Listening like a speech-training app: Expert and non-expert listeners' goodness ratings of children's speech.

Speech training apps are being developed that provide automatic feedback concerning children's production of known target words, as a score on a 1-5 scale. However, this 'goodness' scale is still poorly understood. We investigated listeners' ratings of 'how many stars the app should provide as feedback' on children's utterances, and whether listener agreement is affected by clinical experience and/or access to anchor stimuli. In addition, we explored the association between goodness ratings and clinical measures of speech accuracy; the Percentage of Consonants Correct (PCC) and the Percentage of Phonemes Correct (PPC). Twenty speech-language pathologists and 20 non-expert listeners participated; half of the listeners in each group had access to anchor stimuli. The listeners rated 120 words, collected from children with and without speech sound disorder. Concerning reliability, intra-rater agreement was generally high, whereas inter-rater agreement was moderate. Access to anchor stimuli was associated with higher agreement, but only for non-expert listeners. Concerning the association between goodness ratings and the PCC/PPC, correlations were moderate for both listener groups, under both conditions. The results indicate that the task of rating goodness is difficult, regardless of clinical experience, and that access to anchor stimuli is insufficient for achieving reliable ratings. This raises concerns regarding the 1-5 rating scale as the means of feedback in speech training apps. More specific listener instructions, particularly regarding the intended context for the app, are suggested in collection of human ratings underlying the development of speech training apps. Until then, alternative means of feedback should be preferred.

Teaching a Child with Cochlear Implant to Read Words with Orthographic Difficulties / Ensino de Leitura de Palavras com Dificuldades Ortográficas para uma Criança com de Implante Coclear / Enseñanza de Lectura de Palabras con Dificultades Ortográficas para Niña Usuaria con Implante Coclear

Abstract Considering the effects of reading on the accuracy of the speech of deaf and hard and hearing children and cochlear implants presented in the scientific literature, the main aim of this study was to evaluate the effects of Module 2 of the ALEPP software regarding teaching words with orthographic difficulties to a cochlear implanted child. The participant was a girl, had nine years of age, with profound bilateral and sensorineural hearing loss. The program aims to teach contingencies of the selection of printed words and syllables conditioned to dictated words and syllables of six different stimuli sets; each set contained 16 words, with a total of 96 teaching words and 64 control words. Probes of 160 words were interspersed with the teaching steps according to the multiple probe design. The participant learned to read the 96 taught words, controlled by the words' minimal units. She presented maintenance of performance and reading generalization of the control words. The number of speech accuracy errors only decreased after the teaching intervention. The results replicated those of previous studies with orthographically easier words and future studies may explore the different types of training provided by the ALEPP and its effects on the accuracy of the speech of cochlear implanted children.

Resumo Considerando os efeitos do ensino de leitura sobre a precisão da fala de crianças com deficiência auditiva e implante coclear apresentados na literatura, o objetivo deste estudo foi verificar os efeitos do Módulo 2 do ALEPP® sobre a precisão da fala em leitura de palavras com dificuldades ortográficas a uma criança usuária de implante coclear. A participante tinha nove anos, com deficiência auditiva profunda, bilateral e sensorioneural. O programa expôs a contingências de ensino de seleção de palavras e sílabas impressas condicionalmente a palavras e sílabas ditadas com seis conjuntos de estímulos (ç, lh, ch, vLc, vNc e vRc); cada conjunto era composto por 16 palavras, totalizando 96 palavras de ensino; outras 64 palavras funcionaram como controle. Testes das 160 palavras intercalaram o ensino de acordo com o delineamento de múltiplas sondas. A participante aprendeu a ler as 96 palavras-alvo de ensino, com estabelecimento de controle pelas unidades mínimas alvo, manutenção de desempenho e generalização na leitura de palavras controle. Erros na precisão da fala diminuíram somente após o ensino. Os resultados replicam estudos anteriores com palavras simples e futuras investigações podem isolar os tipos de treino do ALEPP® e explorar seus efeitos sobre a precisão da fala e sobre o controle pelas unidades mínimas.

Resumen Considerando los efectos de la enseñanza de lectura sobre la precisión del habla en niños con deficiencia auditiva e implante coclear presentados en la literatura, el objetivo de este estudio fue verificar los efectos del Módulo 2 de ALEPP® sobre la enseñanza de lectura de palabras con dificultades ortográficas a una niña usuaria de implante coclear. La participante tenía nueve años, deficiencia auditiva profunda, bilateral y neurossensorial. El programa exposu a contingencias de enseñanza de selecciòn de palabras y silabas impresas condicionalmente a las palabras y silabas dictadas con seis conjuntos de estímulos; cada conjunto estaba compuesto por 16 palabras, totalizando 96 palabras de enseñanza; otras 64 palabras funcionaron como control. Las pruebas de las 160 palabras intercalaron la enseñanza de acuerdo con el delineamiento de múltiples sondas. La participante aprendió a leer las 96 palabras objetivo de enseñanza, con establecimiento de control por las unidades mínimas, mantenimiento de desempeño y generalización en la lectura de palabras control. Los errores en la precisión del habla disminuyeron sólo después de la inserción de la enseñanza. Los resultados replican estudios anteriores con palabras sin dificultades ortográficas y futuras investigaciones pueden explorar los efectos de los tipos de entrenamientos ofrecidos por el ALEPP® y sus efectos sobre la precisión del habla y el control por las unidades mínimas.

Effect of Anodal tDCS on Articulatory Accuracy, Word Production, and Syllable Repetition in Subjects with Aphasia: A Crossover, Double-Blinded, Sham-Controlled Trial.

INTRODUCTION: Transcranial direct-current stimulation (tDCS) has been used to modulate and induce changes in brain function and excitability. tDCS is a promising tool for the treatment of aphasia. OBJECTIVE: To evaluate whether tDCS improves articulatory accuracy and speech production in patients with aphasia after stroke. METHODS AND RESULTS: Twelve right-handed subjects participated in a double-blind, sham-controlled, crossover offline trial. We assessed (1) articulatory accuracy at a naming task, (2) number of words correctly produced, (3) number of syllables repeated correctly, and (4) qualitative assessment of speech. Articulatory accuracy improved when using tDCS over Broca's area in subjects with aphasia post-stroke (p ≤ 0.05). Qualitative improvement in the naming and syllable repetition tasks was observed, but the difference was not statistically significant (respectively, p = 0.15 and p = 0.79). CONCLUSION: The current results corroborate the potential of tDCS to be used as an alternative and complementary treatment for individuals with aphasia.

Movement kinematics and speech accuracy in a nonword repetition task in school-age children who stutter.

We investigated sensorimotor processes in school-age children who do (CWS) and do not stutter (CWNS) in a nonword repetition (NWR) task and evaluated changes in behavioral (percent speech accuracy) and speech kinematics measures (lip aperture variability, movement duration) with practice and retention. Thirteen CWS and 13 CWNS divided into two age groups (younger, 8-12 years; n = 6, older, 13-15 years, n = 7) repeated nonwords varying in phonological properties over two sessions separated by an hour. Participants in both groups also completed several baseline measures, including tests of digit span and nonword repetition (NRT). A marginal trend for lower speech accuracy was noted in the CWS compared to the CWNS in the NWR task. The younger CWS also performed poorly compared to the older CWS and age-matched CWNS in the NRT. Findings provided weak support for limitations in initial encoding and subsequent retrieval of phonemic information. The CWS demonstrated significantly reduced inter-articulatory coordination for the 3-syllable nonwords. While both groups demonstrated significantly slower movements with increase in nonword complexity at the 3-syllable level, such differences were enhanced in the CWS group and influenced further by participant age. Additionally, digit span influenced movement coordination in both groups with only the CWNS showing a significant negative correlation between the digit span scores and movement variability at the onset of practice in Session 1. The findings offer limited support for a sensorimotor integration deficit in CWS and the contributions of cognitive mechanisms to performance in NWR.

Improving oral sentence production in children with cochlear implants: effects of equivalence-based instruction and matrix training.

ᅟ: Children who use cochlear implants (CI) and who are readers usually produce more accurate speech in response to text than to pictures. Equivalence-based instruction (EBI) can be a route to establish functional interdependence between these verbal operants. The present study investigated whether children with CI who read would improve speech accuracy when tacting pictures of scenes after EBI that included dictated sentences, pictures of scenes, and printed sentences. This study evaluated whether teaching verbal relations to diagonal sentences from a matrix with subject-verb-object combinations promoted recombinative generalization to untrained sentences. Participants were three children with CI with a more accurate speech when reading print than when tacting pictures of scenes. They were taught to select pictures of scenes in response to dictated sentences (AB) by matching-to-sample (MTS) and to construct printed sentences in response to dictated sentences (AE) by constructed-response-matching-to-sample (CRMTS). Speech production in response to print (CD) and in response to pictures of scenes (BD) were probed for both trained and untrained sentences, using a multiple baseline design across participants. All participants learned the trained relations, showed emergence of derived relations, and improved speech accuracy when tacting pictures of scenes. They were able to recombine sentence components and tact novel pictures using untrained sentences from the matrix. These results indicate that speech accuracy and generative sentence production can be improved in children with CI from interventions that incorporate EBI and matrix training. TRIAL REGISTRATION: CAAE#01454412.0.0000.5441 registered 01/29/2013.

Improving oral sentence production in children with cochlear implants: effects of equivalence-based instruction and matrix training

Abstract Children who use cochlear implants (CI) and who are readers usually produce more accurate speech in response to text than to pictures. Equivalence-based instruction (EBI) can be a route to establish functional interdependence between these verbal operants. The present study investigated whether children with CI who read would improve speech accuracy when tacting pictures of scenes after EBI that included dictated sentences, pictures of scenes, and printed sentences. This study evaluated whether teaching verbal relations to diagonal sentences from a matrix with subject-verb-object combinations promoted recombinative generalization to untrained sentences. Participants were three children with CI with a more accurate speech when reading print than when tacting pictures of scenes. They were taught to select pictures of scenes in response to dictated sentences (AB) by matching-to-sample (MTS) and to construct printed sentences in response to dictated sentences (AE) by constructed-response-matching-to-sample (CRMTS). Speech production in response to print (CD) and in response to pictures of scenes (BD) were probed for both trained and untrained sentences, using a multiple baseline design across participants. All participants learned the trained relations, showed emergence of derived relations, and improved speech accuracy when tacting pictures of scenes. They were able to recombine sentence components and tact novel pictures using untrained sentences from the matrix. These results indicate that speech accuracy and generative sentence production can be improved in children with CI from interventions that incorporate EBI and matrix training. Trial registration CAAE#01454412.0.0000.5441 registered 01/29/2013.

Practice and retention of nonwords in adults who stutter.

PURPOSE: We investigated short-term practice and retention of nonwords in 10 adults who stutter (Mean age=30.7 years, SD=15.1) and age and sex-matched 10 control participants (Mean age=30.8 years, SD=14.9). METHODS: Participants were required to repeat nonwords varying in length (3, 4, and 6 syllables), phonotactic constraint (PC vs. NPC, on 3-syllable nonwords only), and complexity (simple, complex). They were tested twice with 1h gap between sessions. RESULTS: Logistic mixed model of speech accuracy revealed that the AWS showed a significantly lower probability of correct responses with increasing length and complexity. Analysis of speech kinematics revealed practice effects within Session 1 in AWS seen as a reduction in movement variability for the 3-syllable nonwords; the control group was performing at ceiling at this length. For the 4-syllable nonwords, the control group showed a significant reduction in movement variability with practice, and retained this reduction in Session 2, while the AWS group did not show practice or retention. Group differences were not evident at the 6-syllable level. CONCLUSIONS: Group differences in speech accuracy suggest differences in phonemic encoding and/or speech motor processes. Group differences in changes in movement variability within and between sessions suggest reduced practice and retention in AWS. Relevance of the combined use of both behavioral and kinematic measures to interpret the nature of the skill acquisition deficit in persons who stutter is discussed. EDUCATIONAL OBJECTIVES: At the end of this activity the reader will be able to: (a) summarize the process of skill acquisition; (b) discuss the literature on skill acquisition deficits in adults who stutter, (c) summarize the differences between AWS and control participants in speech accuracy and speech kinematics with short-term practice and retention of nonwords, (d) discuss potential research directions in the area of skill acquisition in AWS.

Nonword repetition and nonword reading abilities in adults who do and do not stutter.

PURPOSE: In the present study a nonword repetition and a nonword reading task were used to investigate the behavioral (speech accuracy) and speech kinematic (movement variability measured as lip aperture variability index; speech duration) profiles of groups of young adults who do (AWS) and do not stutter (control). METHOD: Participants were 9 AWS (8 males, Mean age=32.2, SD=14.7) and 9 age- and sex-matched control participants (Mean age=31.8, SD=14.6). For the nonword repetition task, participants were administered the Nonword Repetition Test (Dollaghan & Campbell, 1998). For the reading task, participants were required to read out target nonwords varying in length (6 vs. 11 syllables). Repeated measures analyses of variance were conducted to compare the groups in percent speech accuracy for both tasks; only for the nonword reading task, the groups were compared in movement variability and speech duration. RESULTS: The groups were comparable in percent accuracy in nonword repetition. Findings from nonword reading revealed a trend for the AWS to show a lower percent of accurate productions compared to the control group. AWS also showed significantly higher movement variability and longer speech durations compared to the control group in nonword reading. Some preliminary evidence for group differences in practice effect (seen as differences between the early vs. later 5 trials) was evident in speech duration. CONCLUSIONS: Findings suggest differences between AWS and control groups in phonemic encoding and/or speech motor planning and production. Findings from nonword repetition vs. reading highlight the need for careful consideration of nonword properties. EDUCATIONAL OBJECTIVES: At the end of this activity the reader will be able to: (a) summarize the literature on nonword repetition skills in adults who stutter, (b) describe processes underlying nonword repetition and nonword reading, (c) summarize whether or not adults who stutter differ from those who do not in the behavioral and kinematic markers of nonword reading performance, (d) discuss future directions for research.