Hemispheric language dominance of language-disordered, articulation-disordered, and normal children.
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Auditory Perception↗
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Oral structural and neuromuscular characteristics in children with normal and disordered articulation.
The primary purpose of this study was to determine whether there were any signs of structural and/or neuromuscular aberrations in the speech mechanisms of children who were previously diagnosed as having "functional" articulation disorders. These children were compared with a group of normally articulating children. Results of in-depth oral mechanism examinations revealed no significant differences between these groups on any of the measures made. The clinical implications of such findings are discussed.
Articulation Disorders↗
The occurrence of developmental apraxia of speech in a mild articulation disorder: a case study.
Although Developmental Apraxia of Speech (DAS) often is considered a severe communication disorder, speech-language pathology literature supports the idea that DAS also can be exhibited in children with mildly disordered articulation. The case study is that of an elementary age client with a seemingly mild "r" articulation problem but who also presented characteristics consistent with DAS. Awareness of the possible presence of DAS when assessing and planning remediation for clients exhibiting mild articulation problems could increase the effectiveness of our professional services to these children.
Apraxias↗
[Clinical characteristics and speech therapy of lingua-apical articulation disorder].
OBJECTIVE: To explore the clinical characteristics and speech therapy of 62 children with lingua-apical articulation disorder. METHODS: Peabody Picture Vocabulary Test (PPVT), Gesell development scales (Gesell), Wechsler Intelligence Scale for Preschool Children (WPPSI) and speech test were performed for 62 children at the ages of 3 to 8 years with lingua-apical articulation disorder. PPVT was used to measure receptive vocabulary skills. GESELL and WPPSI were utilized to represent cognitive and non-verbal ability. The speech test was adopted to assess the speech development. The children received speech therapy and auxiliary oral-motor functional training once or twice a week. Firstly the target sound was identified according to the speech development milestone, then the method of speech localization was used to clarify the correct articulation placement and manner. It was needed to change food character and administer oral-motor functional training for children with oral motor dysfunction. RESULTS: The 62 cases with the apical articulation disorder were classified into four groups. The combined pattern of the articulation disorder was the most common (40 cases, 64.5%), the next was apico-dental disorder (15 cases, 24.2%). The third was palatal disorder (4 cases, 6.5%) and the last one was the linguo-alveolar disorder (3 cases, 4.8%). The substitution errors of velar were the most common (95.2%), the next was omission errors (30.6%) and the last was absence of aspiration (12.9%). Oral motor dysfunction was found in some children with problems such as disordered joint movement of tongue and head, unstable jaw, weak tongue strength and poor coordination of tongue movement. Some children had feeding problems such as preference of eating soft food, keeping food in mouths, eating slowly, and poor chewing. After 5 to 18 times of therapy, the effective rate of speech therapy reached 82.3%. CONCLUSION: The lingua-apical articulation disorders can be classified into four groups. The combined pattern of the articulation errors is the most common one. Most of the apical sounds are replaced by velar sounds. The speech localization method is very useful in the therapy of apical articulation disorder. For children with feeding problems and oral motor dysfunction, it is needed to improve food texture and administer oral motor skill training.
Articulation Disorders↗
Assessment of information processing in children with functional articulation disorders.
OBJECTIVE: The aim of this study was to investigate the information processing skills in children who have functional articulation disorder by using a cognitive-linguistic test battery. MATERIAL-METHODS: Thirty-three children with functional articulation disorder were enrolled in this study. They ranged in age from 6 to 10 years. A control group without articulation disorders was composed of 160 children with similar properties. In the first stage of this study, both groups were administered the Ross Information Processing Assessment Test-Primary. In this test, the scores obtained from eight subtests; namely immediate memory, recent memory, recall of general information, spatial orientation, temporal orientation, organization, problem solving and abstract reasoning, was calculated for both groups. The scores of the eight subtests are combined to form the four composites. These composites are memory quotient, orientation quotient, thinking and reasoning quotient and information processing quotient. Information processing quotient is the best and the most comprehensive estimate of a child's overall information processing ability. In the second stage of the study the articulation-disordered group was divided into two subgroups according the number of the mistakes, which was done at the level of the phoneme. The scores obtained from both subgroups were compared with the scores of the control group. RESULTS: The overall statistical analysis of the scores revealed that; the study group had significantly lower scores than the control group from memory quotient, thinking and reasoning quotient and information processing quotient. When compared to control group, the subgroup who cannot pronounce one phoneme had similar scores from all four composites. Moreover, the children who cannot pronounce multiple phonemes had significantly lower scores from memory quotient, thinking and reasoning quotient and information processing quotient. The results obtained from this study seem to be suggesting that information processing skills of children with functional articulation disorder are significantly low as compared to normal children. CONCLUSIONS: These results are revealing that the information processing skills of children with functional articulation disorder should be investigated in a detailed manner. According to the results obtained from this investigation these children should be put on deficit oriented education programs in addition to articulation therapy.
Articulation Disorders↗
Speech summer camp for treating articulation disorders in cleft palate patients.
INTRODUCTION: Compensatory articulation disorder (CAD) severely affects speech intelligibility of cleft palate children. CAD must be treated with speech therapy. Children can manage articulation better when they use language in event contexts such as every day routines. OBJECTIVE: The purpose of this paper is to study and compare two modalities of speech intervention in cleft palate children with associated CAD. The first modality is a conventional approach providing speech therapy in 1-h sessions, twice a week. The second modality is a speech summer camp in which children received therapy 4h per day, 5 days a week for a period of 3 weeks. We were aimed to determine if a speech summer camp could significantly enhance articulation in CP children with CAD. MATERIALS AND METHODS: Forty-five children with repaired cleft palates who exhibited CAD were studied. A matched control group of 45 children with repaired cleft palate who also exhibited CAD were identified. The patients included in the first group attended a speech summer camp for 3 weeks. The matched control subjects included in the second group received speech therapy aimed to correct CAD twice per-week in 1-h sessions. RESULTS: At the onset of either the summer camp or the speech therapy period, the severity of CAD was evenly distributed with non-significant differences across both groups of patients (p > 0.05). After the summer camp (3 weeks) or 12 months of speech therapy sessions at a frequency of twice per-week, both groups of patients showed a significant decrease in the severity of their CAD (p < 0.05). However, when the distribution of the severity of CAD was compared at the end of the summer camp or the speech therapy period, non-significant differences were found between both groups of patients (p > 0.05). CONCLUSIONS: A speech summer camp is a valid and efficient method for providing speech therapy in cleft palate children with compensatory articulation disorder.
Articulation Disorders↗
Articulation disorders associated with maxillary growth after attainment of normal articulation after primary palatoplasty for cleft palate.
Little attention has been given to the connection between maxillary growth and the emergence of articulation disorders among cleft palate patients who previously successfully attained normal articulation after undergoing primary palatoplasty. Follow-up assessment of 22 surgically treated unilateral cleft lip and palate patients who attained normal articulation before school entry revealed that, during mixed dentition, half the patients exhibited palatalized articulation and half retained normal articulation. To determine the possible effect on articulation of growth changes in dental arch dimensions, a comparison was made of deciduous dentition and mixed dentition oral cavity measurements. Indications are that palatalized articulation occurs in patients with a smaller anterior palatal volume, the presence of linguoversion teeth, and poorer growth ability. Results reveal the importance of early management of dental arch dimensions, and the need for periodic assessment and management of articulation even for patients who attain normal articulation subsequent to primary palatoplasty.
Articulation Disorders↗
Perception of voiceless fricatives by children with a functional articulation disorder.
The two studies presented here examine the relationship between speech perception and speech production errors in children who have a functional articulation disorder. In both experiments, speech perception was assessed with a word identification test, based upon a synthesized continuum of speech stimuli, contrasting the specific phonemes that were associated with production errors in our sample of articulation-disordered subjects. Experiment 1 required subjects to identify words that contrasted the phonemes /s/ and /S/. In this test, adults, normal speaking 5-year-olds, and some articulation-disordered 5-year-olds identified the words seat and sheet appropriately and reliably. However, a subgroup of articulation-disordered children were unable to identify the test stimuli appropriately. Experiment 2 required a second group of subjects to identify words that contrasted the phonemes /s/ and /theta/. Although both adults and normal speaking children responded appropriately to the words sick and thick, in this test, none of the articulation-disordered children was able to identify these words appropriately. It is concluded that, for a subgroup of children who have a functional articulation disorder, production errors may reflect speech perception errors.
Adult↗
[Pharmacotherapy of voice and articulation disorders in aphasia].
The phonation and articulation disorders in a group of aphasics with aphonia/dysarthrophonia could be considerably reduced by the use of medication. The group consisted of 10 apoplectic patients whose resulting aphasia could not be classified because of the vocal impairment. Extrapyramidal motion disorders were proved by laryngoscopy and stroboscopy. A definite improvement of phonation and articulation was observed after L-dopa medication.
Aphasia↗
Morphophonemic rule learning in normal and articulation-disordered children.
This study investigated the phonological learning abilities of articulation-disordered children. Eight normally speaking and eight articulation-disordered kindergarten children were taught an artificial morphophonemic rule. The rule required the subjects to extract and organize phonological information by differentiating among the critical features of stop and fricative consonants. A miniature artificial language paradigm was used to teach the rule by auditorily presenting a limited number of examples of the rule and measuring generalization to untaught items. The groups were compared to determine if they differed in rate or accuracy of learning and generalization of the correct response. Individual patterns of learning were also examined. Results revealed essentially no differences in the way the two groups learned the stop class. In contrast, the disordered children incorporated fricatives into the rule more quickly than the normal children did. In addition, there was a trend for the disordered children to respond with more accuracy ad more generalized responses to the fricatives. This trend was unexpected and is discussed in terms of a sensitive period for learning phonological information.
Articulation Disorders↗
Using electropalatography (EPG) to diagnose and treat articulation disorders associated with mild cerebral palsy: a case study.
Some children with mild cerebral palsy have articulation disorders that are resistant to conventional speech therapy techniques. This preliminary study investigated the use of electropalatography (EPG) to diagnose and treat a long-standing articulation disorder that had not responded to conventional speech therapy techniques in an 8-year-old boy (D) with a congenital left hemiplegia. The targets for EPG therapy were speech errors affecting velar targets /k, g, eta/, which were consistently fronted to alveolar placement [t, d, n]. After 15 sessions of EPG therapy over a 4-month period, D's ability to produce velars improved significantly. The EPG data revealed two features of diagnostic importance. The first was an unusually asymmetrical pattern of tongue-palate contact and the second was unusually long stop closure durations. These features are interpreted as a subtle form of impaired speech motor control that could be related to a mild residual neurological deficit. The results suggest that EPG is of potential benefit for diagnosing and treating articulation disorders in individuals with mild cerebral palsy.
Articulation Disorders↗
An instrumental phonetic study of lingual activity in articulation-disordered children.
Traditional auditory-based assessment procedures for diagnosing articulation disorders are limited in that they provide no direct information on activities of the speech organs. In this study electropalatography (EPG) was used to obtain details of tongue contacts with the hard palate in 4 articulation-disordered children, 2 of whom had been categorized as dysarthric. Their lingual-palatal contact patterns during four repetitions of word lists containing lingual consonants in different phonetic environments, were compared with each other and with a group of normal speakers. EPG provided relevant diagnostic information in that all 4 experimental subjects showed patterns that differed from the normals in both spatial configuration and variability. The nature of their distorted patterns allowed a tentative diagnosis of 2 of the children as verbal dyspraxic.
Alveolar Process↗
The relationship between articulation disorders and motor coordination in children.
This study was designed to examine the relationship between articulation disorders, soft neurological signs, and motor abilities. Fifteen children with articulation problems, as measured by the Templin-Darley Articulation Screening Test and a connected speech sample, were compared with a normal control group (matched for sex and age) on the Quick Neurological Screening Test, the Imitation of Postures test (from the Southern California Sensory Integration Tests), and the 1984 version of the Stott Test of Motor Impairment that has been revised by Henderson. A significant difference was found between the groups on the Motor Impairment Test and the Quick Neurological Screening Test, supporting the hypothesis that the articulation disorder children would have more motor coordination problems and soft neurological signs than the normal children in the control group. There was no between-group difference on the Imitation of Postures test, suggesting that as a group, children with articulation deficits are not dyspraxic. This study supports other research findings stating a relationship between articulation problems and motor impairment, but it also indicates that this motor impairment is not necessarily dyspraxia.
Articulation Disorders↗
Performance of articulation-disordered children on language and perception measures.
Five-year-old articulation-disordered children were classified as syllable reducers or as substituters. They were compared to each other and to normal controls on measures of expressive and receptive language and on preception of word-initial and word-final voicing contrasts. There were significant differences among the groups on several imitative expressive language measures, with the syllable reducers making both deletion and substitution errors and the substituters making substitution errors for functors. There were no significant differences on a receptive language measure, nor in perception of final voicing contrasts, but the articulation-disordered groups performed more poorly than the controls in perception of initial voicing contrasts. Children's familiarity with the stimulus words of the perception task was related to their performance on language measures. Word familiarity appeared to interact with the intrinsic difficulty of stimulus pairs in the case of word-final voicing contrasts.
Articulation Disorders↗
Voicing contrasts and their phonological implications in the speech of articulation-disordered children.
Five-year-old articulation-disordered children, some classified as substituters and some as syllable reducers, were compared with normal child and adult controls in their production of voicing contrasts. These contrasts occurred in minimal pairs containing word-final obstruents and in minimal triples containing word-initial stops and /s/-plus-stop clusters in initial position. Measures of vowel duration, voice onset time (VOT), and frequency of use of phonetic voicing were made from spectrograms. In every comparison the substituters' performance resembled that of the normal controls, as did the syllable reducers' use of VOT in stop singles. The syllable reducers used larger vowel duration ratios than the normal controls in a few minimal pairs and used phonetic voicing less often in word-initial /b d g/. The production data and previously reported perception data were examined for evidence that individual syllable reducers had voicing contrasts in underlying phonological form despite their deletions of obstruents in which these contrasts occurred. Most of the syllable reducers appeared to recognize underlying voicing contrasts in at least a few final obstruents and in some of the initial stop singles.
Articulation Disorders↗
Relationship of tongue-thrust swallowing and anterior open bite with articulation disorders: a clinical study.
A Paediatric dentist may be the first person consulted for professional advice concerning children with speech problems. A positive significant relationship has been hypothesized by some authors between tongue-thrust swallowing and articulation disorders in children. This study was undertaken to find out whether any articulation disorders are associated with the habit of tongue-thrust swallowing, or is it the type of anterior bite that plays an important role in the normal or abnormal speech production in tongue-thrust swallowers. Forty subjects with tongue-thrust swallowing in the age group of 7-16 years were examined. Of these 20 had normal anterior bite while rest had anterior open bite. A word articulation test was used and word level articulation testing was done for initial, medial and final positions. The sounds tested were: Linguoalveolars, Labiodentals, Linguodentals, Linguopalatals, Bilabials and Linguovelars. The results of the study have indicated that the presence of articulation disorders is strongly associated with the anterior open bite present in tongue-thrust swallowers but a simple, direct relationship between the presence of defective consonant sounds and tongue-thrust swallowing has not been found.
Adolescent↗
Linguistic development in cleft palate patients with and without compensatory articulation disorder.
INTRODUCTION: Cleft palate patients frequently show compensatory articulation disorder (CAD). CAD severely affects speech intelligibility and requires a prolonged period of speech intervention. CAD has been considered a phonologic disorder. Thus, it seems necessary to explore the relationship between CAD and language development. OBJECTIVE: To study the relationship between language development and the presence of CAD in cleft palate patients. MATERIALS AND METHODS: Cleft palate children with residual velopharyngeal insufficiency (VPI) after palatal closure, with and without CAD were studied. Only patients with an age ranging from 3 to 8 years were included in the study group. Twenty-nine cleft palate patients with residual VPI and CAD were included in the first group (active). The second group was assembled with 29 cleft palate patients with residual VPI without CAD, matched by age and sex (control). For evaluating language development, all patients were analyzed using the Situational-Discourse-Semantic (SDS) Model [13]. This Model is a valuable tool for conducting naturalistic observation and descriptive assessment of language development. The SDS Model provides a detailed description of three contexts (situational, discourse, and semantic) in ten levels of cognitive and linguistic organization. RESULTS: In all contexts considered by the model of cognitive and linguistic organization used for this study, i.e. SDS, a Fischer exact test demonstrated that patients with CAD showed a significantly higher frequency of language delay as compared with patients without CAD. None of the patients present with CAD showed an adequate level of language development. The degree of language delay was greater in the situational context as compared to the semantic and discourse contexts. CONCLUSIONS: Cleft palate patients present with CAD, demonstrated a significantly higher frequency of delay in language development as compared with cleft palate patients present with VPI without CAD. From the results of this paper, it seems that a detailed evaluation of all aspects of cognitive and linguistic organization should be performed in cleft palate patients, especially in patients present with CAD. Moreover, it seems that speech intervention in cleft palate patients with CAD should address not only the articulation process, but also specific aspects of language development.
Adaptation, Physiological↗
A preliminary investigation of the efficacy of oral motor exercises for children with mild articulation disorders.
Although oral motor therapy is sometimes used to treat articulation disorders in school-age children, several reports question its efficacy. In this case study, four first-grade students, two boys and two girls, received 15 half-hour sessions of oral motor treatment based on Easy Does it for Articulation: An Oral Motor Approach (Strode and Chamberlain,1997). Pre- and post-test measures of the children's articulation indicated no real differences in speech production. These results question the efficacy of general and discrete oral motor exercises because they did not enhance the children's speech production.
Articulation Disorders↗