Purpose: This study primarily investigates the effects and influence of frustration in children with childhood apraxia of speech (CAS) in the setting of intensive treatment. Additionally, the study examines the interrater reliability of the frustration rating scale used in an intensive CAS treatment study. Methods: Frustration and treatment data obtained from 17 participants (between 4;0-9;11 years) with CAS in an intensive treatment research study were retrospectively used to determine potential relationships related to frustration in treatment (target complexity, temporal conditions, session number, CAS severity). Interrater reliability of the frustration rating scale was assessed with 34 randomly selected treatment session videos scored by a blinded second rater and compared to original scores. Results: Interrater reliability of the scale was poor to fair but had relatively close agreement within one scale point. Frustration levels were observed to decrease over the course of the treatment period but were typically greater in the afternoon sessions compared to morning. Participants in the complex target treatment condition with lower frustration also exhibited better outcomes than those with greater frustration. No other relationships were observed. Conclusions: Due to relatively poor interrater reliability of frustration scoring system used to obtain data used in the current study, results of the study should be interpreted cautiously. There may be a relationship between frustration levels in children with CAS and treatment conditions and outcomes, but other factors may influence both variables and further investigation into frustration is necessary to draw stronger conclusions. / Public Health

Childhood apraxia of speech (CAS) is a motor-based disorder that often results in long-term communication challenges, as well as adverse academic and psychosocial consequences. Response to CAS treatment is variable, with some children achieving slow or limited progress. A better understanding of factors associated with treatment response is needed to generate accurate prognoses and guide future development of efficient, targeted treatments. This dissertation research includes two studies. Study 1 examined speech perception skills among children with CAS using a discrimination (AX) task and a mispronunciation detection (MPD) task. Study 2 examined the association between four individual-level characteristics—age, speech accuracy, inconsistency, and perception—and CAS treatment response. Participants included 27 children (Study 2; subset of 12 children for Study 1) involved in an ongoing clinical trial for CAS (i.e., the “parent trial;” ClinicalTrials.gov ID = NCT03903120). Research questions were addressed using nonparametric correlation and t-tests, as well as multivariable linear regression. Results from Study 1 indicated that speech perception ability (1) did not differ by task, (2) did not differ by consonant and vowel conditions, (3) was positively correlated with age and speech accuracy, and negatively associated with speech inconsistency and nonverbal cognition, and (4) did not change after integral stimulation treatment. Results from Study 2 indicated that speech perception ability was the sole significant predictor of CAS treatment response, such that children with better perceptual skills at baseline made greater treatment gains. Further research is needed to replicate and extend these findings. / Communication Sciences

The intent of this thesis is to explore and develop the quantification of AOS features, particularly the deficits of prosodic elements, lexical stress and duration. This study investigated whether PVI can be used as a sensitive tool for the differential diagnosis of AOS. Specifically, we sought to determine whether analysis of vowel length of stressed and unstressed syllables is helpful in differentiating between individuals with AOS and aphasia versus aphasia alone. Significant differences support the hypothesis that PVI, analyzed from vowel length, is uniquely affected in AOS. This yields reason for further research in prosodic deficits in differential diagnosis, as well as application of this theory for a speech-language pathologist.

No description available.

No description available.

Childhood Apraxia of Speech (CAS) is a pediatric motor-speech disorder which has been controversial due to its difficulty to diagnose and little progress in treatment. The purpose of the present study was to examine a principle of motor learning (PML) within the context of an evidence-based treatment for this disorder, as a way to improve outcomes for children with CAS. In particular, this study examines the role of intensity, specifically, massed versus distributed practice, when treating CAS using a modified form of Dynamic Temporal Tactile Cueing (DTTC; Strand et al., 2006). Two participants with CAS between the ages of 5 and 11 received massed and distributed practice on individualized targets in an single-case alternating treatments design with multiple baselines. Accuracy of speech targets on probe tasks was judged by blinded listeners. Results were interpreted through inspection of graphs and calculation of effect sizes. The results of the study showed that massed practice had a marginal benefit over distributed practice. Implications from this study suggest the importance of continued research examining the role of PML in CAS treatment and the value of using a massed-treatment approach when treating CAS. / Communication Sciences

The purpose of the present study was to compare feature retention patterns between children developing speech typically (TD) and children with phonological impairment (PI) and to discuss these findings in terms of characteristics, severity, and implication for the identification of developmental apraxia of speech (DAS). A second purpose was to determine if a relationship exists between phonological knowledge and feature retention. This study consisted of a PI group and a TD group of children, ages four to six. A 245-item speech sample was collected from each subject. Feature retention percentages as well as percent correct underlying representation (PCUR) were calculated for each child. Both PI and TD groups retained place the least, voice the most, with manner falling in between. These patterns corresponded with what past researchers found in studies of children with phonological impairment and children diagnosed with DAS. No significant correlation was found between PCUR and feature retention.

Introdução: A articulação da fala é um dos aspectos fonoaudiológicos mais comprometidos na doença de Parkinson (DP). Pacientes com DP apresentam risco de manifestar apraxia não verbal e verbal. A apraxia não verbal ocorre quando há um déficit na habilidade de sequencialização dos movimentos voluntários não verbais da língua, lábios, mandíbula e outras estruturas orofaciais associadas, e a apraxia verbal é definida como um déficit na habilidade de sequencializar os controles motores necessários para o posicionamento correto dos articuladores durante a produção voluntária da fala. A prevalência com que apraxia da fala ocorre na DP não está bem estabelecida, sendo um distúrbio pouco explorado nesses pacientes. É um estudo inédito, até onde temos conhecimento, quanto à identificação dos erros práxicos verbais na DP. Objetivo: avaliar a prevalência da praxia não verbal e verbal em pacientes com doença de Parkinson, correlacionandoas com idade, escolaridade, tempo de doença e estadiamento da DP (Hoehn e Yahr), assim como correlacionar a apraxia não verbal com a apraxia verbal e identificar os erros práxicos verbais. Método: Estudo quantitativo, observacional, descritivo e de prevalência. Foram avaliados 45 pacientes acometidos pela DP, que realizaram seguimento clínico no ambulatório de Distúrbios do Movimento do Hospital de Clínicas de Porto Alegre, Brasil, através da aplicação do Protocolo de Avaliação da Apraxia da Fala, e o estadiamento da DP foi controlado através da escala de Hoehn e Yahr (H&Y). Resultados: A prevalência de apraxia não verbal e verbal nos pacientes com DP foi de 24,4%. Não houve significância entre apraxia não verbal com idade, escolaridade, tempo de doença, estadiamento da DP (H&Y) e gênero. A correlação entre apraxia verbal e escolaridade foi significante (p≤0,05), mas não houve significância com idade, tempo de doença, estadiamento da DP (H&Y) e gênero. Os tipos de erros práxicos verbais mais frequentes foram as omissões (70,8%). Quanto ao ponto e modo articulatório os fonemas mais alterados foram os dentoalveolares (92%) e os vibrantes (57,7%), consecutivamente. Conclusão: Os pacientes com DP apresentaram apraxia não verbal e verbal com manifestação de muitos erros práxicos verbais, estando a apraxia verbal correlacionada com a escolaridade. / Introduction: The speech articulation is one of the aspects most impaired in Parkinson's disease (PD). Patients PD present risk of expressing nonverbal and verbal apraxia. The nonverbal apraxia occurs when there is a deficit in the sequencing ability of nonverbal voluntary movements of the tongue, lips, jaw and other associated orofacial structures, while the verbal apraxia is defined as a deficit in the ability of sequencing the necessary motor controls in order to place the articulators correctly during the voluntary speech production. The predominance with which apraxia of speech occurs in PD is not well established and rarely explored in these patients. As far as we know, it is an unprecedented study regarding the identification of verbal praxic errors in PD. Objective: To assess the prevalence of nonverbal and verbal apraxia in patients with Parkinson's disease, correlating them with age, education, duration of disease and PD stage (Hoehn e Yahr), as well as to correlate nonverbal with verbal apraxia and identify the verbal praxic errors. Method: Quantitative, observational, descriptive and prevalence study. Forty-five patients with PD were evaluated. They were submitted to the clinical follow-up in the Movement Disorders Clinic of the Cinical Hospital of Porto Alegre, Brazil, through the application of the Speech Apraxia Assessment Protocol. Additionally, the PD stage was controlled through the Hoehn and Yahr scale (H&Y). Results: The prevalence of nonverbal and verbal apraxia in patients with PD was 24.4%. There was no significance between the nonverbal apraxia with age, education, duration of disease, PD stage (H&Y), and genre. The correlation between verbal apraxia and education was significant (p ≤ 0.05), but there was no significance with age, duration of disease, PD stage (H&Y) and genre. Omissions were the most frequent kinds of verbal praxic errors with (70.8 percent). Regarding the place and mode of articulation, the most changed phonemes were the dentoalveolar (92%)and the vibrants (57.7%), consecutively. Conclusion: Patients with PD presented nonverbal and verbal apraxia with manifestation of many verbal praxic errors and verbal apraxia correlated with education levels.

Introdução: A articulação da fala é um dos aspectos fonoaudiológicos mais comprometidos na doença de Parkinson (DP). Pacientes com DP apresentam risco de manifestar apraxia não verbal e verbal. A apraxia não verbal ocorre quando há um déficit na habilidade de sequencialização dos movimentos voluntários não verbais da língua, lábios, mandíbula e outras estruturas orofaciais associadas, e a apraxia verbal é definida como um déficit na habilidade de sequencializar os controles motores necessários para o posicionamento correto dos articuladores durante a produção voluntária da fala. A prevalência com que apraxia da fala ocorre na DP não está bem estabelecida, sendo um distúrbio pouco explorado nesses pacientes. É um estudo inédito, até onde temos conhecimento, quanto à identificação dos erros práxicos verbais na DP. Objetivo: avaliar a prevalência da praxia não verbal e verbal em pacientes com doença de Parkinson, correlacionandoas com idade, escolaridade, tempo de doença e estadiamento da DP (Hoehn e Yahr), assim como correlacionar a apraxia não verbal com a apraxia verbal e identificar os erros práxicos verbais. Método: Estudo quantitativo, observacional, descritivo e de prevalência. Foram avaliados 45 pacientes acometidos pela DP, que realizaram seguimento clínico no ambulatório de Distúrbios do Movimento do Hospital de Clínicas de Porto Alegre, Brasil, através da aplicação do Protocolo de Avaliação da Apraxia da Fala, e o estadiamento da DP foi controlado através da escala de Hoehn e Yahr (H&Y). Resultados: A prevalência de apraxia não verbal e verbal nos pacientes com DP foi de 24,4%. Não houve significância entre apraxia não verbal com idade, escolaridade, tempo de doença, estadiamento da DP (H&Y) e gênero. A correlação entre apraxia verbal e escolaridade foi significante (p≤0,05), mas não houve significância com idade, tempo de doença, estadiamento da DP (H&Y) e gênero. Os tipos de erros práxicos verbais mais frequentes foram as omissões (70,8%). Quanto ao ponto e modo articulatório os fonemas mais alterados foram os dentoalveolares (92%) e os vibrantes (57,7%), consecutivamente. Conclusão: Os pacientes com DP apresentaram apraxia não verbal e verbal com manifestação de muitos erros práxicos verbais, estando a apraxia verbal correlacionada com a escolaridade. / Introduction: The speech articulation is one of the aspects most impaired in Parkinson's disease (PD). Patients PD present risk of expressing nonverbal and verbal apraxia. The nonverbal apraxia occurs when there is a deficit in the sequencing ability of nonverbal voluntary movements of the tongue, lips, jaw and other associated orofacial structures, while the verbal apraxia is defined as a deficit in the ability of sequencing the necessary motor controls in order to place the articulators correctly during the voluntary speech production. The predominance with which apraxia of speech occurs in PD is not well established and rarely explored in these patients. As far as we know, it is an unprecedented study regarding the identification of verbal praxic errors in PD. Objective: To assess the prevalence of nonverbal and verbal apraxia in patients with Parkinson's disease, correlating them with age, education, duration of disease and PD stage (Hoehn e Yahr), as well as to correlate nonverbal with verbal apraxia and identify the verbal praxic errors. Method: Quantitative, observational, descriptive and prevalence study. Forty-five patients with PD were evaluated. They were submitted to the clinical follow-up in the Movement Disorders Clinic of the Cinical Hospital of Porto Alegre, Brazil, through the application of the Speech Apraxia Assessment Protocol. Additionally, the PD stage was controlled through the Hoehn and Yahr scale (H&Y). Results: The prevalence of nonverbal and verbal apraxia in patients with PD was 24.4%. There was no significance between the nonverbal apraxia with age, education, duration of disease, PD stage (H&Y), and genre. The correlation between verbal apraxia and education was significant (p ≤ 0.05), but there was no significance with age, duration of disease, PD stage (H&Y) and genre. Omissions were the most frequent kinds of verbal praxic errors with (70.8 percent). Regarding the place and mode of articulation, the most changed phonemes were the dentoalveolar (92%)and the vibrants (57.7%), consecutively. Conclusion: Patients with PD presented nonverbal and verbal apraxia with manifestation of many verbal praxic errors and verbal apraxia correlated with education levels.

Introdução: A articulação da fala é um dos aspectos fonoaudiológicos mais comprometidos na doença de Parkinson (DP). Pacientes com DP apresentam risco de manifestar apraxia não verbal e verbal. A apraxia não verbal ocorre quando há um déficit na habilidade de sequencialização dos movimentos voluntários não verbais da língua, lábios, mandíbula e outras estruturas orofaciais associadas, e a apraxia verbal é definida como um déficit na habilidade de sequencializar os controles motores necessários para o posicionamento correto dos articuladores durante a produção voluntária da fala. A prevalência com que apraxia da fala ocorre na DP não está bem estabelecida, sendo um distúrbio pouco explorado nesses pacientes. É um estudo inédito, até onde temos conhecimento, quanto à identificação dos erros práxicos verbais na DP. Objetivo: avaliar a prevalência da praxia não verbal e verbal em pacientes com doença de Parkinson, correlacionandoas com idade, escolaridade, tempo de doença e estadiamento da DP (Hoehn e Yahr), assim como correlacionar a apraxia não verbal com a apraxia verbal e identificar os erros práxicos verbais. Método: Estudo quantitativo, observacional, descritivo e de prevalência. Foram avaliados 45 pacientes acometidos pela DP, que realizaram seguimento clínico no ambulatório de Distúrbios do Movimento do Hospital de Clínicas de Porto Alegre, Brasil, através da aplicação do Protocolo de Avaliação da Apraxia da Fala, e o estadiamento da DP foi controlado através da escala de Hoehn e Yahr (H&Y). Resultados: A prevalência de apraxia não verbal e verbal nos pacientes com DP foi de 24,4%. Não houve significância entre apraxia não verbal com idade, escolaridade, tempo de doença, estadiamento da DP (H&Y) e gênero. A correlação entre apraxia verbal e escolaridade foi significante (p≤0,05), mas não houve significância com idade, tempo de doença, estadiamento da DP (H&Y) e gênero. Os tipos de erros práxicos verbais mais frequentes foram as omissões (70,8%). Quanto ao ponto e modo articulatório os fonemas mais alterados foram os dentoalveolares (92%) e os vibrantes (57,7%), consecutivamente. Conclusão: Os pacientes com DP apresentaram apraxia não verbal e verbal com manifestação de muitos erros práxicos verbais, estando a apraxia verbal correlacionada com a escolaridade. / Introduction: The speech articulation is one of the aspects most impaired in Parkinson's disease (PD). Patients PD present risk of expressing nonverbal and verbal apraxia. The nonverbal apraxia occurs when there is a deficit in the sequencing ability of nonverbal voluntary movements of the tongue, lips, jaw and other associated orofacial structures, while the verbal apraxia is defined as a deficit in the ability of sequencing the necessary motor controls in order to place the articulators correctly during the voluntary speech production. The predominance with which apraxia of speech occurs in PD is not well established and rarely explored in these patients. As far as we know, it is an unprecedented study regarding the identification of verbal praxic errors in PD. Objective: To assess the prevalence of nonverbal and verbal apraxia in patients with Parkinson's disease, correlating them with age, education, duration of disease and PD stage (Hoehn e Yahr), as well as to correlate nonverbal with verbal apraxia and identify the verbal praxic errors. Method: Quantitative, observational, descriptive and prevalence study. Forty-five patients with PD were evaluated. They were submitted to the clinical follow-up in the Movement Disorders Clinic of the Cinical Hospital of Porto Alegre, Brazil, through the application of the Speech Apraxia Assessment Protocol. Additionally, the PD stage was controlled through the Hoehn and Yahr scale (H&Y). Results: The prevalence of nonverbal and verbal apraxia in patients with PD was 24.4%. There was no significance between the nonverbal apraxia with age, education, duration of disease, PD stage (H&Y), and genre. The correlation between verbal apraxia and education was significant (p ≤ 0.05), but there was no significance with age, duration of disease, PD stage (H&Y) and genre. Omissions were the most frequent kinds of verbal praxic errors with (70.8 percent). Regarding the place and mode of articulation, the most changed phonemes were the dentoalveolar (92%)and the vibrants (57.7%), consecutively. Conclusion: Patients with PD presented nonverbal and verbal apraxia with manifestation of many verbal praxic errors and verbal apraxia correlated with education levels.