The Effect of Hand Gesture Cues Within the Treatment of /r/ for a College-Aged Adult With Persisting Childhood Apraxia of Speech

"I still have issues with pronunciation of words": A mixed methods investigation of the psychosocial and speech effects of Childhood Apraxia of Speech in adults

PURPOSE

Adolescents with Childhood Apraxia of Speech (CAS) are likely to have persistent speech errors compared to non-CAS peers (Lewis et al., 2018) and may have ongoing psychosocial issues (e.g. Carrigg, Parry, Baker, Shriberg, & Ballard, 2016). Beyond this, little is known about the long-term consequences of CAS in adulthood. This study explored whether adults who were reported to have had CAS as children have ongoing psychosocial or speech impacts.

METHOD

A cross-sectional descriptive design, with mixed-method analyses of demographic, psychosocial, and speech data was used. Data were collected via a four-part online survey. Part one consisted of questions about demographic information and participants' self-reported performance in speech, language and literacy. Parts two and three investigated the psychosocial impacts of CAS using the Brief Fear of Negative Evaluation Scale - Revised (BFNE- R) and The State-Trait Anxiety Inventory (STAI). Part four collected single word and connected speech data via an online audio recording, which was then transcribed following the Connected Speech Transcription Protocol (CoST-P). Analyses of speech characteristics reported in CAS was completed using Phon software.

RESULT

There were 17 participants in part one, 16 in parts two and three, and six in part four. Participants reported elevated levels of state (p = 0.01) and trait (p = 0.0001) anxiety compared to normative data. Ongoing segmental and suprasegmental speech errors were observed, with a significant difference between percent phonemes correct in single words versus connected speech (p = 0.03). Participants who provided a speech sample had difficulty with correct stress, use of juncture, and had increased intra- and inter-word segregation. Participants with better speech reported less anxiety.

CONCLUSION

Psychosocial effects and speech characteristics associated with CAS in childhood appear to persist into adulthood. Confirmation of these results and research to determine treatment and psychosocial support needs past early childhood is warranted.

Effectiveness of Intense Accent Modification Training With Refugees From Burma

PURPOSE

This pilot research project sought to determine if an intensive accent modification training program that included See the Sound-Visual Phonics and prosodic gestures improved articulation, prosody, and intelligibility measures in refugees from Burma.

PARTICIPANTS

Four individuals (two men, two women) aged 20-67 participated in this study, and they were recruited from a state organization supporting refugees who have resettled in the United States.

METHOD

All participants completed the Proficiency in Oral English Communication (POEC) and Assessment of Intelligibility of Dysarthric Speech (AIDS) to measure pre- and posttraining changes. The duration of this study was 6 weeks and consisted of 1 week of pretesting, 4 weeks of accent modification training, and 1 week of posttesting. Participants attended a total of twelve 50-min accent modification training sessions, including eight individual sessions (twice per week) and four group sessions (once per week), which provided a functional way to practice newly acquired skills in a scripted conversational-type format. Trained and untrained articulation and prosody probes were used to establish baselines and measure change.

RESULTS

All four participants showed gains across articulation and prosody (in untrained and trained items). On pre- and posttest measures, three of the four participants also made gains on the broad measures of the AIDS and the POEC.

CONCLUSION

Findings support that a brief and intensive multimodality accent modification program can be beneficial.

Hand Gestures Facilitate the Acquisition of Novel Phonemic Contrasts When They Appropriately Mimic Target Phonetic Features

Purpose Research has shown that observing hand gestures mimicking pitch movements or rhythmic patterns can improve the learning of second language (L2) suprasegmental features. However, less is known about the effects of hand gestures on the learning of novel phonemic contrasts. This study examines (a) whether hand gestures mimicking phonetic features can boost L2 segment learning by naive learners and (b) whether a mismatch between the hand gesture form and the target phonetic feature influences the learning effect. Method Fifty Catalan native speakers undertook a short multimodal training session on two types of Mandarin Chinese consonants (plosives and affricates) in either of two conditions: Gesture and No Gesture. In the Gesture condition, a fist-to-open-hand gesture was used to mimic air burst, while the No Gesture condition included no such use of gestures. Crucially, while the hand gesture appropriately mimicked the air burst produced in plosives, this was not the case for affricates. Before and after training, participants were tested on two tasks, namely, the identification task and the imitation task. Participants' speech output was rated by five Chinese native speakers. Results The perception results showed that training with or without gestures yielded similar degrees of improvement for the identification of aspiration contrasts. By contrast, the production results showed that, while training without gestures did not help improve L2 pronunciation, training with gestures improved pronunciation, but only when the given gestures appropriately mimicked the phonetic properties they represented. Conclusions Results revealed that the efficacy of observing hand gestures on the learning of nonnative phonemes depends on the appropriateness of the form of those gestures relative to the target phonetic features. That is, hand gestures seem to be more useful when they appropriately mimic phonetic features. Supplemental Material https://doi.org/10.23641/asha.13105442.

Tutorial: Motor-Based Treatment Strategies for /r/ Distortions

Purpose This tutorial summarizes current best practices in treating American English /r/ distortions in children with residual speech errors. Method To enhance the effectiveness of clinicians' cueing and feedback, the phonetics of /r/ production is reviewed. Principles of acquisition, which can inform how to practice /r/ in the early stages of therapy, are explained. Elements of therapy that lack scientific support are also mentioned. Results Although there is significant variability in /r/ production, the common articulatory requirements include an oral constriction, a pharyngeal constriction, tongue body lowering, lateral bracing, and slight lip rounding. Examples of phonetic cues and shaping strategies are provided to help clinicians elicit these movements to evoke correct /r/ productions. Principles of acquisition (e.g., blocked practice, frequent knowledge of performance feedback) are reviewed to help clinicians structure the earliest stages of treatment to establish /r/. Examples of approaches that currently lack scientific support include nonspeech oral motor exercises, tactile cues along the mylohyoid muscle, and heterogeneous groupings in group therapy. Conclusion Treatment strategies informed by phonetic science and motor learning theory can be implemented by all clinicians to enhance acquisition of /r/ for children with residual errors. Supplemental Material https://doi.org/10.23641/asha.12771329.