The purpose of this investigation was to study the effects of three modes of stress on error productions of children with developmental apraxia of speech during a sentence repetition task. The study was designed to answer the question: Will there be a significant difference in the number of errors for each mode when: a) training to distinguish among the stress modes is not provided? b) training to distinguish among the stress modes is provided?

Purpose: The occurrence of similar speech and non-speech behaviors in some children with autism and Childhood Apraxia of Speech (CAS) calls for the consideration of CAS in some children with autism. The majority of research on CAS has been conducted with children who are otherwise typically developing. The purpose of this study was to determine whether and to what extent children with autism are being diagnosed with or suspected to have CAS as well as what assessment and treatment methods are currently being used with these children. Method: A nationwide survey of speech-language pathologists (SLPs) working with children ages 0-6 years was distributed through snowball sampling, e-mail distribution lists and Facebook discussion pages. The survey requested information on numbers of children served with autism and suspected CAS as well as the criteria used to identify CAS in children with autism and the treatment methods being used in intervention. Results: 132 surveys were received and analyzed. SLPs from across the United States participated in the study. The mean number of children with autism currently served per participant was 6 children and the mean number of children with autism and suspected CAS per participant was 1. Participants reported suspected CAS in 16% of children with autism. SLPs working in the field the longest and those serving more total children with autism were suspecting CAS in children with autism more often than other participants. Of the total participants, 80% indicated that they would begin assessment for CAS in a child with autism as soon as they notice specific signs of CAS. The most common markers used were difficulty combining and sequencing phonemes and inconsistent production of speech sounds. Participants reported using a wide range of assessment tools to assess for CAS in a child with autism. Participants tended to rely upon informal assessment measures for this population; the most common assessment tool was a connected speech sample. The most commonly used intervention technique with this population was AAC; participants also reported high familiarity with PROMPT as a treatment for CAS. The least commonly used intervention technique was integral stimulation; 62% of the participants indicated that they have no knowledge of the technique. Conclusion: Results revealed that on average, SLPs are suspecting CAS in approximately 1 in 5 children with autism but much fewer children with autism have a second diagnosis of CAS. The decision of when to assess a child with autism for CAS as well as the assessment tools used varied greatly across participants. Participants reported using up to 22 different diagnostic markers to identify CAS in a child with autism. It was also discovered that not all of the traditional diagnostic markers for CAS should necessarily be considered diagnostic markers of CAS in a child with autism (e.g. suprasegmental abnormalities). With no scientific research to date regarding treatment efficacy for the treatment of CAS in children with autism, SLPs are forced to rely on anecdotal data when selecting a treatment to target CAS in a child with autism; SLPs may not be using the most effective treatment methods for this population. Results of the study support continued investigation of CAS in children with autism. There is a strong need for the development of clear diagnostic guidelines for CAS in a child with autism as well as reliable assessment tools that should be used. Further studies are needed to identify the most effective treatment approach for children with CAS and autism and how an SLP should incorporate that treatment into an overall comprehensive treatment approach for autism.

Purpose: Determination of genotypic/phenotypic features of GATAD2B-associated neurodevelopmental disorder(GAND). Methods: Fifty GAND subjects were evaluated to determine consistentgenotypic/phenotypic features. Immunoprecipitation assays utilizing in vitrotranscription–translation products were used to evaluate GATAD2B missensevariants’ ability to interact with binding partners within the nucleosomeremodeling and deacetylase (NuRD) complex. Results: Subjects had clinical findings that included macrocephaly,hypotonia, intellectual disability, neonatal feeding issues, polyhydramnios,apraxia of speech, epilepsy, and bicuspid aortic valves. Forty-one novelGATAD2B variants were identified withmultiple variant types (nonsense, truncating frameshift, splice-site variants,deletions, and missense). Seven subjects were identified with missense variantsthat localized within two conserved region domains (CR1 or CR2) of the GATAD2Bprotein. Immunoprecipitation assays revealed several of these missense variantsdisrupted GATAD2B interactions with its NuRD complex binding partners. Conclusions: A consistent GAND phenotype was caused by a range of geneticvariants in GATAD2B that includeloss-of-function and missense subtypes. Missense variants were present inconserved region domains that disrupted assembly of NuRD complex proteins.GAND’s clinical phenotype had substantial clinical overlap with other disordersassociated with the NuRD complex that involve CHD3 and CHD4, with clinicalfeatures of hypotonia, intellectual disability, cardiac defects, childhoodapraxia of speech, and macrocephaly.

No description available.

No description available.

Acquired apraxia of speech (AOS) is a type of motor speech disorder (MSD) characterized by deficits in the motor planning or programming of speech movements (Duffy, 2005). Because AOS is often a chronic condition that may severely impair intelligibility and, thus, significantly reduce quality of life (Ballard et al., 2015), it is necessary to develop efficient and effective treatment protocols. A previous study by Youmans, Youmans, and Hancock (2011), demonstrated the efficacy of script training in the treatment of AOS. Furthermore, extensive research in general motor learning has shown that feedback is one of the most important components of motor learning (Schmidt & Lee, 2011). Research devoted specifically to speech motor learning has generally favored this view, though few studies have distinguished between the two major types of feedback: feedback providing knowledge of results (KR) and feedback providing knowledge of performance (KP). The present study is the first to examine feedback type in treatment for AOS, and the first to examine the utility of script training specifically for a participant with AOS, but no aphasia. The findings from this single-case experimental design study reveal that, compared to KR, KP resulted in greater improvements in speaking rate. KR and KP feedback resulted in comparable gains for accuracy, but condition differences were difficult to interpret due to unexpected rising baselines for the KR scripts. Both KR and KP scripts, but especially the KP scripts, outperformed the untreated control scripts, providing further support for the efficacy of script training for AOS. / Communication Sciences

Introduktion: Fall är den vanligaste inläggningsorsaken på sjukhus i Sverige. Faktorer som kan påverka att en människa faller är bl.a gångförmågan, balansförmågan samt fallrädslan.Syfte: Syftet med studien är att undersöka promenaders effekt på gång- och balansförmågan samt på fallrädsla hos personer över 65 år med hemtjänst.  Metod: Tjugo deltagare block-randomiserades till två grupper, tio deltagare per grupp. Medelåldern var 77 ± 8 år. Interventionsgruppen promenerade tre gånger i veckan, en gång med hemtjänst och två gånger med fysioterapeut. Kontrollgruppen promenerade en gång i veckan tillsammans med hemtjänsten. Interventionsperioden varade sex veckor. Mätningar av testen 6 minuters gångtest (6MWT), One Leg Stance (OLS) och Falls Efficacy Scale- International (svenska) (FES-I(s)) utfördes före och efter interventionsperioden. För att analysera skillnad mellan grupperna i interventionseffekt användes ANCOVA med uppföljningsvärdet som beroendevariabel. Det utfördes två analyser per variabel, i den ena var enbart baslinjevärdet kovariat och i den andra även kön och ålder.  Resultat: Interventionsgruppen förbättrade gångförmågan med i genomsnitt 35 meter medan kontrollgruppen försämrade sin gångförmåga med 3 meter (p=0,029 resp. p=0,019). Balansen förbättrades med i genomsnitt 2 sekunder i interventionsgruppen och 1 sekund i kontrollgruppen (p=0,528 resp. p=0,510). Fallrädslan minskade med i genomsnitt 6 poäng i interventionsgruppen och 2 poäng i kontrollgruppen (p=0,064 resp. p=0,054).  Slutsats: Att öka antalet promenader under sex veckor har effekt på gångförmågan, men inte på balans eller fallrädsla, bland äldre personer med hemtjänst. Resultaten indikerar på vikten av att inkludera fler promenadinsatser för äldre personer med hemtjänst som en åtgärd i kommuners fallpreventiva arbete. / Introduction: Accidental falls are the most common reason for hospital admissions in Sweden. Factors influencing fall risk include gait ability, balance and fear of falling. Aims: This study aims to examine the effect of walking on gait ability, balance and fear of falling, in home care recipients over 65 years .  Methods: Twenty participants, age 77 ± 8 years, were block-randomized into two groups. The intervention group walked three times a week and the control group once a week. The intervention lasted six weeks. Before and after the intervention the 6-minute walk test (6MWT), One Leg Stance (OLS), and Falls Efficacy Scale-International (Swedish) (FES- I(s)) were conducted. Intervention effect between groups was analyzed using ANCOVA with the follow-up value as the dependent variable. Two analyzes were conducted for each variable: one included the baseline as covariate, the other included gender and age as additional covariates.  Results: The intervention group improved their walking ability with an average of 35 meters, the control group decreased by 3 meters (p=0,029, p=0,019). Balance improved with an average of 2 seconds in the intervention group, 1 second in the control group (p=0,528, p=0,510). Fear of falling decreased with an average of 6 points in the intervention group, 2 points in the control group (p=0,064, p=0,054).  Conclusion: Increasing walks during six weeks improves gait ability but not balance or fear of falling in elderly home care recipients. The results emphasize the need for more walking interventions in fall prevention strategies for the elderly in municipal home care.

The purpose of this study was to evaluate the role of client-directed choice in treatment for a child with childhood apraxia of speech (CAS), as compared to a lack of client-directed choice. One way to exercise control over practice conditions is through incidental choices. In studies of non-speech motor learning, offering opportunities for incidental choice to the learner, thus increasing their autonomy, has been shown to enhance learning (Wulf & Lewthwaite, 2016). Increasing client engagement and buy-in could maximize their level of motivation in treatment, and lead to better learning outcomes. This study used a single-case, alternating treatments design consisting of two conditions (Child-choice and Clinician-choice). The treatment employed prosodic variation during speech practice; the speech practice involved the ASSIST protocol (Maas et al., 2022). Options for prosodic variation were presented using the name and vocal characteristics of three different emotional tones (happy, sad, and angry). Each treatment session alternated between two conditions. In the first condition, the participant chose the tone in which to practice each target. In the second condition, the clinician chose the tone. The primary outcome measure was accuracy, as judged by blinded listeners from recordings. Effect sizes were computed and compared between conditions to address the primary research question (Does client-directed choice enhance learning compared to clinician-directed choice?). Comparison between treated item sets and untreated item sets provided a replication of the overall ASSIST protocol. Preliminary results to date showed no clear effects for either autonomy or treated vs. untreated sets. / Communication Sciences

Made available in DSpace on 2016-04-28T18:22:20Z (GMT). No. of bitstreams: 1 Melissa Catrini.pdf: 760312 bytes, checksum: 41b7e552ae67abf89f80da7e17a54656 (MD5) Previous issue date: 2011-07-15 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / This study was triggered by clinical questions related to the problem of Apraxia. When there is incontestable neurological disease, any articulation disorder is immediately assumed and labeled as a Speech Apraxia or Dysarthria (CRARY,1993) even if an organic damage cannot be effectively confirmed by medical diagnosis or technological devices. The fact is that clinical avaliation tends to follow the same direction: the neurological damage is not detectable, but does it exist! Under such a situation, the suspicion falls on Apraxia of Speech, a pathology usually defined as a motor speech disorder observable in articulatory and prosodic difficulties without muscle damage. Therefore, a question can be raised: what causes that articulatory (functional) symptom? . Apraxia affects the body and the body is, according to the medical viewpoint an object of physiology and pathology. I endeavoured to indicate and justify the strength of that theoretical and clinical discourse, which sustains itself on the philosophical dichotomic opposition between mind and body, i.e., between cognition and organism. Apraxia is, thus, traditionally approached, studied and defined through that perspective. In the present study, Freud is taken as a landmark because he introduced a completely different trend of reasoning which dissolves the philosophical and psychophysical dualism mindbody. Affected by the wreckage of hysteria and the holes of aphasia, he could be state that structure and body functions do not go side by side and a new and revolutionary conception of the body could be introduced and developed in studies of Apraxia the human body is bodylanguage. This thesis tried to follow Freud s theoretical direction concerning the relationship between body and language, this study is conducted in accordance with the reflections on languare pathology and clinic developed within the research group Language acquisition, pathology and clinic, coordinated by Lier-DeVitto and Arantes, at LAEL /PUCSP / A questão que move este trabalho foi deflagrada por questões clínicas relacionadas ao problema das Apraxias. Nos casos em que há incontestável comprometimento neurológico, qualquer presença de distúrbio articulatório é imediatamente assumida como uma Apraxia de Fala ou Disartria (CRARY, 1993). Mesmo quando o comprometimento neurológico não pode ser efetivamente confirmado pelo aparato diagnóstico médico, mas se suspeita de sua existência, o raciocínio clínico tende a seguir a mesma direção. Nessas condições, especificamente, a suspeita recai sobre Apraxia de Fala, patologia comumente definida como um distúrbio motor da fala em que se observam dificuldades articulatórias e prosódicas sem prejuízos musculares. Coloca-se, assim, a questão: o que causaria tais sintomas funcionais? Apraxias têm manifestação no corpo e corpo é, por tradição e direito, objeto (exclusivo) do campo da Fisiologia e da Patologia justifica-se, sem dúvida, a força da discursividade desses estudos sobre o tema que, como tratei de indicar, também opera no domínio da divisão filosófica mente/corpo - melhor entendido, da relação entre razão/cognição e corpo/organismo. É na esfera do dualismo corpo-mente que se inscreve (a)praxia. Entretanto, no presente estudo, Freud comparece dissolvendo o dualismo psicofísico. Nos escombros da histeria e nos furos da afasia, ele viu que estrutura e funcionamento não caminham lado a lado. Daí que outra concepção de corpo deve vir a figurar nos estudos sobre as apraxias. Trata-se do corpo que é Um, aquele que nasce com o ser de linguagem, o falasser, o corpolinguagem. Diante disso, esta tese procurou problematizar a apraxia a partir da relação entre corpo e linguagem. Tarefa cumprida a partir das reflexões encaminhadas no âmbito do Grupo de Pesquisas Aquisição, patologias e clínica de linguagem, coordenado por Lier-DeVitto e Arantes no LAEL/PUCSP

Apraxia of speech (AOS) is a motor speech disorder associated with an impairment in motor planning and programming. It is therefore a logical step to derive treatment of the disorder from the principles of motor learning. Principles of motor learning refer to relatively predictable benefits of certain practice conditions over others (e.g., random practice enhances learning compared to blocked practice). A number of studies have begun to examine principles of motor learning in treatment for AOS (e.g., Austermann Hula et al., 2008; Katz et al., 2010). The current project aims to continue the investigation of motor learning principles and its application to motor speech disorders. In particular, the primary goal of this study is to examine the role of feedback control in treatment for AOS. Two types of feedback control are typically distinguished: self-controlled feedback and clinician-controlled feedback (Chiviacowsky & Wulf, 2004; Chiviacowsky & Wulf, 2007; Janelle, Barba, Frehlich, Tennant, & Cauraugh, 1997; Wulf, 2007). A secondary goal is then to examine the efficacy of script training for AOS. Youmans et al. (2011) provided promising initial evidence supporting its efficacy for AOS, yet no studies have replicated these findings (Ballard et al., 2015). The results of this study suggest that self-controlled feedback is more efficacious in treating adults with AOS than clinician-controlled feedback. Greater improvements of performance for self-controlled feedback were noted especially in accuracy of productions. There was the potential to impact rate of speech as well. Findings across conditions (treated versus untreated scripts) also indicate that script training is an efficacious method of treating adults with AOS. / Public Health