word sine-wave speech stimuli was aurally presented to the children. ResultsThere were no group differences between children with dyslexia and their typically-developing peers, but the children with persistent speech delay had more difficulty than the other two groups. In particular, the children with persistent speech delay had difficulty recognizing words with limited acoustic structure when the stimuli involved a phoneme that they misarticulated in their own speech. ConclusionsThese results suggest a specific difficulty in the perception of temporal fine structure in children with persistent speech delay.

Post Stroke Rehabilitation

The modern stroke rehabilitation programs focuses on specific bio-physiological targets. Modern rehabilitation programs mainly make use of its potential plasticity to compensate for injury. Constraint-induced movement therapy (CIMT), bilateral arm training, and task specific training of the paretic limb, are examples of rehabilitation techniques promoting brain neuro-plasticity. There are many tasks other than locomotor function to be addressed by rehabilitation team. Sensory deficits, speech deficits, dysphagia, memory loss, post stroke central pains and bowel and bladder derangements are among the most important of these challenges that makes a multidisciplinary approach to stroke patients necessary.

Post Stroke Rehabilitation

The modern stroke rehabilitation programs focuses on specific bio-physiological targets. Modern rehabilitation programs mainly make use of its potential plasticity to compensate for injury. Constraint-induced movement therapy (CIMT), bilateral arm training, and task specific training of the paretic limb, are examples of rehabilitation techniques promoting brain neuro-plasticity. There are many tasks other than locomotor function to be addressed by rehabilitation team. Sensory deficits, speech deficits, dysphagia, memory loss, post stroke central pains and bowel and bladder derangements are among the most important of these challenges that makes a multidisciplinary approach to stroke patients necessary.Â

Are individuals with Parkinson's disease capable of speech-motor learning? – A preliminary evaluation

IntroductionThe benefits of different practice conditions in limb-based rehabilitation of motor disorders are well documented. Conversely, the role of practice structure in the treatment of motor-based speech disorders has only been minimally investigated. Considering this limitation, the current study aimed to investigate the effectiveness of selected practice conditions in spatial and temporal learning of novel speech utterances in individuals with Parkinson's disease (PD). MethodsParticipants included 16 individuals with PD who were randomly and equally assigned to constant, variable, random, and blocked practice conditions. Participants in all four groups practiced a speech phrase for two consecutive days, and reproduced the speech phrase on the third day without further practice or feedback. ResultsThere were no significant differences (p > 0.05) between participants across the four practice conditions with respect to either spatial or temporal learning of the speech phrase. Overall, PD participants demonstrated diminished spatial and temporal learning in comparison to healthy controls. Tests of strength of association between participants' demographic/clinical characteristics and speech-motor learning outcomes did not reveal any significant correlations. ConclusionsThe findings from the current study suggest that repeated practice facilitates speech-motor learning in individuals with PD irrespective of the type of practice. Clinicians need to be cautious in applying practice conditions to treat speech deficits associated with PD based on the findings of non-speech-motor learning tasks.

Impact of voice and communication deficits for individuals with cervical spinal cord injury living in the community.

Post-spinal cord injury (SCI), individuals may exhibit mild to moderate impairments in aspects of speech influenced by impaired respiratory support. However, limited research has been conducted into the impact of these impairments on activity and participation when living in the community. To examine the nature and extent of voice and communication function in a group of individuals with cervical SCI living in the community, and to explore participant perceptions of the impact of these deficits on levels of activity and participation. Participants included 14 individuals who had sustained a SCI above C8 level and had returned to living in the community. All completed a series of speech and voice assessments, the Voice Handicap Index, the Australian Therapy Outcome Measures Voice scale, four voice perception questions, and the General Short Form of the Communicative Participation Item Bank. As a group, participants were found to have reduced vocal intensity and phonatory duration. Vocal quality was mildly altered in 93% and pitch control, breath support for speech, speech rate and phrase length impacted in one-quarter or more of the group. All reported impacts, though three individuals reported that their impairments had more extensive impact on communication in daily life. Individuals post-SCI experience mild speech and voice deficits that can have negative impacts on functional communication. The monitoring of communication function may help to identify those individuals who could benefit from additional support and intervention on return to community life.

Core auditory processing deficits in primary progressive aphasia

The extent to which non-linguistic auditory processing deficits may contribute to the phenomenology of primary progressive aphasia is not established. Using non-linguistic stimuli devoid of meaning we assessed three key domains of auditory processing (pitch, timing and timbre) in a consecutive series of 18 patients with primary progressive aphasia (eight with semantic variant, six with non-fluent/agrammatic variant, and four with logopenic variant), as well as 28 age-matched healthy controls. We further examined whether performance on the psychoacoustic tasks in the three domains related to the patients' speech and language and neuropsychological profile. At the group level, patients were significantly impaired in the three domains. Patients had the most marked deficits within the rhythm domain for the processing of short sequences of up to seven tones. Patients with the non-fluent variant showed the most pronounced deficits at the group and the individual level. A subset of patients with the semantic variant were also impaired, though less severely. The patients with the logopenic variant did not show any significant impairments. Significant deficits in the non-fluent and the semantic variant remained after partialling out effects of executive dysfunction. Performance on a subset of the psychoacoustic tests correlated with conventional verbal repetition tests. In sum, a core central auditory impairment exists in primary progressive aphasia for non-linguistic stimuli. While the non-fluent variant is clinically characterized by a motor speech deficit (output problem), perceptual processing of tone sequences is clearly deficient. This may indicate the co-occurrence in the non-fluent variant of a deficit in working memory for auditory objects. Parsimoniously we propose that auditory timing pathways are altered, which are used in common for processing acoustic sequence structure in both speech output and acoustic input.

A systematic review and evaluation of procedures for the induction of speech among persons with developmental disabilities

ABSTRACTObjective: Deficits in vocal speech are common among those with developmental disabilities. This review examines interventions for teaching speech to individuals who presented as nonspeaking, or with low levels of vocalizations at baseline, and assesses evidence-based practice in this area. Methods: Systematic searches identified 78 studies suitable for inclusion. These studies were evaluated in terms of (a) participants, (b) intervention, (c) intervention setting, (d) intervention agent, (e) treatment efficacy, (f) generalization and maintenance of treatment effects, and (g) research rigor. Results: A variety of interventions, primarily behavioral, intended to induce vocal speech were delivered to participants with developmental disabilities aged between six months and 57 years. Treatment efficacy was variable (PND M = 52.9%; range 0%–100%); however, results indicated that behavioral interventions constituted evidence-based practice. Non-behavioral strategies were shown to have received insufficient research evaluation to date. Conclusion: Results indicate that a number of procedures can induce speech among individuals with developmental disabilities.

A Mutation Associated with Stuttering Alters Mouse Pup Ultrasonic Vocalizations

A promising approach to understanding the mechanistic basis of speech is to study disorders that affect speech without compromising other cognitive or motor functions. Stuttering, also known as stammering, has been linked to mutations in the lysosomal enzyme-targeting pathway, but how this remarkably specific speech deficit arises from mutations in a family of general "cellular housekeeping" genes is unknown. To address this question, we asked whether a missense mutation associated with human stuttering causes vocal or other abnormalities in mice. We compared vocalizations from mice engineered to carry a mutation in the Gnptab (N-acetylglucosamine-1-phosphotransferase subunits alpha/beta) gene with wild-type littermates. We found significant differences in the vocalizations of pups with the human Gnptab stuttering mutation compared to littermate controls. Specifically, we found that mice with the mutation emitted fewer vocalizations per unit time and had longer pauses between vocalizations and that the entropy of the temporal sequence wassignificantly reduced. Furthermore, Gnptab missense mice were similar to wild-type mice on an extensive battery of non-vocal behaviors. We then used the same language-agnostic metrics for auditory signal analysis of human speech. We analyzed speech from people who stutter with mutations in this pathway and compared it to control speech and found abnormalities similar to those found in the mouse vocalizations. These data show that mutations in the lysosomal enzyme-targeting pathway produce highly specific effects in mouse pup vocalizations and establish the mouse as an attractive model for studying this disorder.

Mild Hearing Loss Can Impair Brain Function

The emphasis of hearing loss research has been to establish the long-term consequences of permanent, severe to profound deafness. However, auditory processing deficits can be induced by transient, mild hearing loss during childhood. These deficits in perception, speech, and language processing can persist long after normal audibility is restored. One explanation for the persistence of these deficits is that transient hearing loss causes irreversible changes to the central nervous system (CNS) cellular properties that may lead to degraded stimulus encoding. Therefore, this review evaluates the premise that mild hearing loss during development induces behavioral deficits, and that these auditory deficits are causally related to changes within the CNS.

Speech Sound Disorders: What's Motor Got To Do With It?

Speech sound disorders (SSDs) are commonly viewed as involving impaired articulation and/or phonological skills. Speech language pathologists working with individuals with (SSDs) assess the articulation of speech sounds and the coordination of articulatory structures with other components of the speech mechanism, including the phonatory, respiratory, and resonatory subsystems. The sound system of the language and the rules that govern how phonemes are combined are equally critical for clinicians to explore. While the terms “articulation” and “phonology” provide clinicians with a framework for classification, children who are broadly identified with (SSDs) may also display characteristics of a motor speech impairment, which can obscure the decision making process with respect to both diagnosis and treatment. One such motor speech disorder is childhood apraxia of speech (CAS). The focus of this paper is to discuss motor speech deficits in children and to review research that aims to distinguish motor speech patterns in children with (SSDs) with and without CAS. We will also address the relationship between emerging speech motor and linguistic skills.

Auditory rehabilitation after stroke: treatment of auditory processing disorders in stroke patients with personal frequency-modulated (FM) systems

Purpose: Auditory disability due to impaired auditory processing (AP) despite normal pure-tone thresholds is common after stroke, and it leads to isolation, reduced quality of life and physical decline. There are currently no proven remedial interventions for AP deficits in stroke patients. This is the first study to investigate the benefits of personal frequency-modulated (FM) systems in stroke patients with disordered AP. Methods: Fifty stroke patients had baseline audiological assessments, AP tests and completed the (modified) Amsterdam Inventory for Auditory Disability and Hearing Handicap Inventory for Elderly questionnaires. Nine out of these 50 patients were diagnosed with disordered AP based on severe deficits in understanding speech in background noise but with normal pure-tone thresholds. These nine patients underwent spatial speech-in-noise testing in a sound-attenuating chamber (the “crescent of sound”) with and without FM systems. Results: The signal-to-noise ratio (SNR) for 50% correct speech recognition performance was measured with speech presented from 0° azimuth and competing babble from ±90° azimuth. Spatial release from masking (SRM) was defined as the difference between SNRs measured with co-located speech and babble and SNRs measured with spatially separated speech and babble. The SRM significantly improved when babble was spatially separated from target speech, while the patients had the FM systems in their ears compared to without the FM systems. Conclusions: Personal FM systems may substantially improve speech-in-noise deficits in stroke patients who are not eligible for conventional hearing aids. FMs are feasible in stroke patients and show promise to address impaired AP after stroke.Implications for RehabilitationThis is the first study to investigate the benefits of personal frequency-modulated (FM) systems in stroke patients with disordered AP.All cases significantly improved speech perception in noise with the FM systems, when noise was spatially separated from the speech signal by 90° compared with unaided listening.Personal FM systems are feasible in stroke patients, and may be of benefit in just under 20% of this population, who are not eligible for conventional hearing aids.

Interrelations between cognitive dysfunction and motor symptoms of Parkinson's disease: behavioral and neural studies.

Parkinson's disease (PD) is characterized by a range of motor symptoms. Besides the cardinal symptoms (tremor, bradykinesia/akinesia, and rigidity), PD patients also show other motor deficits, including gait disturbance, speech deficits, and impaired handwriting. However, along with these key motor symptoms, PD patients also experience cognitive deficits in attention, executive function, working memory, and learning. Recent evidence suggests that these motor and cognitive deficits of PD are not completely dissociable, as aspects of cognitive dysfunction can impact motor performance in PD. In this article, we provide a review of behavioral and neural studies on the associations between motor symptoms and cognitive deficits in PD, specifically akinesia/bradykinesia, tremor, gait, handwriting, precision grip, and speech production. This review paves the way for providing a framework for understanding how treatment of cognitive dysfunction, for example cognitive rehabilitation programs, may in turn influence the motor symptoms of PD.

Idea density in the life-stories of people with schizophrenia: Associations with narrative qualities and psychiatric symptoms

Disordered speech and language deficits are well-documented in schizophrenia-spectrum disorders. Researchers often assess speech samples using manualized rating systems, though recently computerized language assessment methods have been used more frequently in the study of speech from people with schizophrenia. Most typically, these computerized assessments measure aspects of expressivity (i.e., pause durations, prosody) or use word-count technology; less attention has focused on similar methods that can capture more sophisticated aspects of linguistic complexity (e.g., idea density). The primary objective of the present study was to assess idea density – via a computerized measure – in the life-story narratives of people with schizophrenia (n=32) compared to a group of community control participants (n=15). In the schizophrenia group, we also examined associations between idea density, narrative qualities rated via a manualized measure, and psychiatric symptoms. Our findings indicate that idea density is diminished in individuals with schizophrenia compared to controls. Further, our results suggest that though people with schizophrenia with richer idea density tended to have more developed insight into illness, they also had higher levels of depression, anxiety, and avolition. Implications of these results and suggestions for future research are discussed.

Atypical speech lateralization in adults with developmental coordination disorder demonstrated using functional transcranial Doppler ultrasound.

Research using clinical populations to explore the relationship between hemispheric speech lateralization and handedness has focused on individuals with speech and language disorders, such as dyslexia or specific language impairment (SLI). Such work reveals atypical patterns of cerebral lateralization and handedness in these groups compared to controls. There are few studies that examine this relationship in people with motor coordination impairments but without speech or reading deficits, which is a surprising omission given the prevalence of theories suggesting a common neural network underlying both functions. We use an emerging imaging technique in cognitive neuroscience; functional transcranial Doppler (fTCD) ultrasound, to assess whether individuals with developmental coordination disorder (DCD) display reduced left‐hemisphere lateralization for speech production compared to control participants. Twelve adult control participants and 12 adults with DCD, but no other developmental/cognitive impairments, performed a word‐generation task whilst undergoing fTCD imaging to establish a hemispheric lateralization index for speech production. All participants also completed an electronic peg‐moving task to determine hand skill. As predicted, the DCD group showed a significantly reduced left lateralization pattern for the speech production task compared to controls. Performance on the motor skill task showed a clear preference for the dominant hand across both groups; however, the DCD group mean movement times were significantly higher for the non‐dominant hand. This is the first study of its kind to assess hand skill and speech lateralization in DCD. The results reveal a reduced leftwards asymmetry for speech and a slower motor performance. This fits alongside previous work showing atypical cerebral lateralization in DCD for other cognitive processes (e.g., executive function and short‐term memory) and thus speaks to debates on theories of the links between motor control and language production.

Genetics of human Bardet-Biedl syndrome, an updates.

Bardet-Biedl syndrome (BBS) is an autosomal recessive multisystemic human genetic disorder characterized by six major defects including obesity, mental retardation, renal anomalies, polydactyly, retinal degeneration and hypogenitalism. In several cases of BBS, few other features such as metabolic defects, cardiovascular anomalies, speech deficits, hearing loss, hypertension, hepatic defects and high incidence of diabetes mellitus have been reported as well. The BBS displays extensive genetic heterogeneity. To date, 19 genes have been mapped on different chromosomes causing BBS phenotypes having varied mutational load of each BBS gene. In this review, we have discussed clinical spectrum and genetics of BBS. This report presents a concise overview of the current knowledge on clinical data and its molecular genetics progress upto date.

Abstract 92: Cerebral Microbleeds in Transient Ischemic Attack and Minor Cerebrovascular Events

Background: Transient focal neurological episodes (TFNE) can occur in cerebral amyloid angiopathy (CAA) and can mimic transient ischemic attack (TIA). Hypothesis: Risk factors and outcomes of patients with minor stroke or TIA would differ in patients with and without cerebral microbleeds (CMB), including in patients with lobar microbleeds potentially consistent with CAA. Methods: 431 of 510 patients with high-risk TIA (motor or speech deficits > 5 minutes) or minor stroke in the previously reported CATCH (CT and MRI in the triage of TIA and minor cerebrovascular events to identify high risk patients) study underwent baseline MRI. 416 scans with sufficient quality were analyzed for presence and location of CMB and cortical superficial siderosis. Clinical symptoms, baseline characteristics, recurrent TIA or stroke and 90 day modified Rankin scale (mRs) were prospectively collected. Results: CMB were detected in 65/416 (15.6 %), with a predominantly lobar pattern (75.4 %), and superficial siderosis in 11/416 (2.6 %). In a multivariable logistic regression model adjusted for number of risk factors age was associated with presence of CMB (odds ratio (OR) 1.04; 95 % confidence interval (CI) 1.02 - 1.06, P = 0.001). Presence of CMB was not associated with recurrent stroke or TIA (9.2 % vs. 11.1 %, P=0.65) or unfavorable mRS (> 1) at 90 days (20 % vs. 16 %, P =0.42). Superficial siderosis was present in 11/416 (2.6%). 42 patients (10.1 %) fulfilled modified Boston criteria for possible or probable CAA. Presenting symptoms were not different between patients with vs. without possible/probable CAA, when considering either all patients or just those with TIA. Possible/probable CAA was not associated with recurrent stroke or TIA (7.1 % vs. 11.2 %, P = 0.42) or unfavorable mRs (> 1) at 90 days (23.8 % vs. 15.8 %, P = 0.18). Conclusions: CMB in TIA and minor stroke patients are moderately common but do not strongly predict clinical recurrence and or 90-day functional outcome. Clinical presentations for CAA-related TFNE and TIA might be overlapping, suggesting that MRI may be needed to differentiate them.

Structural brain abnormalities in a single gene disorder associated with epilepsy, language impairment and intellectual disability.

Childhood speech and language deficits are highly prevalent and are a common feature of neurodevelopmental disorders. However, it is difficult to investigate the underlying causal pathways because many diagnostic groups have a heterogeneous aetiology. Studying disorders with a shared genetic cause and shared cognitive deficits can provide crucial insight into the cellular mechanisms and neural systems that give rise to those impairments. The current study investigated structural brain differences of individuals with mutations in ZDHHC9, which is associated with a specific neurodevelopmental phenotype including prominent speech and language impairments and intellectual disability. We used multiple structural neuroimaging methods to characterise neuroanatomy in this group, and observed bilateral reductions in cortical thickness in areas surrounding the temporo-parietal junction, parietal lobule, and inferior frontal lobe, and decreased microstructural integrity of cortical, subcortical-cortical, and interhemispheric white matter projections. These findings are compared to reports for other genetic groups and genetically heterogeneous disorders with a similar presentation. Overlap in the neuroanatomical phenotype suggests a common pathway that particularly affects the development of temporo-parietal and inferior frontal areas, and their connections.

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.

Increased resting-state EEG functional connectivity in benign childhood epilepsy with centro-temporal spikes

PurposeTo explore intrahemispheric, cortico-cortical EEG functional connectivity (EEGfC) in benign childhood epilepsy with rolandic spikes (BECTS). Methods21-channel EEG was recorded in 17 non-medicated BECTS children and 19 healthy controls. 180s of spike- and artifact-free activity was selected for EEGfC analysis. Correlation of Low Resolution Electromagnetic Tomography- (LORETA-) defined current source density time series were computed between two cortical areas (region of interest, ROI). Analyses were based on broad-band EEGfC results. Groups were compared by statistical parametric network (SPN) method. Statistically significant differences between group EEGfC values were emphasized at p<0.05 corrected for multiple comparison by local false discovery rate (FDR). Results(1) Bilaterally increased beta EEGfC occurred in the BECTS group as compared to the controls. Greatest beta abnormality emerged between frontal and frontal, as well as frontal and temporal ROIs. (2) Locally increased EEGfC emerged in all frequency bands in the right parietal area. ConclusionsAreas of increased EEGfC topographically correspond to cortical areas that, based on relevant literature, are related to speech and attention deficit in BECTS children.

Speech and language deficits in separation anxiety disorder

Separation anxiety disorder (SAD) is one of the most commonly occurring pediatric anxiety disorders. Children with SAD are characterized by excessive anxiety of separation from the primary attachment figure. These children exhibit fear of separation from their parents and display behaviors such as clinging, excessive crying, and tantrums. Children with SAD are found to have significant brain changes. SAD can co-occur with other conditions such as autism spectrum disorders, and attention deficit hyperactivity disorder. Past studies have identified not only cognitive deficits in children diagnosed with SAD, but also speech and language deficits, which vary depending on comorbidities. A team-centered approach is essential in the assessment and treatment of children diagnosed with SAD.