Intensive Voice Treatment (Lee Silverman Voice Treatment [LSVT LOUD]) for Children With Down Syndrome: Phase I Outcomes.

PURPOSE: This study examined the effects of an intensive voice treatment Lee Silverman Voice Treatment (LSVT LOUD) on children with Down syndrome (DS) and motor speech disorders. METHOD: A Phase I, multiple baseline, single-subject design with replication across nine participants with DS was used. Single-word intelligibility, acoustic measures of vocal functioning, and parent perceptions of pre- and posttreatment communication function were used as treatment outcome measures. RESULTS: All participants completed the full dose of LSVT LOUD and showed gains on one or more of the outcome measures. Patterns of posttreatment improvements were not consistent across participants but were more frequently observed on trained maximum performance tasks compared to tasks reflecting generalization of the treatment skillset. Some participants exhibited a stronger response to treatment, whereas others showed a mixed or weaker response. Parents liked the treatment protocol, perceived benefits from intensive intervention, and indicated they would strongly recommend LSVT LOUD to other parents who have children with DS and motor speech disorders. CONCLUSIONS: These preliminary results show that children with DS tolerated intensive voice treatment without adverse effects and made select meaningful therapeutic gains. The treatment evidence from this study warrants Phase II treatment studies using LSVT LOUD with a larger group of children with DS.

Changes in Intermuscular Coherence as a Function of Age and Phase of Speech Production During an Overt Reading Task.

PURPOSE: The authors evaluated changes in intermuscular coherence (IMC) of orofacial and speech breathing muscles across phase of speech production in healthy younger and older adults. METHOD: Sixty adults (30 younger = M: 26.97 year; 30 older = M: 66.37 year) read aloud a list of 40 words. IMC was evaluated across phase: preparation (300 ms before speech onset), initiation (300 ms after onset), and total execution (entire word). RESULTS: Orofacial IMC was lowest in the initiation, higher in preparation, and highest for the total execution phase. Chest wall IMC was lowest for the preparation and initiation and highest for the total execution phase. Despite age-related differences in accuracy, neuromuscular modulation for phase was similar between groups. CONCLUSION: These results expand our knowledge of speech motor control by demonstrating that IMC is sensitive to phase of speech planning and production.

Associations Between Voice and Gestural Characteristics of Transgender Women and Self-Rated Femininity, Satisfaction, and Quality of Life.

Purpose Client-based subjective ratings of treatment and outcomes are becoming increasingly important as speech-language pathologists embrace client-centered care practices. Of particular interest is the value in understanding how these ratings are related to aspects of gender-affirming voice and communication training programs for transgender and gender-diverse individuals. The purpose of this observational study was to explore relationships between acoustic and gestural communication variables and communicator-rated subjective measures of femininity, communication satisfaction, and quality of life (QoL) among transfeminine communicators. Method Twelve acoustic and gestural variables were measured from high-fidelity audio and motion capture recordings of transgender women (n = 20) retelling the story of a short cartoon. The participants also completed a set of subjective ratings using a series of Likert-type rating scales, a generic QoL questionnaire, and a population-specific voice-related QoL questionnaire. Correlational analyses were used to identify relationships between the communication measures and subjective ratings. Results A significant negative relationship was identified between the use of palm-up hand gestures and self-rated satisfaction with overall communication. The acoustic variable of average semitone range was positively correlated with overall QoL. No acoustic measures were significantly correlated with voice-related QoL, and unlike previous studies, speaking fundamental frequency was not associated with any of the subjective ratings. Conclusions The results from this study suggest that voice characteristics may have limited association with communicator-rated subjective measures of communication satisfaction or QoL for this population. Results also provide preliminary evidence for the importance of nonverbal communication targets in gender-affirming voice and communication training programs.

Effects of an intensive voice treatment on articulatory function and speech intelligibility in children with motor speech disorders: A phase one study.

Producing speech that is clear, audible, and intelligible to others is a challenge for many children with cerebral palsy (CP) and children with Down syndrome (DS). Previous studies have demonstrated the effectiveness of using the Lee Silverman Voice Treatment (LSVT LOUD®) to increase vocal loudness and improve speech intelligibility in individuals with dysarthria secondary to Parkinson's disease (PD), and some research suggests that it also may be effective for individuals with dysarthria secondary to other conditions, including CP and DS. Although LSVT LOUD targets healthy vocal loudness, there is some evidence of spreading effects to the articulatory system. Acoustic data from two groups of children with secondary motor speech disorders [one with CP (n = 17) and one with DS (n = 9)] who received a full dose of LSVT LOUD and for whom post-treatment intelligibility gains have been previously reported, were analyzed for treatment effects on: 1) vowel duration, 2) acoustic vowel space and 3) the ratio of F2/i/ to F2/u/. Statistically significant changes in vowel duration and acoustic vowel space occurred pre-treatment to 12 weeks post-treatment in the CP group, and increased acoustic vowel space was observed in 5 of the DS participants. The present study provides preliminary evidence of intensive voice treatment spreading effects to the articulatory system in some children with CP and children with DS consistent with previous findings in other populations.

Contributions of Voice and Nonverbal Communication to Perceived Masculinity-Femininity for Cisgender and Transgender Communicators.

Purpose The purpose of this study was twofold: (a) to identify a set of communication-based predictors (including both acoustic and gestural variables) of masculinity-femininity ratings and (b) to explore differences in ratings between audio and audiovisual presentation modes for transgender and cisgender communicators. Method The voices and gestures of a group of cisgender men and women (n = 10 of each) and transgender women (n = 20) communicators were recorded while they recounted the story of a cartoon using acoustic and motion capture recording systems. A total of 17 acoustic and gestural variables were measured from these recordings. A group of observers (n = 20) rated each communicator's masculinity-femininity based on 30- to 45-s samples of the cartoon description presented in three modes: audio, visual, and audio visual. Visual and audiovisual stimuli contained point light displays standardized for size. Ratings were made using a direct magnitude estimation scale without modulus. Communication-based predictors of masculinity-femininity ratings were identified using multiple regression, and analysis of variance was used to determine the effect of presentation mode on perceptual ratings. Results Fundamental frequency, average vowel formant, and sound pressure level were identified as significant predictors of masculinity-femininity ratings for these communicators. Communicators were rated significantly more feminine in the audio than the audiovisual mode and unreliably in the visual-only mode. Conclusions Both study purposes were met. Results support continued emphasis on fundamental frequency and vocal tract resonance in voice and communication modification training with transgender individuals and provide evidence for the potential benefit of modifying sound pressure level, especially when a masculine presentation is desired.

Acoustic Predictors of Gender Attribution, Masculinity-Femininity, and Vocal Naturalness Ratings Amongst Transgender and Cisgender Speakers.

PURPOSE: This study aimed to identify the most salient set of acoustic predictors of (1) gender attribution; (2) perceived masculinity-femininity; and (3) perceived vocal naturalness amongst a group of transgender and cisgender speakers to inform voice and communication feminization training programs. This study used a unique set of acoustic variables and included a third, androgynous, choice for gender attribution ratings. METHOD: Data were collected across two phases and involved two separate groups of participants: communicators and raters. In the first phase, audio recordings were captured of communicators (n = 40) during cartoon retell, sustained vowel, and carrier phrase tasks. Acoustic measures were obtained from these recordings. In the second phase, raters (n = 20) provided ratings of gender attribution, perceived masculinity-femininity, and vocal naturalness based on a sample of the cartoon description recording. RESULTS: Results of a multinomial logistic regression analysis identified mean fundamental frequency (fo) as the sole acoustic measure that changed the odds of being attributed as a woman or ambiguous in gender rather than as a man. Multiple linear regression analyses identified mean fo, average formant frequency of /i/, and mean sound pressure level as predictors of masculinity-femininity ratings and mean fo, average formant frequency, and rate of speech as predictors of vocal naturalness ratings. CONCLUSION: The results of this study support the continued targeting of fo and vocal tract resonance in voice and communication feminization/masculinization training programs and provide preliminary evidence for more emphasis being placed on vocal intensity and rate of speech. Modification of these voice parameters may help clients to achieve a natural-sounding voice that satisfactorily represents their affirmed gender.

Differential Cortical Control of Chest Wall Muscles During Pressure- and Volume-Related Expiratory Tasks and the Effects of Acute Expiratory Threshold Loading.

We examined whether or not coherence between chest wall intercostal and oblique muscles changed as a function of lung volume excursion, alveolar pressure, and muscular demand. We also assessed the effects of acute expiratory threshold loading (ETL) on chest wall muscular control. A total of 15 healthy adults (7 males; average age = 28 years) completed maximum performance and ETL tasks. Chest wall surface electromyographic and kinematic recordings were made. Participants also performed a session of acute ETL. We showed that corticomuscular control of the chest wall varied as a function of lung volume excursion and muscular effort. Acute ETL had some effect on respiratory kinematics but not coherence.

Transcranial direct current stimulation (tDCS) selectively modulates semantic information during reading.

The left angular gyrus has long been implicated in semantic processing. Here we tested whether or not transcranial direct current stimulation (tDCS) over the left angular gyrus modulated reading performance. Adult readers (N = 77) (1) read aloud words that varied in degree of imageability, a semantic word property known to activate the angular gyrus, and (2) completed an N-back task (control task). Individuals were randomly assigned to either the anodal, cathodal or sham stimulation conditions. We found that anodal (p = 0.001) and cathodal (p < 0.001) stimulation impacted how imageability facilitates reading times such that readers who showed the largest imageability effects pre-stimulation showed the greatest reduction in these effects post-stimulation. No effects of stimulation were found in the sham group (p > 0.05) or for the control task (i.e., N-back; p > 0.05). These findings indicate that reading pathways can be modulated via brain stimulation (tDCS) to shift individuals' sensitivity to word-level characteristics, namely imageability.

Changes in White Matter Integrity following Intensive Voice Treatment (LSVT LOUD®) in Children with Cerebral Palsy and Motor Speech Disorders.

Preliminary evidence suggests that intensive voice and speech treatment based on activity-dependent neuroplasticity principles holds promise for affecting positive change in children with cerebral palsy (CP) and motor speech disorders. Diffusion tensor imaging (DTI) allows researchers to make inferences about the integrity of white matter tracks and provides a sensitive measure of neuroplasticity. Previous treatment studies looking at the effects of training on white matter integrity have shown positive results, but these studies have been limited to gross motor function. Eight children with motor speech disorders and CP (3 females; age 8-16 years) and an age- and sex-matched group of typically developing (TD) children participated. Each child with CP completed a full dose of LSVT LOUD® and a 12-week maintenance program. Participants attended 3 recording sessions: before and after treatment, and after the maintenance period. TD children were tested at the same 3 time points. Recording sessions for both groups of children included measures of white matter integrity using DTI and acoustic measures of voice and speech. Fractional anisotropy (FA) was measured for 2 motor tracts and 5 association tracts. In children with CP, we observed an increase in FA in several motor and association tracts immediately following treatment and 12 weeks after treatment. Acoustic data on untrained tasks were correlated with changes in FA detected immediately following treatment and after the 12-week maintenance program. These findings suggest that long-term practice of skills attained during the treatment phase enhances white matter tract integrity in speech production networks.

Changes in brain activity following intensive voice treatment in children with cerebral palsy.

Eight children (3 females; 8-16 years) with motor speech disorders secondary to cerebral palsy underwent 4 weeks of an intensive neuroplasticity-principled voice treatment protocol, LSVT LOUD® , followed by a structured 12-week maintenance program. Children were asked to overtly produce phonation (ah) at conversational loudness, cued-phonation at perceived twice-conversational loudness, a series of single words, and a prosodic imitation task while being scanned using fMRI, immediately pre- and post-treatment and 12 weeks following a maintenance program. Eight age- and sex-matched controls were scanned at each of the same three time points. Based on the speech and language literature, 16 bilateral regions of interest were selected a priori to detect potential neural changes following treatment. Reduced neural activity in the motor areas (decreased motor system effort) before and immediately after treatment, and increased activity in the anterior cingulate gyrus after treatment (increased contribution of decision making processes) were observed in the group with cerebral palsy compared to the control group. Using graphical models, post-treatment changes in connectivity were observed between the left supramarginal gyrus and the right supramarginal gyrus and the left precentral gyrus for the children with cerebral palsy, suggesting LSVT LOUD enhanced contributions of the feedback system in the speech production network instead of high reliance on feedforward control system and the somatosensory target map for regulating vocal effort. Network pruning indicates greater processing efficiency and the recruitment of the auditory and somatosensory feedback control systems following intensive treatment. Hum Brain Mapp 38:4413-4429, 2017. © 2017 Wiley Periodicals, Inc.

The Role of the Supplementary Motor Region in Overt Reading: Evidence for Differential Processing in SMA-Proper and Pre-SMA as a Function of Task Demands.

A differentiation in function between the pre-SMA (i.e., cognitive load) and the SMA-proper (i.e., motor execution) has been described (Zhang et al., Cereb Cortex 22:99-111, 2012). These differential SMA functions may be influential in overt reading tasks. The present study examined the relationships between various segments of the SMA and overt reading through the modulation of task demands in an effort to explore the complexity of the print-to-speech network. Skilled reading adults (N = 15) took part in five overt reading tasks: pure regular word reading, pure exception word reading, mixed regular word and exception word reading, go/no-go reading with nonword foils and go/no-go reading with pseudohomophone foils. Five regions of interest that spanned the pre-SMA to the SMA-proper were isolated. Behaviour-function relationships were tested to examine the associations between performance (response time) and brain activity (percent signal change). Further, the coherence between feedforward (SMA) and feedback (supramarginal gyrus) regions were explored to further refine the print-to-speech network. We found that the pre-SMA was related to cognitively demanding tasks (go/no-go with pseudohomophones), whereas the SMA-proper was related to an automatized task (pure regular words). Notably, only those tasks that required information from the feedback system (i.e., mixed word lists, go/no-go tasks) showed connections between SMA regions and the supramarginal gyrus, which is in line with the role of feedback and feedforward systems in the print-to-speech network. Together, these results support the notion that the pre-SMA and SMA-proper are sensitive to reading tasks that differentially invoke higher cognitive resources (mixed word lists, go/no-go) versus automatized articulation (pure lists), respectively. We discuss our findings in the context of print-to-speech neural networks.

Therapeutic effects of intensive voice treatment (LSVT LOUD®) for children with spastic cerebral palsy and dysarthria: A phase I treatment validation study.

PURPOSE: The aim of the present study was to validate and extend the evaluation of treatment outcomes following LSVT LOUD® in children with dysarthria secondary to cerebral palsy (CP). METHOD: Seven children (5 females, 6-10 years) with spastic quadriplegia and dysarthria received LSVT LOUD. Outcomes included: (a) quantitative and qualitative indices of communication and social functioning representing therapeutic effects and (b) features of the acoustic signal representing physiological effects on the speech mechanism. A matched group of typically developing children served as controls. Testing occurred just prior to (PRE), immediately following (POST), and at 12 weeks post-treatment (FUP). RESULT: Expert listeners preferred voice quality and articulatory precision of children with CP at FUP as compared to PRE. Acoustic data indicated improvements on select measures of vocal functioning at POST with some maintenance at FUP. Single word intelligibility improved immediately POST, but was not maintained at FUP. Parents rated positive changes in characteristics of voice and speech and qualitative changes in communication at both POST and FUP. CONCLUSION: The present study validated some of the previous LSVT LOUD outcomes in children with dysarthria and CP and extended our understanding of therapeutic effects through qualitative data obtained from extensive parent interviews.

Pretreatment Acoustic Predictors of Gender, Femininity, and Naturalness Ratings in Individuals With Male-to-Female Gender Identity.

PURPOSE: The purpose of this study was to describe the pretreatment acoustic characteristics of individuals with male-to-female gender identity (IMtFGI) and investigate the ability of the acoustic measures to predict ratings of gender, femininity, and vocal naturalness. METHOD: This retrospective descriptive study included 2 groups of participants. Speakers were IMtFGI who had not previously received communication feminization treatment (N = 25). Listeners were members of the lay community (N = 30). Acoustic data were retrospectively obtained from pretreatment recordings, and pretreatment recordings also served as stimuli for 3 perceptual rating tasks (completed by listeners). RESULTS: Acoustic data generally were within normal limits for male speakers. All but 2 speakers were perceived to be male, limiting information about the relationship between acoustic measures and gender perception. Fundamental frequency (reading) significantly predicted femininity ratings (p = .000). A total of 3 stepwise regression models indicated that minimum frequency (range task), second vowel formant (sustained vowel), and shimmer percentage (sustained vowel) together significantly predicted naturalness ratings (p = .005, p = .003, and p = .002, respectively). CONCLUSIONS: Study aims were achieved with the exception of acoustic predictors of gender perception, which could be described for only 2 speakers. Future research should investigate measures of prosody, voice quality, and other aspects of communication as predictors of gender, femininity, and naturalness.

Understanding the role of speech production in reading: Evidence for a print-to-speech neural network using graphical analysis.

OBJECTIVE: The neural circuitry associated with language processing is complex and dynamic. Graphical models are useful for studying complex neural networks as this method provides information about unique connectivity between regions within the context of the entire network of interest. Here, the authors explored the neural networks during covert reading to determine the role of feedforward and feedback loops in covert speech production. METHOD: Brain activity of skilled adult readers was assessed in real word and pseudoword reading tasks with functional MRI (fMRI). RESULTS: The authors provide evidence for activity coherence in the feedforward system (inferior frontal gyrus-supplementary motor area) during real word reading and in the feedback system (supramarginal gyrus-precentral gyrus) during pseudoword reading. Graphical models provided evidence of an extensive, highly connected, neural network when individuals read real words that relied on coordination of the feedforward system. In contrast, when individuals read pseudowords the authors found a limited/restricted network that relied on coordination of the feedback system. CONCLUSION: Together, these results underscore the importance of considering multiple pathways and articulatory loops during language tasks and provide evidence for a print-to-speech neural network. (PsycINFO Database Record

Simultaneous Measurement of Breathing Kinematics and Surface Electromyography of Chest Wall Muscles during Maximum Performance and Speech Tasks in Children: Methodological Considerations.

OBJECTIVE: To develop a standardized paediatric protocol for acquiring simultaneous chest wall kinematics and surface electromyography (EMG) of chest wall muscles during maximum performance and speech tasks. PATIENTS AND METHODS: Eighteen healthy participants included: (a) a younger age group (n = 6; ages 4.0-6.5 years), (b) an older age group (n = 6; ages 7.0-10.5 years), and (c) an adult group (n = 8; ages 21-33 years). A child (age 10 years) with spastic-type cerebral palsy (CP) served as a 'proof of protocol feasibility'. Chest wall kinematics and surface EMGs (intercostals, rectus abdominus, external oblique, latissimus dorsi, and erector spinae) were acquired during maximum performance and speech tasks. RESULTS: Successful calibration of the EMG signal and reliable detection of muscle activation onset, offset, and amplitude relative to vital capacity and percent maximum voluntary contraction in children were demonstrated. Kinematic and surface EMG measurements were sensitive to non-speech and speech tasks, age, and neurological status (i.e. CP). CONCLUSION: The simultaneous measurement of kinematics and EMG of the chest wall muscle groups provides a more comprehensive description of speech breathing in children. This protocol can be used for the observation and interpretation of clinical outcomes seen in children with motor speech disorders following treatments that focus on increasing overall respiratory and vocal effort.

Individual and environmental contributions to treatment outcomes following a neuroplasticity-principled speech treatment (LSVT LOUD) in children with dysarthria secondary to cerebral palsy: a case study review.

This study describes the use of a neuroplasticity-principled speech treatment approach (LSVT(®)LOUD) with children who have dysarthria secondary to cerebral palsy. To date, the authors have treated 25 children with mild-to-severe dysarthria, a continuum of gross and fine motor functions, and variable cognitive abilities. From this data set, two case studies are presented that represent as weak or strong responders to LSVT LOUD. These case studies demonstrate how individual and environmental features may impact immediate and lasting responses to treatment. Principles that drive activity-dependent neuroplasticity are embedded in LSVT LOUD and may contribute to positive therapeutic and acoustic outcomes. However, examination of the response patterns indicated that intensity (within and across treatment sessions) is necessary but not sufficient for change. Weak responders may require a longer treatment phase, better timing (e.g., developmentally, socially), and a more prominent desire to communicate successfully during daily activities. Strong responders appear to benefit from the intensity and saliency of treatment as well as from intrinsic and extrinsic rewards for using the trained skills for everyday communication. Finally, possibilities are presented for technological solutions designed to promote accessibility to the intensive task repetition and maintenance required to drive lasting changes.

Modulation of chest wall intermuscular coherence: effects of lung volume excursion and transcranial direct current stimulation.

Chest wall muscle recruitment varies as a function of the breathing task performed. However, the cortical control of the chest wall muscles during different breathing tasks is not known. We studied chest wall intermuscular coherence during various task-related lung volume excursions in 10 healthy adults (34 ± 15 yr; 2 men, 8 women) and determined if transcranial direct current stimulation (tDCS) could modulate chest wall intermuscular coherence during these tasks. Simultaneous assessment of regional intercostal and oblique electromyographic activity was measured while participants performed standardized tidal breathing, speech, maximum phonation, and vital capacity tasks. Lung volume and chest wall kinematics were determined using variable inductance plethysmography. We found that chest wall area of intermuscular coherence was greater during tidal and speech breathing compared with phonation and vital capacity (all P < 0.05) and between tidal breathing compared with speech breathing (P < 0.05). Anodal tDCS increased chest wall area of intermuscular coherence from 0.04 ± 0.09 prestimulation to 0.18 ± 0.19 poststimulation for vital capacity (P < 0.05). Sham tDCS and cathodal tDCS had no effect on coherence during lung volume excursions. Chest wall kinematics were not affected by tDCS. Our findings indicate that lung volume excursions about the midrange of vital capacity elicit a greater area of chest wall intermuscular coherence compared with lung volume excursions spanning the entire range of vital capacity in healthy adults. Our findings also demonstrate that brief tDCS may modulate the cortical control of the chest wall muscles in a stimulation- and lung volume excursion task-dependent manner but does not affect chest wall kinematics in healthy adults.

Understanding white matter integrity stability for bilinguals on language status and reading performance.

Recent studies using diffusion tensor imaging (DTI) have described overall white matter integrity in bilinguals but have not related structural neural pathways to language functions. The current study examined white matter integrity and its relationship to reading skill in monolingual English and bilingual Chinese-English speakers. Eleven monolingual speakers (mean age 28.5 years) and 13 bilingual speakers (mean age 24.2 years; English as a second language was acquired post 5 years of age) participated. Behavioural response times and accuracy rates to name regular and exception words were recorded. Participants were then scanned using a standardized DTI protocol. Fractional anisotropy (FA) and mean diffusivity values were derived from a voxelwise statistical analysis for comparisons between participant groups. Tests for relationships between response time and FA were also conducted. Our results show minimal regions of higher FA for monolinguals when compared to bilinguals and no regions of higher FA for bilinguals when compared to monolinguals, which indicates that white matter integrity may not stabilize in bilinguals until late adulthood. We do show several regions where an increase in FA is associated with faster response times. Interestingly, the FA-response time relationship varies between groups and between word types, which may reflect an increased processing demand for retrieval of difficult words (e.g., exception words). These results provide some support for the interference control and reduced frequency hypotheses outlined by Jones et al. (Cerebr Cortex 22:892-902, 2012). The current findings advance our understanding of the underlying cortical networks associated with language status and reading skill in monolingual and bilingual adults.

Current practices for evaluation of resonance disorders in North America.

Improving treatment outcomes for people with resonance problems (due to velopharyngeal disorders) is a priority for many speech-language pathologists (SLPs), but there exists a limited understanding of the practices SLPs are using to assess and monitor therapeutic effects in this population. The current study was designed to answer the following questions: (1) What are current clinical practices versus best practices for assessing resonance disorders, tracking therapeutic effects, and determining discharge criteria? (2) What assessment practices would SLPs prefer to use with clients who have resonance disorders? (3) What are barriers to SLPs' use of best practices? and (4) What effects do SLP demographics have on clinical practices? Thirty-eight SLPs, specializing in the treatment of resonance disorders, participated in the study. Responses were compared with best practice recommendations derived from the literature. Most clinicians were using low-tech assessment tools, often because they lacked access to high-tech tools. Demographics and training did not affect clinical assessment practices. There is a need to increase the availability of high-tech assessment tools to SLPs practicing in the area of resonance disorders, as consistent use of sophisticated assessment devices would exemplify contemporary thinking about the transfer of knowledge to practice in this area.

Syllable-related breathing in infants in the second year of life.

PURPOSE: This study explored whether breathing behaviors of infants within the 2nd year of life differ between tidal breathing and breathing supporting single unarticulated syllables and canonical/articulated syllables. METHOD: Vocalizations and breathing kinematics of 9 infants between 53 and 90 weeks of age were recorded. A strict selection protocol was used to identify analyzable breath cycles. Syllables were categorized on the basis of consensus coding. Inspiratory and expiratory durations, excursions, and slopes were calculated for the 3 breath cycle types and were normalized using mean tidal breath measures. RESULTS: Tidal breathing cycles were significantly different from syllable-related cycles on all breathing measures. There were no significant differences between unarticulated syllable cycles and canonical syllable cycles, even after controlling for utterance duration and sound pressure level. CONCLUSIONS: Infants in the 2nd year of life exhibit clear differences between tidal breathing and speech-related breathing, but categorically distinct breath support for syllable types with varying articulatory demands was not evident in the present findings. Speech development introduces increasingly complex utterances, so older infants may produce detectable articulation-related adaptations of breathing kinematics. For younger infants, breath support may vary systematically among utterance types, due more to phonatory variations than to articulatory demands.