Clock Drawing Test Performance of Young Adults Based on a One-Shot Case Study.

OBJECTIVE: The clock drawing test (CDT) is being used regularly by medical professionals in a variety of settings to aid in assessing cognitive functioning in adults of all ages. As our technological environment has changed significantly, because of the inception of this measure, the use of and exposure to the analog clock have diminished. We investigated whether young adults, who have grown up in a mainly digital world, can draw and tell time on an analog clock. METHOD: Participants aged 18-30 years (N = 80, Mage = 24.2, SD = 3.93), who self-identified as having normal cognition, completed the CDT, as well as setting hands on a pre-drawn clock and identifying analog clock times. RESULTS: About 25% of participants received a CDT score below the expected range. There was a moderate, positive correlation between analog clock hand setting and time identification in the group who scored below the expected range on the CDT only (rs(16) = 0.472, p = .048). Most participants reported not wearing an analog watch. CONCLUSIONS: Based on these findings, the CDT should be used with caution to screen cognitive functioning in young adults (i.e., aged 18-30 years). Consideration of an alternative approach to screening cognition and modifying cognitive assessments in which the CDT is embedded is recommended for this population. These findings warrant further investigation into CDT performance in the young adult population.

Considerations for the Use of Neuroimaging Technologies for Predicting Recovery of Speech and Language in Aphasia.

Purpose: The number of research articles aimed at identifying neuroimaging biomarkers for predicting recovery from aphasia continues to grow. Although the clinical use of these biomarkers to determine prognosis has been proposed, there has been little discussion of how this would be accomplished. This is an important issue because the best translational science occurs when translation is considered early in the research process. The purpose of this clinical focus article is to present a framework to guide the discussion of how neuroimaging biomarkers for recovery from aphasia could be implemented clinically. Method: The genomics literature reveals that implementing genetic testing in the real-world poses both opportunities and challenges. There is much similarity between these opportunities and challenges and those related to implementing neuroimaging testing to predict recovery in aphasia. Therefore, the Center for Disease Control's model list of questions aimed at guiding the review of genetic testing has been adapted to guide the discussion of using neuroimaging biomarkers as predictors of recovery in aphasia. Conclusion: The adapted model list presented here is a first and useful step toward initiating a discussion of how neuroimaging biomarkers of recovery could be employed clinically to provide improved quality of care for individuals with aphasia.

The effect of speaking rate on serial-order sound-level errors in normal healthy controls and persons with aphasia.

BACKGROUND: Although many speech errors can be generated at either a linguistic or motoric level of production, phonetically well-formed sound-level serial-order errors are generally assumed to result from disruption of phonologic encoding (PE) processes. An influential model of PE (Dell, 1986; Dell, Burger & Svec, 1997) predicts that speaking rate should affect the relative proportion of these serial-order sound errors (anticipations, perseverations, exchanges). These predictions have been extended to, and have special relevance for persons with aphasia (PWA) because of the increased frequency with which speech errors occur and because their localization within the functional linguistic architecture may help in diagnosis and treatment. Supporting evidence regarding the effect of speaking rate on phonological encoding has been provided by studies using young normal language (NL) speakers and computer simulations. Limited data exist for older NL users and no group data exist for PWA. AIMS: This study tested the phonologic encoding properties of Dell's model of speech production (Dell, 1986; Dell,et al., 1997), which predicts that increasing speaking rate affects the relative proportion of serial-order sound errors (i.e., anticipations, perseverations, and exchanges). METHODS & PROCEDURES: The effects of speech rate on the error ratios of anticipation/exchange (AE), anticipation/perseveration (AP) and vocal reaction time (VRT) were examined in 16 normal healthy controls (NHC) and 16 PWA without concomitant motor speech disorders. The participants were recorded performing a phonologically challenging (tongue twister) speech production task at their typical and two faster speaking rates. OUTCOMES & RESULTS: A significant effect of increased rate was obtained for the AP but not the AE ratio. Significant effects of group and rate were obtained for VRT. CONCLUSION: Although the significant effect of rate for the AP ratio provided evidence that changes in speaking rate did affect PE, the results failed to support the model derived predictions regarding the direction of change for error type proportions. The current findings argued for an alternative concept of the role of activation and decay in influencing types of serial-order sound errors. Rather than a slow activation decay rate (Dell, 1986), the results of the current study were more compatible with an alternative explanation of rapid activation decay or slow build-up of residual activation.

Ease of articulation: A replication.

UNLABELLED: Researchers, as well as the lay public and the popular press, have become increasingly concerned about the lack of reproducibility of research findings. Despite this concern, research has shown that replications of previously published work comprise a very small proportion of published studies. Moreover, there are fewer published direct replications of research studies by independent investigators, and this type of replication is much less likely to confirm the results of the original research than are replications by the original investigator or conceptual replications. A search of the communication disorders research literature reveals that direct replications by independent investigators are virtually non-existent. The purpose of this project was to describe the major issues related to research reproducibility and report the results of a direct replication of a study by Locke (1972) regarding ease of articulation. Two methods for rating ease of articulation were employed. We were able to reproduce the results of the original study for the first method, obtaining a moderate positive correlation between our rankings of phoneme difficulty and Locke's rankings. We obtained a very high positive correlation between our phoneme rankings and rankings obtained in the original study for the second method. Moreover, we found a higher correlation between difficulty rankings and order of speech sound acquisition for American English than was found in the original study. Direct replication is not necessary for all studies in communication disorders, but should be considered for high impact studies, treatment studies, and those that provide data to support models and theories. LEARNING OUTCOMES: The reader will be able to: (1) describe the major concerns related to the replicability of research findings; (2) describe the status of research replications in communication disorders; (3) describe how ease of articulation may relate to the order of speech sound acquisition in children; (4) list some types/areas of research that might be candidates for replication in the field of communication disorders.

Does experience in talking facilitate speech repetition?

Speech is unique among highly skilled human behaviors in its ease of acquisition by virtually all individuals who have normal hearing and cognitive ability. Vocal imitation is essential for acquiring speech, and it is an important element of social communication. The extent to which age-related changes in cognitive and motor function affect the ability to imitate speech is poorly understood. We analyzed the distributions of response times (RT) for repeating real words and pseudowords during fMRI. The average RT for older and younger participants was not different. In contrast, detailed analysis of RT distributions revealed age-dependent differences that were associated with changes in the time course of the BOLD response and specific patterns of regional activation. RT-dependent activity was observed in the bilateral posterior cingulate, supplementary motor area, and corpus callosum. This approach provides unique insight into the mechanisms associated with changes in speech production with aging.

The effect of sublexical and lexical frequency on speech production: An fMRI investigation.

There is no consensus regarding the fundamental phonetic units that underlie speech production. There is, however, general agreement that the frequency of occurrence of these units is a significant factor. Investigators often use the effects of manipulating frequency to support the importance of particular units. Studies of pseudoword production have been used to show the importance of sublexical units, such as initial syllables, phonemes, and biphones. However, it is not clear that these units play the same role when the production of pseudowords is compared to the production of real words. In this study, participants overtly repeated real and pseudowords that were similar for length, complexity, and initial syllable frequency while undergoing functional magnetic resonance imaging. Compared to real words, production of pseudowords produced greater activation in much of the speech production network, including bilateral inferior frontal cortex, precentral gyri and supplementary motor areas and left superior temporal cortex and anterior insula. Only middle right frontal gyrus showed greater activation for real words than for pseudowords. Compared to a no-speech control condition, production of pseudowords or real words resulted in activation of all of the areas shown to comprise the speech production network. Our data, in conjunction with previous studies, suggest that the unit that is identified as the basic unit of speech production is influenced by the nature of the speech that is being studied, i.e., real words as compared to other real words, pseudowords as compared to other pseudowords, or real words as compared to pseudowords.

An fMRI investigation of covertly and overtly produced mono- and multisyllabic words.

Studies suggest that the left insula may play an important role in speech motor programming. We used functional magnetic resonance imaging to investigate the role of the left insula in the production of monosyllabic or multisyllabic words during overt and covert speech conditions. The left insula did not show a BOLD response for multisyllabic words (which should require more speech motor programming) that was different from that for monosyllabic words. Left parietal lobe regions showed a greater response for multisyllabic as compared to monosyllabic words. This is consistent with clinical studies showing that left parietal lobe lesions can produce a deficit in speech programming. Despite similarities, covert and overt speech did not demonstrate the same patterns of BOLD response. The BOLD response was greater during overt speech in areas that have been shown to play an important role in speech production including left premotor cortex/BA6, left primary motor cortex, left insula, and left superior temporal gyrus.

Toward a better understanding of the perception of self-produced speech.

UNLABELLED: The subject of how humans hear their own voices while speaking has received sporadic attention. Previous investigations suggest that the voice is heard substantially via bone conduction, implying a different transfer function to the ear--perhaps a low-pass filter--than for purely air-conducted vocalizations. Determining the characteristics of the transfer function of self-produced speech might contribute to a better understanding of self-perception. Such information may have important implications for treating articulation disorders. The efficacy of training discrimination during the remediation of articulation disorders remains unclear, perhaps because clients are asked to discriminate either speech of others or recorded self-speech samples not readily recognized as their own. This study was conducted to determine preference for filtered self-monitored speech in a delayed feedback paradigm. Participants made immediate comparisons of their real-time speech to delayed-recorded filtered self-speech samples. Participants demonstrated a clear preference for low-pass filtered speech, supporting earlier findings, but we were unable to determine the transfer function itself. LEARNING OUTCOMES: As a result of this activity, the learner will be able to describe some reasons why an individual's tape recorded speech typically sounds different to him/her from his/her own, live speech. As a result of this activity, the learner will be able to describe some potential applications for an accurately-characterized transfer function for self-produced speech.