1/8. Aphemia: an isolated disorder of articulation.Aphemia is a disorder with prominent speech abnormality. Since its description by Broca, there has been debate regarding the neuropsychological disorganization underlying aphemia: is aphemia an articulatory disorder or a language disorder? We describe a patient with markedly impaired articulation, but preserved receptive and written language function and buccal-facial coordination. The location of his stroke was in the left precentral gyrus, undercutting a small area of motor and premotor cortex. This case suggests that aphemia can occur as an isolated articulation deficit without language involvement or more widespread bulbar apraxia, and may be a severe form of apraxia of speech.- - - - - - - - - - ranking = 1keywords = apraxia (Clic here for more details about this article) |
2/8. Developmental verbal dyspraxia. II: A developmental perspective on two case studies.A longitudinal study of the speech errors of two school-age children with what was described as developmental verbal dyspraxia is presented. By comparing them with a group of normally developing children matched on articulation age, it was possible to identify speech errors not typical of earlier speech development, involving problems with syllable structure planning and vocal tract coordination. The speech-disordered children could produce more words correctly than the controls, but, when they did make speech errors, these were more serious than those found in the younger children. The speech-disordered children were followed up 4 years later. Although their speech had improved, they presented with the same profile of error types. They had increased intelligibility by adding more word-specific articulations but still had difficulties with novel and complex material. The adoption of a developmental framework in this study allowed the identification of different levels of breakdown within the speech production process. The case-study method is recommended to investigate how these levels may interact and the clinical implications of the findings are outlined.- - - - - - - - - - ranking = 2.6141321736623keywords = dyspraxia (Clic here for more details about this article) |
3/8. Token-to-token variability in developmental apraxia of speech: three longitudinal case studies.Variability in the speech production patterns of children with developmental apraxia of speech (DAS) was investigated in a three-year longitudinal study of three children with DAS. A metric was developed to measure token-to-token variability in repeated word productions from connected speech samples. Results suggest that high levels of total token and error token variability and low levels of word target stability and token accuracy characterize the disorder. overall levels of variability and patterns of change over time differed between participants. Longitudinal patterns were indicative of decreasing total token variability and increasing token accuracy. However, change was not consistently unidirectional for two of the three children in the study, suggesting day-to-day performance differences in addition to within-session variability.- - - - - - - - - - ranking = 2.5keywords = apraxia (Clic here for more details about this article) |
4/8. Crossed apraxia of speech: a case report.The present study reports on the first case of crossed apraxia of speech (CAS) in a 69-year-old right-handed female (SE). The possibility of occurrence of apraxia of speech (AOS) following right hemisphere lesion is discussed in the context of known occurrences of ideomotor apraxias and acquired neurogenic stuttering in several cases with right hemisphere lesion. A current hypothesis on AOS-the dual route speech encoding (DRSE) hypothesis-and predictions based on DRSE were utilized to explore the nature of CAS in SE. One prediction based on the DRSE hypothesis is that there should be no difference in the frequency of occurrence of apraxic errors on words and non-words. This prediction was tested using a repetition task. The experimental stimuli included a list of minimal pairs that signaled voice-voiceless contrasts in words and non-words. Minimal-pair stimuli were presented orally, one at a time. SE's responses were recorded using audio and videotapes. Results indicate that SE's responses were characterized by numerous voicing errors. Most importantly, production of real word minimal pairs was superior to that of non-word minimal pairs. Implications of these results for the DRSE hypothesis are discussed with regard to currently developing perspectives on AOS.- - - - - - - - - - ranking = 3.5keywords = apraxia (Clic here for more details about this article) |
5/8. 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.- - - - - - - - - - ranking = 2keywords = apraxia (Clic here for more details about this article) |
6/8. The interaction of phonetics and phonology in developmental verbal dyspraxia: two case studies.Approaches to the treatment of developmental verbal dyspraxia based upon current theories about phonological development are explored. The author presents the concept of "bridging"; for example, making the transition from one sound to another or from one word to the next, as a reflection of the child's ability to generate hierarchical linguistic structures. The author suggests that children who have developmental dyspraxia must build phonological systems despite the fact that their ability to discover and use these hierarchical structures is impaired. Idiosyncratic patterns are expected, and should be used by the clinician to determine appropriate approaches to remediation for individual children. Case studies illustrate two children's shared difficulties in developing and using phonological hierarchies and the individual differences that provided a basis for appropriate remediation for each child.- - - - - - - - - - ranking = 3.1369586083948keywords = dyspraxia (Clic here for more details about this article) |
7/8. Stimulability considerations in the phonological treatment of a child with a persistent disorder of speech-sound production.The term "persistent sound system disorder" has been used to describe the speech problems of a relatively small group of children that does not respond readily to treatment. This group includes children who have been given diagnoses such as development apraxia of speech. In this article, a rationale is developed for one approach to the treatment of persistent sound system disorder. This approach, which involves broadening of the phonetic inventory early in the treatment process, is contrasted with more traditional motor-programming treatments that emphasize stabilization of a restricted set of inconsistently produced sounds. The treatment procedures advocated in this article are illustrated in a case study. The article concludes with a discussion of evolving theories and technologies that are likely to impact upon the assessment and treatment of children with persistent sound system disorders in the future.- - - - - - - - - - ranking = 0.5keywords = apraxia (Clic here for more details about this article) |
8/8. Slowly progressive anarthria with late anterior opercular syndrome: a variant form of frontal cortical atrophy syndromes.We describe eight patients with slowly progressive speech production deficit combining speech apraxia, dysarthria, dysprosody and orofacial apraxia, and initially no other deficit in other language and non-language neuropsychological domains. Long-term follow-up (6-10 years) in 4 cases showed an evolution to muteness, bilateral suprabulbar paresis with automatic-voluntary dissociation and frontal lobe cognitive slowing without generalised intellectual deterioration. Most disabled patients presented with an anterior opercular syndrome (Foix-Chavany-Marie syndrome), and pyramidal or extrapyramidal signs. CT and MRI findings disclosed asymmetric (left > right) progressive cortical atrophy of the frontal lobes predominating in the posterior inferior frontal region, notably the operculum. SPECT and PET revealed a decreased cerebral blood flow and metabolism, prominent in the left posterior-inferior frontal gyrus and premotor cortex, extending bilaterally in the most advanced cases. Pathological study of two cases showed non-specific neuronal loss, gliosis, and spongiosis of superficial cortical layers, mainly confined to the frontal lobes, with no significant abnormalities in the basal ganglia, thalamus, cerebellum, brain stem (except severe neuronal loss in the substantia nigra in one case), and spinal cord. We propose to call this peculiar syndrome Slowly Progressive Anarthria (SPA), based on its specific clinical presentation, and its metabolic and pathological correlates. SPA represents another clinical expression of focal cortical degeneration syndromes, that may overlap with other similar syndromes, specially primary progressive aphasia and the various frontal lobe dementias.- - - - - - - - - - ranking = 1keywords = apraxia (Clic here for more details about this article) |