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PubMedDate not supplied

Right hemisphere contribution to developmental language disorder: Neuroanatomical and behavioral evidence.

UNLABELLED: Developmental language disorder (DLD) is identified by virtue of the verbal deficits that define it. However, numerous studies have also documented nonverbal deficits in this population. This study attempts to explain the co-occurrence of both verbal and nonverbal deficits in this population from a brain-based perspective. Two samples of adults selected for DLD were compared with subjects without such a history on verbal and nonverbal skills in exploratory and confirmatory studies. Subjects also received MRI scans, which were used to determine the relation between left- and right-hemisphere regions hypothesized to relate to the behavioral skills tested. Results revealed replicable differences between groups on both verbal and nonverbal tasks. In addition, a significant association between performance on tests sensitive to facial affect and spatial rotation with the gray matter volume within the right supramarginal gyrus was found in both samples. These results support the hypothesis of a right hemisphere contribution to the profile of DLD. LEARNING OUTCOMES: As a result of this activity, the participant will be able to describe evidence in support of a role for the right hemisphere in DLD.

Adult↗

PubMedDate not supplied

Brain imaging studies of developmental stuttering.

UNLABELLED: This paper reviews recent brain imaging research on stuttering against a background of studies that the writer and colleagues have been conducting at the University of Texas Health Science Center in San Antonio. The paper begins by reviewing some pertinent background to recent neuroimaging investigations of developmental stuttering. It then outlines the findings from four brain imaging studies that the San Antonio group has conducted using H2(15)O positron emission tomography (PET). Finally, some of the principal findings that are emerging across brain imaging studies of stuttering are reviewed, while also highlighting--and attempting to resolve--some apparent across-study inconsistencies among the findings. Research on stuttering using magnetoencephalogaphy (MEG) and transcranial magnetic stimulation (TMS) is also considered. The findings increasingly point to a failure of normal temporal lobe activation during speech that may either contribute to (or is the result of) a breakdown in the sequencing of processing among premotor regions implicated in phonologic planning. LEARNING OUTCOMES: As a result of this activity, the participant will become familiar with some recent neurophysiological correlates of stuttering and what they suggest about the nature of this disorder.

Brain↗

PubMedDate not supplied

Positron emission tomography in cochlear implant and auditory brainstem implant recipients.

UNLABELLED: Positron emission tomography (PET) imaging was used to evaluate the brain's response to auditory stimulation, including speech. Five cases of adults illustrate the utility of PET to illuminate auditory processing with cochlear or brainstem implants. Subjects showed varying degrees of success in processing speech, which was reflected in the resulting PET images. Functional speech processing was associated with activation in areas classically associated with speech processing. In one patient who did not achieve functional speech processing, activation in frontal regions suggests that the subject used other cognitive strategies to assist auditory processing. LEARNING OUTCOMES: As a result of this activity, the participant will be introduced to the principles of PET and the application of this technology to deaf patients who have received an implanted auditory prosthesis.

Brain↗

PubMedDate not supplied

The neural representation of language in users of American Sign Language.

UNLABELLED: Studies of American Sign Language (ASL) offer unique insights into the fundamental properties of human language. Neurolinguistic studies explore the effects of left and right hemisphere lesions on the production and comprehension of signed language. Following damage to the left hemisphere perisylvian regions, signers, like users of spoken languages, exhibit frank aphasic disturbances. Sign language paraphasia illustrates the linguistic specificity of impairment. A case study involving cortical stimulation mapping (CSM) in a deaf signer provides evidence for the specialization of Broca's area in sign language production. The effects of right hemisphere damage highlight the specialized properties of sign language use. Data from functional magnetic resonance imaging (fMRI) of deaf signers confirm the importance of left hemisphere language structures in the use of signed language, but also reveal the contributions of right hemisphere regions to the processing of ASL. These studies provide new insights into the complementary roles of biology and environment in language representation in the human brain. LEARNING OUTCOMES: As a result of this activity, the participant will read studies of aphasia in users of signed language and a discussion of neurolinguistic studies of paraphasia in ASL. The participant will examine the role of the right hemisphere in language use and findings from a functional imaging study of sentence processing in ASL and English.

Aphasia, Broca↗

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Neuroimaging studies of speech an overview of techniques and methodological approaches.

UNLABELLED: Over the past two decades, there has been an explosion in the use of imaging technology to study the structure and function of the human brain. The purpose of this article is to explore how functional neuroimaging has been applied to the study of speech production. This article begins with a brief review of neuroimaging methods and limitations. Then, two approaches that can be used to study the brain areas that support speech production are illustrated. The first approach is based upon comparisons across different types of language production tasks; the second approach is based upon comparing the effects of different types of stimuli within a single task. Results obtained using these approaches will be used to dissociate the contributions of different brain regions involved in speech production. For example, evidence will be presented that Broca's area contributes to phonological encoding, whereas motor cortex, the supplementary motor area (SMA), and the cerebellum support phonetic encoding and articulation. LEARNING OUTCOMES: As a result of this activity, the participant will be able to describe basic methods for conducting a positron emission tomography study and a functional magnetic resonance imaging study. The participant will also be introduced to two approaches for fractionating the brain regions involved in speech production: (1) comparisons between tasks, and (2) manipulations of stimulus materials. Finally, the participant will be able to summarize a cognitive model of the components of speech production that will be introduced, and potential mappings between these components and particular brain regions will be discussed.

Brain↗

PubMedDate not supplied

The integrity of the syllable in developmental apraxia of speech.

UNLABELLED: Three children with developmental apraxia of speech (DAS) identified the number of syllables in words, judged intrasyllabic sound positions, and constructed syllable shapes within monosyllabic frames. Results suggest that DAS children demonstrate an apparent breakdown in the ability to perceive "syllableness" and to access and compare syllable representations with regard to position and structure. Based on these findings, DAS is viewed as a disorder characterized by an impoverished phonological representation system. LEARNING OUTCOMES: On the basis of this article, the reader will be able to (1) describe the deficits in syllabic perception demonstrated by some participants with DAS; (2) examine the utility of metalinguistic tasks in the differential diagnosis of DAS; and (3) evaluate the findings with respect to competing theoretical perspectives on DAS.

Apraxias↗

PubMedDate not supplied

The effect of dimension and vocabulary age on rapid picture naming in children.

UNLABELLED: This investigation involved measures of the reaction times of normally developing children who were asked to name a series of centrally presented picture stimuli of varying vocabulary age and dimension. Results of the ANOVA on reaction times indicated a significant main effect of vocabulary level and an interaction of Dimension x Vocabulary level for the normally developing children. Post-hoc tests showed significant differences between two- and three-dimensional pictures for higher-level vocabulary items, but not for lower-level vocabulary items. This finding indicates that central operations involved in picture naming are influenced differentially by the physical characteristics of the stimulus items. The finding that two-dimensional higher-level vocabulary items were associated with significantly longer reaction times than the three-dimensional higher-level vocabulary suggests that dimensionality may be a critical feature for rapid lexical access for higher-level picture vocabulary. Clinically, the employment of three-dimensional forms may facilitate access to stored visual object memory for advanced levels of picture vocabulary. LEARNING OUTCOMES: As a result of this activity, participants will be able to (1) identify the various visual and verbal processes involved in the naming of pictures; and (2) understand the influence of physical characteristics of pictures on reaction time in rapid naming tasks.

Age Factors↗

PubMedDate not supplied

Intonation in partner accommodation for aphasia: a descriptive single case study.

UNLABELLED: Previous research has suggested that speaking partners adjust their intonation when conversing with people who are ill or elderly. In the descriptive case study presented in this paper we ask, what adjustments in intonation might be made by the communication partner of an aphasic speaker? A sociolinguistic, semantic analysis of intonation was used to describe the intonation pattern used by the neighbor of an aphasic speaker, during a 15-min natural interaction with the aphasic speaker, his wife, and the first author. The neighbor was found to make more use of two dimensions of intonation that reflected differences in her relationship to the information conveyed, when addressing the aphasic speaker in contrast to when addressing his wife. Firstly, she made proportionally more use of pitch movements associated with referring to shared information, and secondly, she made more use of marked tones (rising-falling, and rising tones). We discuss whether the observed differences may represent an accommodation to speaking to a person with aphasia. LEARNING OUTCOMES: The reader will be able: (1) to recognize the role of intonation in discourse as a resource for the exchange of interpersonal meaning, and (2) to identify when speakers are using intonation as part of their speech accommodation for aphasia.

Aged↗

PubMedDate not supplied

Phonatory characteristics of parkinsonian speech before and after morning medication: the ON and OFF states.

UNLABELLED: After prolonged treatment with L-dopa, patients with Parkinson's disease (PD) experience fluctuations in motor performance. Changes in voice production have been documented perceptually during periods of fluctuation, but few quantitative changes have been found. The purpose of this study is to examine the acoustic-phonatory characteristics of PD speech before and after taking medication, to determine if fluctuations affected phonation. Nine PD patients participated in this study. Multiple analyses were performed, and revealed that fundamental frequency (Fo) variability in vowels and mean Fo were higher, while intensity range was lower in PD patients compared to controls. When the PD subjects were examined after versus before medication, group differences were small, but phonatory improvements were seen in individual subjects. Discussion focuses on physiological changes and variability in PD, and implications of response fluctuations to speech production. LEARNING OUTCOMES: As a result of this activity, the participant will be able to (1) acquire knowledge and understanding of PD and the voice characteristics commonly associated with PD and (2) understand the effects of L-dopa-related fluctuations on voice production in PD.

Aged↗

PubMedDate not supplied

Definitional skill in school-age children with specific language impairment.

UNLABELLED: The purpose of the present study was to investigate the definitional skills in children with specific language impairment (SLI). Fifteen children with SLI and 15 matched control participants were asked to define 10 common high-frequency nouns (e.g., apple, horse, and boat). Definitions were scored for both content and form. Children with SLI scored significantly lower than children with typically developing language for both content and form. Results suggest that lexical access and/or lack of metalinguistic knowledge were potential causes for the lower scores earned by the children with SLI when defining common nouns. Implications for assessment of and intervention for definitional skill are discussed. LEARNING OUTCOMES: The reader will be able to explain the importance of definitional skill and how this skill generally develops in typically developing children. The reader will be able to describe the performance, in terms of content and form, of children with SLI and their typically developing peers in defining common high-frequency nouns. The reader will also be able to discuss what possible impact linguistic knowledge, metalinguistic knowledge, and lexical access have on children with SLI in defining the common nouns in this study.

Achievement↗

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Values in practice and practising values.

UNLABELLED: This paper first explores evidence that speech-language pathologists are experiencing dissatisfaction with their roles and then argues that one source of dissatisfaction may be in a mismatch between personal and organisational values. In order to clarify their notion of values, the authors next present a model that outlines various levels at which values operate in therapy and show how values pervade all aspects of practice. The paper then offers some practical examples of how a new organisation has tried to address overtly the implementation of values in practice, with suggestions for how other practitioners might go about making their own personal and organisational values more explicit. The paper ends with a few caveats about the difficulties and dangers of attending to values and conclude with why it is a beneficial endeavour. LEARNING OUTCOMES: Participants will be able to (1) understand issues and practices that contribute to professional burnout; (2) describe a values-based framework for clinical practice; (3) understand the importance of concerning oneself with values, despite the difficulties in so doing; (4) explore some difficulties in adopting a medical model.

Burnout, Professional↗

PubMedDate not supplied

The validity of functional assessments of communication and the Activity/Participation components of the ICIDH-2: do they reflect what really happens in real-life?

UNLABELLED: This paper aims to provide a better understanding of the nature of functional communication activities so that assessment and treatment efforts are based on a theoretical framework and empirical data. Three sources of information are discussed. The first is the Activity/Participation dimensions of the World Health Organization's International Classification of Functioning, Disability, and Health. The second source is existing assessments of functional communication. The final source is data obtained from observational studies conducted in our research unit. The studies have observed the everyday communication of people with aphasia, people with Traumatic Brain Injury (TBI), and patients in hospital. The simplification of real-life communication in the WHO classification scheme, the variability of item sampling in existing assessments, and the complexity of communication observed in real-life settings has led to the conclusion that there are three levels of functional communication assessment: generic, population-specific, and individualized. Clinicians may choose which level suits their purpose. When clinicians routinely choose from a range of sophisticated functional assessments to inform their therapy, the seed that Martha Taylor Sarno planted and nourished for the past 30 years or more will truly flourish throughout the world of speech-language pathology. LEARNING OUTCOMES: As a result of this activity, participants will (1) understand the theoretical framework and data base that motivates assessment and treatment of functional communication activities, (2) be able to discuss the World Health Organization's Classification of Functioning, Disability and Health and (3) gain information about functional assessment and observational sampling of real world communication activities across three levels.

Aphasia↗

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Motivating for infrastructure change: toward a communicatively accessible, participation-based stroke care system for all those affected by aphasia.

UNLABELLED: This paper provides a rationale for changing the base upon which healthcare services for individuals with stroke and aphasia can be provided. It is a nuts-and-bolts summary of the interactions between the Aphasia Institute and the West Greater Toronto Stroke Network who worked together to effect meaningful change. Further, the article provides a practical set of guidelines for others to use, should they wish to effect such change. LEARNING OUTCOMES: As a result of reading this article, the participant will be able to (1) develop a strong rationale changing the infrastructure related to healthcare services for individuals and families who have incurred stroke and aphasia; (2) describe the activities undertaken at the Aphasia Institute for accomplishing these changes; (3) refer to a practical set of guidelines for effecting infrastructural change.

Aphasia↗

PubMedDate not supplied

Intelligibility as a linear combination of dimensions in dysarthric speech.

UNLABELLED: Speech samples of 79 dysarthric patients (native speakers of English) were judged by two experienced judges by means of a perceptual rating scale covering the four main dimensions of speech production: voice quality, articulation, nasality and prosody as well as overall intelligibility. In order to determine the relative influence of the four basic dimensions on intelligibility in this study group, a multiple regression model was applied. This model shows that intelligibility can be expressed as a linear combination of weighted perceptual dimensions (R2 = 0.89). This expression reveals the relative importance of the individual dimensions on overall intelligibility. Articulation is shown to be the strongest contributor to intelligibility. A group of 16 dysarthric patients (native speakers of Dutch) was used as a control group in order to evaluate the validity of the expression. Judged and calculated ratings (within the 95% prediction intervals) were in agreement for 75% of the patients. These findings may contribute in the construction of a better balanced measure of functional intelligibility. LEARNING OUTCOMES: 2. The impact of articulation on intelligibility is dominant but inclusion of the dimensions "nasality", "voice" and "prosody" results in a more balanced estimation of intelligibility.

Adolescent↗

PubMedDate not supplied

Service delivery framework for adolescents with communication problems who are involved in violence.

UNLABELLED: The purpose of this article is to provide speech-language pathologists (SLPs) with a framework to address the communication problems of adolescents involved in violence. Although it is not considered to be a comprehensive framework for planning intervention programs, it will provide suggestions to assist SLPs to conceptualize their role in addressing the communication needs of these individuals. Recommendations acquired through observations, interviews, and empirical data will form the basis for suggestions. Youth in correctional facilities come from schools and return to schools following their commitment, therefore, research from incarcerated adolescents serves as an appropriate foundation to form the basis for intervention recommendations. Hence, suggestions will apply to SLPs working in correctional facilities and school settings. Intervention programs containing socially and academically relevant activities that focus on assessment, general intervention principles, conversational interaction skills, and multidisciplinary interventions are included in the article. LEARNING OUTCOMES: Readers will understand (1) a framework to address the communication problems of adolescents involved in violence and (2) how research findings support the role of SLPs in addressing the needs of adolescents involved in violence.

Adolescent↗

PubMedDate not supplied

Speech disfluency in centenarians.

UNLABELLED: Other than a single case presentation of a 105-year-old female, no other studies have addressed the speech fluency characteristics of centenarians. The purpose of this study was to provide descriptive information on the fluency characteristics of speakers between the ages of 100-103 years. Conversational speech samples from seven speakers were evaluated for the frequency and types of disfluencies and speech rate. The centenarian speakers had a disfluency rate similar to that reported for 70-, 80-, and early 90-year-olds. The types of disfluencies observed also were similar to those reported for younger elderly speakers (primarily whole word/phrase, or formulative fluency breaks). Finally, the speech rate data for the current group of speakers supports prior literature reports of a slower rate with advancing age, but extends the finding to centenarians. LEARNING OUTCOMES: As a result of this activity, participants will be able to: (1) describe the frequency of disfluency breaks and the types of disfluencies exhibited by centenarian speakers, (2) describe the mean and range of speaking rates in centenarians, and (3) compare the present findings for centenarians to the fluency and speaking rate characteristics reported in the literature.

Aged↗

PubMedDate not supplied

The role of genes in the etiology of specific language impairment.

UNLABELLED: Although specific language impairment (SLI) often runs in families, most pedigrees are not consistent with a single defective gene. Before progress can be made in molecular genetics, we need a better understanding of which aspects of SLI are heritable. Twin studies are useful in allowing us to distinguish genetic from environmental influences. This point is illustrated with a study in which twins were given tests of nonword repetition (regarded as an index of phonological short-term memory) and auditory processing. Children with SLI were impaired on both measures, but these deficits had different origins. Auditory processing problems showed no evidence of genetic influence, whereas the nonword repetition deficit was highly heritable. Future genetic studies of SLI may be most effective if they use measures of underlying cognitive processes, rather than relying on conventional psychometric definitions of disorder. LEARNING OUTCOMES: Information in this manuscript will serve to (1) equip readers with an elementary understanding of methods used in molecular genetic studies of language impairment; (2) familiarise readers with the logic of twin studies in behavioural genetics, using both categorical and quantitative methods; (3) illustrate the importance of phenotype definition for genetic research, and the usefulness of genetic methods in illuminating theoretical relationships between deficits associated with SLI; (4) show how genetically informative methods can be used to study environmental as well as genetic influences on impairment.

Alleles↗

PubMedDate not supplied

Finding susceptibility genes for developmental disorders of speech: the long and winding road.

UNLABELLED: Finding susceptibility genes for complex disorders is the next major challenge facing genetics researchers. The purpose of this paper is to stimulate creative thinking about the gene-finding process for developmental speech disorders (DSDs), specifically disorders of articulation/phonology and stuttering. The paper will begin with a review of existing behavioral genetic studies of these phenotypes. This will be followed by a discussion of roadblocks that may impede the molecular study of DSDs, research that is in very early stages of development. As a third objective, the small number of molecular genetic studies of DSDs that have been published or presented will be described. The paper concludes with a discussion of research strategies that may maximize the success of molecular studies of speech phenotypes. It will be argued that progress will most likely be enhanced if theories about biological systems and processes can be used to narrow the search for candidate susceptibility genes. LEARNING OUTCOMES: The reader will be introduced to findings and conceptual issues that relate to the behavioral and molecular genetic investigation of DSDs. After completing this paper, readers should be able to (a) identify key epidemiological findings for the three speech phenotypes that were discussed (DAS, speech delay, and stuttering); (b) summarize the findings of the behavioral genetic studies of speech disorders that were presented; (c) identify four specific challenges that may impede future molecular genetic studies of these phenotypes; (d) describe the methodological sequence that led to the discovery of the FOXP2 gene; and (e) summarize the two research strategies that were presented to potentially reduce sample heterogeneity for future molecular genetics research.

Age of Onset↗