Gait change in tongue movement.

During locomotion, humans switch gaits from walking to running, and horses from walking to trotting to cantering to galloping, as they increase their movement rate. It is unknown whether gait change leading to a wider movement rate range is limited to locomotive-type behaviours, or instead is a general property of any rate-varying motor system. The tongue during speech provides a motor system that can address this gap. In controlled speech experiments, using phrases containing complex tongue-movement sequences, we demonstrate distinct gaits in tongue movement at different speech rates. As speakers widen their tongue-front displacement range, they gain access to wider speech-rate ranges. At the widest displacement ranges, speakers also produce categorically different patterns for their slowest and fastest speech. Speakers with the narrowest tongue-front displacement ranges show one stable speech-gait pattern, and speakers with widest ranges show two. Critical fluctuation analysis of tongue motion over the time-course of speech revealed these speakers used greater effort at the beginning of phrases-such end-state-comfort effects indicate speech planning. Based on these findings, we expect that categorical motion solutions may emerge in any motor system, providing that system with access to wider movement-rate ranges.

What anticipatory coarticulation in children tells us about speech motor control maturity.

PURPOSE: This study aimed to evaluate the role of motor control immaturity in the speech production characteristics of 4-year-old children, compared to adults. Specifically, two indices were examined: trial-to-trial variability, which is assumed to be linked to motor control accuracy, and anticipatory extra-syllabic vowel-to-vowel coarticulation, which is assumed to be linked to the comprehensiveness, maturity and efficiency of sensorimotor representations in the central nervous system. METHOD: Acoustic and articulatory (ultrasound) data were recorded for 20 children and 10 adults, all native speakers of Canadian French, during the production of isolated vowels and vowel-consonant-vowel (V1-C-V2) sequences. Trial-to-trial variability was measured in isolated vowels. Extra-syllabic anticipatory coarticulation was assessed in V1-C-V2 sequences by measuring the patterns of variability of V1 associated with variations in V2. Acoustic data were reported for all subjects and articulatory data, for a subset of 6 children and 2 adults. RESULTS: Trial-to-trial variability was significantly larger in children. Systematic and significant anticipation of V2 in V1 was always found in adults, but was rare in children. Significant anticipation was observed in children only when V1 was /a/, and only along the antero-posterior dimension, with a much smaller magnitude than in adults. A closer analysis of individual speakers revealed that some children showed adult-like anticipation along this dimension, whereas the majority did not. CONCLUSION: The larger trial-to-trial variability and the lack of anticipatory behavior in most children-two phenomena that have been observed in several non-speech motor tasks-support the hypothesis that motor control immaturity may explain a large part of the differences observed between speech production in adults and 4-year-old children, apart from other causes that may be linked with language development.

Automated Assessment of Oral Diadochokinesis in Multiple Sclerosis Using a Neural Network Approach: Effect of Different Syllable Repetition Paradigms.

Slow and irregular oral diadochokinesis represents an important manifestation of spastic and ataxic dysarthria in multiple sclerosis (MS). We aimed to develop a robust algorithm based on convolutional neural networks for the accurate detection of syllables from different types of alternating motion rate (AMR) and sequential motion rate (SMR) paradigms. Subsequently, we explored the sensitivity of AMR and SMR paradigms based on voiceless and voiced consonants in the detection of speech impairment. The four types of syllable repetition paradigms including /ta/, /da/, /pa/-/ta/-/ka/, and /ba/-/da/-/ga/ were collected from 120 MS patients and 60 matched healthy control speakers. Our neural network algorithm was able to correctly identify the position of individual syllables with a very high average accuracy of 97.8%, with the correct temporal detection of syllable position of 87.8% for 10 ms and 95.5% for 20 ms tolerance value. We found significantly altered diadochokinetic rate and regularity in MS compared to controls across all types of investigated tasks ( ). MS patients showed slower speech for SMR compared to AMR tasks, whereas voiced paradigms were more irregular. Objective evaluation of oral diadochokinesis using different AMR and SMR paradigms may provide important information regarding speech severity and pathophysiology of the underlying disease.

Attention, Speech-Language Dissociations, and Stuttering Chronicity.

The purpose of this study was to investigate the singular and joint contributions of speech-language dissociations and attention (i.e., distractibility and attention span) to stuttering chronicity. Method Participants, aged 3;0-4;11 (years;months) at an initial visit, were classified as persisting (n = 10; 9 boys), recovered (n = 32; 23 boys), and nonstuttering (n = 28; 19 boys) based on multiple speech and language evaluations spread across 2 years. The evaluations included assessments of articulation, receptive and expressive vocabulary, and omnibus receptive and expressive language. These measures were used to identify speech-language dissociations using a correlation-based statistical approach. Attentional characteristics, which included measures of distractibility and attention span, were based on parent report. Analyses investigated between-group differences related to dissociations and attentional characteristics as well as the relation between these indices. Results There were no significant between-group differences for the persisting and recovered groups on measures of speech-language dissociations; however, the recovered group was found to exhibit less optimal attention span than the persisting group. In addition, children with dissociations exhibited less optimal distractibility and attention spans at the final time point than children without dissociations. Conclusions Present results indicate that attention is related to both stuttering chronicity and the presence of speech-language dissociations; however, they do not support the notion that dissociations are associated with stuttering persistence. These results provide novel insights into the complex nature of the association between developmental stuttering, speech-language dissociations, and attention.

Effects of Rate Manipulation on Intelligibility in Children With Cerebral Palsy.

Purpose We evaluated the effects of a speech supplementation strategy to reduce rate and improve intelligibility in children with cerebral palsy. Method Twenty-five children with cerebral palsy (M age = 12.08 years) completed a structured speaking task in 2 speech conditions: habitual speech and slow speech. Fifteen children had mild intelligibility deficits; 10 had moderate-severe intelligibility deficits. In each condition, children repeated utterances of 2-7 words in length. In the habitual speech condition, children used their natural and unaltered speaking rate. In the slow speech condition, children were cued to insert pauses between words. Intelligibility ratings were obtained from orthographic transcriptions by unfamiliar adult listeners (n = 100). Speech rate, in words per minute, was measured for each utterance. Results All children, regardless of severity group, were able to reduce their rate of speech when implementing the slow speech strategy. Only children in the moderate-severe group showed an improvement in intelligibility when implementing the slow speech strategy. Although there was considerable individual variability, there was a greater improvement in intelligibility for longer utterances compared to shorter ones. Conclusion A slow speech strategy may be beneficial for children with moderate-severe intelligibility deficits who speak in longer utterances. Future studies should seek to further examine the clinical feasibility of slow speech for children with reduced intelligibility.

Introducing the Beatalk technique: using beatbox sounds and rhythms to improve speech characteristics of adults with intellectual disability.

BACKGROUND: Individuals with intellectual disability (ID) often demonstrate speech impairments and reduced intelligibility. However, traditional treatment methods, which involve using repetitive verbal and non-verbal exercises, may not be fully suitable for this population. As adults with ID tend to lose interest and motivation facing the demands of a typical speech therapy session, other intervention methods are needed. The current study tested a novel intervention technique, Beatalk, based on practising vocally produced sounds and rhythms, imitating the sounds produced by rhythm machines in an a cappella musical context (i.e., human beatboxing). Human beatboxing may be a particularly effective tool since it involves intense production of speech sounds (phonemes) that can be misarticulated in the presence of speech disorders; it is relatively easy to learn and practice, and is also considered 'fun'. AIMS: As many of the features of beatboxing make it a promising method for speech therapy, this pioneering study aimed to examine its effectiveness in comparison with a traditional speech therapy. METHODS & PROCEDURES: Twelve adults with moderate ID and low speech intelligibility (age 24-48 years) participated in a speech therapy group for 6 weeks. Six participants were assigned to the Beatalk (study) group and six to a traditional (control) therapy group. Pre- to post-treatment changes in speech intelligibility and voice measures were assessed. OUTCOMES & RESULTS: The preliminary data demonstrate that both types of therapy groups resulted in improved performance in articulation accuracy and voice measures, yet the Beatalk technique yielded larger gains. CONCLUSIONS & IMPLICATIONS: The results present initial evidence for the beneficial effect of the Beatalk technique as an intervention tool for adults with ID. It is an easy-to-use technique in the context of speech therapy, and may enhance verbal communication skills in this population.

Kurdish Speech Test: A validation study for children aged 3-5 years.

OBJECTIVES: Speech disorder in children is the most common disorder reported by speech and language pathologists in all languages and its evaluation and diagnosis requires valid and reliable tools. This study aimed to develop a Kurdish Speech Test for children aged 3-5 years and to determine its psychometric properties. METHODS: The validation included 120 monolingual Kurdish-speaking children aged 3-5 years in the city of Bukan, Iran. Content validity was determined according to expert opinions of Kurdish speech and language pathologists and linguists. Test-retest (one-week interval) and scoring-rescoring by two independent examiners were conducted to determine intra- and inter-rater reliability. The tests ability to discriminate between four age groups (36-60 months) was investigated for construct validity. Differences related to gender were assessed. RESULTS: Intra- and inter-rater reliability showed no significant difference between the first and second week of administration (p < 0.001) and scoring-rescoring by two independent raters confirmed the reliability of the Kurdish Speech Test (P < 0.001). Discriminating properties, reflecting construct validity showed higher scores with increasing age. No gender differences were found. CONCLUSION: The Kurdish Speech Test is a reliable and valid instrument for evaluation of articulation in three-to-five-year-old children. Results suggest that the test is appropriate for clinical assessment of children with speech sound disorders.

Three-dimensional printable ultrasound transducer stabilization system.

When using ultrasound imaging of the tongue for speech recording/research, submental transducer stabilization is required to prevent the ultrasound transducer from translating or rotating in relation to the tongue. An iterative prototype of a lightweight three-dimensional-printable wearable ultrasound transducer stabilization system that allows flexible jaw motion and free head movement is presented. The system is completely non-metallic, eliminating interference with co-recorded signals, thus permitting co-collection and co-registration with articulometry systems. A motion study of the final version demonstrates that transducer rotation is limited to 1.25° and translation to 2.5 mm-well within accepted tolerances.

Measuring Articulation Rate: A Comparison of Two Methods.

PURPOSE: Mean articulatory rate (MAR) is an alternative approach to measure articulation rate and is defined as the mean of 5 rate measures in minimally 10 to maximally 20 consecutive syllables in perceptually fluent speech without pauses. This study examined the validity of this approach. METHOD: Reading and spontaneous speech samples were collected from 80 typically fluent adults ranging in age between 20 and 59 years. After orthographic transcription, all samples were subjected to an articulation rate analysis first using the prevailing "global" method, which takes into account the entire speech sample and involves manipulation of the speech sample, and then again applying the MAR method. Paired-samples t tests were conducted to compare global measurements to MAR measurements. RESULTS: For both spontaneous speech and reading, a strong correlation was found between the 2 methods. However, for both speech tasks, the paired-samples t tests revealed a significant difference with MAR values being higher than the global method values. CONCLUSIONS: The MAR method is a valid method to measure articulation rate. However, it cannot be used interchangeably with the prevailing global method. Further standardization of the MAR method is needed before general clinical use can be suggested.

A Phonetic Complexity-Based Approach for Intelligibility and Articulatory Precision Testing: A Preliminary Study on Talkers With Amyotrophic Lateral Sclerosis.

Purpose: This study describes a phonetic complexity-based approach for speech intelligibility and articulatory precision testing using preliminary data from talkers with amyotrophic lateral sclerosis. Method: Eight talkers with amyotrophic lateral sclerosis and 8 healthy controls produced a list of 16 low and high complexity words. Sixty-four listeners judged the samples for intelligibility, and 2 trained listeners completed phoneme-level analysis to determine articulatory precision. To estimate percent intelligibility, listeners orthographically transcribed each word, and the transcriptions were scored as being either accurate or inaccurate. Percent articulatory precision was calculated based on the experienced listeners' judgments of phoneme distortions, deletions, additions, and/or substitutions for each word. Articulation errors were weighted based on the perceived impact on intelligibility to determine word-level precision. Results: Between-groups differences in word intelligibility and articulatory precision were significant at lower levels of phonetic complexity as dysarthria severity increased. Specifically, more severely impaired talkers showed significant reductions in word intelligibility and precision at both complexity levels, whereas those with milder speech impairments displayed intelligibility reductions only for more complex words. Articulatory precision was less sensitive to mild dysarthria compared to speech intelligibility for the proposed complexity-based approach. Conclusions: Considering phonetic complexity for dysarthria tests could result in more sensitive assessments for detecting and monitoring dysarthria progression.

On the development of gestural organization: A cross-sectional study of vowel-to-vowel anticipatory coarticulation.

In the first years of life, children differ greatly from adults in the temporal organization of their speech gestures in fluent language production. However, dissent remains as to the maturational direction of such organization. The present study sheds new light on this process by tracking the development of anticipatory vowel-to-vowel coarticulation in a cross-sectional investigation of 62 German children (from 3.5 to 7 years of age) and 13 adults. It focuses on gestures of the tongue, a complex organ whose spatiotemporal control is indispensable for speech production. The goal of the study was threefold: 1) investigate whether children as well as adults initiate the articulation for a target vowel in advance of its acoustic onset, 2) test if the identity of the intervocalic consonant matters and finally, 3) describe age-related developments of these lingual coarticulatory patterns. To achieve this goal, ultrasound tongue imaging was used to record lingual movements and quantify changes in coarticulation degree as a function of consonantal context and age. Results from linear mixed effects models indicate that like adults, children initiate vowels' lingual gestures well ahead of their acoustic onset. Second, while the identity of the intervocalic consonant affects the degree of vocalic anticipation in adults, it does not in children at any age. Finally, the degree of vowel-to-vowel coarticulation is significantly higher in all cohorts of children than in adults. However, among children, a developmental decrease of vocalic coarticulation is only found for sequences including the alveolar stop /d/ which requires finer spatiotemporal coordination of the tongue's subparts compared to labial and velar stops. Altogether, results suggest greater gestural overlap in child than in adult speech and support the view of a non-uniform and protracted maturation of lingual coarticulation calling for thorough considerations of the articulatory intricacies from which subtle developmental differences may originate.

The Effect of the Speech Task Characteristics on Perceptual Judgment of Mild to Moderate Dysphonia: A Methodological Study.

OBJECTIVE: To study the differences in perceptual ratings of mild and moderate dysphonia related to the speech task, and their impact on intrarater and interrater reliabilities. PATIENTS AND METHODS: Voice recordings of 15 outpatients with mild or moderate dysphonia related to laryngopharyngeal reflux were presented to 6 female experienced judges blinded to the clinical state of the patients. From these, the GRBASI (Grade, Roughness, Breathiness, Asthenia, Strain, and Instability) evaluations were performed on connected speech and sustained vowel of the pretreatment voice recordings and absolute agreement, and both intrarater and interrater reliabilities were assessed. RESULTS: The average GRBASI scores were significantly worse when performed on sustained vowel. Intrarater reliability substantially varied according to the judge and the task. Good interrater reliability was broadly found for the evaluations of all GRBASI components irrespective of the speech task. Concerning agreement, we only found absolute agreement between judges for G and R items assessed on text. CONCLUSION: Average grade of perceptual voice impairment, intrarater reliability, and agreement vary according to the speech task.

Influence of Oral Morphology on Speech Production in Subjects Wearing Maxillary Removable Partial Dentures with Major Connectors.

BACKGROUND/AIMS: Speech impairment during the initial phase of removable partial denture (RPD) treatment can prevent patient adaptation to RPDs. This study was undertaken to investigate the influence of oral morphology on speech production in subjects wearing RPDs with major connectors. METHODS: Two types of connectors were fabricated for 17 subjects with normal dentitions: covering the middle palate (M-bar) and the anterior/posterior palate (AP-bar). Four target sounds ([∫i], [t∫i], [çi], and [ki]) were evaluated under 3 recording conditions: no connector, M-bar, and AP-bar. The mean appearance ratios of correct labels (MARCs) were calculated as parameters representing speech production accuracy with the speech evaluation system. Subgroup analysis was conducted based on palate height, dental arch width, and front space volume of the oral cavity. RESULTS: Based on the multiple linear regression test, a significant association was found between the MARCs of [∫i] with M-bar and front space (p = 0.036). In the subgroup analysis, the AP-bar had a significant effect on the MARCs of [∫i] among subjects with high palate (p = 0.026), narrow arch (p = 0.004), and small front space (p = 0.014). CONCLUSION: RPDs with major connectors could disturb speech production among patients with high palates, narrow arches, and small front spaces.

22q11.2 Deletion: Surgical and Speech Outcomes of Patients With Velopharyngeal Insufficiency Treated With a Superiorly Based Pharyngeal Flap as the Primary Surgery.

The most frequent palate diagnoses in patients with chromosome 22q11.2 deletion syndrome are a classic submucous cleft, occult, and velopharyngeal insufficiency without cleft, which generates alterations in speech that require surgery. Surgical protocols are controversial owing to syndrome characteristics that make their handling more complex. Pharyngeal flap pharyngoplasty is effective for this type of patient. The objective of this study is to examine the surgical management of velopharyngeal insufficiency in patients with chromosome 22 deletion, using a pharyngeal flap as the primary surgery. The clinical records of patients with chromosome 22 deletion and velopharyngeal insufficiency between 2015 and 2017 were analyzed retrospectively. Eight patients underwent pharyngeal flap pharyngoplasty as a primary surgery, including 1 with velopharyngeal insufficiency without a cleft, 1 with a classic submucous cleft, and 6 with occult submucous cleft. The pre- and postoperative protocol performed by speech therapists and surgeons included clinical evaluation of the oral cavity; perceptual, video recording, and nasometry speech evaluation; and videonasopharyngoscopy. All perceptual parameters and nasometry results significantly changed. Of the cases, 88% achieved a flap with the expected width and height and complete closure of the velopharyngeal sphincter. One patient required flap revision. Four of the 8 patients achieved normal resonance, and 2 of 8 showed mild hypernasality. Using the pharyngeal flap pharyngoplasty as a primary technique to correct velopharyngeal insufficiency in patients with chromosome 22 deletion provides satisfactory outcomes and decreases the number of surgeries. Preoperative planning must be conducted carefully and needs to be individualized to be successful.

Articulation or phonology? Evidence from longitudinal error data.

Children's speech difficulties can be motor (phone misarticulation) or linguistic (impaired knowledge of phonological contrasts and constraints). These two difficulties sometimes co-occur. This paper reports longitudinal data from the Early Language in Victoria Study (ELVS) at 4 and 7 years of age. Of 1494 participants, 93 made non-age appropriate speech errors on standardised assessments at 4 years, and were able to be reassessed at 7 years. At 4 years, 85% of these children only made phonological errors, 14% made both articulation and phonological errors and one child only made articulation errors (a lateral lisp). In total, 8 of 13 children making both articulation and phonological errors at 4 years had resolved by 7 years. Unexpectedly, eight children who had demonstrated articulation of fricatives at 4 years, acquired distorted production of ≥ 50% of occurrences of/s, z/ by 7 years. In total, then, 22 children (24% of children with speech difficulties) made articulatory errors at one or both assessments. Case data for all children are presented. Theoretical and clinical implications are considered.

Neurophysiological and cognitive effects of Transcranial Direct Current Stimulation in three girls with Rett Syndrome with chronic language impairments.

BACKGROUND: this study was based on both neurophysiological decelerated activity and communication deficits in Rett Syndrome (RTT). AIMS: the aim was to examine the neurophysiological and cognitive effects of Transcranial Direct Current Stimulation (tDCS) in three girls with RTT with chronic language impairments. METHODS AND PROCEDURES: we proposed an integrated intervention: tDCS and cognitive empowerment applied to language in order to enhance speech production (new functional sounds and new words). Because maximal gains usually are achieved when tDCS is coupled with behavioral training, we applied tDCS stimulation on Broca's area together with linguistic training. OUTCOMES AND RESULTS: the results indicated a general enhancement in language abilities (an increase in the number of vowel/consonant sounds and words and the production and comprehension through discrimination), motor coordination (functional movements), and neurophysiological parameters (an increase in the frequency and power of alpha, beta and theta bands). CONCLUSION AND IMPLICATIONS: we assume that tDCS stimulation combined with the cognitive empowerment applied to language can significantly influence a chronic impairment even in genetic syndromes. Our results provide data that support the role of tDCS in fostering brain plasticity and in particular in empowering speech production and comprehension in girls with RTT.

The Effect of Practice and Visual Feedback on Oral-Diadochokinetic Rates for Younger and Older Adults.

Assessments of oral-diadochokinetic rates are commonly performed to evaluate oral-motor skills. However, the appropriate administration protocol is not defined, and varies across therapists, clinics and laboratories. In three experiments and an auxiliary one, this study analyzes the effects of brief (motor) practice and visual feedback on the performance of 98 younger (20-40 years old) and 78 older adults (over 65) with the sequential motion rate (SMR) version. Overall rates were significantly faster for younger over older adults. Irrespective of age-group, averaged performance was significantly better on the second round, but the third round was found to be superfluous, across experiments and age-groups. Visual feedback (using a mirror) was found to be detrimental for younger adults, eliminating the advantage reaped from a practice round. For older adults, visual feedback did not alter the effect of a practice round. Sensory (visual) degradation is presented as a possible source for this age-related difference. We discuss these findings and suggest an administration protocol for younger and older adults with the SMR version, including a total of two rounds and no visual feedback.

Articulatory Kinematic Characteristics Across the Dysarthria Severity Spectrum in Individuals With Amyotrophic Lateral Sclerosis.

Purpose: The current study investigated whether articulatory kinematic patterns can be extrapolated across the spectrum of dysarthria severity in individuals with amyotrophic lateral sclerosis (ALS). Method: Temporal and spatial articulatory kinematic data were collected using electromagnetic articulography from 14 individuals with dysarthria secondary to ALS and 6 typically aging speakers. Speech intelligibility and speaking rate were used as indices of severity. Results: Temporal measures (duration, speed of articulators) were significantly correlated with both indices of severity. In speakers with dysarthria, spatial measures were not correlated with severity except in 3 measures: tongue movement displacement was more reduced in the anterior-posterior dimension; jaw movement distance was greater in the inferior-superior dimension; jaw convex hull area was larger in speakers with slower speaking rates. Visual inspection of movement trajectories revealed that overall spatial kinematic characteristics in speakers with severe dysarthria differed qualitatively from those in speakers with mild or moderate dysarthria. Unlike speakers with dysarthria, typically aging speakers displayed variable tongue movement and minimal jaw movement. Conclusions: The current study revealed that spatial articulatory characteristics, unlike temporal characteristics, showed a complicated pattern across the severity spectrum. The findings suggest that articulatory characteristics in speakers with severe dysarthria cannot simply be extrapolated from those in speakers with mild-to-moderate dysarthria secondary to ALS.

Quantitative analysis of tongue movement in 14 phonemes of Brazilian Portuguese. / Análise ultrassonográfica quantitativa do movimento da língua em 14 fonemas do Português Brasileiro.

PURPOSE: The aim of this study was to characterize the ultrasonographic pattern of tongue movement in 14 consonant phonemes of Brazilian Portuguese (BP), seeking to identify and describe ultrasonographic parameters that could grasp the difference of manner and place of articulation among these phonemes. METHODS: We selected 20 individuals with typical speech production, aged between 20-30 years of both genders. The selected stimuli included the 14 lingual consonant BP phonemes in the intervocalic context of [a]. Data were collected and analyzed with the use of ultrasound, and the AAA (Articulate Assistant Advanced) and the Ultra-CATS (The Ultrasonographic Contour Analyzer for Tongue Surfaces) softwares. Three ultrasound parameters were used for data analysis: anteriority index (AI), global average of tongue height (GA) and relative anteriority index (RAI). Data were statistically analyzed. RESULTS: ANOVA showed a significant effect on the parameters and the RAI differentiated phonemes as the place (alveolar, pre-palatal, palatal and velar) and manner of articulation (fricative, nasal and occlusive); GA differentiate phonemes only as the place of articulation (alveolar, pre-palatal and velar). CONCLUSION: There was no single US parameter that could differentiate place and manner of articulation simultaneously. The clinical application for analysis of speech production disorders require the use of at least two ultrasound parameters: one to distinguish the place and another to distinguish the articulation manner.