Achieving the next level in cleft speech intervention: A protocol of a randomized sham-controlled trial to provide guidelines for a personalized approach in children with cleft palate.

BACKGROUND: Compensatory cleft speech disorders can severely impact speech understandability and speech acceptability. Speech intervention is necessary to eliminate these disorders. There is, however, currently no consensus on the most effective speech therapy approach to eliminate the different subtypes of compensatory cleft speech disorders. AIMS: To compare the immediate, short- and long-term effects of three well-defined speech intervention approaches (i.e., a motor-phonetic approach, a linguistic-phonological approach and a combined phonetic-phonological approach) on the speech and health-related quality of life (HRQoL) in Belgian Dutch-speaking children with cleft palate with or without cleft lip (CP±L) and different subtypes of compensatory speech disorders (i.e., anterior oral cleft speech characteristics (CSCs), posterior oral CSCs or non-oral CSCs). Besides, the perceived acceptability of these three speech intervention approaches will be investigated from the perspectives of caregivers and children with a CP±L. METHODS & PROCEDURES: A two-centre longitudinal randomized sham-controlled trial was used. Children were randomly assigned to one of the three intervention programmes and received 10 h of speech intervention divided over 2 weeks. Block randomization was used, stratified by age and gender. Primary outcome measures included perceptual speech outcomes. Secondary outcome measures included patient-reported outcomes. OUTCOMES & RESULTS: The results of this trial will provide speech-language pathologists evidence-based guidelines to better tailor intervention approaches to the specific needs of a child with a defined compensatory speech disorder. WHAT THIS PAPER ADDS: What is already known on this subject Speech therapy approaches to address cleft palate speech disorders are broadly divided into two categories: motor-phonetic interventions and linguistic-phonological interventions. Some limited evidence demonstrated the positive effects of these approaches in eliminating compensatory cleft speech disorders. Different studies have reported inter-individual variation, suggesting that one child may benefit more from a particular intervention approach than the other child. Perhaps this variation can be attributed to the specific subtype of compensatory speech disorder (i.e., anterior oral CSC, posterior oral CSC or non-oral CSC). What this paper adds to existing knowledge This paper describes a randomized sham-controlled trial that compared the immediate, short- and long-term effects of three well-defined speech intervention approaches (i.e., a motor-phonetic approach, a linguistic-phonological approach and a combined phonetic-phonological approach) on the speech and HRQoL in Belgian Dutch-speaking children with CP±L and different subtypes of compensatory cleft speech disorders (i.e., anterior oral CSCs, posterior oral CSCs or non-oral CSCs) measured by perceptual and psychosocial outcome measures. Besides, the experienced acceptability of these three speech intervention approaches were investigated from the perspectives of caregivers and children. What are the potential or actual clinical implications of this work? This project provides evidence-based knowledge on patient-tailored cleft speech intervention considering both scientific evidence and the perspectives of caregivers and children. The results aid SLPs in better tailoring intervention approaches to the needs of a child with a specific type of compensatory cleft speech disorder.

Speech outcomes after palatal closure in 3-7-year-old children.

INTRODUCTION: One of the main goals of the team approach in management of oro-facial clefts is to help the children with cleft palate have adequate speech development. OBJECTIVE: The present study aimed to investigate the prevalence of articulation and resonance disorders following palate closure in children who were visited for routine examination by the Isfahan Cleft Care Team between 2011 and 2015, and to study the impact of cleft type and age at the time of palatoplasty on speech outcomes. METHODS: Clinical records of 180 preschool children with repaired cleft palate were reviewed. The percentage of children demonstrating hypernasality, nasal emission, nasal turbulence, and compensatory misarticulations was calculated. The relationship between cleft type and age at the time of palatal surgery, as independent variables, and speech outcomes were examined. RESULTS: 67.7 and 64.5 percent of the children demonstrated respectively moderate/severe hypernasality and nasal emission, and 71.1 percent produced compensatory misarticulations. Age at the time of palatal repair was significantly associated with compensatory misarticulations and also with moderate/severe hypernasality. The prevalence of compensatory misarticulations, significant hypernasality, nasal emission and also nasal turbulence was not significantly different in various types of cleft. CONCLUSIONS: We observed a high prevalence of different speech disorders in preschool children with repaired cleft palate compared to other studies. This can be partly due to late palatal repair in the studied population. Despite many advances in cleft palate management programs in Iran, there are still many children who do not access the interdisciplinary team cares in their early childhood. We should, therefore, try to increase accessibility of appropriate and timely management services to all Iranian children with cleft lip/palate.

Diagnóstico y tratamiento precoz de la hipoacusia unilateral o asimétrica en la infancia: recomendaciones CODEPEH / Early diagnosis and treatment of unilateral or asymmetrical hearing loss in children: CODEPEH recommendations

El objetivo del presente documento es contribuir a la mejora del manejo de la hipoacusia unilateral y de la hipoacusia asimétrica en la infancia. Las sorderas unilaterales afectan a uno por mil de los recién nacidos, aumentando su prevalencia con la edad, debido a los casos de aparición diferida o adquirida. Aunque se ha minimizado el impacto de estas sorderas sobre el desarrollo y los aprendizajes del niño, si no son tratadas provocan secuelas sobre el desarrollo del habla y del lenguaje, así como en el desarrollo global, afectando a la calidad de vida del niño y de su familia. El resultado del trabajo de revisión llevado a cabo se plasma en la formulación de unas recomendaciones orientadas a la mejora clínica diagnóstica y terapéutica de la hipoacusia unilateral y de la hipoacusia asimétrica

The aim of this document is to improve the management and the treatment of unilateral or asymmetrical hearing loss in children. One in one thousand newborn infants has unilateral hearing loss and this prevalence increases with age, due to cases of acquired and delayed-onset hearing loss. Although the impact on the development and learning processes of children of these kinds of hearing loss have usually been minimized, if they are not treated they will impact on language and speech development, as well as overall development, affecting the quality of life of the child and his/her family. The outcomes of the review are expressed as recommendations aimed at clinical diagnosis and therapeutic improvement for unilateral or asymmetrical hearing los

Brief Report: "Um" Fillers Distinguish Children With and Without ASD.

Two laboratories have reported that children with ASD are less likely than their typical peers to fill pauses with um but their use of uh is unaffected (Irvine et al., J Autism Dev Disord 46(3):1061-1070, 2016; Gorman et al., Autism Res 9(8):854-865, 2016). In this brief report, we replicated this finding by comparing the discourse of 7-to-15-year-olds with ASD (N = 31) to that of their typically developing same-age peers (N = 32). The robustness of this easily documented difference in discourse suggests a potentially useful clinical marker of ASD.

Classification of Articulator Movements and Movement Direction from Sensorimotor Cortex Activity.

For people suffering from severe paralysis, communication can be difficult or nearly impossible. Technology systems called brain-computer interfaces (BCIs) are being developed to assist these people with communication by using their brain activity to control a computer without any muscle activity. To benefit the development of BCIs that employ neural activity related to speech, we investigated if neural activity patterns related to different articulator movements can be distinguished from each other. We recorded with electrocorticography (ECoG), the neural activity related to different articulator movements in 4 epilepsy patients and classified which articulator participants moved based on the sensorimotor cortex activity patterns. The same was done for different movement directions of a single articulator, the tongue. In both experiments highly accurate classification was obtained, on average 92% for different articulators and 85% for different tongue directions. Furthermore, the data show that only a small part of the sensorimotor cortex is needed for classification (ca. 1 cm2). We show that recordings from small parts of the sensorimotor cortex contain information about different articulator movements which might be used for BCI control. Our results are of interest for BCI systems that aim to decode neural activity related to (actual or attempted) movements from a contained cortical area.

Use of electropalatography in the treatment of speech disorders in children with Down syndrome: a randomized controlled trial.

BACKGROUND: Electropalatography (EPG) records details of the location and timing of tongue contacts with the hard palate during speech. It has been effective in treating articulation disorders that have failed to respond to conventional therapy approaches but, until now, its use with children and adolescents with intellectual/learning disabilities and speech disorders has been limited. AIMS: To evaluate the usefulness of EPG in the treatment of speech production difficulties in children and adolescents with Down syndrome (DS) aged 8-18 years. METHODS & PROCEDURES: A total of 27 children with DS were assessed on a range of cognitive and speech and language measures and underwent additional EPG assessment. Participants were randomly allocated to one of three age-matched groups receiving either EPG therapy, EPG-informed conventional therapy or 'treatment as usual' over a 12-week period. The speech of all children was assessed before therapy using the Diagnostic Evaluation of Articulation and Phonology (DEAP) and reassessed immediately post- and 3 and 6 months post-intervention to measure percentage consonants correct (PCC). EPG recordings were made of the DEAP assessment items at all time points. Per cent intelligibility was also calculated using the Children's Speech Intelligibility Measure (CSIM). OUTCOMES & RESULTS: Gains in accuracy of production immediately post-therapy, as measured by PCC, were seen for all groups. Reassessment at 3 and 6 months post-therapy revealed that those who had received therapy based directly on EPG visual feedback were more likely to maintain and improve on these gains compared with the other groups. Statistical testing showed significant differences between groups in DEAP scores across time points, although the majority did not survive post-hoc evaluation. Intelligibility across time points, as measured by CSIM, was also highly variable within and between the three groups, but despite significant correlations between DEAP and CSIM at all time points, no statistically significant group differences emerged. CONCLUSIONS & IMPLICATIONS: EPG was an effective intervention tool for improving speech production in many participants. This may be because it capitalizes on the relative strength of visual over auditory processing in this client group. The findings would seem to warrant an increased focus on addressing speech production difficulties in current therapy.

Implementing evidence based practice with limited evidence: The case of language intervention with bilingual children / Introducción de prácticas basadas en la evidencia: caso de intervención en el lenguaje con niños bilingües

Evidence based practice calls for clinical decisions to be based on a combination of research evidence, clinical expertise and client perspectives. A relatively small proportion of the research evidence on language intervention efficacy has focused specifically on bilingual children. This article reviews early research as well as recent findings on language intervention with bilingual children. Main questions targeted by this research include the choice of language of intervention, whether intervention effects transfer from one langage to the other, and whether language skills can be improved indirectly by enhancing underlying language processing and memory skills. Given the relative lack of intervention research on bilingual children, it is appropriate to consider the extent to which findings from the larger available evidence base on monolingual children can be applied. This may vary depending on the clinical question being asked and on the types of monolingual and bilingual environments involved. Given that monolingual and bilingual children are similar in a number of key characteristics that impact their ability to benefit from language treatment, it is proposed that clinicians use their experience and expertise to carefully consider the applicability to bilingual populations of research conducted with monolingual children. New directions in bilingual intervention that research is starting to address are reviewed, which will in time, lead to more sophisticated intervention choices tailored to the individual needs of children, both monolingual and bilingual (AU)

La práctica basada en la evidencia requiere decisiones clínicas basadas en una combinación de evidencia de la investigación, experiencia clínica y perspectivas clientelares. Una proporción relativamente pequeña de la evidencia de la investigación sobre la eficacia de la intervención en el lenguaje se ha centrado específicamente en los niños bilingües. Este artículo revisa la investigación precoz, así como los hallazgos recientes sobre la intervención en el lenguaje con niños bilingües. Muchas de las cuestiones focalizadas por esta investigación incluyen la elección del lenguaje de intervención, mientras que los efectos de la intervención se transfieren de una lengua a otra, así como si pueden mejorarse las técnicas del lenguaje indirectamente al acrecentar el procesamiento del lenguaje subyacente y las habilidades de memoria. Dada la falta de investigación sobre intervención en los niños bilingües, es apropiado considerar el alcance de la aplicación de los hallazgos de la más amplia base de evidencia disponible en los niños monolingües. Ello puede variar dependiendo de la cuestión clínica a plantear y de los tipos de entornos monolingües y bilingües implicados. Dado que los niños monolingües y bilingües son similares en cuanto a una serie de características clave que impactan en su capacidad para beneficiarse del tratamiento del lenguaje, se propone que los clínicos utilicen su experiencia y competencia para considerar minuciosamente la aplicabilidad a las poblaciones bilingües de la investigación realizada con los niños monolingües. Se revisan las nuevas direcciones sobre intervención bilingüe que, en un momento dado, darán lugar a opciones de intervención más sofisticadas adaptadas a las necesidades individuales de los niños, tanto monolingües como bilingües (AU)

Electrophysiological basis of reading related phonological impairment in Chinese speakers with schizophrenia: An ERP study.

It has been reported in alphabetic languages that individuals with schizophrenia showed language-related cognitive impairments including phonological deficits, which were in turn associated with clinical symptoms such as auditory hallucinations and thought disorders. To date, however, the phonological deficits involved in schizophrenia in Chinese and its neural basis have not been well established. In order to establish such a relationship we conducted a behavioral study using lexical tone judgment and digit span tasks as well as an event-related potential (ERP) study with an auditory oddball paradigm, in particular, for P300 effects, the event-related brain potential (ERP) index of discrimination. Chinese patients with schizophrenia and Chinese healthy controls in China participated in the current study. Compared to the healthy controls, the patients with schizophrenia showed significant impairments in phonological processing skills, which in turn significantly correlated with smaller P300 effects. Thus these behavioral and electrophysiological findings in Chinese patients with schizophrenia were critically evaluated in terms of their phonological processing abilities.

Alteraciones orofaciales y electromiografía de superficie en trastornos del neurodesarrollo / Orofacial alterations and surface electromyography in neurodevelopmental disorders

Introducción. La electromiografía de superficie se ha convertido en una técnica muy utilizada para medir la actividad de distintos grupos musculares. Aunque la fiabilidad y validez de la técnica se discuten, existe un cuerpo importante de bibliografía científica que defiende su uso Objetivo. Presentar, mediante un estudio de caso, las dos utilidades básicas de la electromiografía de superficie: la medida de la actividad muscular orofacial y su empleo como biofeedback modulador de la propia actividad muscular. Caso clínico. Niña de 10 años con perfil facial dolicocefálico y prognático, mordida abierta anterior y mordida cruzada bilateral, oclusión clase II de Angle bilateral y deglución atípica con interposición lingual. Se utilizó el electromiógrafo de superficie de ocho canales bipolares MioTool Face, de Miotec Suite 1.0. Se colocaron electrodos de superficie en la musculatura orofacial y los resultados obtenidos se midieron y visualizaron a través de los programas Miograph y Biotrainer. Conclusiones. Los resultados confirman los obtenidos a través de la exploración clínica del paciente y apoyan el uso de estas mediciones para la estimación y validación de modelos mecánicos del sistema masticatorio y deglutorio. El biofeedback electromiográfico se muestra como una técnica eficaz para autocontrolar la fuerza que se realiza en grupos musculares claves en actividades primarias como la masticación y la deglución (AU)

Introduction. Surface electromyography has become a widely used technique for measuring the activity of different muscle groups. Although the reliability and validity of the technique are discussed, there is an important body of scientific literature that defends the use of this technique. Aim. To present through a case study, the two basic uses of surface electromyography: the measurement of orofacial muscular activity and use it as biofeedback modulator of the muscular activity itself. Case report. A 10 years-old girl with a dolichocephalic and prognosis facial profile, anterior open bite and bilateral cross bite, bilateral Angle class II occlusion and atypical swallowing with lingual interposition. The MioTool Face by Miotec Suite 1.0, it could use until 8-channel bipolar surface electromyography. Surface electrodes were placed in the orofacial musculature and the results obtained were measured and visualized through the software Miograph and Biotrainer. Conclusions. The results confirm those obtained through the clinical exploration of the patient and support the use of these measurements for the estimation and validation of mechanical models of the masticatory and swallowing system. Electromyographic biofeedback is shown as an effective technique to self-control the force performed in key muscle groups by performing primary activities such as chewing and swallowing (AU)

Dificultades de comunicación y lenguaje en niños con miopatía nemalínica / Communication and language problems in children with nemaline myopathy

Introducción. La miopatía nemalínica es una enfermedad rara con incidencia de 1 de cada 50.000 nacimientos vivos. Es la más prevalente de las miopatías congénitas, un conjunto heterogéneo de trastornos neuromusculares presentes en el nacimiento o de muy temprana manifestación, que afectan a la musculatura esquelética, y que provocan debilidad, hipotonía y retraso psicomotor, pero con desarrollo cognitivo normal. Objetivo. Revisar los estudios sobre los problemas de comunicación y disfagia de niños con miopatía nemalínica y los posibles abordajes desde la logopedia. Desarrollo. Todos los niños presentan disfagia, con graves problemas para la alimentación durante los tres primeros años que se mitigan con el tiempo. El 50% usará gastrostomía, aunque muchos de ellos mantengan alguna ingesta oral. La miopatía nemalínica provoca un patrón de habla claramente disártrico. La debilidad de la musculatura de la ventilación y de la cara, con limitación para cerrar la boca, conlleva hipofonía, nasalidad y acusada ininteligibilidad. Los estudios sobre tratamientos logopédicos sugieren que, ante la disartria más incapacitante, deberían usar sistemas alternativos de comunicación, en los primeros años de vida, para eliminar la frustración de la falta de expresión útil, y beneficiarse de comunicadores basados en el lenguaje escrito más adelante. En el resto, el objetivo debe ser mejorar la inteligibilidad del habla. Conclusiones. La logopedia puede aportar dos tipos de tratamientos para mejorar la calidad de vida de estos niños: el abordaje de la disfagia y la mejora de las dificultades de expresión a través del habla o de ayudas técnicas. No hay suficiente evidencia científica de la eficacia de estos tratamientos (AU)

Introduction. Nemaline myopathy is a rare disease with an incidence of 1 in every 50,000 live births. It is the most prevalent of the congenital myopathies, a heterogeneous set of neuromuscular disorders present at birth or manifesting at a very early age, which affect the skeletal muscles and give rise to weakness, hypotonia and psychomotor retardation, although cognitive development remains normal. Aim. To review the studies conducted to date on the communication difficulties and dysphagia of children with nemaline myopathy and their possible management based on speech therapy. Development. All the children presented dysphagia, with severe feeding problems during the first three years of life that nevertheless are somewhat mitigated as time goes by. In 50% of cases a gastrostomy will be used, although some oral ingestion is maintained in many of them. Nemaline myopathy gives rise to a clearly dysarthric pattern. The weakness of the muscles involved in ventilation and of the face, with a limited ability to close the mouth, leads to hypophonia, nasality and marked unintelligibility. Studies conducted on treatments based on speech therapy suggest that, in the most disabling cases of dysarthria, alternative systems of communication should be used in the first years of life so as to eliminate the frustration caused by the lack of meaningful expression. Later, communicators based on written language can be used. In the remaining cases, the aim must be to improve speech intelligibility. Conclusions. Speech therapy can contribute to improve the quality of life of these children with two types of treatment: management of their dysphagia and improvement of their communication problems through speech or technical aids. These is insufficient scientific evidence of the effectiveness of these treatments (AU)

Estudio controlado del ritmo del habla en la enfermedad de Parkinson / Speech rate in Parkinson's disease: A controlled study

Introducción: Las alteraciones en el habla aparecen en la mayoría de los pacientes con la enfermedad de Parkinson (EP) en el curso del trastorno. Su origen y gravedad son de interés clínico y diagnóstico. Objetivo: Evaluar los patrones de deterioro en el habla en pacientes con la EP, e identificar diferencias en la velocidad de elocución y articulación en comparación con sujetos de control, empleando un método de análisis automático en una tarea de lectura. Pacientes: Participaron 39 pacientes con la EP y 45 controles asintomáticos igualados en sexo y edad. Los pacientes con la EP, en estado on, no presentaban fluctuaciones motoras ni discinesias durante la evaluación del habla. Resultados: El grupo de pacientes con la EP muestran una significativa reducción de la velocidad de elocución y articulación. No se encontraron correlaciones significativas entre los parámetros del habla estudiados y las características de los pacientes, tales como la dosis de L-dopa, duración del trastorno, edad, ni en las puntuaciones en las escalas UPDRS III o Hoehn y Yahr. Conclusiones: Los pacientes con la EP muestran un patrón característico de deterioro del ritmo del habla. Estos resultados indican que las disfluencias en la EP son el resultado de la alteración del movimiento que afecta a la fisiología de los sistemas de producción del habla

Introduction: Speech disturbances will affect most patients with Parkinson's disease (PD) over the course of the disease. The origin and severity of these symptoms are of clinical and diagnostic interest. Purpose: To evaluate the clinical pattern of speech impairment in PD patients and identify significant differences in speech rate and articulation compared to control subjects. Speech rate and articulation in a reading task were measured using an automatic analytical method. Patients: A total of 39 PD patients in the ‘on’ state and 45 age-and sex-matched asymptomatic controls participated in the study. None of the patients experienced dyskinesias or motor fluctuations during the test. Results: The patients with PD displayed a significant reduction in speech and articulation rates; there were no significant correlations between the studied speech parameters and patient characteristics such as L-dopa dose, duration of the disorder, age, and UPDRS III scores and Hoehn & Yahr scales. Conclusion: atients with PD show a characteristic pattern of declining speech rate. These results suggest that in PD, disfluencies are the result of the movement disorder affecting the physiology of speech production systems

Vocal nodules in school age children / Los nódulos vocales en niños en edad escolar

Introduction. Vocal nodules are the most common organic and functional lesions among the paediatrics population, being the main cause of dysphonia during childhood. In Portugal, a few studies that describe the vocal parameters in school age children with this pathology were found. The objective of this paper is to analyse the perceptual and acoustic vocal parameters of school age children with vocal nodules and to compare them with a group of children without vocal nodules. Methodology. The perceptual and acoustic parameters of 5 children, of both genders, aged from 7 years and 2 months to 12 years and 10 months, where clinical diagnosis of vocal nodules were analysed. The following assessment instruments were used: software Praat, GRBASI scale, maximum phonation time and s/z coefficient. The obtained data was compared to children without vocal nodules. The Mann-Whitney U test, with p < .05 significance level, in SPSS Statistics, version 22.0 was used for statistical analysis. The results are presented as mean and standard deviations. Results. Statistically significant differences were registered between the group of vocal nodules vs. the group without vocal nodules, on the following parameters: fundamental frequency, shimmer, HNR, maximum phonation time for /a/ e /z/, s/z coefficient and GRBASI. On jitter and maximum phonation time for /s/ there were no statistically significant differences. Discussion and conclusions. This study underlines the importance of assessing the perceptual and acoustic parameters in children with vocal nodules (AU)

Introducción. Los nódulos vocales son las lesiones orgánicas funcionales más comunes en la población pediátrica, la principal causa de disfonía en la infancia. En Portugal se encontraron pocos estudios que describan los parámetros vocales de los niños en edad escolar con esta patología. El objetivo de este trabajo es analizar los parámetros acústico-perceptivos vocales de niños en edad escolar con nódulos vocales y compararlos con un grupo de niños sin nódulos vocales. Metodología. Se analizaron los parámetros acústico-perceptivos de 5 niños de ambos sexos, con edades entre 7 años y 2 meses y 12 años y 10 meses, con diagnóstico clínico de nódulos vocales. Se utilizaron los instrumentos de evaluación: software Praat, rango GRBASI, el tiempo máximo de fonación y el coeficiente s/z. Los datos obtenidos se compararon con los de los niños sin nódulos vocales. El análisis estadístico utilizando la prueba U de Mann-Whitney, con nivel de significación de p < .05, el SPSS Statistics, versión 22.0. Los resultados se presentan como medias y desviaciones estándar. Resultados. Hubo diferencias estadísticamente significativas entre el grupo de nódulos vocales frente al grupo sin nódulos vocales en los parámetros: frecuencia fundamental, shimmer, HNR, tiempo máximo de fonación de /a/ y /z/, el coeficiente s/z y GRBASI. En jitter y tiempo máximo de fonación de /s/, no hubo diferencias estadísticamente significativas. Discusión y conclusiones. Este trabajo subraya la importancia de la evaluación de los parámetros acústico-perceptivos en los niños con nódulos vocales (AU)

Phonological recovery in Spanish developmental dyslexics through the tip-of-the-tongue paradigm.

BACKGROUND: Developmental dyslexics have difficulties accessing and retrieving the phonological form of words, in the absence of a deficit at the semantic level. The aim of this work was to study, through the Tip-of-the-tongue (TOT) paradigm, the problems of lexical access in Spanish-speaking developmental dyslexics and the relationship with their phonological awareness. METHOD: A group of developmental dyslexics (14) and other children without reading difficulties (14), aged 7 to 12, performed a picture naming task of medium and low frequency and a task of phonological awareness. RESULTS: The results indicated that dyslexic children generally show a greater number of TOT phenomena than the control group. Despite being able to provide semantic information of the drawing, they had difficulties retrieving partial phonological information. CONCLUSIONS: These results indicate that developmental dyslexic children have particular difficulty in accessing the phonological form of words, which may be interesting for the development of intervention programs for these children.

Articulation rate: effects of age, fluency, and syntactic structure

(Reportamos los hallazgos básicos sobre los efectos del índice de articulación, derivados de la investigación experimental sobre la planificación de oraciones de los niños. Los experimentos fueron diseñados para evaluar los procesos de producción con atención a las variables sintácticas, a la vez que se controlaban las variables léxicas y fonológicas. Las mediciones del índice de articulación reflejaron que: (1) los índices difirieron entre niños (de 3 a 8,11) y adultos, donde los índices de los adultos fueron considerablemente más rápidos que los de los niños; (2) los efectos de la expresión de fluidez y falta de fluidez del sujeto sobre las subseries de fluidez difirieron para adultos y niños; y (3) el patrón del índice de articulación para las oraciones de relativo y las oraciones coordinadas difirió tanto de un tipo de oraciones a otro como dentro del grupo de edad (AU)

We report basic findings on articulation rate effects derived from experimental research on children's sentence planning. The experiments were designed to evaluate production processes with attention to syntactic variables while controlling for lexical and phonological variables. Articulatory rate measures showed (1) rates differed for children (3–8.11) and adults, with adult rates significantly faster than child rates; (2) the effects of fluent and dysfluent host utterances on fluent substrings differed for adults and children; (3) rate patterns for relative clause and conjoined clause utterances differed, both from each other and across age group (AU)

Exaggerated object affordance and absent automatic inhibition in alien hand syndrome.

Patients with alien hand syndrome (AHS) experience making apparently deliberate and purposeful movements with their hand against their will. However, the mechanisms contributing to these involuntary actions remain poorly understood. Here, we describe two experimental investigations in a patient with corticobasal syndrome (CBS) with alien hand behaviour in her right hand. First, we show that responses with the alien hand are made significantly more quickly to images of objects which afford an action with that hand compared to objects which afford an action with the unaffected hand. This finding suggests that involuntary grasping behaviours in AHS might be due to exaggerated, automatic motor activation evoked by objects which afford actions with that limb. Second, using a backwards masked priming task, we found normal automatic inhibition of primed responses in the patient's unaffected hand, but importantly there was no evidence of such suppression in the alien limb. Taken together, these findings suggest that grasping behaviours in AHS may result from exaggerated object affordance effects, which might potentially arise from disrupted inhibition of automatically evoked responses.

Evidence for a preserved sensitivity to orthographic redundancy and an impaired access to phonological syllables in French developmental dyslexics.

To evaluate the orthographic and phonological processing skills of developmental dyslexics, we (a) examined their abilities to exploit properties of orthographic redundancy and (b) tested whether their phonological deficit extends to spelling-to-sound connections for large-grain size units such as syllables. To assess the processing skills in dyslexics, we utilized the illusory conjunction paradigm to investigate the nature of reading units in French dyslexic and control children matched in reading age. In control children, reading units were defined by both orthographic redundancy and phonological syllable information. In dyslexics, however, reading units were defined only by orthographic redundancy. Therefore, despite their impairment in reading acquisition, developmental dyslexics have the ability to encode and exploit letter frequency co-occurrences. In contrast, their access to phonological syllables from letters was impaired, suggesting that their phonological deficit extends to large grain-size phonological units.

On the importance of considering individual profiles when investigating the role of auditory sequential deficits in developmental dyslexia.

The goal of this study was to gain a better understanding of the relationship between non-verbal auditory disorders and developmental dyslexia. This question has led to conflicting results in the literature, which we argued might be due to a failure to consider the heterogeneity of dyslexic profiles. This study included three groups of adult participants: unimpaired readers and dyslexic readers with or without a phonological deficit. Auditory temporal processing deficits, as measured by stream segregation thresholds, were present in most dyslexic participants with phonological disorders. In contrast, most dyslexic participants with preserved phonological skills had normal auditory stream segregation thresholds. Overall, the present study leads to a better understanding of the relationship between phonological and sequential auditory processing disorders in developmental dyslexia. In addition, it demonstrates for the first time the importance of considering the heterogeneity of individual cognitive profiles when investigating the role of auditory deficits in developmental dyslexia.

Developmental dyslexia: exploring how much phonological and visual attention span disorders are linked to simultaneous auditory processing deficits.

The simultaneous auditory processing skills of 17 dyslexic children and 17 skilled readers were measured using a dichotic listening task. Results showed that the dyslexic children exhibited difficulties reporting syllabic material when presented simultaneously. As a measure of simultaneous visual processing, visual attention span skills were assessed in the dyslexic children. We presented the dyslexic children with a phonological short-term memory task and a phonemic awareness task to quantify their phonological skills. Visual attention spans correlated positively with individual scores obtained on the dichotic listening task while phonological skills did not correlate with either dichotic scores or visual attention span measures. Moreover, all the dyslexic children with a dichotic listening deficit showed a simultaneous visual processing deficit, and a substantial number of dyslexic children exhibited phonological processing deficits whether or not they exhibited low dichotic listening scores. These findings suggest that processing simultaneous auditory stimuli may be impaired in dyslexic children regardless of phonological processing difficulties and be linked to similar problems in the visual modality.

Tongue mobility in patients with cerebral palsy.

BACKGROUND/AIM: In children with cerebral palsy speech is a big problem. Speech of these children is more or less understandable, depending on the degree of reduced mobility of articulatory organs. Reduced mobility is affected by inability to control facial grimacing and poor muscle strength when performing targeted movements. The aim of this study was to determine the mobility of tongue in patients with cerebral palsy. METHODS: The study included a sample of 34 children--patients with cerebral palsy who had been treated in the Special Hospital for the Cerebral Palsy and Developmental Neurology in Belgrade. The patients were divided according to the determined diagnosis into two groups: Quadriparesis spastica (n = 11) and Morbus Little (n = 16). The children, aged 8-12 years, had preserved intelectual abilities, and all of them had preserved hearing. The study was conducted during the period from January to September 2009. The functional state of articulatory organs in both groups was tested by the C-test that examines the anatomic structure and mobility of the articulatory organs. RESULTS: Our research showed that both groups of the patients had impaired functional state of the tongue - the most mobile articulatory organ. Also, the research showed that the functional state of the tongue was worse in children diagnosed with Quadriparesis spastica. A statistically significant correlation between the diagnosis and the functional state of the tongue, the tongue test performance and the retention of the tongue in a given position was found (r = 0.594, p < 0.005; r = 0.816, p < 0.01 and r = 0.738, p < 0.001, respectively). CONCLUSION: A large percentage of children with cerebral palsy were not able to establish control over the position of articulatory organs, especially the tongue, and its retention in a given position, all of which affect the quality of speech.

El lenguaje en el envejecimiento: procesos de recuperación léxica / Language in aging: lexical retrieval processes

En los últimos años, ha existido un interés creciente por entender la naturaleza del lenguaje en el envejecimiento, no solo por tratar de describir el modo en que este dominio cambia con la edad, sino también por la particular cualidad que su complejidad e interdependencia con otros procesos cognitivos le confieren sirviendo de marco en el desarrollo de teorías generales sobre el envejecimiento, al tiempo que brindando la oportunidad de examinar los sustratos neurobiológicos asociados al deterioro funcional y la preservación cognitiva. Aunque el procesamiento lingüístico parece resistir el avance de la edad, lo cierto es que cambios asociados al proceso de envejecimiento surgen también en el lenguaje. Sin embargo, el envejecimiento no afecta al lenguaje de un modo global, sino específicamente produciendo asimetrías, entre las que destaca un marcado deterioro de la producción frente a un relativo mantenimiento de la comprensión o un aumento del vocabulario. El propósito de este trabajo es revisar los principales cambios estructurales y funcionales que acontecen en el cerebro con la edad, así como los declives que a nivel cognitivo de ellos se derivan, con particular interés en el efecto que estos cambios pueden tener en el lenguaje, y en especial en los procesos de recuperación léxica. Se considera también el efecto de factores sociales, tales como el nivel educativo y la posición socioeconómica. El artículo aborda además los déficits de acceso léxico asociados a enfermedad neurológica, concretamente a deterioro cognitivo leve y enfermedad de Alzheimer (AU)

In the last few years, interest in understanding the nature of language in aging has grown. This interest concerns how this domain changes with age. Furthermore, because of its complexity and interdependence with other cognitive processes, language provides a framework to develop general theories on aging and to examine the neurobiological substrates in relation to functional impairment and cognitive preservation. Although linguistic processes seem not to be impaired as a result of age, age-related changes do affect language. However, not all linguistic processes are affected equally. Aging causes a marked deterioration in language production versus a relative preservation of comprehension or an increase in vocabulary. The aim of this study was to review age-related changes in brain structure and function, as well as the resulting cognitive decline, with particular focus on the effect that these changes might have on language, especially on the processes of lexical retrieval. The role of social variables, such as education and socioeconomic status are also considered. Deficits in lexical access related to neurological disorders such as mild cognitive impairment and Alzheimer's disease are also discussed (AU)