Encoding, memory, and transcoding deficits in Childhood Apraxia of Speech.

A central question in Childhood Apraxia of Speech (CAS) is whether the core phenotype is limited to transcoding (planning/programming) deficits or if speakers with CAS also have deficits in auditory-perceptual encoding (representational) and/or memory (storage and retrieval of representations) processes. We addressed this and other questions using responses to the Syllable Repetition Task (SRT) [Shriberg, L. D., Lohmeier, H. L., Campbell, T. F., Dollaghan, C. A., Green, J. R., & Moore, C. A. (2009). A nonword repetition task for speakers with misarticulations: The syllable repetition task (SRT). Journal of Speech, Language, and Hearing Research, 52, 1189-1212]. The SRT was administered to 369 individuals in four groups: (a) typical speech-language (119), (b) speech delay-typical language (140), (c) speech delay-language impairment (70), and (d) idiopathic or neurogenetic CAS (40). CAS participants had significantly lower SRT competence, encoding, memory, and transcoding scores than controls. They were 8.3 times more likely than controls to have SRT transcoding scores below 80%. We conclude that speakers with CAS have speech processing deficits in encoding, memory, and transcoding. The SRT currently has moderate diagnostic accuracy to identify transcoding deficits, the signature feature of CAS.

Extensions to the Speech Disorders Classification System (SDCS).

This report describes three extensions to a classification system for paediatric speech sound disorders termed the Speech Disorders Classification System (SDCS). Part I describes a classification extension to the SDCS to differentiate motor speech disorders from speech delay and to differentiate among three sub-types of motor speech disorders. Part II describes the Madison Speech Assessment Protocol (MSAP), an ∼ 2-hour battery of 25 measures that includes 15 speech tests and tasks. Part III describes the Competence, Precision, and Stability Analytics (CPSA) framework, a current set of ∼ 90 perceptual- and acoustic-based indices of speech, prosody, and voice used to quantify and classify sub-types of Speech Sound Disorders (SSD). A companion paper provides reliability estimates for the perceptual and acoustic data reduction methods used in the SDCS. The agreement estimates in the companion paper support the reliability of SDCS methods and illustrate the complementary roles of perceptual and acoustic methods in diagnostic analyses of SSD of unknown origin. Examples of research using the extensions to the SDCS described in the present report include diagnostic findings for a sample of youth with motor speech disorders associated with galactosemia, and a test of the hypothesis of apraxia of speech in a group of children with autism spectrum disorders. All SDCS methods and reference databases running in the PEPPER (Programs to Examine Phonetic and Phonologic Evaluation Records) environment will be disseminated without cost when complete.

Perceptual and acoustic reliability estimates for the Speech Disorders Classification System (SDCS).

A companion paper describes three extensions to a classification system for paediatric speech sound disorders termed the Speech Disorders Classification System (SDCS). The SDCS uses perceptual and acoustic data reduction methods to obtain information on a speaker's speech, prosody, and voice. The present paper provides reliability estimates for the two perceptual methods (narrow phonetic transcription; prosody-voice coding) and the acoustic analysis methods the SDCS uses to describe and classify a speaker's speech competence, precision, and stability. Speech samples from 10 speakers, five with significant motor speech disorder and five with typical speech, were re-measured to estimate intra-judge and inter-judge agreement for the perceptual and acoustic methods. Each of the speakers completed five speech tasks (total = 50 datasets), ranging in articulatory difficulty for the speakers, with consequences for the difficulty level of data reduction. Point-to-point percentage of agreement findings for the two perceptual methods were as high or higher than reported in literature reviews and from previous studies conducted within the laboratory. Percentage of agreement findings for the acoustics tasks of segmenting phonemes, editing fundamental frequency tracks, and estimating formants ranged from values in the mid 70% to 100%, with most estimates in the mid 80% to mid 90% range. Findings are interpreted as support for the perceptual and acoustic methods used in the SDCS to describe and classify speakers with speech sound disorders.

A nonword repetition task for speakers with misarticulations: the Syllable Repetition Task (SRT).

PURPOSE: Conceptual and methodological confounds occur when non(sense) word repetition tasks are administered to speakers who do not have the target speech sounds in their phonetic inventories or who habitually misarticulate targeted speech sounds. In this article, the authors (a) describe a nonword repetition task, the Syllable Repetiton Task (SRT), that eliminates this confound and (b) report findings from 3 validity studies. METHOD: Ninety-five preschool children with speech delay and 63 with typical speech completed an assessment battery that included the Nonword Repetition Task (NRT; C. Dollaghan & T. F. Campbell, 1998) and the SRT. SRT stimuli include only 4 of the earliest occurring consonants and 1 early occurring vowel. RESULTS: Study 1 findings indicated that the SRT eliminated the speech confound in nonword testing with speakers who misarticulate. Study 2 findings indicated that the accuracy of the SRT to identify expressive language impairment was comparable to findings for the NRT. Study 3 findings illustrated the SRT's potential to interrogate speech processing constraints underlying poor nonword repetition accuracy. Results supported both memorial and auditory-perceptual encoding constraints underlying nonword repetition errors in children with speech-language impairment. CONCLUSION: The SRT appears to be a psychometrically stable and substantively informative nonword repetition task for emerging genetic research and other research with speakers who misarticulate.

Clinical ventilator adjustments that improve speech.

STUDY OBJECTIVES: We sought to improve speech in tracheostomized individuals receiving positive-pressure ventilation. Such individuals often speak with short phrases, long pauses, and have problems with loudness and voice quality. SUBJECTS: We studied 15 adults with spinal cord injuries or neuromuscular diseases receiving long-term ventilation. INTERVENTIONS: The ventilator was adjusted using lengthened inspiratory time (TI), positive end-expiratory pressure (PEEP), and combinations thereof. RESULTS: When TI was lengthened (by 8 to 35% of the ventilator cycle), speaking time increased by 19% and pause time decreased by 12%. When PEEP was added (5 to 10 cm H(2)O), speaking time was 25% longer and obligatory pauses were 21% shorter. When lengthened TI and PEEP were combined (with or without reduced tidal volume), their effects were additive, increasing speaking time by 55% and decreasing pause time by 36%. The combined intervention improved speech timing, loudness, voice quality, and articulation. Individual differences in subject response to the interventions were substantial in some cases. We also tested high PEEP (15 cm H(2)O) in three subjects and found speech to be essentially identical to that produced with a one-way valve. CONCLUSIONS: These simple interventions markedly improve ventilator-supported speech and are safe, at least when used on a short-term basis. High PEEP is a safer alternative than a one-way valve.