Electropalatographic Study of Speech Sound Errors in Adults with Acquired Aphasia

Traditionally speech errors in adults with acquired aphasia have been described as either apraxic errors, characteristic of anterior lesions in the cerebral cortex affecting areas such as Broca's area, or phonemic paraphasic errors due to posterior lesions in areas such as Wernicke’s area. However, studies have reported overlap in the descriptions of apraxic and phonemic paraphasic errors despite the assumption that these errors arise from different levels in the speech planning and execution process. For example, phonemic substitutions are associated with both types of error. Part of the problem is due to difficulties in identifying the precise nature and source of the errors which cannot be resolved by auditory perceptual judgements alone. This study investigates, by means of elcctropalatography (EPG), the location and timing of contact patterns produced by ten adults with acquired aphasia. The subjects were variously diagnosed by traditional classification as Broca’s aphasic with or without apraxia, conduction and anomic. These subjects variously demonstrated atypical patterns when compared to ten control speakers such as: increased temporal and/or spatial variability; specific difficulties in the sequencing and timing of two adjacent lingual consonants; and the presence of intrusive lingual/palatal contact patterns. These errors were usually undetected through auditory analysis. The atypical patterns were not associated uniquely with a particular aphasic syndrome but were subject specific and often related to the site of the lesion within the brain, for example, the basal ganglia. Both subjects diagnosed with apraxia of speech and those with phonemic paraphasia produced the EPG patterns noted above. The EPG data provided insights into the nature and origins of errors such as substitutions which were unavailable from auditory-based analysis. Many of these error patterns could be accounted for by modification to Dell’s model of spreading activation (Dell, 1980, 1985, 1986, 1990). The results have important implications for therapeutic intervention since accurate diagnosis is crucial for effective intervention

The Journey of Life Before, During and After Foster Care and the Path to Resilience

Children who are impacted by abuse and situations that result in foster care have the ability to overcome trauma with the support of stable and nurturing adults. This presentation will take participants on a journey of the life of a foster child from the early years to adulthood from the point of view of a foster child, social worker, and teacher

Long-term condition management in adults with intellectual disability in primary care: a systematic review

Background: Adults with intellectual disabilities have higher morbidity and earlier mortality than the general population. Access to primary health care is lower, despite a higher prevalence of many long-term conditions. Aim: To synthesise the evidence for the management of long-term conditions in adults with intellectual disabilities and identify barriers and facilitators to management in primary care. Design & setting: Mixed-methods systematic review. Method: Seven electronic databases were searched to identify both quantitative and qualitative studies concerning identification and management of long-term conditions in adults with intellectual disability in primary care. Both the screening of titles, abstracts, and full texts, and the quality assessment were carried out in duplicate. Findings were combined in a narrative synthesis. Results: Fifty-two studies were identified. Adults with intellectual disabilities are less likely than the general population to receive screening and health promotion interventions. Annual health checks may improve screening, identification of health needs, and management of long-term conditions. Health checks have been implemented in various primary care contexts, but the long-term impact on outcomes has not been investigated. Qualitative findings highlighted barriers and facilitators to primary care access, communication, and disease management. Accounts of experiences of adults with intellectual disabilities reveal a dilemma between promoting self-care and ensuring access to services, while avoiding paternalistic care. Conclusion: Adults with intellectual disabilities face numerous barriers to managing long-term conditions. Reasonable adjustments, based on the experience of adults with intellectual disability, in addition to intervention such as health checks, may improve access and management, but longer-term evaluation of their effectiveness is required

Spatial & temporal variability of sibilants in children with down’s syndrome

This paper presents findings from EPG analysis of word initial /s/ and /ʃ/ in twenty five children with Down’s syndrome (DS) and ten cognitively age-matched typically developing children (TD). Spatial and temporal variability measures show evidence of increased variability in all attempts of target /s/ and /ʃ/ for the speakers with DS. The findings also show evidence of high levels of spatial variability in children with DS and typically developing children in perceptually acceptable productions of the target sounds. These findings support previous research that links speech production difficulties in children with DS to impaired speech motor ability

Powerful tools for motor-based treatment approaches

Since the phonological revolution in the 1970s, SLTs have embraced phonological intervention when dealing with speech sound disorders (SSDs) and largely turned their backs on articulatory approaches. Joffe and Pring (2008) surveyed 98 clinicians working with children with speech difficulties and found the most common approaches used with this client group were auditory discrimination, minimal pairs and phonological awareness, with articulatory approaches used only ‘sometimes’ by around half of respondents. While there is good evidence that phonological impairments can be remediated with these types of phonological therapies (Law, Garrett and Nye, 2003), there remains a proportion of children with persistent SSDs for whom traditional phonological approaches do not provide the whole solution. For these children, the likely root of the impairment is motoric (Gibbon et al, 1999 )

Glucagon-Like Peptide-1 Modulates Neurally-Evoked Mucosal Chloride Secretion in Guinea Pig Small Intestine In Vitro.

Glucagon-like peptide-1 (GLP-1) acts at the G protein-coupled receptor, GLP-1R, to stimulate secretion of insulin and to inhibit secretion of glucagon and gastric acid. Involvement in mucosal secretory physiology has received negligible attention. We aimed to study involvement of GLP-1 in mucosal chloride secretion in the small intestine. Ussing chamber methods, in concert with transmural electrical field stimulation (EFS), were used to study actions on neurogenic chloride secretion. ELISA was used to study GLP-1R effects on neural release of acetylcholine (ACh). Intramural localization of GLP-1R was assessed with immunohistochemistry. Application of GLP-1 to serosal or mucosal sides of flat-sheet preparations in Ussing chambers did not change baseline short-circuit current (Isc), which served as a marker for chloride secretion. Transmural EFS evoked neurally mediated biphasic increases in Isc that had an initial spike-like rising phase followed by a sustained plateau-like phase. Blockade of the EFS-evoked responses by tetrodotoxin indicated that the responses were neurally mediated. Application of GLP-1 reduced the EFS-evoked biphasic responses in a concentration-dependent manner. The GLP-1 receptor antagonist exendin-(9 –39) suppressed this action of GLP-1. The GLP-1 inhibitory action on EFS-evoked responses persisted in the presence of nicotinic or vasoactive intestinal peptide receptor antagonists but not in the presence of a muscarinic receptor antagonist. GLP-1 significantly reduced EFS-evoked ACh release. In the submucosal plexus, GLP-1R immunoreactivity (IR) was expressed by choline acetyltransferase- IR neurons, neuropeptide Y-IR neurons, somatostatin-IR neurons, and vasoactive intestinal peptide-IR neurons. Our results suggest that GLP-1R is expressed in guinea pig submucosal neurons and that its activation leads to a decrease in neurally evoked chloride secretion by suppressing release of ACh at neuroepithelial junctions in the enteric neural networks that control secretomotor functions

The center for creative conservation: fostering novel collaborations for regional sustainability

Broad environmental and social forces are affecting our regional ecosystems and impacting the communities who depend on them in diverse ways. Addressing these complex social-ecological challenges necessitates growth in the collective wisdom of society. The Center for Creative Conservation at the University of Washington is addressing this need by promoting innovative solutions to complex environmental problems through fostering collaborations across broadly diverse disciplines, sectors, and communities. We strive to learn and apply best practices of transdisciplinarity, meaning authentically engaging different modes of knowing toward novel and integrated ideas, methods, and applications. For example, we convene medical researchers with ecologists, urban planners, educators, and environmental justice advocates to understand how contact with nature benefits human health, and how we can design green cities, educational programs, and policies that simultaneously support conservation, health, and social equity goals. We support a group of Tribal researchers and community members, climate scientists, science communicators, anthropologists, and artists working to illustrate the consequences of climate change through filming a human-centered story about the effects of sea level rise on a Native village. We also support a group of archaeologists, ethnobotanists, Native elders, and tribal educators who are developing a program to reintroduce the Native land management practices of burning and digging needed to maintain camas prairie ecosystems. In these and other initiatives, we create and support opportunities for researchers, practitioners, and community members to share knowledge, generate cross-cutting solutions, build relationships, and collectively build social-ecological resilience. We are excited to share outcomes and lessons learned from two years of work, and look forward to engaging in new collaborations with our Salish Sea colleagues

Book Reviews

Book Reviews Poverty in America by RALPH SELIGMAN and ASOKE BASU Social Development: Conceptual, Methodological and Policy Issues by JOHN F. JONES and RAMA S. PANDEY Single Rooms: Stories of an Urban Subculture by ELLIE WINBERG and TOM WILSON The States of Welfare: A Comparative Analysis of Social Policy by JOAN HIGGIN