Effects of Online Augmented Kinematic and Perceptual Feedback on Treatment of Speech Movements in Apraxia of Speech

Abstract

Apraxia of speech (AOS) is a motor speech disorder characterized by disturbed spatial and temporal parameters of movement. Research on motor learning suggests that augmented feedback may provide a beneficial effect for training movement. This study examined the effects of the presence and frequency of online augmented visual kinematic feedback (AVKF) and clinician-provided perceptual feedback on speech accuracy in 2 adults with acquired AOS. Within a single-subject multiple-baseline design, AVKF was provided using electromagnetic midsagittal articulography (EMA) in 2 feedback conditions (50 or 100%). Articulator placement was specified for speech motor targets (SMTs). Treated and baselined SMTs were in the initial or final position of single-syllable words, in varying consonant-vowel or vowel-consonant contexts. SMTs were selected based on each participant’s pre-assessed erred productions. Productions were digitally recorded and online perceptual judgments of accuracy (including segment and intersegment distortions) were made. Inter- and intra-judge reliability for perceptual accuracy was high. Results measured by visual inspection and effect size revealed positive acquisition and generalization effects for both participants. Generalization occurred across vowel contexts and to untreated probes. Results of the frequency manipulation were confounded by presentation order. Maintenance of learned and generalized effects were demonstrated for 1 participant. These data provide support for the role of augmented feedback in treating speech movements that result in perceptually accurate speech production. Future investigations will explore the independent contributions of each feedback type (i.e. kinematic and perceptual) in producing efficient and effective training of SMTs in persons with AOS.

Positional targets for lingual consonants defined using electromagnetic articulography

“…The tongue trajectories containing location information are beginning to be successfully used in speech recognition algorithms based on kinematic signals, which aim to enhance existing acoustic-based recognition models (Wang et al, 2010). Additionally, positional target similar to ones shown here have been used to treat place of articulation in motor speech disorders (see Katz, Bharadwji, & Carstens, 1999;McNeil et al, 2010). Our results suggest that certain sounds are characterised by positional distinctiveness, with can be used effectively for enhancement of speech recognition and feedback-based treatments.…”

Motor-Based Intervention Protocols in Treatment of Childhood Apraxia of Speech (CAS)

“…Although some studies reported findings consistent with the motor learning literature [14••,41,47], others failed to find clear and consistent differences between conditions [42,43,45,51,52], or reported opposite effects for some participants [22•,44]. It is likely that differences in tasks, measures, and populations contribute to this mixed pattern.…”

“…For individuals with speech/voice impairments, studies have examined practice amount [14••], practice schedule [22•,41,42], practice variability [43], practice distribution (massed vs. distributed) [42,44,45], feedback type (verbal knowledge of results vs. biofeedback knowledge of performance) [46], feedback frequency [21,47–51], feedback timing (immediate vs. delayed) [48] and attentional focus [52]. Although some studies reported findings consistent with the motor learning literature [14••,41,47], others failed to find clear and consistent differences between conditions [42,43,45,51,52], or reported opposite effects for some participants [22•,44].…”

Ultrasound visual feedback for acquired apraxia of speech: A case report

“…However, the majority of the research on visual feedback for articulation has focused on children rather than adults with acquired AOS. One exception is a recent series of studies with adults with AOS which suggest that visual feedback using electromagnetic articulography (EMA) can facilitate learning of tongue positions during speech and non-speech tasks (Katz, Bharadwaj, & Carstens, 1999;Katz et al, 2007;McNeil et al, 2010). These studies provide promising evidence that visual information can be used to aid in acquisition and learning of sound patterns in individuals with AOS; however, limiting factors in the clinical implementation of this technology include the availability of EMA, the set-up requirements for the technology (i.e., attaching sensors to the tongue), and the practical limitation of the number of sensors that can be attached.…”