Intra-participant variability in Parkinson's disease: An electropalatographic examination of articulation

The articulation of individuals with dysarthria has traditionally been described as consistent. However, conflicting findings have resulted from research examining intra-participant variation in the articulation of individuals with Parkinson's disease (PD) and hypokinetic dysarthria. The current study used electropalatography (EPG) to examine the degree of intra-participant variation in both tongue-palate contact patterns and duration of contact in a group of speakers with PD and hypokinetic dysarthria including consonant imprecision (n = 8). The study also aimed to determine if ageing contributed to any articulatory instability observed. Therefore, two control groups were employed consisting of aged adult (n = 7) and young adult (n = 8) speakers respectively. Participants were asked to read aloud the phrase “I saw a CVC today” were C = /t/, /s/, and /l/ and V = /a/. Intra-participant variation in tongue-palate contact was measured using the absolute and relative variability indexes. Coefficients of variation of duration of tongue contact were employed to examine intra-participant variation in consonant duration. In contrast to the study hypotheses, similar levels of intra-participant variation were observed across the three groups. However, a trend towards increased intra-participant variation in consonant duration was noted in the group with PD. The results of the study suggest that, at least spatially, the articulatory errors of individuals with PD are consistent across repetitions. Research including increased participant numbers and individuals exhibiting greater severity of dysarthria is required to provide further understanding of intra-participant variation in consonant duration in PD.     

Having your cake and eating it: The apparent paradox of long-term outcomes of SLI

The primary objective of this study was to determine the effectiveness of electropalatography (EPG) home training using a portable training unit (PTU) for clients with residual articulation disorders. The participants were five Japanese children with cleft lip and palate ranging in age from 8 to 13 years when they began EPG home training. These children had residual articulation disorders caused by abnormal tongue-palate contact, although four of them had received conventional speech therapy for 3 to 8 years before starting EPG training. The WinEPG system (Articulate Instruments, Edinburgh) was used to make recordings during the initial assessment and the monthly follow-up. The participants received EPG training sessions when they attended for their monthly recordings. A training programme was developed for each participant, and they were instructed to carry out their homework assignments using the PTU. After 7 to 9 months of home training, marked changes in the EPG patterns and “centre of gravity” values were observed in four of the five participants. The remaining one participant, who had not experienced speech therapy before, needed a longer period of EPG training to achieve good results. Our preliminary data suggested that EPG home training was effective in school-aged participants who had residual articulation disorders.     

Tongue–palate contact during selected vowels in children with speech sound disorders

Abstract

There is evidence that complete tongue–palate contact across the palate during production of vowels can be observed in some children with speech disorders associated with cleft palate in the English-speaking and Japanese-speaking populations. Although it has been shown that this is not a feature of typical vowel articulation in English-speaking adults, tongue-palate contact during vowel production in typical children and English-speaking children with speech sound disorders (SSD) have not been reported in detail. Therefore, this study sought to determine whether complete tongue–palate contact occurs during production of five selected vowels in 10 children with SSD and eight typically-developing children. The results showed that none of the typical children had complete contact across the palate during any of the vowels. However, of the 119 vowels produced by the children with SSD, 24% showed complete contact across the palate during at least a portion of the vowel segment. The results from the typically-developing children suggest that complete tongue–palate contact is an atypical articulatory feature. However, the evidence suggests that this pattern occurs relatively frequently in children with SSD. Further research is needed to determine the prevalence, cause, and perceptual consequence of complete tongue–palate contact.     

双唇音构音障碍的临床特点和语音训练

目的探讨双唇音构音障碍的临床特点和训练方法。方法分析92 例功能性构音障碍(FAD)患者和85 例腭裂术后构音障碍患者双唇音构音障碍的特点;再各选择20 例有双唇音构音障碍的患者进行语音训练。结果FAD患者中/p/置换成/b/占同类患者有双唇音构音错误总人数的78.8%,腭裂术后构音障碍患者中/b/脱落和置换分别占30.2%和60.4%。经过语音训练,两类患者双唇音构音错误的个数显著减少(P<0.001)。结论双唇音构音障碍在FAD患者中主要为/p/音的不送气化,在腭裂术后构音障碍患者中主要表现为/b/音的脱落和置换;语音训练效果显著。     

Acoustic and tongue kinematic vowel space in speakers with and without dysarthria

Purpose: The purpose is to investigate acoustic and tongue body kinematic vowel dispersion patterns and vowel space in speakers with and without dysarthria secondary to amyotrophic lateral sclerosis (ALS).

Method: Acoustic and tongue kinematic vowel spaces were examined at the same time sampling point using electromagnetic articulography in 11 speakers with dysarthria secondary to ALS and 11 speakers without dysarthria. Tongue kinematic data were collected from the tongue body sensor (～25?mm posterior from the tongue apex). A number of acoustic and tongue body kinematic variables were tested.

Result: The result showed that the acoustic and tongue kinematic vowel dispersion patterns are different between the groups. Acoustic and tongue body kinematic vowel spaces are highly correlated; however, unlike acoustic vowel space, tongue body kinematic vowel space was not significantly different between the groups.

Conclusion: Both acoustic and tongue kinematic vowel dispersion patterns are sensitive to the group difference, especially with high vowels. The tongue kinematic vowel space approach is too crude to differentiate the speakers with dysarthria secondary to ALS from speakers without dysarthria. To examine tongue range of motion in speakers with dysarthria, a more refined articulatory kinematic approach needs to be examined in the future.     

Temporal and spatial aspects concerning the realizations of the voicing contrast in German alveolar and postalveolar fricatives

This study investigates the phonetic realizations of voicing contrast in alveolar and postalveolar fricatives production in different word positions in order to understand the temporal and spatial production strategies used in the control of voicing and frication, and to provide a frame of reference for speech therapy despite the inter-speaker variation. Seven native speakers of German, originally coming from various regions, participated in the experiment. Acoustic signals were recorded onto DAT, and tongue palate contact patterns were recorded by means of electropalatography (EPG). The temporal parameters were measured using the acoustic signals and the spatial parameters were measured based on the EPG data. The corpus included real words with // occurring at word initial, medial and final positions. Temporal results showed that differences in the overall frication duration for voicing contrast occur at almost all positions (with longer duration for voiceless phonemes). However, voicing during the frication interval was a less reliable discriminator, particularly for Southern German speakers and at word final position. We found a positive correlation between the relative voicing duration and the amount of tongue palate contact for subjects who produced voicing. Especially for the postalveolars, voicing also coincides with more front articulation. Results are discussed with respect to laryngeal-oral co-ordination and aerodynamics.     

Electropalatography in home training of retracted articulation in a Swedish child with cleft palate: Effect on articulation pattern and speech

The aim was to evaluate the effectiveness of electropalatography (EPG) in home training of persistent articulation errors in an 11-year-old Swedish girl born with isolated cleft palate. The /t/ and /s/ sounds were trained in a single subject design across behaviours during an eight month period using a portable training unit (PTU). Both EPG analysis and perceptual analysis showed an improvement in the production of /t/ and /s/ in words and sentences after therapy. Analysis of tongue-contact patterns showed that the participant had more normal articulatory patterns of /t/ and /s/ after just 2 months (after approximately 8 hours of training) respectively. No statistically significant transfer by means of intelligibility in connected speech was found. The present results show that EPG home training can be a sufficient method for treating persistent speech disorders associated with cleft palate. Methods for transfer from function (articulation) to activity (intelligibility) need to be explored.     

Acoustic-temporal aspects of stop-plosives in the speech of Persian-speaking children with cleft lip and palate

Purpose: The main objective was to examine temporal parameters of stop-plosives in Persian-speaking children with repaired cleft lip and palate (CLP).

Method: Eleven children with repaired bilateral CLP and 20 typically-developing children participated in the study. Stop-gap duration (SGD) and voice-onset time (VOT) were measured based on digital waveform and spectrographic displays.

Result: Separate linear mixed model analyses showed significantly longer SGDs for children with CLP for all plosives in word-mid and final positions. Furthermore, children with CLP tend to produce longer VOTs for all voiceless plosives.

Conclusion: Persian-speaking children with repaired CLP prolong stop-gap segments, similar to findings reported for English-speaking children with CLP. Prolonged segments may be due to an active strategy to increase oral air pressure and/or improve perceptual accuracy of speech segments.     

Evaluating a new clinical palatometry system

EPG (Electropalatography) is a visual feedback device designed for clinical and research applications centered on articulation in terms of tongue-to-hard palate contact. EPG has been shown to be effective for a range of speech sound disorders. Several EPG systems have been marketed. One factor that has limited access to EPG treatment, especially in a clinical setting, is the cost of manufacturing the pseudopalates. A new EPG system from Logometrix utilizes a glued on strip of electrodes rather than individually placed electrodes, significantly reducing production expense. Clinical use of the new EPG system is reviewed for 13 clients with varying speech sound disorders, for whom EPG was beneficial in phonetic treatment. Two children were unable to tolerate the pseudopalates, suggesting that practice palates without electrodes be utilized.     

Multislice Display of the Fetal Face Using 3‐Dimensional Ultrasonography

Objective. Multislice 3‐dimensional ultrasonography (3DUS) allows ultrasonographic volume data to be presented in parallel slices. Our aim was to develop a technique using a multislice display to specifically differentiate the maxilla (primary palate) from the mandible and to display the orbits in a single image in fetuses with normal anatomy and cleft lip/palate. Methods. Three‐dimensional ultrasonographic volumes of the fetal face were acquired in 142 patients (49 prospective and 93 retrospective). Fifteen patients had a confirmed diagnosis of cleft lip with or without cleft palate. Three readers manipulated volumes in a standardized fashion to show the orbits, maxilla, and mandible. The best interslice distance was determined. Image quality was assessed. Results. The mean gestational age of the fetuses was 23 weeks (range, 11–38 weeks). The mean interval distance used varied from 3 to 3.7 mm (range, 1–5.8 mm). The interval distance correlated with gestational age (Spearman ρ = 0.66; P < .0001). Image quality obtained through multislice evaluation of the orbits, maxilla, and mandible was high and did not vary with gestational age, interval distance, retrospective versus prospective acquisition, or 3DUS versus 4‐dimensional volumes. A higher image quality rating was associated with axial and sagittal planes of acquisition as opposed to coronal and oblique planes (Wilcoxon P < .002). All cases of cleft lip with or without cleft palate were correctly identified retrospectively. Conclusions. Multislice 3DUS evaluation of the fetal face can be performed successfully with high image quality. This technique can be used to consistently and accurately differentiate the fetal primary palate and mandible. Fetuses with cleft lip with or without cleft palate can be identified with confidence.     

Analysis of the candidate genes responsible for non-syndromic cleft lip and palate in Japanese people

In order to assess the association of alleles for candidate genes with non-syndromic cleft lip and palate, DNA samples from 43 Japanese patients were compared with those from 73 control subjects with respect to the genes encoding transforming growth factor alpha (TGFalpha), TGFbeta and gamma-aminobutyric acid type A receptor beta3 (GABRB3). The restriction fragment length polymorphisms of the 3'-non-coding region of the TGFalpha gene K-primer region were observed after digestion with NcoI and HinfI. Allele 4 was the most common among cases of cleft lip with or without cleft palate, whereas allele 2 was the most common among controls. A significant difference was found in this region between groups with cleft lip (with or without cleft palate) and controls (chi2=10.190; P=0.017). Three alleles of the TGFbeta2 gene were tested, and allele 2 was the most common in both cases and controls. The proportion of allele 2 in the case group was greater than that in the control group, showing a significant difference between cases of cleft lip (with or without cleft palate) and controls (chi(2)=19.208; P<0.0001). No significant differences in variants of TGFbeta3 or GABRB3 between case and control populations were observed. Thus it is concluded that TGF genes play a role in craniofacial development, and that alleles of TGFalpha or/and TGFbeta2 are associated with cleft lip and cleft palate in Japanese populations.     

Near-empty review provides low-level support for use of Electropalatography (EPG) as a treatment for articulation disorders due to cleft palate

This review provides a summary and appraisal commentary on the treatment review by Lee, A. S.-Y., Law, J., & Gibbon, F. E. (2009). Electropalatography for articulation disorders associated with cleft palate. Cochrane Database of Systematic Reviews, Issue 3. Art no.: CD006854. DOI: 10.1002/14651858. CD006854.pub2

     

单侧完全性唇腭裂患者下颌骨对称性分析

目的 探讨单侧完全性唇腭裂患者下颌骨两侧垂直向对称性。方法 52名单侧完全性唇腭裂患者作为观察组,52名同龄正常牙合人群作为对照组,两组病例拍摄全景片,对下颌关节高度（CH）,升支高度（RH）及升支关节高度总和（CH+RH）进行测量和分析,所得数据行配对样本T检验和独立样本T检验。结果 单侧完全性唇腭裂患者下颌骨健患侧垂直高度中CH,RH,CH+RH均存在统计学差异(P<0.05),对照组左右侧各项高度测量指标均无统计学差异。组间分析关节高度（CH）及关节升支高度（CH+RH）存在统计学差异(P<0.05)。结论 单侧完全性唇腭裂患者下颌骨健患侧垂直向不对称,且其与正常牙合人群比较存在差异。正常牙合人群下颌骨垂直向左右侧对称。     

Normal adult speakers' tongue palate contact patterns for alveolar oral and nasal stops

This study compared tongue palate contact patterns for oral stops (/t/, /d/) with those for the nasal stop /n/ in order to provide normative data for diagnosing and treating individuals with speech disorders. Electropalatographic (EPG) data were recorded from 15 English speaking adults for word initial /t/, /d/ and /n/ in a high and a low vowel context. EPG frames were classified according to three criteria: (1) anterior constriction; (2) bilateral constriction; and (3) zero posterior central contact. Total amount of contact and variability were also measured. The results showed that almost all (99%) stops met Criteria 1 and 3, with fewer articulations (88% of /t/; 83% of /d/ and 55% of /n/) meeting Criterion 2. Although all stops had similar spatial patterns, /t/ and /d/ had more contact and were more likely to have bilateral constriction than /n/. There were no differences in variability between /t/, /d/ and /n/, however. The clinical implications of the results for the management of individuals with speech disorders are discussed.     

Speech production,intelligibility and oromotor function in seven individuals with Möbius sequence

Abstract

Purpose: Möbius sequence is a rare disease characterized by congenital facial and abducent nerve palsy. Other cranial nerves may be affected. Cleft palate, intellectual disability and neuropsychiatric disorders are associated with the diagnosis. The aim was to explore speech production, intelligibility and oromotor function in a group of individuals with Möbius sequence.

Method: Three children (5–11 years) and four adults (26–54 years) were recruited to the study via the Swedish Möbius syndrome association. In addition to cranial nerve dysfunction, two had a hearing impairment, one Asperger syndrome and one a cleft palate. Perceptual assessments included an evaluation of intelligibility in single words and spontaneous speech, the percentage of phonemes correct (PPC) and screening of orofacial functions (NOT-S). Objective measurements were used for the evaluation of nasality, lip force and tongue force.

Result: Three individuals had severely impaired intelligibility, two slightly impaired and two had fully intelligible speech. The PPC varied between 59.3–100%. Five individuals had bilateral facial palsy, two unilateral facial palsy and six tongue impairment. One had a slightly increased nasalance score. Compensatory strategies were being effectively used.

Conclusion: This case series contributes more in-depth knowledge of speech production, intelligibility and oromotor function in this rare condition.     

The effect of phonotactic constraints in German-speaking children with delayed phonological acquisition: Evidence from production of word-initial consonant clusters

In this study the effect of phonotactic constraints concerning word-initial consonant clusters in children with delayed phonological acquisition was explored. Twelve German-speaking children took part (mean age 5;1). The spontaneous speech of all children was characterized by the regular appearance of the error patterns fronting, e.g., Kuh“cow” /ku:/ →[tu:], or stopping, e.g., Schaf“sheep” /a:f/ →[ta:f], which were inappropriate for their chronological age. The children were asked to produce words (picture naming task, word repetition task) with initial consonant clusters, in which the application of the error patterns would violate phonotactic sequence constraints. For instance, if fronting would apply in /kl-/, e.g., Kleid“dress”, it would be realized as the phontactically illegal consonant cluster /tl-/. The results indicate that phonotactic constraints affect word production in children with delayed phonological developments. Surprisingly, we found that children with fronting produced the critical consonants correctly significantly more often in word-initial consonant clusters than in words in which they appeared as singleton onsets. In addition, the results provide evidence for a similar developmental trajectory of acquisition in children with typical development and in children with delayed phonological acquisition.     

孕早期超声观察腭线筛查胎儿唇腭裂

目的 评价孕早期超声观察腭线筛查胎儿唇腭裂的价值。方法 回顾性分析14 360胎接受超声颈后透明层厚度（NT）检查的孕早期胎儿,观察胎儿腭线表现,记录胎儿转归,评价孕早期超声观察腭线筛查胎儿唇腭裂的效能。结果 孕早期超声提示14 327胎（14 327/14 360,99.77%）腭线正常,其中7胎经随访证实存在唇腭裂;33胎（33/14 360,0.23%）腭线异常,其中4胎腭线为小裂隙,随访证实无唇腭裂,29胎随访证实腭线异常,包括小裂隙8胎、大裂隙4胎、前部缺失11胎及腭线变细/变短6胎。孕中期超声提示36胎唇腭裂,并于出生后或经引产证实,包括4胎单纯唇裂、10胎单纯继发性腭裂、17胎单侧唇腭裂,5胎双侧唇腭裂。超声观察腭线预测胎儿唇腭裂的敏感度为80.56%（29/36）,特异度为99.97%（14 320/14 324）,阳性预测值为87.88%（29/33）,阴性预测值为99.95%（14 320/14 327）。结论 孕早期超声观察胎儿NT平面腭线可作为筛查胎儿唇腭裂的指标,值得推广。     

Effects of utterance rate and length on the spatiotemporal index in Parkinson’s disease

Abstract

Purpose: To characterise labial articulatory pattern variability using the spatiotemporal index (STI) in speakers with idiopathic Parkinson’s disease (PD) across different speaking rates and syllable-sentence conditions compared to age- and sex-matched healthy controls.

Method: Ten speakers with mild–severe idiopathic PD and 10 controls produced “pa” and the Rainbow Passage at slow, typical and fast speech rates. Upper lip and lower lip kinematics were digitised during a motion capture system. Data were analysed using linear mixed modelling.

Result: Regardless of the participant group, a high STI value was observed in the fast speech rate for the “pa” syllable condition, particularly for movements of the lower lip. As utterance rate increased, the control group showed the highest variability, followed by PD OFF and PD ON conditions. Syllable “pa” showed a greater STI value compared to both the first and second utterance of Rainbow Passage.

Conclusion: PD manifests sufficient residual capacity to achieve near-normal motor compensation to preserve the consistency of lower lip movements during speech production. The lack of a significant difference in lip STI values between ON-OFF medication states suggests that dopaminergic treatment does not influence stability of speech for individuals with mild-moderate stage PD.