Purpose: We explored the reliability and validity of 2 quantitative approaches to document presence and severity of speech properties associated with apraxia of speech (AOS). Method: A motor speech evaluation was administered to 39 individuals with aphasia. Audio-recordings of the evaluation were presented to 3 experienced clinicians to determine AOS diagnosis and to rate severity of 11 speech dimensions. Additionally, research assistants coded 11 operationalized metrics of articulation, fluency, and prosody in the same speech samples and in recordings from 20 neurologically healthy participants. Results: Agreement among the 3 clinicians was limited for both AOS diagnosis and perceptual scaling, but inter-observer reliability for the operationalized metrics was strong. The relationships between most operationalized metrics and mean severity ratings for corresponding perceptual dimensions were moderately strong and statistically significant. Both perceptual scaling and operationalized quantification approaches were sensitive to the presence or absence of AOS. Conclusions: Perceptual scaling and operationalized metrics are promising quantification techniques that can help establish diagnostic transparency for AOS. However, because satisfactory reliability cannot be assumed for scaling techniques, effective training and calibration procedures should be implemented. Operationalized metrics show strong potential for enhancing diagnostic objectivity and sensitivity.

Purpose: To examine the effects and generalization of a modified script training intervention, delivered partly via videoconferencing, on dialogue scripts that were produced by 2 individuals with aphasia. Method: Each participant was trained on 2 personally relevant scripts. Intervention sessions occurred 3 times per week, with a combination of in-person meetings and videoconferencing, and lasted for 3 weeks per script. This study followed a multiple baseline design across scripts. Measures of accuracy, grammatical productivity, speaking rate, and articulatory fluency were obtained during baseline, intervention, and maintenance phases. Generalization probes were administered by challenging participants to engage in a conversation about their script topic with conversation partners who did not follow the script. Results: Both participants showed improvement on all dependent variables for both scripts during and after the intervention phase. Generalization samples showed improved grammatical morpheme use and increased rate of speech over prebaseline samples. Conclusion: There is evidence that script training intervention can improve accuracy, grammatical productivity, speaking rate, and articulatory fluency in script production tasks as well as in more functional conversational tasks. Videoconferencing is a viable method of conducting script training intervention when it is supported by face-to-face intervention sessions, slight modifications to the procedure, and an emphasis on self-cuing skills.

Purpose: In comparison to the large literature on moderate to severe aphasia, very little is known about aphasia of the mildest severity and whether intervention may be warranted. The purpose of this pilot study was to characterize challenges experienced by people who have recovered to the point that they score normally on aphasia batteries yet report they continue to have aphasia. Method: Five people with aphasia who scored above the Western Aphasia Battery–Aphasia Quotient ( Kertesz, 2007 ) cutoff for aphasia participated in a semistructured interview. A descriptive qualitative design was used to analyze subjective descriptions of difficulties in everyday communication situations within a framework for living with aphasia. Results: Participants reported salient communication difficulties, reduced social participation, difficulties returning to work, a continual need to concentrate when engaging in language tasks, and a keen awareness of persisting impairments. Conclusion: People with very mild aphasia experience salient language difficulties, and these difficulties have an adverse effect on multiple domains of living successfully with aphasia. Further investigation toward better methods of assessment and intervention is warranted.

The purposes of this study were to identify how individuals with MTBI are assessed, to determine the referral process to and from speech-language pathologists (SLPs), to describe the frequency, structure, and nature of treatment, to identify how individuals with MTBI and their families are educated about the injury and counselled, and to assess current follow-up procedures. One-hundred and forty-three hospital and rehabilitation centre based SLPs from North Carolina and Illinois responded to a survey developed to address these areas of interest. Findings indicated current diagnostic tools used by SLPs lack the sensitivity to detect the subtle cognitive communication deficits associated with MTBI, referral and follow-up procedures are not sufficiently implemented in facilities to meet the growing needs of individuals with MTBI, and SLPs would benefit from increased training regarding the management of individuals with MTBI including educating and counselling patients and their families.

Purpose This study was conducted to evaluate the clinical utility of error variability for differentiating between apraxia of speech (AOS) and aphasia with phonemic paraphasia. Method Participants were 32 individuals with aphasia after left cerebral injury. Diagnostic groups were formed on the basis of operationalized measures of recognized articulatory and prosodic characteristics of AOS and phonemic paraphasia. Sequential repetitions of multisyllabic words were elicited as part of a motor speech evaluation and transcribed phonetically. Four metrics of variability at the syllable and word levels were derived from these transcripts. Results The measures yielded different magnitudes of variability. There were no group differences between participants who displayed speech profiles consistent with AOS and participants who displayed speech profiles indicative of aphasia with phonemic paraphasia. Rather, correlation coefficients and analyses of covariance showed that the variability metrics were significantly mediated by overall error rate. Additionally, variability scores for individuals with salient diagnoses of AOS and conduction aphasia were inconsistent with current diagnostic guidelines. Conclusions The results do not support diagnostic validity of error variability for differentiating between AOS and aphasia with phonemic paraphasia. Future research using error variability metrics should account for overall error rate in the analysis and matching of participant groups.

Recent research on 5- to 11-year-old children’s perception of stop consonants and vowels indicates that they can generally identify these sounds with relatively high accuracy from short duration stimulus onsets [Ohde et al., J. Acoust. Soc. Am. 97, 3800–3812 (1995); Ohde et al., J. Acoust. Soc. Am. 100, 3813–3824 (1996)]. The purpose of the current experiments was to determine if younger children, aged 3–4 years, can also recover consonant and vowel features from stimulus onsets. Ten adults, ten 3-year olds, and ten 4-year-olds listened to synthesized syllables composed of combinations of [b d g] and [i u ɑ]. The synthesis parameters included manipulations of the following stimulus variables: formant transition (moving or straight), noise burst (present or absent), and voicing duration (10, 30, or 46 ms). Developmental effects were found for the perception of both stop consonants and vowels. In general, adults identified these sounds at a significantly higher level than children, and perception by 4-year-olds was significantly better than 3-year-olds. A developmental effect of dynamic formant motion was obtained, but it was limited to only the [g] stop consonant. Stimulus duration affected the children’s perception of vowels indicating that they may utilize additional auditory information to a much greater extent than adults. The results support the importance of information in stimulus onsets for syllable identification, and developmental changes in sensitivity to these cues for consonant and vowel perception.