The measurement of meaning

Purpose Speech and other oral functions such as swallowing have been compared and contrasted with oral behaviors variously labeled quasispeech, paraspeech, speechlike, and nonspeech, all of which o...

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Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review

This review looks at the nature and impact of communication changes in Parkinson's disease, approaches to assessment and directions for intervention. This is especially important since medical and surgical interventions that help limb movement are largely ineffective, or even detrimental, for speech. Most people with Parkinson's disease notice changes to their communication. Voice alters early on-even in the prodromal stage. Later, articulation may impair intelligibility further. These changes impact on mood and social participation. However, a full characterisation of communication changes in Parkinson's must acknowledge that changes are far more pervasive and varied than a quiet voice. Communication is affected by marked dysprosody, cognitive-linguistic impairment, alterations to social interaction and pragmatics. Changes entail not just expressive elements but also receptive. A comprehensive evaluation of potential communication challenges faced by people with Parkinson's disease must cover all these aspects. Similarly, interventions that ignore the breadth and depth of changes will always remain incomplete.

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Communication changes in Parkinson's disease.

Purpose Although dysarthria affects the large majority of individuals with cerebral palsy (CP) and can substantially complicate everyday communication, previous research has provided an incomplete ...

Dysarthria in Adults With Cerebral Palsy: Clinical Presentation and Impacts on Communication.

Background Differential diagnosis and treatment planning of developmental speech disorders (DSD) remains a major challenge in paediatric speech-language pathology. Different classification systems exist, in which subtypes are differentiated based on their theoretical cause and in which the definitions generally refer to speech production processes. Accordingly, various intervention methods have been developed aiming at different parts of the speech production process. Diagnostic classification in these systems, however, is primarily based on a description of behavioural speech symptoms rather than on underlying deficits. Purpose In this paper, we present a process-oriented approach to diagnosis and treatment planning of DSD. Our framework comprises two general diagnostic categories: developmental delay and developmental disorder. Within these categories, treatment goals/targets and treatment methods are formulated at the level of processes and rules/representations. Conclusion A process-oriented approach to diagnosis and treatment planning holds important advantages, offering direct leads for treatment aimed at the underlying impairment, tailored to the specific needs of the individual and adjusted to the developmental trajectory.

/pdf/a-psycholinguistic-framework-for-diagnosis-and-treatment-61jgjd3u10.pdf

A Psycholinguistic Framework for Diagnosis and Treatment Planning of Developmental Speech Disorders

Friedreich ataxia (FRDA) is the most frequent recessive ataxia in the Western world. Dysarthria is a cardinal feature of FRDA, often leading to severe impairments in daily functioning, but its exact characteristics are only poorly understood so far. We performed a comprehensive evaluation of dysarthria severity and the profile of speech motor deficits in 20 patients with a genetic diagnosis of FRDA based on a carefully selected battery of speaking tasks and two widely used paraspeech tasks, i.e., oral diadochokinesis and sustained vowel productions. Perceptual ratings of the speech samples identified respiration, voice quality, voice instability, articulation, and tempo as the most affected speech dimensions. Whereas vocal instability predicted ataxia severity, tempo turned out as a significant correlate of disease duration. Furthermore, articulation predicted the overall intelligibility score as determined by a systematic speech pathology assessment tool. In contrast, neurologists' ratings of intelligibility--a component of the "Scale for the Assessment and Rating of Ataxia"--were found to be related to perceived speech tempo. Obviously, clinicians are more sensitive to slowness of speech than to any other feature of spoken language during dysarthria evaluation. Our results suggest that different components of speech production and trunk/limb motor functions are differentially susceptible to FRDA pathology. Furthermore, evidence emerged that paraspeech tasks do not allow for an adequate scaling of speech deficits in FRDA.

Friedreich ataxia: dysarthria profile and clinical data.

Patterns of dysarthria in spinocerebellar ataxias (SCAs) and their discriminative features still remain elusive. Here we aimed to compare dysarthria profiles of patients with (SCA3 and SCA6 vs. Friedreich ataxia (FRDA), focussing on three particularly vulnerable speech parameters (speaking rate, prosodic modulation, and intelligibility) in ataxic dysarthria as well as on a specific oral non-speech variable of ataxic impairment, i.e., the irregularity of oral motor diadochokinesis (DDK). 30 Patients with SCA3, SCA6, and FRDA, matched for group size (n = 10 each), disease severity, and disease duration produced various speech samples and DDK tasks. A discriminant analysis was used to differentiate speech and non-speech parameters between groups. Regularity of DDK was specifically impaired in SCA3, whereas impairments of speech parameters, i.e., rate and modulation were stronger affected in SCA6. Speech parameters are particularly vulnerable in SCA6, while non-speech oral motor features are notably impaired in SCA3.

Comparing speech characteristics in spinocerebellar ataxias type 3 and type 6 with Friedreich ataxia.

Measures of performance rates in speech-like or volitional nonspeech oral motor tasks are frequently used to draw inferences about articulation rate abnormalities in patients with neurologic movement disorders. The study objective was to investigate the structural relationship between rate measures of speech and of oral motor behaviors different from speech. A total of 130 patients with neurologic movement disorders and 130 healthy subjects participated in the study. Rate data was collected for oral reading (speech), rapid syllable repetition (speech-like), and rapid single articulator movements (nonspeech). The authors used factor analysis to determine whether the different rate variables reflect the same or distinct constructs. The behavioral data were most appropriately captured by a measurement model in which the different task types loaded onto separate latent variables. The data on oral motor performance rates show that speech tasks and oral motor tasks such as rapid syllable repetition or repetitive single articulator movements measure separate traits.

Oral Motor Abilities Are Task Dependent: A Factor Analytic Approach to Performance Rate.

Purpose Standardized clinical assessment of dysarthria is essential for management and research. We present a new, fully standardized dysarthria assessment, the Bogenhausen Dysarthria Scales (BoDyS...

Theresa Schölderle

Papers

Dysarthria in Adults With Cerebral Palsy: Clinical Presentation and Impacts on Communication.

Friedreich ataxia: dysarthria profile and clinical data.

Comparing speech characteristics in spinocerebellar ataxias type 3 and type 6 with Friedreich ataxia.

Oral Motor Abilities Are Task Dependent: A Factor Analytic Approach to Performance Rate.

Gauging the Auditory Dimensions of Dysarthric Impairment: Reliability and Construct Validity of the Bogenhausen Dysarthria Scales (BoDyS).