Problems in speech sound production in young children. An inventory study of the opinions of speech therapists

Objective

Analysis of examination procedure and diagnosis of articulation problems by speech therapists.

Study design

Survey study.

Materials and methods

Eighty-five Dutch speech therapists (23% response), working in private practises or involved in language screening procedures in Youth Health Care, were questioned regarding the incidence of articulation problems in their practices, the manner of examination, the normative data used, and the importance attached to identifying articulation problems.

Results

According to the speech therapists, articulation problems are present in the majority of children (90%) in their practices. In children between 2 and 5 years of age, 45%; in children between 5 and 8 years of age, 36%; above age 8, about 14% of the children still have articulation problems. Despite their opinion that articulation problems often form a separate aspect of language development, all respondents indicated that they always investigate the speech sound development as part of a total speech and language examination. Frequently, more than one instrument is used. However, none of these instruments are standardised. The speech therapists prefer to examine the children at about 4 years of age, despite their opinion that the speech sounds develop until about 6 years of age. For them, this raises the problem to distinguish between articulation in development and articulation problems. They have the opinion that early treatment is important because of assumed relations with social-emotional development and reading and writing abilities later on.

Conclusion

The speech therapists taking part in this study have a good view of the speech sound development of young children. However, due to their concern about communication, social-emotional development, and reading and writing abilities later on, they prefer to identify and treat articulation problems at an early age. More detailed research into the variations in speech sound development, in relation to language development, is needed in order to arrive at effective normative data.     

An evaluation of the aurora system as a flesh-point tracking tool for speech production research

PURPOSE: Northern Digital Instruments (NDI; Waterloo, Ontario, Canada) manufactures a commercially available magnetometer device called Aurora that features real-time display of sensor position tracked in 3 dimensions. To test its potential for speech production research, data were collected to assess the measurement accuracy and reliability of the system. METHOD: First, sensors affixed at a known distance on a rigid ruler were moved systematically through the measurement space. Second, sensors attached to the speech articulators of a human participant were tracked during various speech tasks. RESULTS: In the ruler task, results showed mean distance errors of less than 1 mm, with some sensitivity to location within the measurement field. In the speech tasks, Euclidean distance between jaw-mounted sensors showed comparable accuracy; however, a high incidence of missing samples was observed, positively correlated with sensor velocity. CONCLUSIONS: The real-time positional feedback provided by the system makes it potentially useful in speech therapy applications. The overall missing data rate observed during speech tasks makes use of the system in its current form problematic for the quantitative measurement of speech articulator movements; however, NDI is actively working to improve the Aurora system for use in this context.     

A study of developmental speech and language disorders in twins.

Fifty-seven same-sex twin sets (32 monozygotic and 25 dizygotic) were examined for concordance of speech and language disorders. Results showed monozygotic twins to have higher concordance than dizygotic twins. In addition, monozygotic twins were more similar in the types of disorders they presented than dizygotic twins. Positive family histories for speech, language, and learning disorders were reported in the nuclear families of the twins.     

Using visible speech to train perception and production of speech for individuals with hearing loss.

The main goal of this study was to implement a computer-animated talking head, Baldi, as a language tutor for speech perception and production for individuals with hearing loss. Baldi can speak slowly; illustrate articulation by making the skin transparent to reveal the tongue, teeth, and palate; and show supplementary articulatory features, such as vibration of the neck to show voicing and turbulent airflow to show frication. Seven students with hearing loss between the ages of 8 and 13 were trained for 6 hours across 21 weeks on 8 categories of segments (4 voiced vs. voiceless distinctions, 3 consonant cluster distinctions, and 1 fricative vs. affricate distinction). Training included practice at the segment and the word level. Perception and production improved for each of the 7 children. Speech production also generalized to new words not included in the training lessons. Finally, speech production deteriorated somewhat after 6 weeks without training, indicating that the training method rather than some other experience was responsible for the improvement that was found.     

Posterior pharyngeal wall position in the production of speech.

The posterior pharyngeal wall has been assumed to be stationary during speech. The present study examines this assumption in order to assess whether midsagittal widths in the pharyngeal region can be inferred from measurements of the anterior pharyngeal wall. Midsagittal magnetic resonance images and X-ray images were examined to determine whether the posterior pharyngeal wall from the upper oropharynx to the upper laryngopharynx shows anterior movement that can be attributed to variables in speech: vowel quality in both English and Japanese; vowels versus consonants as classes of speech sounds; sustained versus dynamically produced speech; and isolated words versus sentences. Measurements were made of the distance between the anterior portion of the vertebral body and the pharyngeal wall. The first measurement was on a line traversing the junction between the dens and the body of the second cervical vertebra (C2). The next three measurements were on lines at the inferior borders of the bodies of C2, C3, and C4. The measurements showed very little movement of the posterior pharyngeal wall, none of it attributable to speech variables. Therefore, the position of the posterior pharyngeal wall in this region can be eliminated as a variable, and the anterior portion of the pharynx alone can be used to estimate vocal cavities.     

The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review.

PURPOSE: This article presents the results of a meta-analysis to determine the effect of augmentative and alternative communication (AAC) on the speech production of individuals with developmental disabilities. METHOD: A comprehensive search of the literature published between 1975 and 2003, which included data on speech production before, during, and after AAC intervention, was conducted using a combination of electronic and hand searches. RESULTS: The review identified 23 studies, involving 67 individuals. Seventeen of these studies did not establish experimental control, thereby limiting the certainty of evidence about speech outcomes. The remaining 6 studies, involving 27 cases, had sufficient methodological rigor for the "best evidence analysis" (cf. >R. E. Slavin, 1986). Most of the participants (aged 2-60 years) had mental retardation or autism; the AAC interventions involved instruction in manual signs or nonelectronic aided systems. None of the 27 cases demonstrated decreases in speech production as a result of AAC intervention, 11% showed no change, and the majority (89%) demonstrated gains in speech. For the most part, the gains observed were modest, but these data may underestimate the effect of AAC intervention on speech production because there were ceiling effects. CONCLUSIONS: Future research is needed to better delineate the relationship between AAC intervention and speech production across a wider range of participants and AAC interventions.     

Final consonant discrimination in children: effects of phonological disorder, vocabulary size, and articulatory accuracy.

Preschool-age children with phonological disorders were compared to their typically developing age peers on their ability to discriminate CVC words that differed only in the identity of the final consonant in whole-word and gated conditions. The performance of three age groups of typically developing children and adults was also assessed on the same task. Children with phonological disorders performed more poorly than age-matched peers, and younger typically developing children performed more poorly than older children and adults, even when the entire CVC word was presented. Performance in the whole-word condition was correlated with receptive vocabulary size and a measure of articulatory accuracy across all children. These results suggest that there is a complex relationship among word learning skills, the ability to attend to fine phonetic detail, and the acquisition of articulatory-acoustic and acoustic-auditory representations.     

An apparatus to measure pressure, flow and speech parameters in patients producing speech using the Groningen valve prosthesis.

We present a validated method of determining in vivo pressure, flow and voice parameters from patients using tracheo-oesophageal voice prostheses post laryngectomy. This apparatus was constructed simply using equipment which should be available in most large Otolaryngology Departments. There was good agreement between measurements made over two separate sessions of in vivo opening pressure, maximum flow through the device and maximum voice amplitude and these were significant. These measurements may be useful in monitoring patient progress and also in elucidating the mechanics of prosthesis failure.     

Acoustical changes of loudly spoken speech and their effects on speech recognition in hearing-impaired listeners.

The level of speech is usually increased in conversations with unaided hearing-impaired listeners. However, the speaker may talk at conversational levels to aided hearing-impaired persons. In this case, the level of speech is electronically increased by the hearing aid. In the present study, the acoustical changes of loudly spoken speech and their effects on speech recognition were investigated in 20 patients with sensorineural hearing loss. Eight test words of the German Speech Intelligibility Test ('Freiburger Sprachtest') were recorded at original levels of 60 and 75 dB SPL by a male speaker. Both recordings were presented to hearing-impaired subjects at a playback level of 75 dB SPL. Thus, the level of the 60 dB SPL recording was increased electronically by 15 dB. For the 75 dB SPL recording, playback and recording levels were identical. The average whole-word score was 49% for the 60 dB SPL recording and 39% for the 75 dB SPL recording. This difference was statistically significant (0.002 less than P less than 0.005). The results of the speech recognition ability tests could be explained by the acoustical changes of the loudly spoken speech. In the 75 dB SPL recording, the levels of voiceless fricatives, nasals and plosives were significantly lower than in the 60 dB SPL recording. Spectrally, the fundamental frequency was increased and the configuration of the first formant was altered in the 75 dB SPL recording. The significance of the findings for clinical speech audiometry and hearing aid evaluation is discussed.     

Precursors to speech in infancy: the prediction of speech and language disorders.

During the canonical stage of infant babbling, infants produce well-formed syllables, often in reduplicated sequences such as "bababa." Although nearly all infants with normal hearing begin the canonical stage by 10 months of age, a few are delayed, and these infants may be of special interest. Recent studies indicate that late onset of canonical babbling may be a predictor of disorders. A simple screening procedure that focuses on canonical babbling was used to evaluate over 3400 infants at risk who were about 10 months of age. Among infants who showed late onset of canonical babbling, fewer than half had been previously diagnosed as having a significant medical problem that might have accounted for the delay. A follow-up study indicated that infants with delayed canonical babbling had smaller production vocabularies at 18, 24, and 30 months than did infants in the control group. The results suggest that late onset of canonical babbling, a factor that can be monitored effectively through an interview with a parent, can predict delay in the onset of speech production.     

Contextual variables related to inconsistent /s/ and /z/ production in the spontaneous speech of children.

The relationship between phonetic context and inconsistent productions of /s/ and /z/ in the spontaneous speech of three approximately three-year-old children was investigated using a nonlexically constrained segmentation, the VCnV syllable. Cn represents any number of consonants occurring between two vowels. The results indicate that of the speech segments surrounding /s/ and /z/ only the identity of consonants following these segments was significantly related to the accuracy of /s/ and /z/ production. The implications of the data for models of speech production are discussed.     

Changes in the human vocal tract due to aging and the acoustic correlates of speech production: a pilot study.

This investigation used a derivation of acoustic reflection (AR) technology to make cross-sectional measurements of changes due to aging in the oral and pharyngeal lumina of male and female speakers. The purpose of the study was to establish preliminary normative data for such changes and to obtain acoustic measurements of changes due to aging in the formant frequencies of selected spoken vowels and their long-term average spectra (LTAS) analysis. Thirty-eight young men and women and 38 elderly men and women were involved in the study. The oral and pharyngeal lumina of the participants were measured with AR technology, and their formant frequencies were analyzed using the Kay Elemetrics Computerized Speech Lab. The findings have delineated specific and similar patterns of aging changes in human vocal tract configurations in speakers of both genders. Namely, the oral cavity length and volume of elderly speakers increased significantly compared to their young cohorts. The total vocal tract volume of elderly speakers also showed a significant increment, whereas the total vocal tract length of elderly speakers did not differ significantly from their young cohorts. Elderly speakers of both genders also showed similar patterns of acoustic changes of speech production, that is, consistent lowering of formant frequencies (especially F1) across selected vowel productions. Although new research models are still needed to succinctly account for the speech acoustic changes of the elderly, especially for their specific patterns of human vocal tract dimensional changes, this study has innovatively applied the noninvasive and cost-effective AR technology to monitor age-related human oral and pharyngeal lumina changes that have direct consequences for speech production.     

Acoustic integrity of speech production in children with moderate and severe hearing impairment.

Ten normally hearing and 10 age-matched subjects with moderate-to-severe hearing impairment were recorded producing a protocol of 18 basic syllables [/pi/,/pa/,/pu/;/bi/,/ba/,/bu/; /ti/,/ta/,/tu/ ;/di/,/da/,/du/; /ki/,/ka/,/ku/; /gi/,/ga/,/gu/] repeated five times. The resulting 90 syllables were digitized and measured for (a) total duration; (b) voice-onset time (VOT) of the initial consonant; (c) fundamental frequency (F0) at midpoint of vowel; and (d) formant frequencies (F1, F2, F3), also measured at midpoint of vowel. Statistical comparisons were conducted on (a) average values for each syllable, and (b) standard deviations. Although there were numerical differences between normally hearing and hearing-impaired groups, few differences were statistically significant.     

An automated system for the analyses of temporal speech patterns: description of the hardware and software

A system (WELMAR II) is described for analyzing time patterns of speech on small computers. Temporal speech patterning refers to the pacing of the sounds and silences that make up a stream of speech. The system is particularly useful for research involving clinical populations since it has been shown that speech rhythms are sensitive to interpersonal influence, to dimensions of personality, and to psychological pathology.     

Optimizing the perception of soft speech and speech in noise with the Advanced Bionics cochlear implant system

Abstract

Objective: This study aimed to provide guidelines to optimize perception of soft speech and speech in noise for Advanced Bionics cochlear implant (CI) users. Design: Three programs differing in T-levels were created for ten subjects. Using the T-level setting that provided the lowest FM-tone, sound-field threshold levels for each subject, three additional programs were created with input dynamic range (IDR) settings of 50, 65 and 80 dB. Study sample: Subjects were postlinguistically deaf adults implanted with either the Clarion CII or 90K CI devices. Results: Sound-field threshold levels were lowest with T-levels set higher than 10% of M-levels and with the two widest IDRs. Group data revealed significantly higher scores for CNC words presented at a soft level with an IDR of 80 dB and 65 dB compared to 50 dB. Although no significant group differences were seen between the three IDRs for sentences in noise, significant individual differences were present. Conclusions: Setting Ts higher than the manufacturer's recommendation of 10% of M-levels and providing IDR options can improve overall speech perception; however, for some users, higher Ts and wider IDRs may not be appropriate. Based on the results of the study, clinical programming recommendations are provided.

Sumario

Objetivo: Este estudio buscó proporcionar pautas para optimizar la percepción del lenguaje suave y del lenguaje en ruido para usuarios del implante coclear (IC) de Advanced Bionics. Diseño: Se crearon tres programas para diez pacientes, que eran diferentes en sus niveles T. Al usar el control de nivel T que proporcionaba el tono FM más bajo, con niveles de umbral en campo libre para cada sujeto, se crearon tres programas adicionales con controles de ingreso del rango dinámico IRD de 50, 65 y 80 dB. Muestra de Estudio: Los sujetos fueron sordos adultos postlingüísticos implantados con los modelos Clarion CII o 90K CI. Resultados: Los niveles de umbral en campo libre fueron más bajos con los niveles T colocados 10% más alto que los niveles M y con los dos IDR más anchos. Los datos del grupo revelaron puntuaciones significativamente mayores con palabras CNC presentadas en un nivel suave con un IDR de 80 dB y 65 dB comparados con 50 dB. No obstante que no se encontraron diferencias significativas en los grupos entre los tres IDR para oraciones en ruido, si se presentaron diferencias significativas individuales. Conclusiones: La colocación de los niveles T más altos en 10% que la recomendación del fabricante, sobre los niveles M y el proporcionar opciones de IDR, en general pueden mejorar la percepción del lenguaje; no obstante, niveles mayores de T y IDR más anchas, pueden no ser apropiados para algunos usuarios. Con base en los resultados de este estudio, se proporcionan recomendaciones clínicas para la programación.