Effect of Voice and Articulation Parameters of a Home-Based Serious Game for Speech Therapy in Children With Articulation Disorder: Prospective Single-Arm Clinical Trial.

BACKGROUND: Articulation disorder decreases the clarity of language and causes a decrease in children's learning and social ability. The demand for non-face-to-face treatment is increasing owing to the limited number of therapists and geographical or economic constraints. Non-face-to-face speech therapy programs using serious games have been proposed as an alternative. OBJECTIVE: The aim of this study is to investigate the efficacy of home therapy on logopedic and phoniatric abilities in children with articulation disorder using the Smart Speech game interface. METHODS: This study is a prospective single-arm clinical trial. Children with articulation disorders, whose Urimal Test of Articulation and Phonology (U-TAP) was -2 SDs or less and the Receptive and Expressive Vocabulary Test score was -1 SD or more, were enrolled. A preliminary evaluation (E0) was conducted to check whether the children had articulation disorders, and for the next 4 weeks, they lived their usual lifestyle without other treatments. Prior to the beginning of the training, a pre-evaluation (E1) was performed, and the children trained at home for ≥30 minutes per day, ≥5 times a week, over 4 weeks (a total of 20 sessions). The Smart Speech program comprised oral exercise training, breathing training, and speech training; the difficulty and type of the training were configured differently according to the participants' articulation error, exercise, and vocal ability. After the training, postevaluation (E2) was performed using the same method. Finally, 8 weeks later, postevaluation (E3) was performed as a follow-up. A voice evaluation included parameters such as maximum phonation time (MPT), fundamental frequency (F0), jitter, peak air pressure (relative average perturbation), pitch, intensity, and voice onset time. Articulation parameters included a percentage of correct consonants (PCC; U-TAP word-unit PCC, U-TAP sentence-unit PCC, and three-position articulation test) and alternate motion evaluation (diadochokinesis, DDK). Data obtained during each evaluation (E1-E2-E3) were compared. RESULTS: A total of 13 children with articulation disorders aged 4-10 years were enrolled in the study. In voice parameters, MPT, jitter, and pitch showed significant changes in repeated-measures ANOVA. However, only MPT showed significant changes during E1-E2 (P=.007) and E1-E3 (P=.004) in post hoc tests. Other voice parameters did not show significant changes. In articulation parameters, U-TAP, three-position articulation test (TA), and DDK showed significant changes in repeated-measures ANOVA. In post hoc tests, U-TAP (word, sentence) and TA showed significant changes during E1-E2 (P=.003, .04, and .01) and E1-E3 (P=.001, .03, and .003), and DDK showed significant changes during E1-E2 only (P=.03). CONCLUSIONS: Home-based serious games can be considered an alternative treatment method to improve language function. TRIAL REGISTRATION: Clinical Research Information Service KCT0006448; https://cris.nih.go.kr/cris/search/detailSearch.do/20119.

Articulation-Function-Associated Cortical Developmental Changes in Patients with Cleft Lip and Palate.

Cleft lip and palate (CLP) is one of the most common craniofacial malformations. Overall, 40-80% of CLP patients have varying degrees of articulation problems after palatoplasty. Previous studies revealed abnormal articulation-related brain function in CLP patients. However, the association between articulation disorders and cortical structure development in CLP patients remains unclear. Twenty-six CLP adolescents (aged 5-14 years; mean 8.88 years; female/male 8/18), twenty-three CLP adults (aged 18-35 years; mean 23.35 years; female/male 6/17), thirty-seven healthy adolescents (aged 5-16 years; mean 9.89 years; female/male 5/16), and twenty-two healthy adults (aged 19-37 years; mean 24.41 years; female/male 19/37) took part in the experiment. The current study aims to investigate developmental changes in cortical structures in CLP patients with articulation disorders using both structural and functional magnetic resonance imaging (MRI). Our results reveal the distinct distribution of abnormal cortical structures in adolescent and adult CLP patients. We also found that the developmental pattern of cortical structures in CLP patients differed from the pattern in healthy controls (delayed cortical development in the left lingual gyrus (t = 4.02, cluster-wise p < 0.05), inferior temporal cortex (z = -4.36, cluster-wise p < 0.05) and right precentral cortex (t = 4.19, cluster-wise p < 0.05)). Mediation analysis identified the cortical thickness of the left pericalcarine cortex as the mediator between age and articulation function (partial mediation effect (a*b = -0.48), 95% confident interval (-0.75, -0.26)). In conclusion, our results demonstrate an abnormal developmental pattern of cortical structures in CLP patients, which is directly related to their articulation disorders.

Nonverbal Oro-Motor Exercises: Do They Really Work for Phonoarticulatory Difficulties?

Articulation disorders are deficiencies in the realization of speech sounds unrelated to organic or neurological disorders. Over the last decade, there has been a debate on the efficiency of non-verbal oro-motor exercises, which are orofacial movements programmed and organized in an intentional and coordinated way to control lips, tongue, and soft palate muscles. Of the 122 children evaluated, 52 presented articulatory difficulties. An intervention with nonverbal oro-motor exercises was applied, and children were again assessed following treatment. The results showed no differences between the experimental and control groups, either in the number of sounds that improved after this period or in the severity of difficulties (we categorized those with articulation difficulties in two to six sounds as 'medium' and those with difficulties in articulating more than seven sounds as 'severe'). These results indicated that nonverbal oro-motor exercises alone are not efficient for intervention in difficulties in the realization of sounds in 4-year-old children.

Exploratory Study on the Prevalence of Speech Sound Disorders in a Group of Valencian School Students Belonging to 3rd Grade of Infant School and 1st Grade of Primary School / Estudio exploratorio sobre la prevalencia de trastornos fonológicos en un grupo de escolares valencianos de tercer grado de educación infantil y primero de primaria

Dyslalia or sound speech disorder is the most common speech production difficulty among school children. This epidemiological study aims to know the prevalence of SSD in school children and to analyze the relationship between articulatory disorders and bad oral habits, age, gender and socioeconomic situation. Two hundred and ninety children between 4 and 7 years old were evaluated by means of the Marc Monfort Test, a myofunctional test, and a questionnaire was applied to families. The results show that 51.4% of the schoolchildren present SSD. The most frequent type of error is distortion followed by substitution. Multiple dyslalia is more frequent than simple dyslalia. The relation of dependence between phonetic alterations and masculine gender is observed, as well as a decrease of articulation disorders as age increases and a significant relation between bad oral habits and the presence of dyslalia.

La dislalia o trastorno fonológico es la dificultad en la producción del habla más frecuente entre escolares. Este estudio epidemiológico pretende conocer la prevalencia de TF en escolares y analizar la relación de las alteraciones articulatorias y los malos hábitos orales, la edad, el género y la situación socioeconómica. Se evalúan 290 niños y niñas entre 4 y 7 años mediante el Test de Marc Monfort, un examen miofuncional y la aplicación de un cuestionario a las familias. Los resultados muestran que el 51.4% de los escolares presentan TF. El tipo de error más frecuente es el de distorsión, seguido del de sustitución. Es más frecuente la dislalia múltiple que la simple. Se observa la relación de dependencia entre las alteraciones fonéticas y el género masculino, así como una disminución de trastornos de articulación a medida que aumenta la edad y una relación significativa entre los malos hábitos orales y la presencia de dislalias.

Influência da qualidade das próteses totais na prevalência de disfunção temporomandibular / Influence of quality of total prostheses on the prevalence of temporomandibular disorder

Introduction Temporomandibular disorder (TMD) involves the mastication and temporomandibular articulation muscles. Completely toothless patients with prostheses should be thoroughly assessed since edentulism causes damage that can lead to TMD onset. Objective This study aims to assess the effect of the technical quality of total prostheses (TPs) on TMD occurrence in patients with bimaxillary TPs. Material and method 154 patients responded to a questionnaire to obtain personal data, information regarding prostheses, anamnestic index for TMD, and the prosthesis quality index. Result Of the 154 patients examined, 64 (41.6%) had no TMD, 61 (39.6%) had mild TMD, 23 (14.9%) moderate, and only 6 (3.9%) showed severe TMD. As for the quality of total prosthesis, 78 (50.6%) completely toothless individuals had satisfactory TPs while 76 (49.4) presented unsatisfactory prostheses. Regarding the time using total prosthesis, around 50% of individuals with up to 10 years use presented some degree of TMD and 70% of individuals with over 10 years presented TMD. Conclusion Considering the methodology used and the population studied, we conclude that the quality of the TPs did not influence the incidence of TMD.

Introdução A disfunção temporomandibular (DTM) é uma desordem que envolve os músculos da mastigação e da articulação temporomandibular. Pacientes desdentados totais e que utilizam protéses requerem uma avaliação criteriosa, já que o edentulismo leva a prejuízos que podem contribuir para o aparecimento de DTM. Objetivo O objetivo deste presente estudo foi avaliar o efeito da qualidade técnica das próteses totais (PTs) na incidência de DTM em pacientes portadores de PTs bi-maxilares. Material e método Foi aplicado um questionário a 154 pacientes contendo os dados pessoais, o histórico das próteses, o índice anamnésico para DTM e o índice de qualidade de prótese. Resultado Dos 154 pacientes examinados, 64 (41,6%) estavam livres de DTM, 61 (39,6%) possuíam DTM leve, 23 (14,9%), moderada e apenas 6 (3,9%) mostravam DTM severa. Quanto à qualidade da prótese total, 78 (50,6%) desdentados totais portavam PTs satisfatórias e 76 (49,4) estavam com próteses insatisfatórias. Quanto ao tempo de uso da prótese total, cerca de 50% dos indivíduos com até 10 anos de uso apresentaram algum grau de DTM e 70% dos indivíduos com mais de 10 anos acusaram a presença de DTM. Conclusão Considerando-se a metodologia empregada e a população estudada, pôde-se concluir que a qualidade das PTs não influenciou na presença de DTM.

Clinical Utility of Repeated Urimal Test of Articulation and Phonation for Patients with Childhood Apraxia of Speech.

Childhood apraxia of speech (CAS) causes inconstant oromotor production. We investigated the clinical efficacy of repeated urimal test of articulation and phonation (U-TAP) in CAS patients. Twenty-eight children were recruited: 19 with CAS and 9 with functional articulation disorder (FAD). Four age-matched typically developing children were also recruited. U-TAP was performed twice repeatedly, and the error rate of consonant accuracy (CA) was measured. Preschool Receptive-Expressive Language Scale (PRES) was also performed. The mean U-TAP CA showed a significant difference between the three groups, with 42.04% for CAS, 77.92% for FAD, and 99.68% for the normal group (p < 0.05). The mean difference between the two U-TAP CAs was 10.01% for CAS, 0.82% for FAD, and no difference for the normal group, revealing a significant intergroup difference between CAS and FAD (p < 0.05). For the expressive and receptive PRES scores, CAS group showed significantly decreased results compared to FAD and normal group. Only in the CAS group, expressive PRES showed significant decrease rather than receptive PRES score. The CAS group showed a significant difference in the two U-TAP CA compared to the FAD and normal groups. This result implies that repeated U-TAP can be useful for supportive diagnostic tool for CAS by detecting poor reliability of phonation.

Phonological development in school-aged Kuwaiti Arabic children with Down syndrome: A pilot study.

BACKGROUND: Studies on atypical phonological development are very limited for Arabic, and to date no studies on Arabic have investigated the development of phonology in children with conditions such as Down Syndrome. Arabic, like other Semitic languages, is rich in consonants and consonantal variation. However, it differs greatly from region to region, and so reports on individual dialects or regional dialects are necessary. Kuwaiti Arabic, the focus of the present paper, is similar to other dialects in the Gulf region. AIM: This is a preliminary study to examine the phonological development of school-aged Kuwaiti Arabic-speaking children with Down Syndrome in order to start to address the research gap noted above. METHODS & PROCEDURES: Six Kuwaiti Arabic-speaking children were recruited for this pilot study from integrated public schools where children with disabilities and typically developing children are enrolled in the State of Kuwait: three male and three female students, age range of 5;10-12;3 years. All participants had the same single word speech test of 100 words. The first author, a native speaker of Kuwaiti Arabic, audio-recorded and phonetically transcribed the sample with the help of two speech-language pathologists from Kuwait. Reliability was confirmed by the first author and another expert rater. Both match and mismatch analyses were performed and compared to existing literature. OUTCOMES & RESULTS: Overall consonant accuracy across participants was 50%, with a variety of matches across consonant categories. However, the participants also exhibited a wide range of mismatches across positions in words and phonological features (place, manner, and laryngeal features). Place substitutions were the most frequent. Some sounds exhibited double (place and manner) mismatches. The most common word structure mismatch was consonant cluster reduction (no matches for word-initial clusters). Mismatch patterns resembled both those of normally developing Kuwaiti children and those of English speakers with Down Syndrome in certain ways. CONCLUSIONS & IMPLICATIONS: This pilot study provides preliminary information for clinicians regarding the speech or children with Down Syndrome (DS), not only in Kuwait but also in the Gulf region where there are similarities to Kuwaiti Arabic.

Behavioral Interventions to Treat Speech Sound Disorders in Children With Autism.

Children with autism are at a higher risk of being affected by speech disorders and often require remedial intervention. Eikeseth and Nesset (Journal of Applied Behavior Analysis, 36(3), 325-337, 2003) used sufficient-response exemplar training of vocal imitation in conjunction with prompting, chaining, and shaping procedures to successfully teach 2 typically developing children to articulate several Norwegian words with blends. The present study extends and adapts these procedures to children with autism. Participants were TA, an 11-year-old boy, and KS, a 15-year-old girl, both with autism and speech sound disorders. For each participant, 3 sets of 10 words with specific blends in the initial position were targeted for training. Vocal imitation training with within-stimulus prompts was used for both participants. For KS, lip-tongue-teeth position prompts and chaining were added during the training of certain words. A multiple-baseline across-behaviors (word sets with target blends) design demonstrated improvement in the articulation of trained words and generalization of correct articulation to untrained words with both participants. The findings suggest that speech sound disorders in children with autism can be addressed with behavioral interventions.

Palatal augmentation prostheses in individuals treated for head and neck cancer: Effects on speech and oral transport.

BACKGROUND: Negative side effects affecting articulation and oral transport are common after treatment for head and neck cancer (HNC). The aim of this study was to assess the effects on speech and patient-reported experience of palatal augmentation prostheses (PAP) in this patient group. METHODS: Twenty consecutive patients who had received a PAP were included. We performed a blinded randomized listener assessment of recordings of the patients' speech with and without the PAP. Patient-reported experiences were collected from medical records. RESULTS: The listener assessment showed that production of velar sounds improved significantly for 12 of 19 patients; 12 of 19 patients also reported easier or better speech with the PAP. All six patients treated for tongue cancer reported speech improvement. Seven of 20 patients reported better transport of food or saliva. CONCLUSION: A PAP can help patients treated for HNC to more precisely articulated velar consonants and can benefit oral transport.

Rehabilitation of speech disorders following glossectomy, based on ultrasound visual illustration and feedback.

Intraoral surgery for tongue cancer usually induces speech disorders that have a negative impact on communication and quality of life. Studies have documented the benefit of tongue ultrasound imaging as a visual articulatory feedback for speech rehabilitation. This study aims to assess specifically the complementary contribution of visual feedback to visual illustration (i.e. the display of ultrasound video of target language movements) for the speech rehabilitation of glossectomised patients. Two therapy conditions were used alternately for ten glossectomised French patients randomly divided into two cohorts. The IF cohort benefitted from 10 sessions using illustration alone (IL condition) followed by 10 sessions using illustration supplemented by visual feedback (IL+F condition). The FI cohort followed the opposite protocol, i.e. the first 10 sessions with the IL+F condition, followed by 10 sessions with the IL condition. Phonetic accuracy (Percent Consonants Correct) was monitored at baseline (T0, before the first series) and after each series (T1 and T2) using clinical speech-language assessments. None of the contrasts computed between the two conditions, using logistic regression with random effects models, were found to be statistically significant for the group analysis of assessment scores. Results were significant for a few individuals, with balanced advantages in both conditions. In conclusion, the use of articulatory visual feedback does not seem to bring a decisive advantage over the use of visual illustration, though speech therapists and patients reported that ultrasound feedback was useful at the beginning. This result should be confirmed by similar studies involving other types of speech disorders.

The Neurocognition of Developmental Disorders of Language.

Developmental disorders of language include developmental language disorder, dyslexia, and motor-speech disorders such as articulation disorder and stuttering. These disorders have generally been explained by accounts that focus on their behavioral rather than neural characteristics; their processing rather than learning impairments; and each disorder separately rather than together, despite their commonalities and comorbidities. Here we update and review a unifying neurocognitive account-the Procedural circuit Deficit Hypothesis (PDH). The PDH posits that abnormalities of brain structures underlying procedural memory (learning and memory that rely on the basal ganglia and associated circuitry) can explain numerous brain and behavioral characteristics across learning and processing, in multiple disorders, including both commonalities and differences. We describe procedural memory, examine its role in various aspects of language, and then present the PDH and relevant evidence across language-related disorders. The PDH has substantial explanatory power, and both basic research and translational implications.

Caracterización Y Tipos De Errores Articulatorios En Pacientes Con Labio Y Paladar Hendido / Characterization And Types Of Articulation Errors In Individuals With Cleft Lip And Palate

Introducción: La condición de labio y paladar hendido (LPH) es una malformación frecuente a nivel mundial; en Colombia la presentan 16 por cada 10000 nacidos vivos, resultando mayormente en Trastorno del habla por presencia de Articulaciones Compensatorias. Objetivo: Caracterizar a la población colombiana residentes en Bogotá respecto a errores articulatorios y fonemas afectados por la condición de LPH. Materiales y métodos: Estudio observacional descriptivo donde se incluyeron 108 historias clínicas de pacientes evaluados en el año 2016 tomando datos de valoración fonoaudiológica y categorías de Universal Parameters for Reporting Speech Outcome in individuals with Cleft Palate. Resultados: La Oclusión Glotal se correlaciona con el 40,06% de los errores; el 21,47% y el 15,38% de los errores involucran los fonemas dentoalveolares oclusivo /t/ y fricativo /s/, respectivamente. El sexo femenino corresponde al 44,44%, sin embargo, presenta 5,77% más errores que el masculino. El grupo de 7 a 36 años presenta una mayor cantidad de errores con 65,06% (203) junto con el de LPH con 77,24% teniendo la cifra más alta entre los grupos con 241. El 75% de la población presenta alteraciones del habla, el 41,66% de ellos presenta fistula e hipernasalidad. Conclusiones: Existen variaciones en la sustitución de fonemas de alta presión por diferentes tipos articulaciones compensatorias, sin embargo, la Oclusión Glotal el tipo de compensación prevalente y los fonemas dentoalveolares los más afectados, sin distinción de género, edad, lugar de nacimiento o residencia. Edades superiores, el sexo femenino y la condición de LPH, son factores que pueden presentar una severidad más profunda del trastorno.

Introduction: Cleft lip and palate (CLP) is a frequent malformation worldwide, in Colombia affects 16 for every 10,000 live births, resulting mainly in speech disorder due to the presence of compensatory articulations (CAs). Objective: To characterize the Colombian population residing in Bogotá regarding articulatory errors and phonemes affected by CLP. Materials and methods: Descriptive observational study that includes 108 medical records of patients evaluated in 2016 taking data from speech and language assessment and categories of Universal Parameters for Reporting Speech Outcome in individuals with Cleft Palate. Results: Glottal stop correlates with 40.06% of the errors, 21.47% and 15.38% of the errors involved dentoalveolar phonemes occlusive /t/ and fricative /s/, respectively. Female sex corresponds to 44,44%, nevertheless, it presents 5.77% more errors than males. The group of 7 to 36 years old presents a greater number of errors 65.06% (203) with LPH 77.24% have the highest number among the groups 241. The 75% of the population presents alterations of speech, 41.66% of them present fistula and hypernasality. Conclusions: There are variations on the substitution of high-pressure phonemes for different types of compensatory articulation errors, however, the Glottal Stop is the prevalent type of CAs and dentoalveolar phonemes are the most affected, without distinction of gender, age, place of birth or residence. Older ages, female gender, and CLP are factors that may present a deeper severity of the disorder.

Development of Diagnosis, Assessment and Rehabilitation Solution of Articulation Disorders for Children Using WHO Family International Classifications / 中国康复理论与实践

Results and Conclusion:Articulation disorder for children is classified to Developmental Speech Sound Disorder (6A01.0). It involves in the eye, ear and related structures (s2), structures involved in voice and speech (s3), especially structure of external ear (s240), structure of middle ear (s250) and structure of inner ear (s260); voice and speech functions (b3), especially articulation functions (b320); communication (d3), learning and applying knowledge (d1), interpersonal interactions and relationships (d7), and community, social and civic life (d9), especially speaking (d330), conversation (d350), using communication devices and techniques (d360) and acquiring language (d133). The assessment of articulation disorder should be covered articulation accuracy and motor function of articulation. A holistic rehabilitation solution for children with articulation disorder has been developed, involving in body structure, body function, activities and participation, and environmental factors, including assessment, training and treatment, educational counseling, and psychological and social support. Objective:To explore the diagnosis of diseases and functioning of articulation function and conduct content analysis of assessment tools in Chinese, and to construct framework of rehabilitation solution based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (Children and Youth version) (ICF-CY) and International Classification of Health Interventions (ICHI). Methods:The diagnosis of disease and functioning was discussed with ICD-11 and ICF. The assessment tools were analyzed with ICF. A holistic rehabilitation solution was constructed with ICF and ICHI.

Interference of dentofacial deformities in the acoustic characteristics of speech sounds / Interferência das deformidades dentofaciais nas características acústicas dos sons da fala

ABSTRACT Purpose: to verify speech characteristics regarding the production of fricative sounds in people with dentofacial deformities (DFD), through acoustic analysis, evaluating possible interferences of the variation of the osseous bases in the articulation of speech. Methods: fifteen adults of both genders, aged between 17 and 42, participated in the study. They were distributed in three groups: GII (n = 5) Skeletal Class II, GIII (n = 5) Skeletal Class III, and CG (n = 5) without DFD. All of them had their voices recorded, with key words containing the fricative sounds of Brazilian Portuguese (BP), and acoustically analyzed; the parameters: duration, intensity, and formants F1, F2. The Mann-Whitney test was used to compare the groups. Results: there were differences (p <0.05) when comparing GII and GIII with CG. For the variable duration GIII obtained higher value in the fricative sound /z/ (r = 0.016, p <0.05). The variable intensity was higher for GII in /z/ (r = 0.028, p <0.05), and higher for GIII in /f/ (r = 0.028, p <0.05), /v/ (r = 0.028, p<0.05) and /ʃ/ (r = 0.036, p <0.05). For the variable F1, GII obtained a higher value for the syllable /za/ (r = 0.047, p <0.05). In the variable F2, GII obtained the lowest value in the syllable /ʒa/ (r = 0.047, p <0.05). Conclusion: the disharmony of the maxillomandibular osseous bases results in interference in speech acoustic characteristics regarding fricative sounds.

RESUMO Objetivo: verificar as características da fala quanto a produção dos sons fricativos em indivíduos com deformidades dentofaciais (DDF), por meio da análise acústica, analisando possíveis interferências da variação das bases ósseas na articulação da fala. Métodos: participaram 15 indivíduos adultos, ambos os sexos, com idade entre 17 a 42 anos. Distribuídos em 3 grupos: GII (n=5) Classe II esquelética, GIII (n=5) Classe III esquelética e GC (n=5) sem (DDF). Todos tiveram suas vozes gravadas, com "palavras-chave" contendo os sons fricativos do português brasileiro (PB), e analisadas acusticamente, os parâmetros: duração, intensidade, e formantes F1, F2. Para a comparação entre os grupos foi utilizado o Teste de Mann-Whitney. Resultados: houve diferenças (p<0,05) ao comparar GII e GIII com GC. Para a variável duração GIII obteve valor maior no som fricativo /z/ (r=0,016; p<0,05). A variável intensidade foi maior para o GII em /z/ (r=0,028; p<0,05), e maior para o GIII em /f/ (r=0,028; p<0,05), /v/ (r=0,028; p<0,05) e /ʃ/ (r=0,036; p<0,05). Para a variável F1, GII obteve valor maior para a sílaba /za/ (r=0,047; p<0,05). Na variável F2 o GII obteve valor mais baixo na sílaba /ʒa/ (r=0,047; p<0,05). Conclusão: a desarmonia das bases ósseas maxilomandibulares resulta em interferência nas características acústicas da fala quanto aos sons fricativos.

Three-dimensional ultrasound evaluation of tongue posture and its impact on articulation disorders in preschool children with anterior open bite.

Background Tongue posture plays an important role in the etiology of anterior open bite (AOB) and articulation disorders, and is crucial for AOB treatment planning and posttreatment stability. Clinical assessment of tongue posture in children is unreliable due to anatomical limitations. The aim of the study was to present functional diagnostics using three-dimensional ultrasound (3DUS) assessment of resting tongue posture in comparison to clinical assessment, and the associations between the improper tongue posture, otorhinolaryngological characteristics, and articulation disorders in preschool children with AOB. Patients and methods A cross-sectional study included 446 children, aged 3-7 years, 236 boys and 210 girls, examined by an orthodontist to detect the prevalence of AOB. The AOB was present in 32 children. The control group consisted of 43 children randomly selected from the participants with normocclusion. An orthodontist, an ear, nose and throat (ENT) specialist and a speech therapist assessed orofacial and ENT conditions, oral habits, and articulation disorders in the AOB group and control group. Tongue posture was also assessed by an experienced radiologist, using 3DUS. The 3DUS assessment of tongue posture was compared to the clinical assessment of orthodontist and ENT specialist. Results The prevalence of AOB was 7.2%. The AOB group and the control group significantly differed regarding improper tongue posture (p < 0.001), and articulation disorders (p < 0.001). In children without articulation disorders from both groups, the improper tongue posture occured less frequently than in children with articulation disorders (p < 0.001). After age adjustment, a statistical regression model showed that the children with the improper tongue posture had higher odds ratios for the presence of AOB (OR 14.63; p < 0.001) than the others. When articulation disorders were included in the model, these odds ratios for the AOB became insignificant (p = 0.177). There was a strong association between the improper tongue posture and articulation disorders (p = 0.002). The 3DUS detected the highest number of children with improper resting tongue posture, though there was no significant difference between the 3DUS and clinical assessments done by orthodontist and ENT specialist. Conclusions The 3DUS has proved to be an objective, non-invasive, radiation free method for the assessment of tongue posture and could become an important tool in functional diagnostics and early rehabilitation in preschool children with speech irregularities and irregular tongue posture and malocclusion in order to enable optimal conditions for articulation development.

Articulation or phonology? Evidence from longitudinal error data.

Children's speech difficulties can be motor (phone misarticulation) or linguistic (impaired knowledge of phonological contrasts and constraints). These two difficulties sometimes co-occur. This paper reports longitudinal data from the Early Language in Victoria Study (ELVS) at 4 and 7 years of age. Of 1494 participants, 93 made non-age appropriate speech errors on standardised assessments at 4 years, and were able to be reassessed at 7 years. At 4 years, 85% of these children only made phonological errors, 14% made both articulation and phonological errors and one child only made articulation errors (a lateral lisp). In total, 8 of 13 children making both articulation and phonological errors at 4 years had resolved by 7 years. Unexpectedly, eight children who had demonstrated articulation of fricatives at 4 years, acquired distorted production of ≥ 50% of occurrences of/s, z/ by 7 years. In total, then, 22 children (24% of children with speech difficulties) made articulatory errors at one or both assessments. Case data for all children are presented. Theoretical and clinical implications are considered.

Longitudinal follow-up to evaluate speech disorders in early-treated patients with infantile-onset Pompe disease.

BACKGROUND: Patients with infantile-onset Pompe disease (IOPD) can be treated by recombinant human acid alpha glucosidase (rhGAA) replacement beginning at birth with excellent survival rates, but they still commonly present with speech disorders. This study investigated the progress of speech disorders in these early-treated patients and ascertained the relationship with treatments. METHODS: Speech disorders, including hypernasal resonance, articulation disorders, and speech intelligibility, were scored by speech-language pathologists using auditory perception in seven early-treated patients over a period of 6 years. Statistical analysis of the first and last evaluations of the patients was performed with the Wilcoxon signed-rank test. RESULTS: A total of 29 speech samples were analyzed. All the patients suffered from hypernasality, articulation disorder, and impairment in speech intelligibility at the age of 3 years. The conditions were stable, and 2 patients developed normal or near normal speech during follow-up. Speech therapy and a high dose of rhGAA appeared to improve articulation in 6 of the 7 patients (86%, p = 0.028) by decreasing the omission of consonants, which consequently increased speech intelligibility (p = 0.041). Severity of hypernasality greatly reduced only in 2 patients (29%, p = 0.131). CONCLUSION: Speech disorders were common even in early and successfully treated patients with IOPD; however, aggressive speech therapy and high-dose rhGAA could improve their speech disorders.

Peripheral facial palsy: Speech, communication and oral motor function.

OBJECTIVES: The aim of the present study was to examine the effect of acquired unilateral peripheral facial palsy on speech, communication and oral functions and to study the relationship between the degree of facial palsy and articulation, saliva control, eating ability and lip force. MATERIALS AND METHODS: In this descriptive study, 27 patients (15 men and 12 women, mean age 48years) with unilateral peripheral facial palsy were included if they were graded under 70 on the Sunnybrook Facial Grading System. The assessment was carried out in connection with customary visits to the ENT Clinic and comprised lip force, articulation and intelligibility, together with perceived ability to communicate and ability to eat and control saliva conducted through self-response questionnaires. RESULTS: The patients with unilateral facial palsy had significantly lower lip force, poorer articulation and ability to eat and control saliva compared with reference data in healthy populations. The degree of facial palsy correlated significantly with lip force but not with articulation, intelligibility, perceived communication ability or reported ability to eat and control saliva. CONCLUSION: Acquired peripheral facial palsy may affect communication and the ability to eat and control saliva. Physicians should be aware that there is no direct correlation between the degree of facial palsy and the possible effect on communication, eating ability and saliva control. Physicians are therefore recommended to ask specific questions relating to problems with these functions during customary medical visits and offer possible intervention by a speech-language pathologist or a physiotherapist.

Observation of the clinical effect of acupuncture combined with speech rehabilitation training in the treatment of dysarthria after stroke / 中国基层医药

Objective To analyze the clinical effect of acupuncture combined with speech rehabilitation training in the treatment of dysarthria after stroke.Methods 88 patients with dysarthria after stroke were selected as study subjects,and they were randomly divided into the control group and the treatment group,44 cases in each group. The control group was treated with speech rehabilitation training,and the treatment group was treated with acupuncture combined with speech rehabilitation training.At the end of treatment,the dysarthria efficacy,a number of aand the incidence of adverse reactions were observed and compared between the two groups.Results The cure rate(9.09%) and total effective rate (77.27%)in the control group were significantly lower than those in the treatment group (25.00%,97.73%),and the differences were statistically significant(χ2 =3.94,8.42,all P 0.05),after treatment,the number of ain the control group was (7.39 ±3.67),which was significantly lower than (16.32 ±7.83)in the treatment group(t =4.20,P 0.05).Conclusion For post -stroke patients with dysarthria,acupuncture combined with speech rehabilitation training has good treatment effect,and the method can increase the number of aof patients,and has high security,it is worthy of widely application in clinic.

Praxia não verbal na fonoaudiologia: revisão de literatura / Nonverbal praxis in speech pathology: literature review

RESUMO A Fala é definida como representação motora da Linguagem, em que há a coordenação de três processos neurológicos: organização de conceitos, formulação e expressão simbólica; programação do ato motor envolvido na produção da fala; e sua própria produção motora. O Controle Motor da Fala, que ordena a contração muscular para a sua execução, inclui o planejamento, a preparação de movimentos e a execução de planos para resultar em contrações musculares e deslocamentos de estruturas que culminarão na articulação da Fala. Os estudos científicos nacionais e internacionais vislumbram um novo campo de atuação fonoaudiológica para o trabalho com a fala alterada, com a estimulação da Praxias Não Verbais. O objetivo deste trabalho é revisar, na bibliografia, o tratamento dado às praxias orais e não verbais e pontuar suas aplicações clínicas no âmbito fonoaudiológico. Realizou-se uma busca nas bases de dados PubMed, Lilacs e Scielo. As 40 citações selecionadas foram avaliadas de forma crítica. Os artigos mostraram que a Praxia Não Verbal pode ser estimulada para o trabalho clínico com a Fala, no entanto, não há descrição do trabalho fonoaudiológico, tampouco um detalhamento dos exercícios em sequência que poderiam ser utilizados. Nenhum artigo apontou para o modo como as Praxias Não Verbais deveriam ser trabalhadas, nem mesmo como estimular a programação motora para a Fala. Este estudo propõe a necessidade clínica de criar instrumentos de intervenção fonoaudiológica que incluam a estimulação das Praxias Não Verbais para o trabalho com a articulação da Fala.

ABSTRACT Speech is defined as a motor representation of language, where there is a coordination of three neurological processes: organization of concepts, formulation and symbolic expression; motor act of programming involved in speech production and own motor speech production. The Motor Speech Control, that orders the muscle contraction for the execution of Speech, includes planning, preparing movements and the implementation of plans to result in muscle contractions and dislocations of structures that will culminate in the articulation of Speech. National and international scientific papers envision a new speech playing field for working with a Speech changed with the stimulation of non-verbal Praxis. The aim of this study was to review the national and international literature which the treatment given to Oral Praxis and non verbal and scores the clinical applications in the Speech therapy. We conducted a search in the databases PubMed, Lilacs and Scielo. The 40 selected citations were assessed critically as the objectives, results and conclusions. The articles showed that non-verbal praxis can be stimulated for clinical work with speech, but nevertheless, there is not a description of this speech therapy. Any article referred that the non-verbal Praxis should be worked, not even how to stimulate motor programming for Speech. This study suggests the clinical necessity to create speech therapy tools that include stimulation of non-verbal Praxis to work with the articulation of Speech.