Strand, Edythe A.

Purpose In this article, the authors address the hypothesis that the severe and persistent speech disorder reported in persons with galactosemia meets contemporary diagnostic criteria for Childhood Apraxia of Speech (CAS). A positive finding for CAS in this rare metabolic disorder has the potential to impact treatment of persons with galactosemia and inform explanatory perspectives on CAS in neurological, neurodevelopmental, and idiopathic contexts. Method Thirty-three youth with galactosemia and significant prior or persistent speech sound disorder were assessed in their homes in 17 states. Participants completed a protocol yielding information on their cognitive, structural, sensorimotor, language, speech, prosody, and voice status and function. Results Eight of the 33 participants (24%) met contemporary diagnostic criteria for CAS. Two participants, 1 of whom was among the 8 with CAS, met criteria for ataxic or hyperkinetic dysarthria. Groupwise findings for the remaining 24 participants are consistent with a classification category termed Motor Speech Disorder–Not Otherwise Specified (Shriberg, Fourakis et al., 2010a). Conclusion The authors estimate the prevalence of CAS in galactosemia at 18 per hundred—180 times the estimated risk for idiopathic CAS. Findings support the need to study risk factors for the high occurrence of motor speech disorders in galactosemia despite early compliant dietary management.

AbstractPurpose: The purpose of this article is to present a brief description of the neuroanatomical correlates, pathophysiology, and clinical presentation of corticobasal ganglionic degeneration, (often referred to as corticobasal degeneration, or CBD) and progressive supranuclear palsy (PSP).Methods: Descriptions of the clinical characteristics of the two degenerative syndromes are presented, including a discussion of the similarities and differences. The speech and language disorders associated with each are described, including progressive aphasia, progressive non-fluent aphasia (PNFA), progressive apraxia of speech (AOS), and dysarthria.Results and Conclusions: CBD and PSP have a number of commonalities in clinical characteristics and in pathology. Both progressive aphasia and apraxia of speech have been associated with CBD and PSP. Clinicians who evaluate patients exhibiting a progressive neurologic disease and who identify either progressive aphasia, PNFA and/or progressive AOS should consider CBD or PSP as a possible medical diagnosis.

Abstract Purpose: Amyotrophic lateral sclerosis (ALS) is a progressive neurologic disease that frequently affects speech and swallowing. The purpose of this article is to emphasize the role of the speech-language pathologist (SLP) in management of the progressive speech and swallowing symptoms. Methods: A review of the neurologic degeneration and resulting symptoms of ALS are presented, including the cognitive, sensory and speech-language changes that accompany the progressive motor impairment. The important role of the SLP on a multidisciplinary team is described. Approaches to management of both swallowing and speech are discussed. Results and Conclusions: ALS is a progressive, degenerative neurologic disease. SLPs play a vital role in helping patients maintain effective communication and manage dysphagia symptoms.

PurposeThe purpose of this systematic review was to examine the current evidence for the use of oral motor exercises (OMEs) on speech (i.e., speech physiology, speech production, and functional speech outcomes) as a means of supporting further research and clinicians' use of evidence-based practice.MethodThe peer-reviewed literature from 1960 to 2007 was searched for articles examining the use of OMEs to affect speech physiology, production, or functional outcomes (i.e., intelligibility). Articles that met selection criteria were appraised by 2 reviewers and vetted by a 3rd for methodological quality, then characterized as efficacy or exploratory studies.ResultsFifteen studies met inclusion criteria; of these, 8 included data relevant to the effects of OMEs on speech physiology, 8 on speech production, and 8 on functional speech outcomes. Considerable variation was noted in the participants, interventions, and treatment schedules. The critical appraisals identified significant weaknesses in almost all studies.ConclusionsInsufficient evidence to support or refute the use of OMEs to produce effects on speech was found in the research literature. Discussion is largely confined to a consideration of the need for more well-designed studies using well-described participant groups and alternative bases for evidence-based practice.

PurposeTo review the principles of neural plasticity and make recommendations for research on the neural bases for rehabilitation of neurogenic speech disorders.MethodA working group in speech motor control and disorders developed this report, which examines the potential relevance of basic research on the brain mechanisms involved in neural plasticity and discusses possible similarities and differences for application to speech motor control disorders. The possible involvement of neural plasticity in changes in speech production in normalcy, development, aging, and neurological diseases and disorders was considered. This report focuses on the appropriate use of functional and structural neuroimaging and the design of feasibility studies aimed at understanding how brain mechanisms are altered by environmental manipulations such as training and stimulation and how these changes might enhance the future development of rehabilitative methods for persons with speech motor control disorders.ConclusionsIncreased collaboration with neuroscientists working in clinical research centers addressing human communication disorders might foster research in this area. It is hoped that this article will encourage future research on speech motor control disorders to address the principles of neural plasticity and their application for rehabilitation.

PurposeTo review the content and psychometric characteristics of 6 published tests currently available to aid in the study, diagnosis, and treatment of motor speech disorders in children.MethodWe compared the content of the 6 tests and critically evaluated the degree to which important psychometric characteristics support the tests' use for their defined purposes.ResultsThe tests varied considerably in content and methods of test interpretation. Few of the tests documented efforts to support reliability and validity for their intended purposes, often when relevant information was probably available during the test’s development.ConclusionsProblems with the reviewed tests appear related to overly broad plans for test development and inadequate attention to relevant psychometric principles during the development process. Recommendations are offered for future test revisions and development efforts that can benefit from recent research in test development and in pediatric motor speech disorders.