Talapraxi är en talmotorikstörning som drabbar planeringen och programmeringen av talet, vilket visar sig som avvikelser i artikulation och prosodi. I dag finns inget svenskt test för utredning av talapraxi. Syftet med studien var därför att utforma ett testbatteri på svenska som är känsligt även för lindriga grader av talapraxi. Detta test pilotnormerades på 50 friska deltagare.  För att kunna studera hur kön, ålder och utbildningsnivå kan inverka på prestationen i testbatteriet, eftersträvades en jämn fördelning när det gäller dessa demografiska bakgrundsvariabler. Uppgifterna konstruerades baserat på tidigare forskning gällande de typiska perceptuella dragen vid talapraxi och på testuppgifter som tidigare har visat sig vara känsliga för talapraxi. Deltagarnas prestation varierade mellan testbatteriets olika uppgifter. På några uppgifter hade en stor andel av deltagarna alla rätt, medan andra uppgifter visade sig vara utmanande även för friska personer. Inga signifikanta könsskillnader fanns för prestationerna på någon av uppgifterna i testbatteriet. Utbildningsnivå och ålder påverkade däremot prestationen på vissa uppgifter. Generellt var effektstyrkorna för utbildningsnivå större än för ålder. Testbatteriet bör i framtiden kunna ge ett bra underlag för bedömning av huruvida talapraxi föreligger eller inte. Det bör också kunna användas vid bedömning av talapraxins svårighetsgrad. För att gå vidare med utvecklingen av testbatteriet bör man fortsätta normeringen på ett större antal personer samt kliniskt validera det på personer med diagnostiserad talapraxi. / Apraxia of speech (AOS) is a motor speech disorder that affects the planning and programming of speech, resulting in articulatory and prosodic distortions. To this date there is no available test in Swedish for assessment of AOS. Therefore, the aim of this study was to construct a test battery that enables the assessment of level of severity of the disorder, including mild AOS. A pilot standardization was performed on 50 healthy speakers. In order to determine whether the performance on the test battery is affected by sex, age or level of education, the selection of participants was stratified by these variables. The tasks were constructed based on previous research regarding the perceptual characteristics of AOS, taking into account also the types of tasks that have proved to be challenging for patients with AOS. The performance varied between different tasks of the test battery. On some tasks a high portion of the participants got very high scores, while other tasks were shown to be challenging even for healthy speakers. No significant sex differences were found on any of the tasks. However, age and level of education significantly affected the performance on some of the tasks. Overall, the effect sizes for level of education were larger than for age. In the future, the test battery should be able to determine the presence or absence and severity of AOS. For further development of the test battery, the standardization should continue using a larger sample. A clinical validation on patients with diagnosed AOS is also of great importance.

The purpose of this research effort was to examine whether the feature retention patterns and phonological knowledge of children with suspected apraxia of speech (AOSc) in comparison to those of children with phonological impairment (PI). A second purpose was to determine if a relationship exists between phonological knowledge and feature retention. The study consisted of three groups of children: PI, AOSc, and typically developing (TD), ages four to seven. A 245-item speech sample was collected from each group. Feature retention percentages and phonological knowledge, represented by percent correct underlying representations (PCUR) were calculated for each child. All groups retained place the least, followed by manner, with voicing being retained most. The null hypothesis was confirmed, with PI and AOSc groups exhibiting no significant differences across feature retention percentages or phonological knowledge. The positive correlation of voicing retention and PCUR of the AOSc group was the only significant relationship found.

Two preschool males who presented with the characteristics of developmental verbal dyspraxia were enrolled in a phonological cycles intervention approach. Initially, each child's deviant phonological processes were analyzed by the CAPD and target patterns and words selected for remediation. A continuous speech sample was obtained and analyzed to measure intelligibility by percentage and rating on a seven point scale. A time-space probe was developed based on targeted and non-targeted phonemes and administered prior to the first intetvention session. Using the selected targeted patterns and words, an individualized remediation plan was developed, and the phonological process cycling approach used. Each subject participated in 60 minutes of intervention for each targeted pattern to complete the first cycle in approximately 10 weeks. The time-space probes were administered approximately every two weeks.

This thesis describes three boys diagnosed with dyspraxia and their whanau (families and extended families) as they enter and become part of a community gymnastics group in a city in New Zealand. The study builds on literature that has defined dyspraxia in terms of dysfunction, but generally failed to resolve the disorder. Through the social perspective of health and well-being, participation of children and adults with disabilities has been explored in terms of the person and the environments in which they participate; however, the influence activity itself has on participation has not been thoroughly described. There has been a growing interest in the participation of children with disabilities in recreation and leisure activities and this study provides an in depth cultural perspective of such participation in New Zealand context. This study aims to answer the question "What do children with dyspraxia and their whanau do in a gymnastics group, and what does it mean to them to participate?". The overarching question is "What is the culture of a community gymnastics group in which children with dyspraxia participate?". Ethnographic methodology is employed to ensure that the participants' perspectives, including the beliefs, values and meaning that their participation holds is portrayed, while the associated activities and behaviours are also captured. As the boys with dyspraxia and their whanau entered the gym, they built on their previous experiences to make sense of what they needed to do and what meaning the environment held. I had not planned on the boys being integrated with an established group, but on the first night they spontaneously joined in with a noncompetitive, mixed age, boys group. The parents perceived the Club as professional, while the boys were initially intimidated. Fortunately, the equipment, which made the gym look like a playground, enticed the boys to participate. To shift the boys from their initial perception of the gym being a playground, the coaches used two styles of An Ethnography of Children with Dyspraxia Participating in Gymnastics coaching to support and encourage their participation, while suppressing behaviour that did not fit with the norms of the Club. The boys needed to develop gymnastics skills and fit into the group to become gymnasts. The boys succeeded in fitting into the group by both developing skills and adapting their behaviour, while the type of boys without dyspraxia, the style of coaching afforded, the range of equipment and the activity of gymnastics itself meant that some of their initial difficulties were accommodated and they were seen as group members. The participants developed values and beliefs about what the boys participation in the group meant. Having fun and developing confidence and fitness were highlighted, while the social aspects (making friends and the whanau experiences) were also seen as important. The parents and coaches felt that the boys' experiences in gymnastics had an impact on them that would transfer to the world beyond the gym. This study contributes a qualitative perspective on the participation of children with disabilities in a sports occupation, with a focus on the cultural context of their participation.

Das 3. Herbsttreffen Patholinguistik fand am 21. November 2009 an der Universität Potsdam statt. Der vorliegende Tagungsband enthält die drei Hauptvorträge zum Schwerpunktthema „Von der Programmierung zu Artikulation: Sprechapraxie bei Kindern und Erwachsenen“. Darüber hinaus enthält der Band die Beiträge aus dem Spektrum Patholinguistik, sowie die Abstracts der Posterpräsentationen. / The 3rd Herbsttreffen Patholinguistik was held on November 21st, 2009 at the University of Potsdam. These proceedings contain the three main lectures of the central topic „From programming to articulation: Apraxia of speech of children and adults “. Additionally this volume contains the contributions of Spektrum Patholinguistik, as well as the abstracts of the poster presentations.

Thesis (Ph.D.)--University of Canterbury, 2007. / Typescript (photocopy). Includes bibliographical references (leaves 243-263). Also available via the World Wide Web.

Darbe atlikta teorinė kalbėjimo motorikos sutrikimų: dizartrijos ir apraksijos sampratos ir vaikų, turinčių skirtingą kalbos neišsivystymo lygį kalbos supratimo analizė. Iškelta hipotezė, kad vaikų, pasižyminčių skirtingos kilmės kalbėjimo motorikos pakitimais, yra nevienodas kalbos supratimo lygmuo. Buvo atliktas tyrimas, kurio tikslas - atskleisti vaikų, turinčių skirtingos kilmės kal-bėjimo motorikos sutrikimų, kalbos supratimo skirtumus. Tyrimo duomenys apdoroti Microsoft Excel programa. Tyrime dalyvavo 20 Respublikinės universitetinės ligoninės Vaiko Raidos centro pacientų, 10 Vilniaus vaikų ugdymo centro “Viltis” ugdytinių, pasižyminčių įvairiais kalbėjimo motorikos sutrikimais (6 -7 metų). Empirinėje dalyje nagrinėjami kalbos motorikos sutrikimų: dizartrijos ir apraksijos atsiradimo priežastys, jų rūšys, laipsniai, vaikų kalbos supratimas ir jo kaita vaikams, turintiems skirtingą kalbos neišsivystymo lygį bei nevienodą kalbėjimo motorikos sutrikimą. Svarbiausios empirinio tyrimo išvados: 1. Tirtieji vaikai, turintys įvairių kalbėjimo motorikos sutrikimų, pasižymi vidutinišku kalbos supratimu. 2. Kalbos supratimas vaikams su skirtingais kalbėjimo motorikos sutrikimais yra nevienodas: vaikai, pasižymintys dizartrija, kalbą supranta tiksliau, negu vaikai, pasižymintys apraksija. 3. Žieviniai pažeidimai nulemia sudėtingesnį kalbos supratimo sutrikimą, todėl, esant apraksijai, galima kalbėti tik apie dalinį kalbos supratimą. / The written work consists of theoretical analysis of motor speech disorders: dysarthria and apraxia, as well as the level of understanding of speech by children with dysarthria and apraxia. The hypothesis was formed that children with motor speech disorders of different origins have a different level of understanding of speech. The research, which goal was to show the difference of understanding of speech by children with motor speech disorders of different origins, was made. 20 patients from the National University Hospital’s Child Development Centre and 10 pupils from the Educational Centre "Viltis" took part at the research. All of them have motor speech disorders of different origins; their age is 6-7 years old. The empiric part describes motor speech disorders: the reasons of the appearance of dysarthria and apraxia, their kinds, levels, the understanding of speech by children with different level of speech abilities and different motor speech disorders. The important conclusions made: 1. Children with different motor speech disorders have a medium understanding of speech. 2. The understanding of speech by children with different motor speech disorders is not the same. The children with dysarthria show a better understanding of speech, in comparison to the children with apraxia. 3. The cortex dysfunction becomes a cause of serious disturbances of speech understanding that is why the children with apraxia can understand speech only partly.

Eating problems and nutritional status were studied in a consecutive series of 104 stroke patients admitted to emergency hospital care. During their stay in hospital eating problems were observed in 46 patients. Certain common types of eating problems were identified: aberrant eating behaviour as regards chewing,lokalization or swallowing, eating small amounts, hoarding of food in the mouth, leakage of food from the mouth and unawareness of eating problems. Poor nutritional status occurred in 16 % of the patients on admission and in 22 % on discharge from the stroke unit. A subgroup of 32 patients hospitalized for 21 days or longer was studied for three weeks. On at least one occasion during these three weeks a poor nutritional status was observed in 18 patients, of whom 17 had eating problems. All subjects who had eating problems during their hospital stay, plus those patients without eating problems but with neurological deficits and those living in a nursing home one year after the stroke (n=36) were selected for a longitudinal study 18 months after the onset of stroke. Eating problems were identified in 23 of these patients during their hospital stay while 21 had such problems when they were followed up. Two patients who could not eat due to severe dysphagia (after a stroke) for three years and 18 months respectively, were successfully trained to eat normally. One patient exhibited impaired oral and hypopharyngeal function and the other impaired hypo- pharyngeal function and a spastic crico-pharyngeal muscle. In both patients training in swallowing was the main remedical measure and one of them also had a myotomy of the spastic muscle. / <p>[2] s., s. 1-45: sammanfattning, s. 49-130: Härtill 6 uppsatser</p> / digitalisering@umu

Corticobasal Syndrome (CBS) is a rare movement and cognitive disorder. There is significant heterogeneity observed in it clinical presentation, neuroimaging, pathology and genetics. Understanding this heterogeneity is a priority and may help to shed light on underlying pathogenic mechanisms. We first demonstrated that truncating mutations in the progranulin gene (PGRN) can cause familial CBS associated with frontotemporal lobar degeneration (FTLD)-ubiquitin pathology. This study identified a mutation in PGRN (Intervening Sequence 7+1 guanine > adenine [IVS7+1G>A]) that segregated with CBS in a family. The mutation was predicted to result in a shortened messenger RNA (mRNA) sequence and the absence of the mutant PGRN allele was confirmed in the reverse transcriptase-polymerase chain reaction (RT-PCR) product, which supported the model of haploinsufficiency for PGRN-linked disease. In a second familial study, clinical, radiological, genetic, and pathological studies were performed to contrast clinical features of the affected members. Sequencing PGRN revealed a novel, heterozygous cytosine-adenine dinucleotide deletion in exon 11 (g.2988_2989delCA, P439_R440fsX6). The proband`s clinical diagnosis was frontotemporal dementia and parkinsonism (FTDP). The proband’s brother with the same mutation presented initially as a progressive non-fluent aphasia (PNFA), and later evolved into a CBS. Pathological analysis revealed Frontotemporal Lobar Degeneration-Ubiquitin (FTLD-U)/ TAR DNA-binding protein 43 (TDP43) positive pathology. The next studies shift away from pathogenic mechanisms to focus on brain-behavioural correlations and phenotypic heterogeneity in a prospective sample of 31 CBS cases. We provide the first direct correlative analysis between the severity of ideomotor apraxia, a common sign in CBS, and cerebral SPECT perfusion imaging. Reductions in perfusion within the left inferior parietal lobule (t=5.7, p=0.03, Family-Wise Error [FWE] corrected), including the left angular gyrus (t=5.7, p=0.02, FWE corrected), were associated with more severe ideomotor apraxia. We stratified the sample into CBS presenting with early motor features (CBS-M; n=9) or early dementia (CBS-D; n=22), which identified that CBS-M were more likely to have cortical sensory loss than CBS-D (p=0.005). In contrast, the presence of aphasia was found to be more common and severe in CBS-D compared to CBS-M (p=0.02). CBS-M patients had significantly reduced perfusion in the right supplementary and premotor areas compared to CBS-D (p<0.05).

Corticobasal Syndrome (CBS) is a rare movement and cognitive disorder. There is significant heterogeneity observed in it clinical presentation, neuroimaging, pathology and genetics. Understanding this heterogeneity is a priority and may help to shed light on underlying pathogenic mechanisms. We first demonstrated that truncating mutations in the progranulin gene (PGRN) can cause familial CBS associated with frontotemporal lobar degeneration (FTLD)-ubiquitin pathology. This study identified a mutation in PGRN (Intervening Sequence 7+1 guanine > adenine [IVS7+1G>A]) that segregated with CBS in a family. The mutation was predicted to result in a shortened messenger RNA (mRNA) sequence and the absence of the mutant PGRN allele was confirmed in the reverse transcriptase-polymerase chain reaction (RT-PCR) product, which supported the model of haploinsufficiency for PGRN-linked disease. In a second familial study, clinical, radiological, genetic, and pathological studies were performed to contrast clinical features of the affected members. Sequencing PGRN revealed a novel, heterozygous cytosine-adenine dinucleotide deletion in exon 11 (g.2988_2989delCA, P439_R440fsX6). The proband`s clinical diagnosis was frontotemporal dementia and parkinsonism (FTDP). The proband’s brother with the same mutation presented initially as a progressive non-fluent aphasia (PNFA), and later evolved into a CBS. Pathological analysis revealed Frontotemporal Lobar Degeneration-Ubiquitin (FTLD-U)/ TAR DNA-binding protein 43 (TDP43) positive pathology. The next studies shift away from pathogenic mechanisms to focus on brain-behavioural correlations and phenotypic heterogeneity in a prospective sample of 31 CBS cases. We provide the first direct correlative analysis between the severity of ideomotor apraxia, a common sign in CBS, and cerebral SPECT perfusion imaging. Reductions in perfusion within the left inferior parietal lobule (t=5.7, p=0.03, Family-Wise Error [FWE] corrected), including the left angular gyrus (t=5.7, p=0.02, FWE corrected), were associated with more severe ideomotor apraxia. We stratified the sample into CBS presenting with early motor features (CBS-M; n=9) or early dementia (CBS-D; n=22), which identified that CBS-M were more likely to have cortical sensory loss than CBS-D (p=0.005). In contrast, the presence of aphasia was found to be more common and severe in CBS-D compared to CBS-M (p=0.02). CBS-M patients had significantly reduced perfusion in the right supplementary and premotor areas compared to CBS-D (p<0.05).