Speech Motor Development Research Articles

Vocal Characteristics of Children With Cerebral Palsy and Anarthria.

This study aimed to investigate the vocal characteristics of children with cerebral palsy (CP) and anarthria using the stage model of vocal development. Vocal characteristics of 39 children with CP and anarthria around 4 years of age were analyzed from laboratory-based caregiver-child interactions. Perceptual coding analysis was conducted using the Stark Assessment of Early Vocal Development-Revised to examine vocal complexity, volubility, and consonant diversity. Children predominately produced vocalizations corresponding to the two earliest stages of vocal development characterized by vowel-like utterances. They showed a limited attainment of consonantal features with low consonant diversity and variably low vocal rates. Our results demonstrate that underlying neurological impairments resulting in an anarthric status in children with CP affect the progression of speech motor development and their ability to advance beyond early vocal stages. These findings highlight the importance of considering alternative communication modalities for children demonstrating similar vocal characteristics beyond expected periods of development.

Shared and Separate Neuromuscular Underpinnings of Swallowing and Motor Speech Development in the School-Age Years.

Despite co-occurrence of swallowing and speech disorders in childhood, there is limited research on shared and separate neuromuscular underpinnings of these functions. The purpose of this study was to (a) compare neuromuscular control of swallowing and speech between younger and older children and (b) determine similarities and differences in neuromuscular control of swallowing and speech. Twenty-six typically developing children (thirteen 7- to 8-year-olds and thirteen 11- to 12-year-olds) completed this cross-sectional study. Neuromuscular control was evaluated using surface electromyography of submental muscles and superior and inferior orbicularis oris muscles during parallel tasks of swallowing and speech. Outcome measures included normalized mean amplitude, burst duration, time to peak amplitude, and bilateral synchrony, which were examined using mixed-effects models. For normalized mean amplitude, burst duration, and time to peak amplitude, there were significant two- and three-way interactions between muscle group, task, and age group, indicating that older and younger children demonstrated different muscle activation patterns, and these patterns varied by muscle and task. No differences were noted between groups for bilateral synchrony. For parallel tasks, children demonstrated different magnitudes of normalized mean amplitude and time to peak amplitude of speech and swallowing. However, they demonstrated a similar pattern: increases in magnitude as task complexity increased. Children continue to demonstrate refinement of their neuromuscular control of swallowing and speech between 7-8 and 11-12 years of age, and there are both shared and separate elements of neuromuscular control between these two vital functions. To improve generalizability of findings, future research should include longitudinal analysis of swallowing and speech development, as well as measures of central neurophysiology. https://doi.org/10.23641/asha.23796258.

Neurocomputational modeling of speech motor development.

This review describes a computational approach for modeling the development of speech motor control in infants. We address the development of two levels of control: articulation of individual speech sounds (defined here as phonemes, syllables, or words for which there is an optimized motor program) and production of sound sequences such as phrases or sentences. We describe the DIVA model of speech motor control and its application to the problem of learning individual sounds in the infant's native language. Then we describe the GODIVA model, an extension of DIVA, and how chunking of frequently produced phoneme sequences is implemented within it.

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

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

Characterizing Speech Sound Productions in Bilingual Speakers of Jamaican Creole and English: Application of Durational Acoustic Methods.

This study examined the speech acoustic characteristics of Jamaican Creole (JC) and English in bilingual preschoolers and adults using acoustic duration measures. The aims were to determine if, for JC and English, (a) child and adult acoustic duration characteristics differ, (b) differences occur in preschoolers' duration patterns based on the language spoken, and (c) relationships exist between the preschoolers' personal contextual factors (i.e., age, sex, and percentage of language [%language] exposure and use) and acoustic duration. Data for this cross-sectional study were collected in Kingston, Jamaica, and New York City, New York, United States, during 2013-2019. Participants included typically developing simultaneous bilingual preschoolers (n = 120, ages 3;4-5;11 [years;months]) and adults (n = 15, ages 19;0-54;4) from the same linguistic community. Audio recordings of single-word productions of JC and English were collected through elicited picture-based tasks and used for acoustic analysis. Durational features (voice onset time [VOT], vowel duration, whole-word duration, and the proportion of vowel to whole-word duration) were measured using Praat, a speech analysis software program. JC-English-speaking children demonstrated developing speech motor control through differences in durational patterns compared with adults, including VOT for voiced plosives. Children's VOT, vowel duration, and whole-word duration were produced similarly across JC and English. The contextual factor %language use was predictive of vowel and whole-word duration in English. The findings from this study contribute to a foundation of understanding typical bilingual speech characteristics and motor development as well as schema in JC-English speakers. In particular, minimal acoustic duration differences were observed across the post-Creole continuum, a feature that may be attributed to the JC-English bilingual environment. https://doi.org/10.23641/asha.21760469.

Oral and Laryngeal Articulation Control of Voicing in Children with and without Speech Sound Disorders.

Voicing contrast is hard to master during speech motor development, and the phonological process of consonant devoicing is very frequent in children with Speech Sound Disorders (SSD). Therefore, the aim of this study was to characterise the oral and laryngeal articulation control strategies used by children with and without SSD as a function of place of articulation. The articulation rate and relative oral airflow amplitude (flow) were used to analyse how children controlled oral articulation; fundamental frequency (fo), open quotient (OQ), and a classification of voicing were used to explore laryngeal behaviour. Data from detailed speech and language assessments, oral airflow and electroglottography signals were collected from 13 children with SSD and 17 children without SSD, aged 5; 0 to 7; 8, using picture naming tasks. Articulation rate and flow in children with and without SSD were not significantly different, but a statistically reliable effect of place on flow was found. Children with and without SSD used different relative fo (which captures changes in fo during the consonant-vowel transition) and OQ values, and place of articulation had an effect on the strength of voicing. All children used very similar oral articulation control of voicing, but children with SSD used less efficient laryngeal articulation strategies (higher subglottal damping and more air from the lungs expelled in each glottal cycle) than children without SSD.

Homoeopathy for infantile spasms: An open label, single arm, clinical trial

Background: Treatment of infantile spasms (ISs) with allopathic medicines along with homeopathy is poorly understood in context with the seizure profile, psychomotor outcome, and electroencephalogram (EEG) changes. Objectives: The objective of the study was to evaluate the role of homeopathic treatment in seizure control, psychomotor development, and EEG changes in patients of IS. Materials and Methods: An open label, single-arm, clinical trial was conducted. Patients found eligible were enrolled (n = 30) and given individualized homeopathic intervention along with conventional medicine for 3 months. Follow-up assessment was done weekly based on 7 points: Sense of well-being, changes in cognitive behavior, changes in activity level, changes in seizure ictal period, changes in hypsarrhythmia, changes in speech, and gross and fine motor development. Results: About 76.66% (n = 23) of patients had improved clinically (sense of well-being, activity level, and seizure ictal period). Cognitive behavior improved in 50% (n = 9), while hypsarrhythmia improved in 16.66% (n = 5) of patients. Speech improved in 13.33% (n = 4), while gross and fine motor skills improved in 21% (n = 4) and 16% (n = 4), respectively. Calcarea carbonica (n = 4, 13.33%), Arsenic album (n = 4, 13.33%), Causticum (n = 4, 13.33%), Lycopodium (n = 3, 10%), and Nux vomica (n = 2, 6.66%) were frequently used medicines. Conclusion: Homeopathy plays a positive role in seizures in IS patients. More multicentric, randomized trials are required to make conclusions.

A Potential Role for Reinforcement Learning in Speech Production.

Reinforcement learning, the ability to change motor behavior based on external reward, has been suggested to play a critical role in early stages of speech motor development and is widely used in clinical rehabilitation for speech motor disorders. However, no current evidence exists that demonstrates the capability of reinforcement to drive changes in human speech behavior. Speech provides a unique test of the universality of reinforcement learning across motor domains: Speech is a complex, high-dimensional motor task whose goals do not specify a task to be performed in the environment but ultimately must be self-generated by each speaker such that they are understood by those around them. Across four experiments, we examine whether reinforcement learning alone is sufficient to drive changes in speech behavior and parametrically test two features known to affect reinforcement learning in reaching: how informative the reinforcement signal is as well as the availability of sensory feedback about the outcomes of one's motor behavior. We show that learning does occur and is more likely when participants receive auditory feedback that gives an implicit target for production, although they do not explicitly imitate that target. Contrary to results from upper limb control, masking feedback about movement outcomes has no effect on speech learning. Together, our results suggest a potential role for reinforcement learning in speech but that it likely operates differently than in other motor domains.

Developmental Courses in Childhood Dysarthria: Longitudinal Analyses of Auditory-Perceptual Parameters.

Purpose The aim of this longitudinal study was to describe developmental courses of childhood dysarthria against the background of typical speech motor development by collecting auditory-perceptual data. Method Fourteen children (four girls, 10 boys; 5;1-8;4 [years;months] at Time 1) with neurological conditions (CNC) and 14 typically developing children (CTD) matched for age and gender were assessed at three points in time over an 18-month period. Speech samples were collected using the Bogenhausener Dysarthrie Skalen-Kindliche Dysarthrien (BoDyS-KiD; in English: Bogenhausen Dysarthria Scales-Childhood Dysarthria), a German tool for the assessment of childhood dysarthria, and analyzed by means of nine perceptual scales covering all clinically relevant speech components. Age normalization was performed according to a method published recently. Data from the matched controls were used to estimate whether the gradients of the CNC group's developmental trajectories exceeded those of typical development. Results The children with neurological conditions presented heterogeneous speech profiles with a wide range of severity. At the group level, relatively stable trajectories of the age-normalized dysarthria total score were found over the observation period. The nine perceptual scales showed more or less parallel developments. All patients except two followed the growth curve describing the developmental course of the typically developing children. Conclusions Most children took advantage of the developmental dynamics as they developed parallel to the age norm. With its comprehensive description of the developmental courses of 14 children with neurological conditions, this study may contribute to a more valid, statistically verified clinical assessment of the course of childhood dysarthria.

Comparing global motor characteristics in children and adults with childhood apraxia of speech to a cerebellar stroke patient: evidence for the cerebellar hypothesis in a developmental motor speech disorder

ABSTRACT Individuals with childhood apraxia of speech (CAS) have motor deficits in systems beyond speech and also global deficits in sequential processing, consistent with cerebellar dysfunction. We investigated the cerebellar hypothesis of CAS in 18 children and adolescents with CAS, 11 typical controls, an adult with a probable CAS history, and an adult with a history of a cerebellar stroke. Compared to the controls, children and adolescents with CAS had the greatest difficulty with rapid syllable repetition when alternating between two different syllables types, less difficulty when switching among three different syllables, and no difficulty when repeating the same syllable. They also showed difficulty with alternating but not repetitive key tapping. Motor speeds during the syllable repetition and key tapping tasks where correlated, consistent with a central motor delimiter that governs both systems. Participants with CAS obtained low scores in a test of fine motor ability, where the tasks required rapid integration of complex hand movement sequences. The adult with the probable CAS history obtained motor performance scores that generally resembled those in the children and adolescents with CAS, consistent with motor deficits that persist into adulthood. The participant with the cerebellar stroke history showed deficits in tests of fine and gross motor ability as well as balance. His repetitive and alternating key tapping was slow in the ipsilateral hand relative to the stroke lesion. The shared deficits in sequential motor functions among all participants with CAS and the cerebellar stroke patient are consistent with persisting cerebellar dysfunctions in CAS.

Motor speech impairment predicts expressive language in minimally verbal, but not low verbal, individuals with autism spectrum disorder.

Background and aims:Developmental motor speech impairment has been suspected, but rarely systematically examined, in low- and minimally verbal individuals with autism spectrum disorder. We aimed to investigate the extent of motor speech impairment in this population and its relation to number of different words produced during a semi-structured language sample.Methods:Videos of 54 low-verbal and minimally verbal individuals (ages 4;4–18;10) performing portions of a speech praxis test were coded for signs of motor speech impairment (e.g., childhood apraxia of speech). Age, autism spectrum disorder severity, nonspeech oral-motor ability, speech production ability, nonverbal IQ, and receptive vocabulary were compared between groups.Results:Four groups emerged: (1) speech within normal limits (n=12), (2) non-childhood apraxia of speech impairment (n=16), (3) suspected childhood apraxia of speech (n=13), and (4) insufficient speech to rate (n=13). Groups differed significantly in nonspeech oral-motor ability, speech production ability, nonverbal IQ, and receptive vocabulary. Overall, only speech production ability and receptive vocabulary accounted for significant variance in number of different words. Receptive vocabulary significantly predicted number of different words only in Groups 1 and 2, while speech production ability significantly predicted number of different words only in Groups 3 and 4.Conclusions and implications:If replicated, our findings have important implications for developing much-needed spoken language interventions in minimally verbal individuals with autism spectrum disorder.

The Effects of Syntactic Complexity and Sentence Length on the Speech Motor Control of School-Age Children Who Stutter.

Early childhood stuttering is associated with atypical speech motor development. Compared with children who do not stutter (CWNS), the speech motor systems of school-age children who stutter (CWS) may also be particularly susceptible to breakdown under increased processing demands. The effects of increased syntactic complexity and sentence length on articulatory coordination were investigated. Kinematic, temporal, and behavioral indices of articulatory coordination were quantified for school-age CWS (n = 19) and CWNS (n = 18). Participants produced 4 sentences varying in syntactic complexity (simple declarative/complex declarative with a relative clause) and sentence length (short/long). Lip aperture variability (LAVar) served as a kinematic measure of interarticulatory consistency over repeated productions. Articulation rate (syllables per second) was also calculated as a related temporal measure. Finally, we computed accuracy and stuttering frequency percentages for each sentence to assess task performance. Increased sentence length, but not syntactic complexity, increased LAVar in both groups. This effect was disproportionately greater for CWS compared with CWNS. No group differences were observed for articulation rate. CWS were also less accurate in their sentence productions than fluent peers and exhibited more instances of stuttering when processing demands associated with length and syntactic complexity increases. The speech motor systems of school-age CWS appear to be particularly vulnerable to processing demands associated with increased sentence length, as evidenced by increased LAVar. Increasing the length and complexity of the sentence stimuli also resulted in reduced production accuracy and increased stuttering frequency. We discuss these findings within a motor control framework of speech production.

A Lag in Speech Motor Coordination During Sentence Production Is Associated With Stuttering Persistence in Young Children.

The purpose of this study was to determine if indices of speech motor coordination during the production of sentences varying in sentence length and syntactic complexity were associated with stuttering persistence versus recovery in 5- to 7-year-old children. We compared children with persistent stuttering (CWS-Per) with children who had recovered (CWS-Rec), and children who do not stutter (CWNS). A kinematic measure of articulatory coordination, lip aperture variability (LAVar), and overall movement duration were computed for perceptually fluent sentence productions varying in length and syntactic complexity. CWS-Per exhibited higher LAVar across sentence types compared to CWS-Rec and CWNS. For the participants who successfully completed the experimental paradigm, the demands of increasing sentence length and syntactic complexity did not appear to disproportionately affect the speech motor coordination of CWS-Per compared to their recovered and fluent peers. However, a subset of CWS-Per failed to produce the required number of accurate utterances. These findings support our hypothesis that the speech motor coordination of school-age CWS-Per, on average, is less refined and less mature compared to CWS-Rec and CWNS. Childhood recovery from stuttering is characterized, in part, by overcoming an earlier occurring maturational lag in speech motor development.

Parent–child interaction in motor speech therapy

Purpose: This study measures the reliability and sensitivity of a modified Parent–Child Interaction Observation scale (PCIOs) used to monitor the quality of parent–child interaction. The scale is part of a home-training program employed with direct motor speech intervention for children with speech sound disorders.Method: Eighty-four preschool age children with speech sound disorders were provided either high- (2×/week/10 weeks) or low-intensity (1×/week/10 weeks) motor speech intervention. Clinicians completed the PCIOs at the beginning, middle, and end of treatment. Inter-rater reliability (Kappa scores) was determined by an independent speech-language pathologist who assessed videotaped sessions at the midpoint of the treatment block. Intervention sensitivity of the scale was evaluated using a Friedman test for each item and then followed up with Wilcoxon pairwise comparisons where appropriate.Results: We obtained fair-to-good inter-rater reliability (Kappa = 0.33–0.64) for the PCIOs using only video-based scoring. Child-related items were more strongly influenced by differences in treatment intensity than parent-related items, where a greater number of sessions positively influenced parent learning of treatment skills and child behaviors.Conclusion: The adapted PCIOs is reliable and sensitive to monitor the quality of parent–child interactions in a 10-week block of motor speech intervention with adjunct home therapy.Implications for rehabilitationParent-centered therapy is considered a cost effective method of speech and language service delivery. However, parent-centered models may be difficult to implement for treatments such as developmental motor speech interventions that require a high degree of skill and training.For children with speech sound disorders and motor speech difficulties, a translated and adapted version of the parent–child observation scale was found to be sufficiently reliable and sensitive to assess changes in the quality of the parent–child interactions during intervention.In developmental motor speech interventions, high-intensity treatment (2×/week/10 weeks) facilitates greater changes in the parent–child interactions than low intensity treatment (1×/week/10 weeks).On one hand, parents may need to attend more than five sessions with the clinician to learn how to observe and address their child’s speech difficulties. On the other hand, children with speech sound disorders may need more than 10 sessions to adapt to structured play settings even when activities and therapy materials are age-appropriate.

Voxel-based morphometry in opera singers: Increased gray-matter volume in right somatosensory and auditory cortices

In contrast to instrumental musicians, professional singers do not train on a specific instrument but perfect a motor system that has already been extensively trained during speech motor development. Previous functional imaging studies suggest that experience with singing is associated with enhanced somatosensory-based vocal motor control. However, experience-dependent structural plasticity in vocal musicians has rarely been studied. We investigated voxel-based morphometry (VBM) in 27 professional classical singers and compared gray matter volume in regions of the “singing-network” to an age-matched group of 28 healthy volunteers with no special singing experience. We found right hemispheric volume increases in professional singers in ventral primary somatosensory cortex (larynx S1) and adjacent rostral supramarginal gyrus (BA40), as well as in secondary somatosensory (S2) and primary auditory cortices (A1). Moreover, we found that earlier commencement with vocal training correlated with increased gray-matter volume in S1. However, in contrast to studies with instrumental musicians, this correlation only emerged in singers who began their formal training after the age of 14years, when speech motor development has reached its first plateau. Structural data thus confirm and extend previous functional reports suggesting a pivotal role of somatosensation in vocal motor control with increased experience in singing. Results furthermore indicate a sensitive period for developing additional vocal skills after speech motor coordination has matured.

Diagnosis of Childhood Apraxia of Speech: A Systematic Review

This review employed to establish frequency usage of clinical markers and diagnostic tests for childhood apraxia of speech. following databases were searched for published papers between 1980 and 2015 looking for clinical studies used the six introduced tests for motor speech performance; Web of Science, Scopus, CINAHL and Pubmed. . The review considered articles which for children at or below elementary school age with diagnosis of childhood apraxia of speech. Fifty seven articles met the inclusion criteria. Studies included other developmental motor speech disorders as well as childhood apraxia of speech were excluded. Twenty four articles excluded from the study and thirty three studies were reviewed. Twenty articles were in diagnostic tests and thirteen articles were in clinical markers. The Verbal Motor Production Assessment for Children is the most reliable diagnostic test for diagnosis of childhood apraxia of speech, and Inconsistency as well as vowel errors are the most frequent clinical markers.

Cognitive and linguistic influences on speech motor development

Speech development is affected by the interaction of the development of various domains, including motor control and language. Infants demonstrate strong associations between speed and range of movement of the lips and jaw with cognitive (attention, memory) and language (number of words understood/expressed, number of gestures used) skills during language acquisition (Nip et al., 2011). In addition, goal-directed vocal behaviors (e.g., words) are produced with faster lip and jaw speeds in infants (Nip et al., 2009). Similar task-related changes can be observed in older children. Tasks requiring greater language formulation demands (e.g., re-telling stories) are produced with greater movement speeds and oral excursions than tasks requiring fewer demands (e.g., repeating syllables) (Nip &amp; Green, 2013). Kinematic descriptions of speech production may provide insight into the acoustic consequences of adapting movement strategies for different tasks; increasing oral excursions may be a strategy to increase articulatory precision and may account for the reduced speaking rate during speaking tasks requiring greater demands (Nip &amp; Green, 2013). In addition, coordination of articulatory movements is highly associated with intelligibility in children with and without speech disorders (Nip, in press). Understanding the interactions among motor control and language may explain patterns of speech development.

Speech motor planning and execution deficits in early childhood stuttering.

BackgroundFive to eight percent of preschool children develop stuttering, a speech disorder with clearly observable, hallmark symptoms: sound repetitions, prolongations, and blocks. While the speech motor processes underlying stuttering have been widely documented in adults, few studies to date have assessed the speech motor dynamics of stuttering near its onset. We assessed fundamental characteristics of speech movements in preschool children who stutter and their fluent peers to determine if atypical speech motor characteristics described for adults are early features of the disorder or arise later in the development of chronic stuttering.MethodsOrofacial movement data were recorded from 58 children who stutter and 43 children who do not stutter aged 4;0 to 5;11 (years; months) in a sentence production task. For single speech movements and multiple speech movement sequences, we computed displacement amplitude, velocity, and duration. For the phrase level movement sequence, we computed an index of articulation coordination consistency for repeated productions of the sentence.ResultsBoys who stutter, but not girls, produced speech with reduced amplitudes and velocities of articulatory movement. All children produced speech with similar durations. Boys, particularly the boys who stuttered, had more variable patterns of articulatory coordination compared to girls.ConclusionsThis study is the first to demonstrate sex-specific differences in speech motor control processes between preschool boys and girls who are stuttering. The sex-specific lag in speech motor development in many boys who stutter likely has significant implications for the dramatically different recovery rates between male and female preschoolers who stutter. Further, our findings document that atypical speech motor development is an early feature of stuttering.

Chapter 9 - Role of the auditory system in speech production

This chapter reviews evidence regarding the role of auditory perception in shaping speech output. Evidence indicates that speech movements are planned to follow auditory trajectories. This in turn is followed by a description of the Directions Into Velocities of Articulators (DIVA) model, which provides a detailed account of the role of auditory feedback in speech motor development and control. A brief description of the higher-order brain areas involved in speech sequencing (including the pre-supplementary motor area and inferior frontal sulcus) is then provided, followed by a description of the Hierarchical State Feedback Control (HSFC) model, which posits internal error detection and correction processes that can detect and correct speech production errors prior to articulation. The chapter closes with a treatment of promising future directions of research into auditory-motor interactions in speech, including the use of intracranial recording techniques such as electrocorticography in humans, the investigation of the potential roles of various large-scale brain rhythms in speech perception and production, and the development of brain-computer interfaces that use auditory feedback to allow profoundly paralyzed users to learn to produce speech using a speech synthesizer.

Multi‐sensory treatment for children with developmental motor speech disorders

What this paper adds? What is already known on the subject? Multi-sensory treatment approaches have been shown to impact outcome measures positively, such as accuracy of speech movement patterns and speech intelligibility in adults with motor speech disorders, as well as in children with apraxia of speech, autism and cerebral palsy. However, there has been no empirical study using multi-sensory treatment for children with speech sound disorders (SSDs) who demonstrate motor control issues in the jaw and orofacial structures (e.g. jaw sliding, jaw over extension, inadequate lip rounding/retraction and decreased integration of speech movements). What this paper adds? Findings from this study indicate that, for speech production disorders where both the planning and production of spatiotemporal parameters of movement sequences for speech are disrupted, multi-sensory treatment programmes that integrate auditory, visual and tactile–kinesthetic information improve auditory and visual accuracy of speech production. The training (practised in treatment) and test words (not practised in treatment) both demonstrated positive change in most participants, indicating generalization of target features to untrained words. It is inferred that treatment that focuses on integrating multi-sensory information and normalizing parameters of speech movements is an effective method for treating children with SSDs who demonstrate speech motor control issues.