Cases reported "Speech Disorders"

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1/27. When is a /k/ not a [k]? EPG as a diagnostic and therapeutic tool for abnormal velar stops.

    This case study describes a boy who at the age of eight years did not have consistent or contrastive use of velar stops in his spontaneous speech. The use of electropalatography (EPG) revealed abnormal tongue-palate contact for both velar and alveolar stops, all of which were perceived as normal, there was excess contact in the palatal region for all alveolars and velars in a word initial position and double velar/palatal articulation for velars in a word final position. Therapy using EPG for visual feedback was highly successful and post therapy data showed normal-looking EPG patterns for alveolar and velar stops. The assessment, diagnostic and therapeutic implications are discussed.
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2/27. Foix-Chavany-Marie (anterior operculum) syndrome in childhood: a reappraisal of Worster-Drought syndrome.

    Foix-Chavany-Marie syndrome (FCMS) is a distinct clinical picture of suprabulbar (pseudobulbar) palsy due to bilateral anterior opercular lesions. Symptoms include anarthria/severe dysarthria and loss of voluntary muscular functions of the face and tongue, and problems with mastication and swallowing with preservation of reflex and autonomic functions. FCMS may be congenital or acquired as well as persistent or intermittent. The aetiology is heterogeneous; vascular events in adulthood, nearly exclusively affecting adults who experience multiple subsequent strokes; CNS infections; bilateral dysgenesis of the perisylvian region; and epileptic disorders. Of the six cases reported here, three children had FCMS as the result of meningoencephalitis, two children had FCMS due to a congenital bilateral perisylvian syndrome, and one child had intermittent FCMS due to an atypical benign partial epilepsy with partial status epilepticus. The congenital dysgenetic type of FCMS and its functional epileptogenic variant share clinical and EEG features suggesting a common pathogenesis. Consequently, an increased vulnerability of the perisylvian region to adverse events in utero is discussed. In honour of Worster-Drought, who described the clinical entity in children 40 years ago, the term Worster-Drought syndrome is proposed for this unique disorder in children.
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3/27. Worster-Drought and congenital perisylvian syndromes-a continuum?

    A 5-year-old female was evaluated because of severe speech and expressive language delay. On examination, she could hardly speak and communicated through gestures. She manifested severe dysarthria and difficulty in protruding and moving her tongue laterally. She lacked coordination of the swallowing process, with drooling and an increased mental reflex. Her cognitive development was normal, and no associated neurologic dysfunction of the limbs was noted. On follow-up, the child experienced two episodes of seizures at 6 years of age. magnetic resonance imaging of the brain demonstrated perisylvian and frontal polymicrogyria. Clinical and radiologic findings demonstrated a similarity and continuum between congenital suprabulbar paresis (Worster-Drought syndrome) and perisylvian syndrome.
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4/27. Fiery tongues and mystical motivations: glossolalia in a forensic population is associated with mania and sexual/religious delusions.

    Comparisons are made between a nonrandom sample of 18 glossolalists and 130 non-glossolalists admitted to a maximum-security forensic hospital. The glossolalic mentally disordered offender exhibited a predominance of diagnoses in the manic spectrum, and was typically psychotic. The delusions, hallucinations, and crimes were predominately of a religious and sexual nature. Glossolalist perpetrators tended to be female. We review the extant research on glossolalia in both normal and clinical samples. and integrate our findings, the first study of glossolalia in a forensic setting.
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5/27. Cineradiographic assessment of articulatory mobility in the dysarthrias.

    This paper describes cineradiographic techniques for the assessment of articulatory mobility in dysarthric subjects. Sample data for the mobility ranges of articulatory points on the tongue, lower lip, and jaw are presented for four normal speakers and four dysarthric speakers. In addition, fleshpoint displacements during the articulatory movements of the dysarthric subjects are used to illustrate abnormalities in the range, rate, and direction of speech movements. Discussion of the point-parameterized cineradiographic data emphasizes possibilities for the clinical evaluation of dysarthric impairments.
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6/27. Advances in EPG for treatment and research: an illustrative case study.

    Electropalatography (EPG), a technique which reveals tongue-palate contact patterns over time, is a highly effective tool for speech research. We report here on recent developments by Articulate Instruments Ltd. These include hardware for Windows-based computers, backwardly compatible (with reading EPG3) software systems for clinical intervention and laboratory-based analysis for EPG and acoustic data, and an enhanced clinical interface with client and file management tools. We focus here on a single case study of a child aged 10 /-years who had been diagnosed with an intractable speech disorder possibly resulting ultimately from a complete cleft of hard and soft palate. We illustrate how assessment, diagnosis and treatment of the intractable speech disorder are undertaken using this new generation of instrumental phonetic support. We also look forward to future developments in articulatory phonetics that will link EPG with ultrasound for research and clinical communities.
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7/27. Duplication of 5q15-q23.2: case report and literature review.

    BACKGROUND: Pure partial trisomy of chromosome 5q is rare and cases have ranged over the entire region, making it difficult to describe a good phenotypic correlation to the cytogenetic duplication. CASE: We present a 4.5-year-old girl with a de novo direct duplication of chromosome 5q15-q23.2. She has moderate developmental delay with lack of speech, microcephaly, and subtle dysmorphic features including prominent forehead, bulbous nose, epicanthic folds, protruding tongue, and slightly posteriorly-rotated ears. CONCLUSIONS: A comparison is made with other similar duplication cases reported in the literature and a general description of a proximal 5q duplication phenotype is given, with lack of speech as the principal feature.
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8/27. Visual display of tongue-palate contact: electropalatography in the assessment and remediation of speech disorders.

    The technique of electropalatography (EPG) records the location and timing of tongue contacts with the hard palate during continuous speech. Recent developments in hardware and software design of the reading electropalatograph are described and applications of the technique in assessment and remediation of a variety of speech disorders are outlined. In assessment, it is shown that EPG can provide insights into possible origins of auditorily perceived errors, and case descriptions illustrate how this information can lead to a more rationalised approach to treatment. In therapy, the provision of real-time visual feedback of tongue movement can be effective in the remediation of certain types of intractable speech problems. Finally, the importance of techniques such as EPG in the objective evaluation of treatment procedures is discussed in the light of the increasing demand for accountability within the speech therapy service.
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9/27. Lingual activity in two speech-disordered children's attempts to produce velar and alveolar stop consonants: evidence from electropalatographic (EPG) data.

    research is accumulating to suggest that, in the process of phonological acquisition, children pass through a stage of producing subphonemic acoustic cues to distinguish target phonemic contrasts. These subtle, or covert, distinctions occur unnoticed by a transcriber, yet their existence is viewed as having potentially important theoretical and clinical implications. In this study, the technique of electropalatography (EPG) was used to investigate tongue placement in two speech-impaired subjects (sisters), during their attempts to produce alveolar/velar stop contrasts, and their EPG printouts compared to those of a normal subject. Transcription of the impaired subjects' speech showed that, whilst one was able overtly to produce the contrast, the other was using the phonological process of alveolar backing, and so was judged not to have the contrast. However, contrary to the predictions made based on the auditory transcription, the EPG data revealed that both children were making similar, and clearly distinguishable, lingual-palate contacts for the two places of articulation. Examination of the data revealed that the subject who was overtly producing the contrast was able to control the precise sequence of tongue movements necessary in the release phase of the two classes of stops. This critical stage in alveolar/velar stop production had not been mastered by the subject who was not producing a perceptible distinction. The clinical relevance of these findings is discussed.
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10/27. A lingual mucogingival problem associated with ankyloglossia: a case report.

    This report reviews the relationship between lingual frena, gingival recession, and tongue-tie, and describes a man with tongue-tie, localised gingival recession, and a speech impediment. The patient was treated surgically, with a satisfactory result 11 years later.
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