Understanding speech disorders for clinical practice

Speech is the vocal utterance of language and it is considered disordered in three underlying ways: voice, articulation, and fluency, its disorder is to be studied from same pattern. The features that should be considered in determining a voice disorder are: Volume: how loudly or softly we speak, Pitch: how pleasant or unpleasant Quality: the highness or lowness of one’s voice, Rate: the speed at which one speaks. Homeoapthic repertory shows these symptoms, but caution is mechanical problem should not consider as dynamic derangement.

Pauta de pesquisa para apraxia del habla infantil en hispanohablantes: traducción y validación cultural / Check list for childhood apraxia of speech in spanish-speaking population: translation and validation

La apraxia del habla infantil (AHI) es un trastorno pediátrico poco común, en el que, si el niño o niña no es diagnosticado a tiempo, puede desencadenar graves consecuencias a futuro. Los métodos de diagnóstico existentes para este trastorno se encuentran disponibles en idiomas distintos al español, lo que conlleva una dificultad para encontrar un método de diagnóstico válido y consensuado por los fonoaudiólogos para aplicarse a la población hispanohablantes. Es por estoque este estudio pretende dar un primer aporte, realizando la traducción de una herramienta de pesquisa apta para el idioma español, que permita facilitar la labor fonoaudiológica en el diagnóstico. El método que se utilizará es el de traducción y validación de una herramienta de evaluación en salud, al cual se va a incorporar el análisis de un panel de expertos para brindarle validez al instrumento. Los resultados muestran una amplia aceptación del instrumento (94%resultados positivos) con un buen acuerdo entre jueces (IRR inter rater reliability) presentada como probabilidad de acuerdo para todo el instrumento de 0,57 (57%). En conclusión, este estudio brinda una pauta de pesquisa para la AHI, con el fin de facilitar la evaluación fonoaudiológica temprana de los niños y niñas, permitiendo que los usuarios puedan acceder a una atención especializada y confiable acordes con el diagnóstico.

Childhood apraxia of speech (CAS), is a rare disorder during childhood, and it can trigger serious consequences in the future if not treated promptly. The existing diagnostic methods for this disorder are found in the English language only, which leads to difficulties in finding valid and agreed diagnostic methods by speech therapists to apply to the Spanish-speaking population. Hence, this study aims to provide the translation of an evaluation tool which is suitable for Spanish-speaking countries and that facilitates phonoaudiological work in the diagnosis. The method that will be used is that of translation-retranslation, to which the analysis of an expert opinion will be incorporated to give validity to the instrument. The results expose a wide acceptance of the instrument (94% of positive results) with substantial agreement among experts (IRR inter rater reliability), presented as agreement probability for the entire instrument of 0.57 (57%). In conclusion, this study provides a research pattern for AHI, to facilitate the early phonoaudiological evaluation of children, allowing the patients to access reliable care regarding to diagnosis.

Rate and rhythm control strategies for apraxia of speech in nonfluent primary progressive aphasia / Estratégias de controle de ritmo e taxa de fala para a apraxia de fala na afasia progressiva primária não-fluente

ABSTRACT The nonfluent/agrammatic variant of primary progressive aphasia is characterized by apraxia of speech and agrammatism. Apraxia of speech limits patients' communication due to slow speaking rate, sound substitutions, articulatory groping, false starts and restarts, segmentation of syllables, and increased difficulty with increasing utterance length. Speech and language therapy is known to benefit individuals with apraxia of speech due to stroke, but little is known about its effects in primary progressive aphasia. This is a case report of a 72-year-old, illiterate housewife, who was diagnosed with nonfluent primary progressive aphasia and received speech and language therapy for apraxia of speech. Rate and rhythm control strategies for apraxia of speech were trained to improve initiation of speech. We discuss the importance of these strategies to alleviate apraxia of speech in this condition and the future perspectives in the area.

RESUMO A variante não-fluente/agramática da afasia progressiva primária caracteriza-se por apraxia de fala e agramatismo. A apraxia de fala limita a comunicação devido a redução no fluxo de fala, substituição de sons, tentativas articulatórias, falsos inícios de fala e reinícios, segmentação de sílabas, e aumento da dificuldade conforme o aumento do enunciado. A terapia fonoaudiológica é benéfica em casos de apraxia de fala decorrentes de acidente vascular cerebral, porém pouco se sabe sobre seus efeitos na afasia progressiva primária. Este artigo é um relato de caso de uma mulher de 72 anos, analfabeta e trabalhadora do lar, que foi diagnosticada com afasia progressiva não-fluente e recebeu terapia fonoaudiológica para apraxia de fala. Estratégias de controle do ritmo e da taxa de fala foram utilizadas a fim de melhorar a iniciação da fala. A importância de estratégias para minimizar a apraxia de fala e as perspectivas futuras na área são discutidas neste artigo.

Corticobasal Syndrome Initially Presenting with Apraxia of Speech

Apraxia of speech is a disorder of speech programming and planning. We report a 64-year-old woman presenting with progressive apraxia of speech that evolved into right-side-dominant akinesia-rigidity syndrome over a 7-year period. Her motor symptoms were highly consistent with corticobasal syndrome, and neuroimaging revealed atrophy and hypometabolism in the left premotor and supplementary motor areas, which are relevant to apraxia of speech. This case illustrates that apraxia of speech may be an initial manifestation of corticobasal syndrome.

Speech Evaluation for Apraxia of Speech with Chinese / 中国康复理论与实践

Objective To explore the evaluation for apraxia of speech (AOS) with Chinese. Methods 20 Chinese cases with AOS were assessed with Chinese material referred from Motor Speech Evaluation (MSE) using. Results The subtest of multiple repetitions of multisyl-labic words was the most difficult and single repetitions of monosyllabic words was the easiest for AOS patients (P<0.05). The score of the short sentences negatively correlated with both the scores of repetition ability (r=-0.865) and the fluency of speech (r=-0.614) (P<0.001). Conclusion Chinese material referred from MSE can be used for evaluation of AOS with Chinese.

Pure Apraxia of Speech: A Case Report

Apraxia of speech (AOS) is the impairment of motor programming. However, the exact nature of this deficit remains unclear. In particular, AOS without other speech-language deficit is called pure AOS, but it is very rare. When diagnosing AOS, the characteristic of articulation is considered a crucial criterion, which has been proposed for differentiating AOS from phonological and dysarthric disorders. The present study reports on pure AOS in a 37-year-old right-handed male after a left insular, front, temporal infarction. This report may be useful for further AOS study and diagnosis in the clinical setting.

The relationship between working memory and apraxia of speech / A interrelação entre memória operacional e apraxia de fala

The present study aimed to verify the relationship between working memory (WM) and apraxia of speech and explored which WM components were involved in the motor planning of speech. A total of 22 patients and 22 healthy adults were studied. These patients were selected according to the following inclusion criteria: a single brain lesion in the left hemisphere, presence of apraxia of speech and sufficient oral comprehension. This study involved assessment of apraxia of speech and evaluation of working memory capacity. The performance of apraxic patients was significantly poorer than that of controls, where this reached statistical significance. The study concluded that participants with apraxia of speech presented a working memory deficit and that this was probably related to the articulatory process of the phonoarticulatory loop. Furthermore, all apraxic patients presented a compromise in working memory.

O objetivo do presente estudo foi verificar a interrelação entre memória operacional e apraxia verbal e explorar quais os componentes desta memória estariam envolvidos na programação motora da fala. Foram avaliados 22 pacientes apráxicos e 22 controles. Todos os participantes foram submetidos a avaliação da apraxia de fala. Para investigar a memória operacional, foram aplicados o teste de span de dígitos na ordem direta e inversa, um teste de repetição de palavras longas e curtas e o Rey Auditory Verbal Learning Test, que investiga, além da alça articulatória, o buffer episódico. O desempenho dos apráxicos em todos os testes de memória foi estatisticamente significante mais baixo que o desempenho dos controles. Concluímos que indivíduos com apraxia apresentam um déficit na memória operacional e que este déficit está mais relacionado ao processo articulatório da alça fonoarticulatória.

Effect of Character Communication on Apraxia of Speech:A Case Report / 中国康复理论与实践

@#Objective To observe the effect of character communication on apraxia of speech.Methods A case reported.Results and Conclusion Character communication can improve the speech of the apraxia of speech.

Habilidades práxicas orofaciais na infância / Non verbal oral abilities in childhood

A apraxia orofacial é a inabilidade para executar qualquer movimentação envolvendo estruturas dos órgãos fonoarticulatórios, decorrente de alteração do Sistema Nervoso Central. Em muitos casos, a avaliação das habilidades práxicas orofaciais é fundamental para complementar o diagnóstico fonoaudiológico, principalmente em crianças com distúrbios articulatórios. A proposta deste trabalho foi verificar como crianças pequenas, sem alterações neurológicas, são capazes de realizar adequadamente movimentos de órgãos fonoarticulatórios ditos práxicos. Foram avaliadas 60 crianças com idade de 3 a 4 anos e 11 meses, em amostra homogênea quanto à idade e ao sexo. Dos oito movimentos práxicos orofaciais propostos, as crianças de 3 anos realizaram média de 3,5±1,9 exercícios, e crianças de 4 anos, média de 4,9±1,7. Com este trabalho esperamos ter contribuído para o estabelecimento de parâmetros de normalidade em relação às habilidades práxicas orofaciais que possam ser utilizados na prática clínica.

Non Verbal Oral Abilities In Childhood: Non verbal apraxia is a deficit in the ability of sequencing oral movements usually related to brain lesion. In many cases, the assessment of non verbal apraxia is important to diagnosis, adding important information essentially in children with deficits in speech production. The aim of this study was to identify the performance of young children, without neurological impairments, in non verbal oral movements execution. Sixthy children aged from 3 to 4 years and 11 months old were assessed with a battery composed by eight non verbal movements. Children with 3 years old performed 3,5±1,9 movements, and children with 4 years old performed 4,9±1,7 movements. With this study we could find parameters of normal children non verbal oral gesture production that can be used in a clinical assessment of speech.

Pure Apraxia of Speech after the Left Insular Infarction

Apraxia of speech (AOS) is a disorder in programming the speech musculature to produce the correct sounds of words in the proper sequence. Pure AOS without other speech-language deficit is very rare. We report a patient with AOS without aphasia developed after the left insular infarction. For the case of impaired speech production, AOS should be recognized as a differential diagnosis. Correct diagnosis and early institution of speech therapy may have important implications in the prognosis of AOS.

A Case of Frontotemporal Dementia Presenting with Apraxia of Speech

Apraxia of speech (AOS) is a speech disorder due to an impaired ability to program the positioning of the speech musculature and the sequencing of muscle movements. It differs from dysarthria because speech errors are inconsistent depending on the locus of the sound. We report a 66-year-old man who presented with AOS which evolved into frontotemporal dementia 5 years later. Initial neuropsychological test showed mainly buccofacial apraxia and frontal lobe dysfunction. Brain FDG-PET disclosed hypometabolism in frontotemporal region.