Speech sound development in typically developing 2-7-year-old Dutch-speaking children: A normative cross-sectional study.

BACKGROUND: Dutch is a West-Germanic language spoken natively by around 24 million speakers. Although studies on typical Dutch speech sound development have been conducted, norms for phonetic and phonological characteristics of typical development in a large sample with a sufficient age range are lacking. AIM: To give a detailed description of the speech sound development of typically developing Dutch-speaking children from 2 to 7 years. METHODS & PROCEDURES: A total of 1503 typically developing children evenly distributed across the age range of 2;0-6;11 years participated in this normative cross-sectional study. The picture-naming task of the Computer Articulation Instrument (CAI) was used to collect speech samples. Speech development was described in terms of (1) percentage consonants correct-revised (PCC-R) and percentage vowels correct (PVC); (2) consonant, vowel and syllabic structure inventories; (3) degrees of complexity (phonemic feature hierarchy); and (4) phonological processes. OUTCOMES & RESULTS: A two-way mixed analysis of variance (ANOVA) confirmed a significant increase in the number of PCC-R and PVC between the ages of 2;0 and 6;11 years (p < 0.001). The consonant inventory was found to be complete at 3;7 years of age for the syllable-initial consonants, with the exception of the voiced fricatives /v/ and /z/, and the liquid /r/. All syllable-final consonants were acquired before age 4;4 years. At age 3;4 years, all children had acquired a complete vowel inventory, and at age 4;7 years they produced most syllable structures correctly, albeit that the syllable structure CCVCC was still developing. All phonological contrasts were produced correctly at 3;8 years of age. Children in the younger age groups used more phonological simplification processes than the older children, and by age 4;4 years, all had disappeared, except for the initial cluster reduction from three to two consonants and the final cluster reduction from two to one consonant. CONCLUSIONS & IMPLICATIONS: This paper describes a large normative cross-sectional study of Dutch speech sound development which, in clinical practice, can help Dutch speech-language pathologists to differentiate children with delayed or disordered speech development from typically developing children. What this paper adds What is already known on this subject In recent years many studies have been conducted worldwide to investigate speech sound development in different languages, including several that explored the typical speech sound development of Dutch-speaking children, but none of these latter studies explored both phonetic and phonological progress within a comprehensive age range and a large sample that is representative of the Dutch population. What this study adds to existing knowledge This study serves to fill this gap by providing normative cross-sectional results obtained in 1503 typically developing Dutch-speaking children aged between 2;0 and 6;11 years on informative parameters of speech development: PCC-R and PVC, consonant, vowel and syllabic structure inventories, degrees of complexity (phonemic feature hierarchy), and phonological simplification processes. What are the potential or actual clinical implications of this work? The detailed description of typical Dutch speech sound development provides speech-language pathologists with pertinent information to determine whether a child's speech development progresses typically or is delayed or disordered.

How Well Does Diadochokinetic Task Performance Predict Articulatory Imprecision? Differentiating Individuals with Parkinson's Disease from Control Subjects.

OBJECTIVE: To investigate whether syllables produced in an oral diadochokinetic (DDK) task may be quantified so that persons with Parkinson's disease (PD) perceived to have reduced articulatory precision when reading may be correctly identified using that quantification. PATIENTS AND METHODS: Syllable sequences from 38 speakers with PD and 38 gender- and age-matched control speakers (normal controls [NC]) were quantified acoustically and evaluated in terms of (1) the speakers' ability to accurately predict speaker group membership (PD or NC) and (2) their ability to predict reduced/non-reduced articulatory precision. RESULTS: A balanced accuracy of 80-93% in predicting speaker group membership was achieved. The best measures were related to the proportion of a syllable made up of a vowel, amplitude slope and syllable-to-syllable variation in duration and amplitude. The best material was that based on /ka/. Reduced articulatory precision was accurately predicted from DDK measures in 89% of the samples. Release-transient prominence and voicing during the onset of plosives were particularly strong predictors. CONCLUSIONS: DDK sequences can predict articulatory imprecision as observed in another speech task. The linking of performance across speech tasks probably requires measures of stability in syllable durations and amplitudes, as well as measures of subsyllabic acoustic features.

Necesidad de una evaluación e intervención en esclerosis lateral amiotrófica / Need for an evaluation and intervention in amyotrophic lateral sclerosis

Antecedentes: La esclerosis lateral amiotrófica es una enfermedad neurodegenerativa rara y de rápido progreso que causa un deterioro en las motoneuronas de la corteza cerebral, tronco encefálico (bulbo) y la médula espinal. Entre las alteraciones más comunes se encuentra la disartria y otros problemas logopédicos que requieren de una intervención de la que actualmente no existen protocolos. Objetivo: El objetivo de este estudio es crear un protocolo de evaluación de disartria en pacientes con esclerosis lateral amiotrófica en español, que evalúe la respiración, fonación, articulación, resonancia en estos pacientes, para obtener con exactitud los aspectos afectados de cada paciente y elaborar un tratamiento que se adapte al paciente. Materiales y métodos: El estudio se realiza con 3 pacientes de esclerosis lateral amiotrófica bulbar con un estado leve-moderado de la enfermedad. Para la evaluación se utilizaron un protocolo breve de evaluación de la disartria y el protocolo de evaluación de la disartria elaborado para este trabajo. Resultados: Tras la evaluación final se comprobó una mejoría en todos los apartados evaluados tras la intervención. Con el protocolo mejorado, se obtuvieron mejores resultados en los distintos apartados. Conclusiones: Los resultados obtenidos han sido óptimos debido a la utilización del protocolo adaptado a las necesidades y a la aplicación de tratamientos específicos que producen una evolución positiva de la enfermedad

Background: Amyotrophic lateral sclerosis is a rare, rapidly progressing neurodegenerative disease that causes deterioration in the motor neurons of the cerebral cortex, brainstem, and spinal cord. Among the most common disorders are dysarthria and other logopaedic problems that require intervention for which there are currently no protocols. Objective: The objective of this study is to create a protocol for the evaluation of patients with amyotrophic lateral sclerosis in Spanish, which evaluates respiration, phonation, articulation, and resonance in these patients, in order to accurately obtain the symptoms of each patient and a develop a treatment adapted to the patient. Materials and methods: The study was carried out with 3 patients with bulbar amyotrophic lateral sclerosis with a mild-moderate state of the disease. For evaluation, a short protocol to assess dysarthria and the protocol for evaluating dysarthria prepared for this study were used. Results: After the final evaluation, an improvement was observed in all the sections evaluated after the intervention. With the improved protocol, better results were obtained in the different sections. Conclusions: The results were optimal due to the use of the protocol adapted to needs and the application of specific treatments that have a positive effect on the outcome of the disease

Aplicación del índice acústico de calidad vocal para la cuantificación objetiva de la severidad de la disfonía / Application of the acoustic voice quality index for objective measurement of dysphonia severity

Introducción: En las últimas décadas se han estudiado muchos parámetros acústicos con el fin de cuantificar la disfonía, sin embargo las medidas actuales podrían no ser sensibles a la calidad vocal percibida. En un metaanálisis donde se evaluó la relación entre la calidad global percibida de la voz se identificaron numerosas medidas acústicas que no dependen de la extracción del periodo fundamental tales como las derivadas del cepstrum y que pueden ser usadas tanto en vocales sostenidas como en habla conectada. Un método específico recientemente diseñado para cuantificar la severidad global de la disfonía es el índice acústico de calidad vocal (AVQI) que es un constructo multivariante que combina múltiples marcadores acústicos para generar un único número que se correlaciona razonablemente con la calidad global vocal. Métodos: Esta investigación se basó en un archivo de voces grabadas procedentes de dos grupos de individuos: 60 personas sanas vocalmente y 58 participantes con trastornos vocales. Se grabaron vocales sostenidas y una muestral de habla conectada para su análisis y así obtener los seis parámetros incluidos en el AVQI utilizando el programa Praat. El análisis estadístico de los resultados se llevó a cabo con el programa SPSS para Windows versión 12.0. Resultados: Correspondencia entre el valor del AVQI y el grado de severidad global de la disfonía: correlación r = 0,68 (p < 0,000), y entre el AVQI y el parámetro B del GRABS: r = 0,68 (p < 0,000). Conclusiones: Los resultados obtenidos muestran una buena correlación con la calidad vocal percibida. En conclusión, el AVQI es una medida multivariante, accesible, factible y razonablemente válida para medir clínicamente la severidad global de la severidad de la disfonía (AU)

Introduction: Over the past several decades, many acoustic parameters have been studied as sensitive to and to measure dysphonia. However, current acoustic measures might not be sensitive measures of perceived voice quality. A meta-analysis which evaluated the relationship between perceived overall voice quality and several acoustic-phonetic correlates, identified measures that do not rely on the extraction of the fundamental period, such the measures derived from the cepstrum, and that can be used in sustained vowel as well as continuous speech samples. A specific and recently developed method to quantify the severity of overall dysphonia is the acoustic voice quality index (AVQI) that is a multivariate construct that combines multiple acoustic markers to yield a single number that correlates reasonably with overall vocal quality. Methods: This research is based on one pool of voice recordings collected in two sets of subjects: 60 vocally normal and 58 voice disordered participants. A sustained vowel and a sample of connected speech were recorded and analyzed to obtain the six parameters included in the AVQI using the program Praat. Statistical analysis was completed using SPSS for Windows, version 12.0. Results: Correlation between perception of overall voice quality and AVQI: A significant difference exists (t (95) = 9.5; p<.000) between normal and dysphonic voices. Conclusions: The findings of this study demonstrate the clinical feasibility of the AVQI as a measure of dysphonia severity (AU)

Problemas del lenguaje en niños con parálisis cerebral / Language problems in children with cerebral palsy

La parálisis cerebral es una lesión no progresiva en las estructuras cerebrales que genera un trastorno del movimiento y de la postura. Estas lesiones también pueden afectar otras áreas responsables del desarrollo del lenguaje, tales como el sistema del habla, el sistema lingüístico o el procesamiento léxico, además de conllevar otras comorbilidades en diversas áreas. Objetivo. . Constatar el desarrollo del sistema lingüístico mediante la longitud media de los enunciados verbales y analizar el desempeño del procesamiento léxico que presentaron 142 niños mexicanos con parálisis cerebral cuyas edades comprendían de los 7 a los 13 años. Material y métodos. Mediante una elicitación de datos controlados la población debían nombrar 107 entidades clasificadas en 12 campos semánticos y contar el cuento Frog, Where are you? («Dónde está la ranita») siguiendo las imágenes de la historia para comprobar su longitud media de los enunciados verbales. Results. Solo el 16.9% de estos niños lograron nombrar más de 50 imágenes y contar el cuento que se les había mostrado. La longitud media de los enunciados verbales solo correspondió con la edad cronológica de un solo niño; el resto estuvo por debajo de lo esperado. El 83.1% de los 142 niños con parálisis cerebral evaluados no lograron emitir más de 10 palabras en ambas elicitaciones (AU)

Cerebral palsy is a non-progressive lesion in the brain structures that generates a disorder of movement and posture. These lesions can also affect other areas responsible for the language development system such as speech, linguistic or lexical retrieval system, as well as leading to other comorbidities in various areas. Objective. To observe the development of the language system using the Mean Length of Utterance and an analysis of the lexical retrieval presented in 142 Mexican children with cerebral palsy with ages ranging from 7 to 13 years. Material and methods. Using controlled data elicitation, the children with Cerebral Palsy were to name 107 entities (images) classified into 12 semantic fields and tell a story about «Frog, Where are you?», following the images of the story in order to check the Mean Length of Utterances. Results. Only 16.9% of these children were able to name more than 50 images that were shown and tell a story. The Mean Length of Utterance only corresponded with the chronological age in just one child, with the rest being lower than expected. The vast majority (83.1%) of the 142 children with palsy cerebral assessed did not exceed 10 words (AU)

Swedish Test of Intelligibility for Children (STI-CH)--validity and reliability of a computer-mediated single word intelligibility test for children.

The aim of this study was twofold: first, to describe a new Swedish intelligibility test (Swedish Test of Intelligibility for Children, STI-CH) and second to evaluate its validity and reliability. STI-CH is based on the repetition of single words. Ten children with a speech-sound disorder (4:6-8:3 years of age, mean = 6.0 years) and 10 children with typical speech and language development (4:8-7:4 years of age, mean = 5.9 years) were included. Twenty speech-language pathology students served as listeners. Intra-judge reliability was high (r > 0.92), as was the intra-class correlation of inter-judge reliability (0.97). In terms of validity, there was a significant difference in STI-CH scores between the two groups, and the scores correlated statistically significantly with the Percentage of Consonants Correct (r = 0.94) and with intelligibility in spontaneous speech (r = 0.85). To sum up, the results indicate that STI-CH could be an option for the assessment of intelligibility in Swedish-speaking children, and that the principles used in the development of the test could be of use in the design of intelligibility tests in languages other than Swedish.

Toward a quantitative basis for assessment and diagnosis of apraxia of speech.

PURPOSE: We explored the reliability and validity of 2 quantitative approaches to document presence and severity of speech properties associated with apraxia of speech (AOS). METHOD: A motor speech evaluation was administered to 39 individuals with aphasia. Audio-recordings of the evaluation were presented to 3 experienced clinicians to determine AOS diagnosis and to rate severity of 11 speech dimensions. Additionally, research assistants coded 11 operationalized metrics of articulation, fluency, and prosody in the same speech samples and in recordings from 20 neurologically healthy participants. RESULTS: Agreement among the 3 clinicians was limited for both AOS diagnosis and perceptual scaling, but inter-observer reliability for the operationalized metrics was strong. The relationships between most operationalized metrics and mean severity ratings for corresponding perceptual dimensions were moderately strong and statistically significant. Both perceptual scaling and operationalized quantification approaches were sensitive to the presence or absence of AOS. CONCLUSIONS: Perceptual scaling and operationalized metrics are promising quantification techniques that can help establish diagnostic transparency for AOS. However, because satisfactory reliability cannot be assumed for scaling techniques, effective training and calibration procedures should be implemented. Operationalized metrics show strong potential for enhancing diagnostic objectivity and sensitivity.

Standardization of a phonetic-phonological test for European-Portuguese children.

OBJECTIVE: To develop and standardize a phonetic-phonological test (Teste Fonético-Fonológico-Avaliação da Linguagem Pré-Escolar, TFF-ALPE) for the assessment of European-Portuguese (EP) children's articulation and phonological abilities. PATIENTS AND METHODS: In order to standardize TFF-ALPE, 768 children aged 3;0-6;11 participated in this study. The standardization, validity and reliability of TFF-ALPE were analyzed. RESULTS: TFF-ALPE presents strong cohesion and has strong inter- and intrajudge reliability. There was also a strong correlation between the TFF-ALPE data and those obtained in other studies. The content validity was demonstrated by the description of the test domain and the items that comprise TFF-ALPE. CONCLUSION: TFF-ALPE is a valid and reliable phonetic-phonological assessment instrument that speech-language pathologists can use with EP-speaking children.

Professores em contexto profissional e não profissional: análise objetiva e subjetiva dos aspectos da articulação e da postura / Teachers in a professional and non-professional context: objective and subjective analysis of the two aspects of articulation and posture

A articulação e a postura determinam a configuração do trato vocal, definindo a produção da voz. 0 objetivo foi caracterizar o perfil dos professores com e sem queixa vocal; descrever e comparar, por meio de análise objetiva e subjetiva, os comportamentos articulatórios e posturais. Portanto, foi aplicado um protocolo e os professores foram audiografados dentro e fora do contexto profissional. As imagens da articulação foram analisadas de forma objetiva (software Image Tool) e subjetiva com observação da postura por quatro juízes). A partir dos dados, sugere-se que o aumento da articulação tenha relação com o processo de alfabetização e não como prevenção às alterações vocais. Estas, associadas às mudanças posturais, podem levar ao aparecimento ou ao agravamento de um problema vocal. A metodologia proposta permite outras aplicabilidades na fonoaudiologia

Selective alteration of native, but not second language articulation in a patient with foreign accent syndrome.

The present study deals with a right-handed female polyglot suffering from a Foreign Accent Syndrome (FAS) which affects her native language (L1), but not her other languages learnt since the age of 12. She had a small infarct in the left corona radiata as the result of a carotid occlusion. Her L1 was Spanish, but she also had a good command of French, English and Catalan (L2). Aphasia tests did not reveal any other significant alteration in any language. Analyses of pre-morbid and post-morbid voice recordings revealed that FAS affected Spanish dramatically, but no important changes were observed for French. Results were interpreted as showing that different brain areas control articulation of L1 and L2 learnt after a critical period.

Pronunciation of irregular words is preserved in dementia, validating premorbid IQ estimation.

The National Adult Reading Test (NART), used to estimate premorbid mental ability, involves pronunciation of irregular words. The authors demonstrate that, after controlling for age 11 IQ test scores, mean NART scores do not differ in people with and without dementia. The correlation between age 11 IQ and NART scores at about age 80 was similar in the groups with (r = 0.63, p < 0.001) and without (r = 0.60, p < 0.001) dementia. These findings validate the NART as an estimator of premorbid ability in mild to moderate dementia.

Conversational skills of preschool and school-age children with cleft lip and palate.

OBJECTIVE: The purpose of this study was to examine the conversational skills of preschool and school-age children with cleft lip and palate. DESIGN: The children were audio- and videotaped during interactions with an unfamiliar adult. In addition, standardized measures of speech and language were administered, and ratings of resonance were obtained. Comparisons were made between the children with cleft lip and palate and their same-age peers on measures of conversational participation and a standardized test of pragmatic skills. PARTICIPANTS: Participants were 20 children with unilateral cleft lip and palate (10 preschoolers and 10 school-age children) recruited from the Craniofacial Team at Rainbow Babies and Children's Hospital, Cleveland (OH) and 20 noncleft peers matched for gender, age, and socioeconomic status. MAIN OUTCOME MEASURES: Separate comparisons were made for the preschool children with cleft lip and palate and their noncleft peers, and the school-age children with cleft lip and palate and their noncleft peers on eight measures of conversational assertiveness/responsiveness and the standardized tests of pragmatics. Next, each child with cleft lip and palate was classified for level of conversational participation. RESULTS: Paired t tests revealed no significant differences between the preschool and school-age children with cleft lip and palate and their noncleft peers in level of conversational participation. However, individual child comparisons revealed less assertive profiles of conversational participation for 50% of the preschool and 20% of the school-age children with cleft lip and palate. CONCLUSIONS: Children with cleft lip and palate may show a less assertive style of conversational participation, at least during the preschool years. Therefore, craniofacial team evaluations should include examination of conversational competency, particularly for children who are demonstrating difficulty with other aspects of speech, language, or social development.

Palatoplasty: Furlow's double reversing Z-plasty versus intravelar veloplasty.

OBJECTIVE: To evaluate the efficacy of Furlow's double reversing z-plasty (Furlow) versus intravelar veloplasty with longitudinal closure including palatal muscle reorientation (IVV). DESIGN: Retrospective, single-institution, single-surgeon comparison. PATIENTS: One hundred nineteen consecutive cleft palate patients were enrolled; 34 syndromic and 9 language-impaired patients were removed from speech and reoperation analysis. Furlow and IVV groups were similar with respect to sex and mean age at primary repair. INTERVENTIONS: One surgeon performed all surgery and one of two speech pathologists conducted language and speech evaluations at 3 years of age without prior knowledge of the surgical technique utilized. OUTCOME MEASURES: Outcome measures included frequency of palatal fistulae, speech abnormalities, and need for secondary pharyngoplasty procedures. RESULTS: Patients who had undergone IVV demonstrated a 34% higher incidence of hoarseness, nasal escape, and hypernasality at 3 years of age than did Furlow patients. These same patients likewise required significantly more secondary pharyngoplasty procedures. No significant difference was noted between fistulae frequencies. CONCLUSIONS: These findings suggest that Furlow palatoplasty may provide a better clinical outcome than intravelar veloplasty.

Speech changes after maxillary advancement in 40 cleft lip and palate patients.

In this study, we retrospectively investigated speech intelligibility changes in 40 patients at the Australian Cranio-Facial Unit who underwent Le Fort I maxillary advancement between 1978 and 1995. Resonance, articulation, and velopharyngeal sphincteric function, which were assessed before and after surgery, were analyzed in conjunction with details of the surgery in an attempt to identify the factors affecting speech intelligibility. Of the 40 patients, 10 experienced improved speech (improved intelligibility group), 18 demonstrated no detectable changes in speech (unchanged intelligibility group), and 12 presented with worsened speech intelligibility (deteriorated intelligibility group). The average amount of advancement was 9.4 mm in the improved and unchanged intelligibility groups and 12.2 mm in the deteriorated intelligibility group. There was a statistically significant difference in the average amount of advancement between the improved and unchanged groups and the deteriorated intelligibility group. In the improved intelligibility group, 9 patients demonstrated improved articulation and 7 had reduced hyponasality. Conversely, in the deteriorated intelligibility group, 10 patients demonstrated increased hypernasality. Intelligibility ratings appeared to depend on the balance between the benefits of amelioration of hyponasality and misarticulations and the debit of increased hypernasality. The amount of maxillary advancement has a direct bearing on speech intelligibility. The amelioration of speech intelligibility improves if the amelioration of distorted articulation and hyponasality overrides any increase in hypernasality.

[The neurophysiological aspects of the recurrent functioning of the "hidden" variables of the speech apparatus]. / Neirofiziologicheskie aspekty rekurrentnogo funktsionirovaniia "skrytykh" peremennykh rechevogo apparata.

The "hidden" recurrent structure is established of temporal organization of acoustic speech signal. Such "hidden" recurrence can be revealed only due to experimentally established existence of two qualitatively different modes in the temporal organization of stutterers' speech. A theoretical model of speech generation is developed with a logistical property of "hidden" parameters in order to explain this phenomenon. This model is stated in terms of chaotic dynamics and is based on the neurophysiological striopallidal mechanisms which are realized under conditions of polysensory afferent impulsation. The effects of speech memory and actualization of its traces are explained on the basis of our earlier concept of perception of the rhythmical speech sequence. This concept allowed us to discuss the experimentally observed phenomenon of inhibitory modulation under conditions of both ipsi- and contralateral global negative feedback.

Interobserver agreement of perceived intelligibility of magnitude of r in children.

This study was designed to test whether independent listeners could correctly classify 162 stimuli (words) that started with a multiple trill, magnitude of r, followed by a vowel magnitude of a. The sounds were from 27 Spanish children between the ages of 3.0 and 6.6 years, pronouncing Spanish words current in their vocabulary. Twelve listeners were presented with the recordings of the children's magnitude of r production and were instructed to rate the intelligibility of the pronounced sound as high, medium, or low. Inter-rater agreement ranged from 85 to 96%. Analyses of variance for each of the three production categories showed that there were significant differences, so it seems possible to classify the words starting with a trilled magnitude of r based on auditory-perceptual features into three broad categories according to intelligibility.

Estudo da aquisiçäo do sistema fonológico: o uso de processos fonológicos em crianças de três a sete anos / Study of the phonological system acquisition: phonological processes in childrens from 3 to 7 years old

O objetivo do estudo foi verificar o uso dos processos fonológicos. Foram sujeitos da pesquisa 64 crianças entre 3:0 e 7:0 anos, divididas em 8 grupos, e um grupo de mäes. Todas as crianças tinham fala inteligível, pertenciam à classe sócio-econômica baixa e residiam na cidade de Säo Paulo. Os resultados mostraram que os processos de eliminaçäo de consoante final e de simplificaçäo do encontro consonantal foram utilizados produtivamente até os 7:0 anos; o de frontalizaçäo da palatal e o de posteriorizaçäo para palatal foram utilizados até os 4:6 anos. Os resultados encontrados podem contribuir para um melhor diagnóstico e também para orientaçäo de profissionais e pais

A statistical causal model for the assessment of dysarthric speech and the utility of computer-based speech recognition.

The evaluation of the degree of speech impairment and the utility of computer recognition of impaired speech are separately and independently performed. Particular attention is paid to the question concerning whether or not there is a relationship between naive listeners' subjective judgements of impaired speech and the performance of a laboratory version of a speech recognition system. It is a difficult task to relate a speech impairment rating with speech recognition accuracy. Towards this end, a statistical causal model is proposed. This model is very appealing in its structure to support inference, and thus can be applied to perform various assessments such as the success of automatic recognition of dysarthric speech. The application of this model is illustrated with a case study of a dysarthric speaker compared against a normal speaker serving as a control.