New perspectives on speech motor planning and programming in the context of the four- level model and its implications for understanding the pathophysiology underlying apraxia of speech and other motor speech disorders

BACKGROUND : The complexity of speech motor control, and the incomplete conceptualisation of phases in the transformation of the speech code from linguistic symbols to a code amenable to a motor system, tend to obscure the understanding of acquired apraxia of speech (AOS). The four-level framework (FLF) of speech sensorimotor control suggests the differentiation between speech motor planning, programming and execution and locate the locus of disruption in AOS in the motor planning phase. Currently, terminological confusion and uncertainty regarding phases in speech motor control still complicate the characterisation of AOS. This neuromotor disorder is inconsistently described in the literature as a “planning or programming”, “planning and programming”, or as a “planning and/or programming” disorder. PURPOSE : To describe a new version of the FLF, the FL (four-level) model, which further explicates and differentiates between speech motor planning, programming, and execution levels or phases of processing; to integrate concepts from computational modelling into the FL model and propose distinct control architectures for both the planning and programming levels; and to identify the loci and nature of disruption in the motor planning phase which could explain the pathophysiology and core features of AOS. DISCUSSION AND CONCLUSIONS : A four-level model is presented that differentiates two pre-execution phases and an execution phase. The first pre-execution phase is controlled by a motor planner and involves an inverse model, an efference copy, and a forward model for each sound or over-learnt utterance. This phase also involves a forward predictive planner which enables the system to handle the planning of several sounds and to plan coarticulation of sounds. The motor planner is operated according to an auxiliary forward model architecture. AOS is depicted as a breakdown at several possible points in the motor planning phase. The second pre-execution phase is driven by a motor program generator and predictive controller that is governed by an integral forward model architecture. The final execution phase is portrayed as being driven by closed loop control. The conceptualization of the programmer challenges the traditional view of execution and not only that of planning as is generally accepted. The implications for the classification of motor speech disorders are discussed. Future research should address the exact nature of articulatory movements and other features of speech across the range of planning, pure programming, programming-execution and pure execution disorders.https://www.tandfonline.com/loi/paph202021-05-21hj2020Speech-Language Pathology and Audiolog

Idiosyncratic sound systems of the South African Bantu languages : research and clinical implications for speech-language pathologists and audiologists

The objective of this article is to create awareness amongst speech-language pathologists and audiologists in South Africa regarding the difference between the sound systems of Germanic languages and the sound systems of South African Bantu languages. A brief overview of the sound systems of two Bantu languages, namely isiZulu and Setswana, is provided. These two languages are representative of the Nguni language group and the Sotho group respectively. Consideration is given to the notion of language-specific symptoms of speech, language and hearing disorders in addition to universal symptoms. The possible impact of speech production, language and hearing disorders on the ability to produce and perceive speech in these languages, and the challenges that this holds for research and clinical practice, are pointed out.http://www.sajcd.org.za/am201

Struikelblokke in kruislinguistiese en -kulturele pediatriese spraak-taalterapie en strategieë vir die bevordering van kultuurveilige praktyke : 'n omvangsbepaling

CITATION: Botha, M., Gerber, B. & Van der Merwe, A. 2021. Struikelblokke in kruislinguistiese en -kulturele pediatriese spraak-taalterapie en strategieë vir die bevordering van kultuurveilige praktyke : 'n omvangsbepaling. LitNet Akademies, 18(3):673-701.The original publication is available at https://www.litnet.co.zaIn ’n kultureel en linguisties diverse land soos Suid-Afrika bestaan daar ’n belangrike behoefte om spraak-taalterapiedienste te lewer wat kultuurveilig van aard is. ’n Omvattende lys van strategieë wat terapeute kan volg om hierdie behoefte te vervul, ontbreek egter. ’n Lys van verwagte struikelblokke in kruislinguistiese en -kulturele praktyke kan spraak-taalterapeute (STT’s) help om voor te berei vir kruislinguistiese en -kulturele interaksies en om begrip, eerbied en empatie vir hul kliënte te ontwikkel. Met die doel om ’n raamwerk vir kultuurveilige spraak-taalterapie-praktyke voor te stel, het hierdie omvangsbepaling internasionale en plaaslike literatuur deursoek vir die struikelblokke wat verwag kan word asook doeltreffende strategieë wat STT’s wêreldwyd ontwikkel het waar hulle kruislinguisties en -kultureel praktiseer. Die aard en omvang van die navorsing wat reeds op die gebied van kruislinguistiese en -kulturele pediatriese spraak-taalterapie gedoen is, is ook bepaal. ’n Soekstrategie is as metode ontwikkel om toepaslike artikelsin elektroniese databasisse uit te wys. Twaalf artikels is in die omvangsbepaling ingesluit. Primêre struikelblokke tydens kruislinguistiese en -kulturele spraak-taalterapie wat geïdentifiseer is, het taal- en kommunikasiestruikelblokke, tekorte aan toepaslike evaluasie- en terapiemateriaal, en tekort aan toepaslike opleiding behels. Voorgestelde strategieë vir goeie kruislinguistiese en -kulturele spraak-taalterapie het bestaan uit die uitbreiding tot ’n meer diverse werkerskorps, die vestiging van goeie verstandhoudings met versorgers, en aanpassings in kommunikasie. Hierdie omvangsbepaling bied die enigste opsomming van die strategieë vir kruislinguistiese en -kulturele pediatriese spraak-taalterapie wat STT’s wêreldwyd in die afgelope twintig jaar ontwikkel het, asook moontlike struikelblokke wat verwag kan word. Die bydrae word vergroot deur verwysing na die Suid-Afrikaanse konteks. Bevindinge aangaande die aard en omvang van die literatuur stel ook ’n basislyn as vertrekpunt vir die beplanning van verdere navorsing.Publisher's versio

Nurses’ views on promotion and the influence of race, class and gender in relation to the Employment Equity Act

CITATION: Van Der Heever, M. M., Van Der Merwe, A. S. & Crowley, T. 2019. Nurses’ views on promotion and the influence of race, class and gender in relation to the Employment Equity Act. SA Journal of Industrial Psychology, 45(0):a1611, doi:10.4102/sajip.v45i0.1611.The original publication is available at https://sajip.co.zaPublication of this article was funded by the Stellenbosch University Open Access FundOrientation: Regardless of the implementation of the Employment Equity Act (EEA), No. 55 of 1998 and the abolishment of apartheid in 1994, African and mixed-race females are under-represented in managerial positions in the public sector of the Western Cape (WC) in South Africa and nationally in the private health sector. Research purpose: The purpose was to explore the views of nurses about promotion to managerial positions in view of the Employment Equity Act (EEA) and the possible influence of race, class and gender. Motivation for the study: South Africa has a history of racial hierarchies and gender inequities. It was therefore important to explore the influence of the EEA and race, class and gender on the promotion of nurses in the post-apartheid context. Research approach/design and method: A cross-sectional descriptive survey design was completed. Six hundred and eighty-eight (n = 688) nurses consented to participate and 573 (83%) questionnaires were returned. Main findings: Race as a social construct surfaced in the superior viewing of white and the inferior viewing of African nurses. Mixed-race and white nurses seemed disgruntled with the EEA because of the benefits it holds for African nurses. African nurses seemed angered by their under-representation in managerial positions in the private and public sectors in the WC. White nurses seemed convinced that African, mixed-race and Indian nurses experience upward mobility. Mixed-race nurses (public sector WC) showed concerns about the career successes of males in a female-dominated profession. Practical/managerial implications: Managerial structures should be required to invest in diversity training, create awareness of the noble intentions of the EEA and communicate the relevance of employment equity plans. Contribution/value-add: The findings provided evidence that reflected a need for diversity training and the creation of awareness about the longstanding influence of racial and gender hierarchies.https://sajip.co.za/index.php/SAJIP/article/view/1611Publisher's versio

Vocal effectiveness of speech-language pathology students : before and after voice use during service delivery

BACKGROUND : As a professional voice user, it is imperative that a speech-language pathologist’s (SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours, poor vocal hygiene and environmental factors. OBJECTIVES : To determine the effect of service delivery on the perceptual and acoustic features of voice. METHOD : A quasi-experimental., pre-test–post-test research design was used. Participants included third- and final-year speech-language pathology students at the University of Pretoria (South Africa). Voice parameters were evaluated in a pre-test measurement, after which the participants provided two consecutive hours of therapy. A post-test measurement was then completed. Data analysis consisted of an instrumental analysis in which the multidimensional voice programme (MDVP) and the voice range profile (VRP) were used to measure vocal parameters and then calculate the dysphonia severity index (DSI). The GRBASI scale was used to conduct a perceptual analysis of voice quality. Data were processed using descriptive statistics to determine change in each measured parameter after service delivery. RESULTS : A change of clinical significance was observed in the acoustic and perceptual parameters of voice. CONCLUSION : Guidelines for SLPs in order to maintain optimal vocal effectiveness were suggested.http://www.sajcd.org.zaam2016Speech-Language Pathology and Audiolog

What can speech production errors tell us about cross-linguistic processing in bilingual aphasia? Evidence from 4 English/Afrikaans speaking individuals with aphasia.

In an effort to inform clinical practice and our understanding of bilingual aphasia, we examined differential performance in lexical retrieval abilities between first (L1) and second acquired language (L2), types of errors produced, and if performance was influenced by degree of cognate overlap in 4 bilingual aphasic individuals. Methods: A case series analysis of four Afrikaans/English bilingual aphasic individuals whose confrontation naming data were subjected to broad phonetic transcription was employed. Research questions were directed toward between language differences in lexical retrieval abilities, the influence of performance by degree of cognate overlap and types of errors produced. Results: Three participants showed significantly higher whole word confrontation naming accuracy in L1 relative to L2. One participant showed no difference. Performance for everyone was the poorest for low cognate overlap words. The largest proportion of error type for 3 participants in both L1 and L2 was omission. Discussion: These findings show that while all participants had aphasia, their relative naming impairments were consistent with their relative proficiency and use patterns prior to their stroke. The participant without between language differences was equally proficient in both languages and the remaining 3 participants showed an advantage consistent with the language used most frequently

What can speech production errors tell us about crosslinguistic processing in bilingual aphasia? Evidence from four English/Afrikaans bilingual individuals with aphasia

INTRODUCTION : The aim of this study is contribute to clinical practice of bilinguals around the globe, as well as to add to our understanding of bilingual aphasia processing, by analysing confrontation naming data from four Afrikaans/English bilingual individuals with acquired aphasia due to a left hemisphere stroke. METHODS : This is a case series analysis of four Afrikaans/English bilingual aphasic individuals following a left cerebrovascular accident. Error analysis of confrontation naming data in both languages was performed. Research questions were directed toward the between language differences in lexical retrieval abilities, types of errors produced and degree of cognate overlap. RESULTS : Three of the four participants showed significantly higher naming accuracy in first acquired language (L1) relative to the second acquired language (L2) and the largest proportion of error type for those three participants in both L1 and L2 was omission. One of the four participants (linguistically balanced) showed no between language accuracy difference. Regarding cognate overlap, there was a trend for higher accuracy for higher cognate words (compared to low). DISCUSSION : This study showed that naming performance in these four individuals was reflective of their relative language proficiency and use patterns prior to their stroke. These findings are consistent with the hierarchical model, in normal bilingual speakers and with persons with bilingual aphasia.http://www.sajcd.org.zaam2016Speech-Language Pathology and Audiolog

What can speech production errors tell us about crosslinguistic processing in bilingual aphasia? Evidence from four English/Afrikaans bilingual individuals with aphasia

INTRODUCTION : The aim of this study is contribute to clinical practice of bilinguals around the globe, as well as to add to our understanding of bilingual aphasia processing, by analysing confrontation naming data from four Afrikaans/English bilingual individuals with acquired aphasia due to a left hemisphere stroke. METHODS : This is a case series analysis of four Afrikaans/English bilingual aphasic individuals following a left cerebrovascular accident. Error analysis of confrontation naming data in both languages was performed. Research questions were directed toward the between language differences in lexical retrieval abilities, types of errors produced and degree of cognate overlap. RESULTS : Three of the four participants showed significantly higher naming accuracy in first acquired language (L1) relative to the second acquired language (L2) and the largest proportion of error type for those three participants in both L1 and L2 was omission. One of the four participants (linguistically balanced) showed no between language accuracy difference. Regarding cognate overlap, there was a trend for higher accuracy for higher cognate words (compared to low). DISCUSSION : This study showed that naming performance in these four individuals was reflective of their relative language proficiency and use patterns prior to their stroke. These findings are consistent with the hierarchical model, in normal bilingual speakers and with persons with bilingual aphasia.http://www.sajcd.org.zaam2016Speech-Language Pathology and Audiolog

A speech motor learning approach to treating apraxia of speech : rationale and effects of intervention with an adult with acquired apraxia of speech

Background: In this paper the rationale for a treatment of apraxia of speech, the speech motor learning (SML) approach, is described and the effects of its application explored. The SML approach endeavours to address the underlying inability to plan and program the production of different speech motor targets (SMTs) in changing phonetic contexts and in utterances exceeding a single word/nonword in length. Aims: The aims of the study were to determine (1) if treatment effects generalised to untreated nonwords and untreated real words with trained vowels and consonants, (2) if a learning effect was maintained, (3) if the treatment task hierarchy of the SML approach could be confirmed, and (4) if the number of speech errors judged perceptually declined across the treatment period on treated and untreated stages. Methods & Procedures: A multiple baseline single-participant design across behaviours and contexts was used to assess the effects of treatment with a speaker with chronic pure AOS. The first six stages of an eleven-stage treatment hierarchy were consecutively treated. The last five remained untreated. Outcomes & Results: During treatment, production of untrained nonwords and words containing trained and untrained SMTs improved. For three treated stages the improvement was greater during the treatment phase than during baseline, for words, nonwords, or both. Stage 4 vowels only improved once treatment commenced. Untreated consonant clusters of Stage 10 improved negligibly. Improvement was maintained 2 years post-treatment. The number of speech errors decreased across the treatment period. Conclusions: Preliminary evidence is provided supporting a general improvement in speech motor planning and programming ability for this participant. The relative value of components of the SML approach needs to be verified in future.http://www.psypress.com/aphasiologynf201