Blog Archives

Neural bases of childhood speech disorders: lateralization and plasticity for speech functions during development

Current models of speech production in adults emphasize the crucial role played by the left perisylvian cortex, primary and pre-motor cortices, the basal ganglia, and the cerebellum for normal speech production. Whether similar brain-behaviour relationships and leftward cortical dominance are found in childhood remains unclear. Here we reviewed recent evidence linking motor speech disorders (apraxia of speech and dysarthria) and brain abnormalities in children and adolescents with developmental, progressive, or childhood-acquired conditions. We found no evidence that unilateral damage can result in apraxia of speech, or that left hemisphere lesions are more likely to result in dysarthria than lesion to the right. The few studies reporting on childhood apraxia of speech converged towards morphological, structural, metabolic or epileptic anomalies affecting the basal ganglia, perisylvian and rolandic cortices bilaterally. Persistent dysarthria, similarly, was commonly reported in individuals with syndromes and conditions affecting these same structures bilaterally. In conclusion, for the first time we provide evidence that longterm and severe childhood speech disorders result predominantly from bilateral disruption of the neural networks involved in speech production.

from Neuroscience and Biobehavioral Reviews

Lesions to the posterior insular cortex cause dysarthria

Conclusions:  Owing to the known extensive spectrum of cortical and subcortical somatosensory and motor connections, it seems that the IC might be one region involved in the generation of speech motor execution.

from the European Journal of Neurology

Reproducibility and Validity of Patient-Rated Assessment of Speech, Swallowing, and Saliva Control in Parkinson’s Disease

The ROMP provides a reliable and valid instrument to evaluate patient-perceived problems with speech, swallowing, and saliva control in patients with PD or AP.

from Archives of Physical Medicine and Rehabilitation

Auditory discrimination as a condition for E-learning based Speech Therapy: A proposal for an Auditory Discrimination Test (ADT) for adult dysarthric speakers

The results of the healthy control group show that the majority of the ADT items meet our criterion for sensitivity to diminished auditory discrimination. The poorer performance of dysarthric patients across all subtests supports the sensitivity of the ADT. However, further research involving larger and more homogeneous groups of neurological patients is required.

Learning outcomes: Readers will be encouraged to 1) identify potential factors that may hinder web based speech training, 2) estimate the value of assessing auditory discrimination skills as a vital condition for (web based) speech training in dysarthric patients.

from the Journal of Communication Disorders

Intensive Voice Treatment (LSVT®LOUD) for Parkinson’s disease following Deep Brain Stimulation of the Subthalamic Nucleus

Results support LSVT LOUD for treating voice and speech in individuals with PD following STN-DBS surgery. However, modifications may be required to maintain functional improvements.

from the Journal of Communication Disorders

An Exploration of Listener Variability in Intelligibility Judgments

Conclusions: These findings suggest that seemingly objective intelligibility tests are subject to a number of factors that affect scores.

from American Journal of Speech Language Pathology

Modulation of dysarthropneumophonia by low-frequency STN DBS in advanced Parkinson’s disease

Chronic treatment with low-frequency STN DBS may have a beneficial impact on dysarthropneumophonia, even in advanced PD patients.

from Movement Disorders

Speech characteristic associated with three genotypes of ataxia

These results support previous characterizations of ataxic dysarthria, and provide further information about the speech characteristics of genetic subtypes. Task demands affect perceptual ratings. Voice characteristics may be key to differentiating ataxic subtypes. As the genetic disorders that affect speech become better understood, more detailed characterizations of motor control systems should emerge.

from the Journal of Communication Disorders

An Acoustic Study of the Relationships Among Neurologic Disease, Dysarthria Type, and Severity of Dysarthria

Conclusions: These findings were discussed with respect to (a) the relationship between acoustic characteristics and speech intelligibility and (b) dysarthria classification.

from the Journal of Speech, Language, and Hearing Research

Oro-buccal symptoms (dysphagia, dysarthria, and sialorrhea) in patients with Parkinson’s disease: preliminary analysis from the French COPARK cohort

Oro-buccal symptoms were present in two of three patients with moderate PD, the presence of each symptoms being significantly correlated with that of the two others.

from the European Journal of Neurology

Communication changes in Parkinson’s disease

This article offers an overview of changes to speech and voice that arise in PD and the impact these underlying changes have on speech naturalness, intelligibility and participation in social life. Assessment and treatment are not a focus, but lessons for these areas are drawn from the description of the nature of overall changes.

from Revista de Logopedia, Foniatría y Audiología

Role of cerebellum in fine speech control in childhood: Persistent dysarthria after surgical treatment for posterior fossa tumour

Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen long-term after surgical treatment for childhood PFT, unselected for the presence of post-operative mutism (mean time post-surgery = 6y10 m, range 1;4–12;6 years, two had post-operative mutism), and examine factors affecting outcome. Twenty-six age- and sex- matched healthy controls were recruited for comparison. Participants in both groups had speech assessments using detailed perceptual and acoustic methods. Over two-thirds of the group (69%) with removal of PFT had a profile of typically mild dysarthria. Prominent speech deficits included consonant imprecision, reduced rate, monopitch and monoloudness. We conclude that speech deficits may persist even up to 10 years post-surgery in participants who have not shown mutism in the acute phase. Of cases with unilateral lesions, poorer outcomes were associated with right cerebellar tumours compared to left, consistent with the notion based on adult data that speech is controlled by reciprocal right cerebellar/left frontal interactions. These results confirm the important role of the cerebellum in the control of fine speech movements in children.

from Brain and Language

Classification of Speech and Language Profiles in 4-Year-Old Children With Cerebral Palsy: A Prospective Preliminary Study

Conclusions: The results of this study provide preliminary support for the classification of speech and language abilities of children with CP into 4 initial profile groups. Further research is necessary to validate the full classification system.

from the Journal of Speech, Language, and Hearing Research

Perception of speech disorders: Difference between the degree of intelligibility and the degree of severity

Conclusion: There is an argument for measuring intelligibility at the surface code level with a word recognition test or ordinal scales and for allowing the use of interval scales for severity judgment.

from Audiological Medicine

Communication disorders in the elderly

The percentage of elderly individuals in the general population is increasing because of rising average life expectancy. Elderly people today enjoy much more active and more communicative lives than previous generations. However, due to age related changes and the increasing prevalence of diseases affecting phonation, articulation, respiration, speech, deglutition and their neurological regulation mechanisms – dysphonia, dysarthria, aphasia/dysphasia and dysphagia, they are becoming more frequent in this population group. These communication disorders can cause social isolation, anxiety and depression. Patients and family members alike suffer from the negative impact these disorders have on communication and quality of life. The prevalence of age related voice problems in the elderly is reported to be as high as 20–47%, for speech and/or language problems 70–75%, and up to 40% for dysphagia. There is a growing need for effective therapeutic approaches to communication disorders in the elderly. Physiological age related changes, the causes of communication disorders in the elderly, their impact on daily life, and rehabilitative options are presented.

from Audiological Medicine