Cases reported "Articulation Disorders"

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1/4. Efficacy of speech intervention using electropalatography with a cochlear implant user.

    Electropalatography (EPG) has become relatively well established as a safe and convenient technique for use in the assessment, diagnosis and treatment of children and adults with articulation disorders. EPG's wide applicability is reflected in the range of different cases that has been researched in recent years. Some research has been carried out using EPG therapy for deaf individuals who use hearing aids, however there are no similar studies for cochlear implant users. The purpose of this single case study is to explore the technique of EPG as a therapeutic intervention to treat voiceless velar stop consonant sound production in a deaf child cochlear implant user. EPG therapy was offered as a last resort when traditional therapy failed to achieve specific changes. During therapy, a list of familiar words was practised, using the visual feedback provided by EPG. The client's articulation was assessed using objective (EPG printouts) and subjective (listener ratings) measures at four assessment points. Changes were found to be statistically significant. Generalization of the newly-acquired skills to untaught words containing voiceless velars was also observed. The results are discussed in the broader context of implications of this type of therapy with deaf clients.
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2/4. 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.
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3/4. Selective alteration of native, but not second language articulation in a patient with foreign accent syndrome.

    The present study deals with a right-handed female polyglot suffering from a Foreign Accent syndrome (FAS) which affects her native language (L1), but not her other languages learnt since the age of 12. She had a small infarct in the left corona radiata as the result of a carotid occlusion. Her L1 was Spanish, but she also had a good command of French, English and Catalan (L2). aphasia tests did not reveal any other significant alteration in any language. Analyses of pre-morbid and post-morbid voice recordings revealed that FAS affected Spanish dramatically, but no important changes were observed for French. Results were interpreted as showing that different brain areas control articulation of L1 and L2 learnt after a critical period.
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4/4. rehabilitation of communication impairment in dystonia musculorum deformans.

    Augmentative and alternative communication (AAC) aids were used in three young, intellectually normal patients with dystonia musculorum deformans (DMD) who had severe speech and writing impediments. These aids included speech therapy, communication boards, and voice synthesizers for verbal communication and typewriters, memowriters, and computer software and printers for written communication. At times customized accessing was needed which required specific adaptive modifications. Implementation of the AAC aids system was determined effective for DMD patients in view of the intellect-sparing nature of the disorder. Improvement was hampered by the progressive nature of the disease and by the emotional stress of accepting the long-term use of AAC. Correct and early diagnosis of communication impediments are crucial for the appropriate AAC aids prescription and implementation. An AAC protocol is suggested to meet the special communication needs of DMD patients.
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