PURPOSE: Children with speech errors who have reduced motor skill may be more likely to develop residual errors associated with lifelong challenges. Drawing on models of speech production that highlight the role of somatosensory acuity in updating motor plans, this pilot study explored the relationship between motor skill and speech accuracy, and between somatosensory acuity and motor skill in children. Understanding the connections among sensorimotor measures and speech outcomes may offer insight into how somatosensation and motor skill cooperate during speech production, which could inform treatment decisions for this population. METHOD: Twenty-five children (ages 9-14) produced syllables in an /ɹ/ stimulability task before and after an ultrasound biofeedback treatment program targeting rhotics. We first tested whether motor skill (as measured by two ultrasound-based metrics of tongue shape complexity) predicted acoustically measured accuracy (the normalized difference between the second and third formant frequencies). We then tested whether somatosensory acuity (as measured by an oral stereognosis task) predicted motor skill, while controlling for auditory acuity. RESULTS: One measure of tongue shape complexity was a significant predictor of accuracy, such that higher tongue shape complexity was associated with lower accuracy at pre-treatment but higher accuracy at post-treatment. Based on the same measure, children with better somatosensory acuity produced /ɹ/ tongue shapes that were more complex, but this relationship was only present at post-treatment. CONCLUSION: The predicted relationships among somatosensory acuity, motor skill, and acoustically measured /ɹ/ production accuracy were observed after treatment, but unexpectedly did not hold before treatment. The surprising finding that greater tongue shape complexity was associated with lower accuracy at pre-treatment highlights the importance of evaluating tongue shape patterns (e.g., using ultrasound) prior to treatment, and has the potential to suggest that children with high tongue shape complexity at pre-treatment may be good candidates for ultrasound-based treatment.
Apraxias , Language Development Disorders , Speech Sound Disorder , Stuttering , Adolescent , Child , Humans , Pilot Projects , Speech , Speech Production Measurement , Speech Sound Disorder/therapy
PURPOSE: Somatosensory targets and feedback are instrumental in ensuring accurate speech production. Individuals differ in their ability to access and respond to somatosensory information, but there is no established standard for measuring somatosensory acuity. The primary objective of this study was to determine which of three measures of somatosensory acuity had the strongest association with change in production accuracy in a vowel learning task, while controlling for the better-studied covariate of auditory acuity. METHOD: Three somatosensory tasks were administered to 20 female college students: an oral stereognosis task, a bite block task with auditory masking, and a novel phonetic awareness task. Individual scores from the tasks were compared to their performance on a speech learning task in which participants were trained to produce novel Mandarin vowels with visual biofeedback. RESULTS: Of the three tasks, only bite block adaptation with auditory masking was significantly associated with performance in the speech learning task. Participants with weaker somatosensory acuity tended to demonstrate larger increases in production accuracy over the course of training. CONCLUSIONS: The bite block adaptation task measures proprioceptive awareness rather than tactile acuity and assesses somatosensory knowledge implicitly, with limited metalinguistic demands. This small-scale study provides preliminary evidence that these characteristics may be desirable for the assessment of oral somatosensory acuity, at least in the context of vowel learning tasks. Well-normed somatosensory measures could be of clinical utility by informing diagnosis/prognosis and treatment planning.
