Showing papers on "Dysarthria published in 1991"

Articulatory deficits in parkinsonian dysarthria: an acoustic analysis.

Abstract: Twelve patients with idiopathic Parkinson's disease had acoustic speech analysis of sentence utterances to provide information on speech tempo and accuracy of articulation. As a measure of rate of speech the duration of opening-closing movements during articulation was determined from speech wave variables. The intensity of sound emission during articulatory closure as required for stop consonant production, for example, magnitude of p, magnitude of t, magnitude of k, was used as an index of the degree of closure. Speech tempo was not significantly different from normal. The patients, however, had a reduced capacity of completing articulatory occlusion. This was interpreted as reflecting a reduction in movement amplitude of the articulators. Articulatory "undershoot" was not uniform but influenced by linguistic demands in that the closures associated with a stressed syllable were performed at the expense of unstressed ones. Furthermore, switching between opening and closing movements of the articulators in sentence production seemed undisturbed. These results indicate that motor planning of speech differs from arm movement control.

Neurological and neuropsychiatric spectrum of Wilson's disease: a prospective study of 45 cases.

Abstract: Forty-five patients with Wilson's disease (WD) were prospectively studied: 27 had neurological deficits, 12 hepatic signs, and 6 were asymptomatic. Kayser-Fleischer rings occurred in 23 of the neurological patients and in only 4 of the hepatic patients. Neurological features were extremely variable with respect to frequency and severity. Most frequent were dysdiadochokinesis (25 patients), dysarthria (23), bradykinesia (17), and posture tremor (14). Fifteen, mainly long-term treated patients, presented with rather discrete neurological abnormalities which predominantly consisted of dysarthria and various forms of tremor. Eight patients had a parkinsonian type of neurological WD associated with signs of an organic mood syndrome. Three patients were predominantly hyperkinetic, presenting with dystonic and choreatic movements. In 1 patient, ataxia was the predominant neurological feature. There was a clear-cut correlation between the severity of neurological impairment and the restriction in functional capacity. Nine patients were not able to engage in salaried employment or were retired. Psychiatric symptoms and behavioural disorders were common, varying from mild personality and psychological disturbances to severe psychiatric illness resembling psychotic disorders and major depressive syndromes. Significant mental deterioration was not found in the patients. Disturbances of mood were observed in 12 patients, all of whom had neurological abnormalities. There was a history of an attempted suicide in 7 patients, and a history of an organic delusional syndrome in 3.

Speech deterioration in amyotrophic lateral sclerosis: a case study.

Abstract: Few detailed reports have been published on the nature of speech and voice changes during the course of amyotrophic lateral sclerosis (ALS). The subject of this case study is a woman who was diagno...

Progressive loss of speech output and orofacial dyspraxia associated with frontal lobe hypometabolism.

Abstract: Three patients are described with slowly progressive loss of speech and dysarthria associated with orofacial dyspraxia, initially with intact written language, who subsequently developed more widespread cognitive abnormalities. Positron emission tomography (PET) revealed bifrontal hypometabolism in all of the patients, most marked in the inferior and lateral portions of both frontal lobes, with some extension into the parietal and temporal cortices in one case. These patients may represent a further example of focal progressive cortical degeneration.

The interpretation of dysprosody in patients with Parkinson's disease.

Abstract: Prosodic features in the speech production of 21 patients with idiopathic Parkinson's disease were tested. The appreciation of vocal and facial expression was also examined in the same patients. Significant intergroup differences were found in the prosody production tasks but, in contrast to previous results, not in the receptive tasks on the recognition and appreciation of prosody and of facial expression. The discrepancy between the production and recognition of prosodic features does not support the suggestion that dysprosody in Parkinson's disease is necessarily a disorder of processing emotional information that could be misinterpreted as a dysarthria.

Reliability and Agreement of Ratings of Ataxic Dysarthric Speech Samples With Varying Intelligibility

Abstract: Indices of interjudge reliability and inter- and intrajudge agreement were calculated from the ratings made by 15 experienced speech clinicians on five deviant speech dimensions with respect to 15 ...

Childhood motor speech disability

Abstract: 1.The Nature of Childhood Motor Speech Disability. Introduction: Childhood Dysarthria versus Developmental Verbal Dyspraxia. Definition of Terms. Characteristics of Childhood Dysarthria. 2.The Neurology of Childhood Motor Speech Disability. The Motor System. Cortical Level. Descending Motor Pathways. Subcortical Level. Peripheral Motor System Pathways. Clinical Neurology of the Childhood Dysarthrias. Clinical Neurology of Developmental Verbal Dyspraxia. 3.The Childhood Dysarthrias of Cerebral Palsy. Introduction. Spastic Syndromes. Dyskinetic Syndromes. Ataxic Syndromes. 4.The Childhood Dysarthrias of the Lower Motor Neuron. Introduction. Lower Motor-Unit Dysarthrias. 5.Developmental Verbal Dyspraxia. Controversial Issues. Single Case Studies: Evidence for the Disorder. Recent Developments. 6.Assessment. Introduction to Childhood Dysarthria Assessment. Oral-Motor Evaluation of the Prespeaking Child. Clinical Testing for Dysphagia. Abnormal Oral Reflexes and Deviant Oral-Motor Behavior. Radiologic Examination in the Dysphagic Child. Oral-Motor Evaluation of the Speaking Child. Assessment of Speech Production Subsystems in Childhood Dysarthria. Cognitive-Linguistic Assessment. Developmental Verbal Dyspraxia Assessment. 7.Issues in Speech Management of Childhood Dysarthria. Introduction. Prespeech Oral-Motor Training and Early Intervention. Later Oral-Motor Management. Technology in Childhood Dysarthria. 8.Therapy for Childhood Motor Speech Disability. A Subsystems Approach to the Management of Childhood Dysarthrias. Respiratory Dysfunction. Laryngeal Dysfunction. Velopharyngeal Dysfunction. Articulatory Muscle Dysfunction. Management of Developmental Verbal Dyspraxia. Index.

Cerebellar voice tremor: an acoustic analysis.

Abstract: Patients with cerebellar disease may exhibit tremulous phonation as part of their dysarthria. The results of an acoustic analysis of cerebellar voice tremor in a patient with hereditary ataxia and presenting with a purely cerebellar syndrome are reported. Analysis included computation of speech intensity contours, fundamental frequency contours, and spectral parameters from sustained productions of vowels and voiceless fricatives. Fundamental frequency contours during sustained phonation of vowels showed rhythmic oscillations at a rate of about 3 Hz. No concomitant periodicity could be detected for the parameters characterising voiceless fricative production. The results indicate an impairment of phonatory control in relation to the maintenance of a constant isometric activity of the internal laryngeal muscles. Cerebellar voice tremor may therefore be classified as a form of postural tremor.

Language functions in progressive supranuclear palsy

Abstract: Language functions were studied in 6 patients with clinically diagnosed progressive supranuclear palsy who conformed to the characteristic pattern of 'subcortical dementia'. Dysarthria, reading difficulties and disturbances of handwriting were present in all patients. Some patients showed additional deficits including visual dyslexia, constructional dysgraphia and an increased rate of self-corrections and misnamings in object confrontation naming. In most instances, the naming errors referred to an object visually similar to the target object, suggesting that visual misperception is the major cause of the naming disorder. It is concluded that a variety of language impairments may develop secondary to other neurological and neuropsychological changes in progressive supranuclear palsy.

Clinical anatomic study of pure dysarthria.

Abstract: Nine patients with pure dysarthria underwent computed tomography or magnetic resonance imaging. Eight patients had infarcts of lacunar or larger size in the internal capsule: four in the superior portion of the anterior limb or adjacent corona radiata and four in the superior portion of the genu or the adjacent corona radiata. In one patient, there was a small infarct in the bulbar motor cortex. Dysarthria was transient and characterized by poor articulation in all cases. Five patients also had contralateral facial weakness, and three patients with lesions in the genu had minimal and transient involvement of the contralateral fingers. These three cases appeared to be variants of the dysarthria-clumsy hand syndrome. We submit that this syndrome should sometimes be regarded as a stroke syndrome rather than always as a lacunar syndrome.

The use of strategies to increase speech intelligibility in cerebral palsy: an experimental evaluation.

Abstract: The effects of strategies on the intelligibility of cerebral-palsied speech were experimentally evaluated. Listeners were asked to identify words in sentences spoken by subjects whose dysarthria wa...

Computer recognition of the speech of adults with cerebral palsy and dysarthria

Abstract: Ten speakers with cerebral palsy and dysarthria and 13 nondisabled speakers were tested using a Shadow VET/2 speech recognition system installed in an Apple Ile computer. The speakers each produced four types of stimuli: 12 consonants followed by a neutral vowel, 12 vowels in an h-d environment, 12 words defined as easy and 12 words defined as difficult for dysarthric speakers. Using all four types of stimuli, the dysarthric speakers had scores above chance, but they had significantly fewer stimuli recognized by the computer than the nondisabled speakers. For the dysarthric group, vowels in an h-d environment and both types of words were recognized significantly more often than the consonants followed by a neutral vowel. For the nondisabled group, the vowels in an h-d environment were recognized significantly more often than consonants followed by a neutral vowel, and both types of words were recognized more often than vowels. Confusion matrices and a discussion of item errors were used to further compare...

Respiratory Kinematics in Speakers with Cerebellar Disease

Abstract: The respiratory abilities of a group of 12 speech disordered subjects with cerebellar disease were assessed using both spirometric and kinematic techniques and compared to those of a group of 12 no...

Prognostic factors for return to work in stroke patients with aphasia

Abstract: Few studies with stroke patients seem to have addressed the extent to which aphasia is a factor preventing gainful employment. One study showed that patients with aphasia after stroke returned to work only half as often as those with dysarthria or with unimpaired speech function (Howard et al. 1985). The patient's perception of the total hanhcap was found to be more predictive of returning to work than the level of speech. Furthermore, Zangwill (Lebrun and Hoops 1974) has noted that the vocational rehabilitation of manual workers is often easier, although aphasics can perform mental work.

A test for the detection of speech and language disorders in the acute phase after stroke. Development and clinical application

Abstract: No standardized assessment of aphasic symptoms for stroke patients in the acute phase has as yet been published in the German language. Current test batteries such as the AAT are too time-consuming and cannot be performed on severely impaired patients. A short test for the examination of aphasic and dysarthric symptoms has been developed which contains 7 subtests in three main areas: spontaneous speech, comprehension and planning of movements, speech and language abilities. Since abilities in acute cases may only be functionally impaired and often only detectable after stimulation, standardized stimulation is applied in most of the subtests. In this way it is possible to test acute stroke patients for aphasic and dysarthric symptoms. The course of recovery in a typical case is described.

Postlingual deaf speech and the role of audition in speech production: comments on Waldstein's paper [R.S. Waldstein, J. Acoust. Soc. Am. 88, 2099-2114 (1990)].

Abstract: Using acoustic analysis techniques, Waldstein [J. Acoust. Soc. Am. 88, 2099–2114 (1990)] reported abnormal speech findings in postlingual deaf speakers. She interpreted her findings to suggest that auditory feedback is important in motor speech control. However, it is argued here that Waldstein’s interpretation may be unwarranted without addressing the possibility of neurologic deficits (e.g., dysarthria) as confounding (or even primary) causes of the abnormal speech in her subjects.

Symptom Pattern and Recovery Outcome in Childhood Aphasia: A Methodological and Theoretical Critique

Abstract: Two of the most distinguishing features attributed to the childhood aphasias are the symptom pattern and recovery course (Hecean, 1976; Satz & Bullard-Bates, 1981). With respect to symptom pattern, childhood aphasia, in contrast to adult aphasia, has long been characterized by its nonfluency. This position dates from the early reports of Bernhardt (1885) and Freud (1897/1968) who both noted the poverty of spontaneous speech and the telegraphic expression following left unilateral brain injury. They described the aphasia as primarily motor in type, with initial mutism followed by reduced initiative for speech, hesitations, dysarthria, and impoverishment of lexical stock. Ihese early reports also noted the absence or rarity of logorrhea, paraphasia, and auditory comprehension defects, which suggested a dissociation between output (expression) and input (comprehension). This position has largely prevailed throughout the twentieth century (Assal & Campiche, 1973; Basser, 1962; Benson, 1972; Branco-Lefere, 1950; Byers & McLean, 1962; Geschwind, 1973; Guttmann, 1942; Poetzl, 1926).

Voice problems in the dysarthric patient

Abstract: Speech therapy for voice disorders of neurological origin used to be considered as unrealistic and of limited value, particularly in progressive disorders (Peacher 1949, Sarno 1968). This attitude has gradually changed with reports of successful research and case studies (Canter 1965a,b, Rosenbek and La Pointe 1978, Scott et al. 1984). There are a limited number of type-specific treatments available, but the same kinds of therapy can be applied to many types of dysarthria, the emphasis of treatment altering for each individual.

Adjusting dysarthric speech timing using neural nets

Abstract: Speech timing problems associated with dysarthria often involve the presence of periods of extraneous silence and nonspeech sounds as well as inappropriately timed or misplaced speech gestures. This study evaluated the performance of neural networks in detecting the presence of inappropriate or nonspeech sounds and extraneous silence. The “opt” neural network program [E. Barnard and R. Cole, OGC Tech. Rep. No. CSE 89‐014] that uses a conjugate gradient algorithm to adjust node weights was trained to recognize breaths and silence in a reading of the rainbow passage by a single dysarthric (Cerebral Palsy) talker. Input to the network consisted of a sequence of frames of parameters derived from spectral analysis of the speech. The output was a binary (speech/nonspeech) decision for the segment of signal corresponding to the middle frame of the input sequence. Networks of various size and configuration were trained on half the available data and tested on the remaining data. The best network configurations correctly identified approximately 99% of the frames in the training set and about 97% of the frames in test datasets.