Retrospective study of treatment outcome for individuals with aphasia

Measurement of outcomes subsequent to treatment and documentation of the efficiency with which outcomes are achieved is critical information for healthcare policy makers and third-party payers. This study employed the ASHA Functional Communication Measure (FCM) scales to retrospectively analyse charts of 20 aphasic patients. By discharge, both severe and moderate groups gained a median (across modalities) of 1 FCM level. The severe group remained dependent for communication, while the moderately impaired group typically achieved independent communication levels. Efficiency (amount of FCM level gain relative to number of treatment sessions) was greater for the moderate group; average number of treatment sessions was 40 for the severe group and 22 for the moderate group

An evaluation of the effectiveness of PROMPT therapy in improving speech production accuracy in six children with cerebral palsy

This study evaluates perceptual changes in speech production accuracy in six children (3 – 11 years) with moderate-to-severe speech impairment associated with cerebral palsy before, during, and after participation in a motor-speech intervention program (Prompts for Restructuring Oral Muscular Phonetic Targets). An A1BCA2 single subject research design was implemented. Subsequent to the baseline phase (phase A1), phase B targeted each participant’s first intervention priority on the PROMPT motor-speech hierarchy. Phase C then targeted one level higher. Weekly speech probes were administered, containing trained and untrained words at the two levels of intervention, plus an additional level that served as a control goal. The speech probes were analysed for motor-speech-movement-parameters and perceptual accuracy. Analysis of the speech probe data showed all participants recorded a statistically significant change. Between phases A1 – B and B – C 6/6 and 4/6participants, respectively, recorded a statistically significant increase in performance level on the motor speech movement patterns targeted during the training of that intervention. The preliminary data presented in this study make a contribution to providing evidence that supports the use of a treatment approach aligned with dynamic systems theory to improve the motor-speech movement patterns and speech production accuracy in children with cerebral palsy

Familial Amyotrophic Lateral Sclerosis with a focus on C9orf72 Hexanucleotide GGGGCC Repeat Expansion Associated ALS with Frontotemporal Dementia

Amyotrophic Lateral Sclerosis (ALS) is a rare and fatal neurodegenerative disorder resulting in the loss of motor neurons from the spinal cord and frontal cortex. The patterns of neurodegeneration, affected regions, age of onset, and time course of disease progression are all highly variable between and within variants of the disease. Familial ALS (fALS), inherited versions of ALS due to genetic changes, accounts for between 5-20% of all ALS cases, while the rest are sporadic, with either no causative mutation identified or no familial history of ALS. Recently, the discovery of C9orf72 hexanucleotide repeat expansions have been identified as one of the most common causes of familial ALS, with some patients presenting with dual phenotypes of ALS and frontotemporal dementia, leading to new hypotheses about the nature of neurodegenerative diseases. Despite the continued discovery of new ALS causative genes, little is known about the pathogenesis of the disease. While almost all variants include the presence of intracellular protein inclusions, the site of the protein plaques and involved proteins varies between genetic and phenotypic variants of this disease. Due to the lack of clear pathogenic mechanisms, several hypotheses have been developed to explain the process of neurodegeneration. Autophagy, the process of self-eating, leading to destruction of damaged or excess proteins and organelles, has been implicated as being altered in ALS. Multiple variants have demonstrated altered mitochondrial morphology and cellular energetic dynamics, which could explain previous observations that implicate the process of apoptosis in cellular death. Many of the involved proteins in ALS have functional roles for intracellular, nucleocytoplasmic, and axonal transport of various proteins or RNA. These three competing hypotheses are currently the most prominent hypotheses in the pathogenesis of ALS, and have largely been considered as separate and competing in past research. Is there a chance that the true pathogenesis leading to neuronal destruction via apoptosis involve all three hypotheses? Altered protein and RNA transport dynamics could lead to changes in cellular stress responses or overload autophagy pathways, leading to exacerbated cellular stress responses, leading to alterations in mitochondrial morphology and eventually cell death via apoptosis

FORMOFFA: An automated formant, moment, fundamental frequency, amplitude analysis of normal and disordered speech

A system for semi-automatic, multi-parameter acoustic analysis is described. The system, called FORMOFFA (For = FORmants, Mo = MOments, FF = Fundamental Frequency, A = Amplitude), operates on a PC microcomputer by adaptations of commercially available software. Data displays include a deterministic time record of instantaneous values, and an ergodic time-compressed distribution. In this report the technique is developed with a one-word example, and some measurement and reliability issues are described. The analysis possibilities are then illustrated with several applications: (1) segmental analysis of normal speech, (2) acoustic assessment of the effects of a progressive neurological disease (amyotrophic lateral sclerosis) on sentence production, (3) acoustic study of palatal lift management of a patient with traumatic brain injury, and (4) phonetic assessment of word production by a subject with dysarthria. Although the current technique is recommended as a research tool, this kind of analysis promises several advantages for clinical application, including semi-automaticity, efficiency, parsimony, and relevance to both segmental and suprasegmental levels of analysis