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MARIA GRIGOS, PHD CCC-SLP NEW YORK UNIVERSITY
HTI SEMINAR MARCH 16, 2012
THE ROAD TO UNDERSTANDING
SPEECH MOTOR CONTROL IN CHILDREN WITH
SPEECH SOUND DISORDERS
HTI SEMINAR MARCH 16, 2012
Speech Motor
Development
Cognitive Development
Linguistic Development
Social Development
Perceptual Development
OUR APPROACH Speech motor development § What can we learn about development of
speech motor control through movement analysis?
§ How is this feasible in young children?
§ Combining kinematic, acoustic & perceptual information
HTI SEMINAR MARCH 16, 2012
SPEECH SOUND DISORDERS Speech motor control in children with speech sound disorders
§ Childhood apraxia of speech (CAS)
§ Dysarthria § Articulation/phonological impairments
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CONTROVERSIES IN CAS?
Underlying deficit in CAS?
Speech & nonspeech characteristics associated with CAS?
Appropriate assessment & treatment
procedures for children with CAS?
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UNDERLYING DEFICIT IN CAS?
Planning, programming and/or execution of speech movements
(Bradford & Dodd, 1984; Crary, 1984; Grunwell & Yavas, 1988; Nijland et at, 2002; 2003; Van der Merwe, 2009, Grigos & Kolenda, 2010; Maasen et al, 2010; Shriberg, 2010; Terband et al, 2010).
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EVIDENCE OF A MOTOR DEFICIT IN CAS
Increased within-subject variability in coarticulation patterns in CAS than controls (Nijland et al, 2002).
Larger kinematic stiffness values in tongue tip and LL in CAS than controls during oral closure (Terband et al., 2008).
Improved segmental accuracy over time accompanied by decreased duration and increased movement stability (Grigos and Kolenda, 2010).
Increased LL movement amplitude in both CAS and SD groups; higher variability of tongue tip movement trajectories in CAS than controls (Terband et al., 2011).
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THEORETICAL PERSPECTIVE DYNAMIC SYSTEMS APPROACH
Motor control and coordination
Relationship between internal & external factors
• Self-organization • Rate limiters
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NEWELL’S CONSTRAINT MODEL (NEWELL, 1986)
Individual Constraints
Task Constraints
Environmental Constraints
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Speech Sound Disorders
BROAD RESEARCH FOCUS
Subtype CAS
SD
TD Controls
How does speech motor control differ between children with speech sound disorders & children with typical speech and language development?
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DEVELOPMENTAL CHANGES IN ORAL ARTICULATOR MOVEMENT Duration: longer in children than adults
§ Jaw (Grigos et al, 2005; Grigos, 2009)
§ Lower lip (Goffman & Malin, 1999; Goffman & Smith, 1999; Smith & Goffman, 1998, Walsh et al, 2006)
§ Tongue (Cheng et al, 2007)
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DEVELOPMENTAL CHANGES IN ORAL ARTICULATOR MOVEMENT
Variability: decreases over the course of development
§ Duration (Grigos et al, 2005; Sharkey & Folkins, 1985)
§ Displacement (Sharkey & Folkins, 1985; Smith & McLean-Muse, 1986; Watkin & Fromm, 1984)
§ Movement pattern variability (Goffman & Smith, 1999; Grigos, 2009; Smith & Goffman, 1998)
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DEVELOPMENTAL CHANGES IN ORAL ARTICULATOR MOVEMENT Coordination: improves with development
§ UL, LL and Jaw (Green, et al 2000; Grigos et al, 2005).
§ UL & LL (Smith et al, 1995; Walsh et al 2006; Sasisekeran et al 2010)
§ Tongue-tip/tongue-body (tongue palatal contact) (Cheng et al, 2007).
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HOW DO THESE SKILLS DEVELOP IN CHILDREN WITH
SPEECH SOUND DISORDERS?
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RESEARCH QUESTIONS
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Differences in oral articulator movement between CAS, SD, TD?
Differences in movement variability between CAS, SD & TD?
Differences in movement coordination between CAS, SD & TD?
Impact of word length on articulatory control?
1
2
3
4
METHOD
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PARTICIPANTS
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CAS 11 4.5 (2.8 – 5.8)
SD 7 4.9 (3.3 – 6.9)
TD 24 5.2 (3.1 – 8.4)
N Mean Age (Range)
ASSESSMENT TASKS
Single word test of articulation/phonology Spontaneous speech sample – 100 word
Real and nonword repetition tasks Phrase/sentence repetition tasks
Single and multi-syllable sequencing tasks Oral motor structure and function
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ASSESSMENT MEASURES
Consonant & vowel accuracy Phonetic inventory
Phonological process analysis Consistency
Segmentation Lexical stress
Repetition tasks: rate and accuracy
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ASSESSMENT OTHER AREAS TESTED
Nonverbal cognition Receptive language Expressive language
Hearing
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DIAGNOSING CAS ASHA position statement on CAS (ASHA, 2007) Three characteristics: § Inconsistent Errors § Articulatory transitions § Prosodic errors
Across contexts § Single words § Connected speech § Repetition tasks
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Other characteristics: § Articulatory groping § Metathetic errors § Sequencing errors § Vowel errors § Timing errors § Omissions/Distortions § Reduced phonetic inventory § Change with increase in
linguistic complexity § Progress in treatment
(cf. Hall, Jordan & Robin, 1993; Velleman & Strand, 1994; Shriberg, Aram & Kwiatkowski, 1997a,b,c; Davis et al., 1998; Odell & Shriberg, 2001, Shriberg et al 2003; ASHA, 2007).
PARTICIPANT PROFILES
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Inconistent Sequencing Vowel Prosodic Slow Reduced Groping Errors Errors Errors Errors Progress Inventory
EXPERIMENTAL SETUP
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POP PUPPET
PUPPYPOP
ORAL ARTICULATOR MOVEMENT Optical Tracking System (Vicon)
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PROCEDURE Target words elicited during play
10-15 productions per word Accurate productions selected for analysis
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1 syllable
• pop
2 syllable
• puppet
3 syllable
• puppypop
MOVEMENT TRAJECTORY ANALYSIS
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ANALYSES
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Transcription PCC PVC PEC Prosody
Kinematic Duration
Displacement Velocity
Variability Coordination
RESULTS
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TRANSCRIPTION ANALYSIS
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Word Length Group PCC (%) PVC(%) PEC (%)
1 syllable
CAS 85.5 89.6 71.6 SD 96.0 96.0 72.8 TD 99.3 99.8 82.1
2 syllable CAS 89.5 86.6 53.8 SD 94.1 94.6 78.9 TD 99.1 96.9 83.9
3 syllable CAS 86.8 84.6 50.4
SD 96.8 100.0 65.0
TD 96.4 98.5 95.7
RESEARCH QUESTIONS
HTI SEMINAR MARCH 16, 2012
Differences in oral articulator movement between CAS, SD, TD?
Differences in movement variability between CAS, SD & TD?
Differences in movement coordination between CAS, SD & TD?
Impact of word length on articulatory control?
1
2
3
4
MOVEMENT DURATION
*
0
0.3
0.6
0.9
POP PUPPET PUPPYPOP
Dur
atio
n (s
ec)
CAS
SD
TD
* = Main Effect of Group, p<.01 HTI SEMINAR MARCH 16, 2012
AVERAGE VELOCITY
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0
10
20
30
40
50
60
POP PUPPET PUPPYPOP
Dura
tion
(sec
)
CAS SD TD
ORAL OPENING & CLOSING MOVEMENTS
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0
2
4
6
8
10
12
14
16
0
2
4
6
8
10
12
14
16 Opening Closing
JAW DISPLACEMENT
= CAS = SD =TD
pop puppet puppypop pop puppet puppypop HTI SEMINAR MARCH 16, 2012
HTI SEMINAR MARCH 16, 2012
Opening Closing
LIP APERTURE
0
5
10
15
20
25
0
5
10
15
20
25
= CAS = SD =TD
pop puppet puppypop pop puppet puppypop
RESEARCH QUESTIONS
HTI SEMINAR MARCH 16, 2012
Differences in oral articulator movement between CAS, SD, TD?
Differences in movement variability between CAS, SD & TD?
Differences in movement coordination between CAS, SD & TD?
Impact of word length on articulatory control?
1
2
3
4
JAW STABILITY
0
5
10
15
20
25
30
35
POP PUPPET PUPPYPOP
STI
CAS
SD
TD
*
* = Main Effect of Group, p=.038 HTI SEMINAR MARCH 16, 2012
INDIVIDUAL VARIATION - DURATION
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0
0.1
0.2
0.3 Co
fficie
nt o
f var
iatio
n (s
d/m
ean)
CAS
SD
TD
pop puppet puppypop
RESEARCH QUESTIONS
HTI SEMINAR MARCH 16, 2012
Differences in oral articulator movement between CAS, SD, TD?
Differences in movement variability between CAS, SD & TD?
Differences in movement coordination between CAS, SD & TD?
Impact of word length on articulatory control?
1
2
3
4
MOVEMENT COORDINATION Within Trial: Crosscorrelation between articulator pairs (Jaw-Lower Lip, Jaw-Upper Lip, Upper Lip-Lower Lip)
• Peak Correlation
• Lag
Across Trials: Repeatability of Movement Sequence
Lip Aperture
• Spatiotemporal Index (STI)
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SPATIAL COUPLING: PEAK CORRELATION MAIN EFFECT OF LENGTH NO GROUP OR INTERACTION EFFECT
0
0.2
0.4
0.6
0.8
1
CAS SD TD Correla3
on Coe
fficien
t
Group
Jaw-‐ Lower Lip
0
0.2
0.4
0.6
0.8
1
CAS SD TD Correla3
on Coe
fficien
t
Group
Jaw-‐Upper Lip
0
0.2
0.4
0.6
0.8
1
CAS SD TD Correla3
on Coe
fficien
t
Group
Upper Lip-‐Lower Lip
POP
PUPPET
PUPPYPOP
F(2,15)=26.177, p<.0001 F(2,15)=4.868, p=.015
F(2,15)=9.629, p=.001 HTI SEMINAR MARCH 16, 2012 Moss & Grigos, in preparation
0
0.01
0.02
0.03
0.04
CAS SD TD
Lag (sec.)
Group
Jaw-‐Lower Lip
0
0.01
0.02
0.03
0.04
CAS SD TD
Lag (sec.)
Group
Jaw-‐Upper Lip
0
0.01
0.02
0.03
0.04
CAS SD TD
Lag (sec.)
Group
Upper Lip-‐Lower Lip
POP
PUPPET
PUPPYPOP
TEMPORAL SYNCHRONY: LAG MAIN EFFECT OF LENGTH NO GROUP OF INTERACTION EFFECT
F(2,15)=3.745, p=.035 F(2,15)=12.412, p<.0001
HTI SEMINAR MARCH 16, 2012 (Moss & Grigos, in preparation)
COEFFICIENT OF VARIATION: PC MAIN EFFECT OF GROUP NO LENGTH OR INTERACTION EFFECT
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Jaw-‐Lower Lip
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Jaw-‐Upper Lip
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Upper Lip-‐Lower Lip
CAS
SD
TD
F(2,15)= 4.962, p=.022
HTI SEMINAR MARCH 16, 2012 (Moss & Grigos, in preparation)
COEFFICIENT OF VARIATION: PC MAIN EFFECT OF GROUP NO LENGTH OR INTERACTION EFFECT
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Jaw-‐Lower Lip
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Jaw-‐Upper Lip
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Upper Lip-‐Lower Lip
CAS
SD
TD
F(2,15)= 4.962, p=.022
HTI SEMINAR MARCH 16, 2012 (Moss & Grigos, in preparation)
COEFFICIENT OF VARIATION: LAG MAIN EFFECT OF GROUP NO LENGTH OR INTERACTION EFFECT
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Jaw-‐Lower Lip
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Jaw-‐Upper Lip
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Upper Lip-‐Lower Lip
CAS
SD
TD
F (2,15)=4.267, p=.034 F (2,15)=4.366, p=.032
HTI SEMINAR MARCH 16, 2012 (Moss & Grigos, in preparation)
COEFFICIENT OF VARIATION: LAG MAIN EFFECT OF GROUP NO LENGTH OR INTERACTION EFFECT
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Jaw-‐Lower Lip
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Jaw-‐Upper Lip
0
0.2
0.4
0.6
0.8
POP PUPPET PUPPYPOP
Mean CV
Upper Lip-‐Lower Lip
CAS
SD
TD
F (2,15)=4.267, p=.034 F (2,15)=4.366, p=.032
HTI SEMINAR MARCH 16, 2012 (Moss & Grigos, in preparation)
LIP APERTURE STABILITY
0
5
10
15
20
25
30
35
40
45 ST
I
CAS
SD
TD
pop puppet puppypop
*
* = Main Effect of Group, p=.018 HTI SEMINAR MARCH 16, 2012
SUMMARY &
DISCUSSION HTI SEMINAR MARCH 16, 2012
Perceptual
Consonant and vowel errors greater in CAS than SD and TD. Consonant and vowel errors increase as syllable length increases. Error consistency is greater in TD and SD than CAS.
SUMMARY OF FINDINGS
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SUMMARY OF FINDINGS Kinematic
Movement duration longer in CAS/SD than TD. CAS more variable than SD and TD Trend for amplitude to be large in SD in 3 syllable words. Evidence that coordination is poorer in CAS than SD/TD Variable word length effects
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DISCUSSION Broad group differences: CAS/SD vs. TD § Longer duration may reflect adaptations to the
motor plan § Means for increasing stability
Differences between impaired groups: CAS vs. SD § Movement constraints in SD § Movement constraints in CAS
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MOVEMENT STABILITY IN CAS Evidence of motor deficit?
é STI in CAS = reduced ability to generate/execute stable motor plan Degrees of Freedom problem § Greater variability in CAS than SD
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DO CHILDREN WITH CAS HAVE A COORDINATION IMPAIRMENT?
Children with CAS: § Do not differ in degree of spatial-temporal coupling
when productions are accurate.
§ Do differ in the variability of how coupling is achieved each time.
We predict that as speaking tasks become more complex, spatial coupling will decrease, temporal synchrony will increase, and variability will increase. Production errors may occur for these reasons.
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NEWELL’S CONSTRAINT MODEL (NEWELL, 1986)
Speech motor deficits
Task Constraints
Environmental Constraints
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MOVING AHEAD….
§ Error analyses
§ Longitudinal research tracking development of articulatory control in children with early diagnosis of speech delay
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Aviva Moss Panagiota Tampakis
Julie Case Penelope Elias Jessica Storer
NIH NIDCD R03DC009079
NYU Steinhardt
Research Challenge Grant
ACKNOWLEDGEMENTS
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