Apraxia of Speech: Perceptual Analysis of Trisyllabic Words Across Repeated Sampling Occasion

Cameron, Rosalea M.

Mauszycki, Shannon C.

Wambaugh, Julie L.

The Aphasiology Archive

                                                                                                   AOS: Perceptual Analysis                                                           1 Apraxia of Speech: Perceptual Analysis of Trisyllabic Words  Across Repeated Sampling Occasions  The primary characteristics considered to define acquired apraxia of speech (AOS) have continued to evolve, but a few characteristics remain controversial among clinicians and researchers (McNeil, Robin, & Schmidt, 2008). Particularly, the predictability or variability of sound errors in AOS (Croot, 2002). For years, variability of sound errors has been considered a primary characteristic of AOS (Deal & Darley, 1972; Johns & Darley, 1970; Wertz, LaPointe, & Rosenbek, 1984). Apraxic errors were considered to be variable with regard to the location of the error within a word (Johns & Darley; LaPointe & Johns, 1975) and the nature of the error (Johns & Darley; LaPointe & Horner, 1976) across repeated productions of the same stimuli.  Conversely, more recent research with “pure” apraxic speakers and speakers with AOS and accompanying aphasia has suggested that speech sound errors may not be variable (Mauszycki, Dromey, & Wambaugh, 2007; Mauszycki, Wambaugh, & Cameron, in press, 2010; Mlcoch, Darley, & Noll, 1982; McNeil, Odell, Miller, & Hunter, 1995; Shuster & Wambaugh, 2003; Wambaugh, Nessler, Bennett & Mauszycki, 2004). However, there are limited data examining sound errors over time (i.e., beyond a single session). Furthermore, the influence of conditions of stimuli presentation on sound errors remains uncertain.   The purpose of this investigation was to further examine variability of speech production in individuals with AOS and aphasia. Of specific interest were the effects of repeated sampling and conditions of stimulus presentation (i.e., random and blocked by sound) on the variability of error types identified utilizing narrow phonetic transcription.    Method Participants Eleven individuals with AOS and aphasia participated in the study (see Table 1 for participant characteristics and Table 2 for assessment results).  Experimental Stimuli Twenty-eight trisyllabic words served as experimental stimuli. Stimuli were comprised of four exemplars for seven initial target phonemes (i.e., /h, f, m, s, d, r, n/) with a CVC-V-CVC syllable structure with primary stress on the first syllable.  The following words served as experimental stimuli: hesitate, habitat, homicide, halogen, feminine, physical, fabulous, pheromone, magazine, marathon, monotone, medicate, sanitize, sedative, silicone, salivate, dedicate, deficit, dominate, decorate, radical, relative, renovate, ridicule, nominate, navigate, negative, nicotine.  Procedures  Stimuli were elicited at three different sampling times over a 7-day period with each participant. Each sampling time was separated by 2 days (e.g., Tuesday, Friday, and Monday) with each administration occurring at the same time on each sampling occasion.  Stimuli were elicited under two conditions: blocked presentation and randomized presentation. The blocked condition consisted of all exemplars of a sound presented sequentially (i.e., all initial /m/ words). The word order within the block was randomized as was the order of the blocks.                                                                                                       AOS: Perceptual Analysis                                                           2 Data Analyses All speech samples were analyzed perceptually utilizing narrow phonetic transcription via audio-recordings.    Analysis of each target consonant segment involved coding segments as correct or incorrect. Then, errors on target phonemes were coded according to predetermined categories which included substitutions, distortions, distorted substitutions, and omissions (Odell et al., 1990, 1991).  Perceptual Analyses  Mean percentage of errors. The mean percentage of errors overall and for each target sound was calculated by determining the number of times the phoneme was in error and dividing by the total number of occasions the target phoneme occurred in that position providing a percentage for comparison within and across sampling times.  Dominant error type by sound. The dominant error type used on erred productions overall and for each target sound was examined by determining the number of productions that were produced with a dominant error type and dividing by the total number of erred productions.    Reliability Fifteen percent of the productions were randomly selected for reanalysis of narrow phonetic transcription for the purpose of determining intra- and inter-judge reliability. Overall item to item interjudge agreement for narrow phonetic transcription was 83%. For intrajudge reliability, overall item to item agreement for narrow phonetic transcription was 91%.    Results The mean percentage of errors for all target phonemes for the group in each condition across sampling times is displayed in Figure 1. The mean percentage of errors ranged from 26% to 29% for the group. In the random condition, the mean percentage of errors was slightly greater (i.e., 1-2%).    The mean percentage of errors was calculated for the group for each target phoneme in both conditions across the three sampling occasions. The mean percentage of errors for target phonemes from least number of errors to the greatest number of errors in the blocked condition was /h, m, n, r, d, f, s/ and in the random condition was /h, m, n, f, r, d, s/.  For the phoneme /f/, there were a greater number of errors in blocked condition. Figure 2 depicts the mean percentage of errors and standard deviation for each target phoneme in both conditions across the three sampling occasions.     The dominant error type across all sounds was distortions. Figure 3 displays the overall percentage of error types in each condition of stimulus presentation. Overall, the dominant error type was distortion errors in both conditions of stimulus presentation followed by substitutions, distorted substitutions, and omissions. However, the dominant error type varied across phonemes and across sampling occasions and/or conditions. Tables 3 and 4 provide a summarization of number of errors and error types (percentage) for each phoneme at the three sampling occasions in the blocked and random conditions respectively. The dominant error type for the target phonemes /d/, /r/, /f/, /s/ was distortions and for /n/ was substitutions. The dominant error type for /h/ varied between substitution and distorted                                                                                                    AOS: Perceptual Analysis                                                           3 substitution errors in the blocked condition. In the random condition, the dominant error type for /h/ differed at each sampling occasion from substitution, distorted substitution, and omission errors. For /m/, distortion errors were the dominant error type in both conditions of stimulus presentation, but on one occasion substitutions were the dominant error type in the blocked condition.    Discussion This investigation was designed to examine speech production in 11 individuals with AOS and aphasia, specifically the effects of repeated sampling and conditions of stimulus presentation (blocked and random) on the number of errors and dominant error type for seven target phonemes.    Repeated sampling was found not to have a significant impact on the percentage of errors produced by the group. The overall mean percentage of errors and standard deviation was similar in both conditions of stimuli presentation across the three sampling times. These findings also suggest that the conditions of stimuli presentation did not have a significant influence on the number of errors produced by the group.   Distortions were found to be the dominant error type for the majority of target sounds. A comparison of the number of error types produced by the group in each condition across the three sampling occasions found no obvious pattern of responding by the group in either condition for individual phonemes. That is, condition of stimulus presentation did not appear to influence the type of error produced for a given sound.    The findings from this investigation revealed a greater pattern of consistency in speech sound errors for the group. It appears there was a predictable pattern of sounds errors uncovered for the group for the majority of target phonemes. The implications of these findings will be discussed.   References  Croot, K. (2002). Diagnosis of AOS: Definition and criteria. Seminars in Speech and          Language, 23(4), 267-279.  Dabul, B. (2000). Apraxia Battery for Adults-2. Austin, TX: Pro-Ed.  Deal, J.L., & Darley, F.L. (1972). The influence of linguistic and situation variables on  phonemic accuracy in apraxia of speech. Journal of Speech and Hearing Research, 15, 639-653.  Johns, D.F., & Darley, F.L. (1970). Phonemic variability in apraxia of speech. Journal of  Speech and Hearing Research, 13, 556-583. Kertesz, A. (1982). The Western Aphasia Battery. New York, NY: Grune & Stratton.   LaPointe, L. L., & Horner, J. (1976). Repeated trials of words by patients with  neurogenic phonological selection-sequencing impairment (apraxia of speech). Clinical Aphasiology, 6, 261-277.  LaPointe, L. L., & Johns, D. F. (1975). Some phonemic characteristics of apraxia of  speech. Journal of Communication Disorders, 8, 259-269.  Mauszycki, S.C., Dromey, C., & Wambaugh, J.L. (2007). Variability in apraxia of  speech: A perceptual, acoustic and kinematic analysis of stop consonants. Journal of Medical Speech-Language Pathology, 15, 223-242.                                                                                                     AOS: Perceptual Analysis                                                           4  Mauszycki, S.C., Wambaugh, J.L., & Cameron, R. M. (in press). Apraxia of speech:  Perceptual analysis of bisyllabic word productions across repeated sampling occasions. Journal of Medical Speech-Language Pathology.  Mauszycki, S. C., Wambaugh, J. L., & Cameron, R. M. (2010).  Variability in apraxia of speech: Perceptual analysis of monosyllabic word productions across repeated sampling times. Aphasiology, 24(7, 8). McNeil, M. R., Odell, K., Miller, S. B., & Hunter, L. (1995). Consistency, variability,  and target approximation for successive speech repetitions among apraxic, conduction aphasic, and ataxic dysarthria speakers. Clinical Aphasiology, 23, 39-55.   McNeil, M. R., Robin, D. A., & Schmidt, R. A. (2008). Apraxia of speech: Definition,  differentiation, and treatment. In M.R. McNeil (Ed.), Clinical management of sensorimotor speech disorders (2nd Ed.) (pp. 249-268). New York, NY: Thieme. Mlcoch, A.G., Darley F.L., & Noll, J.D. (1982). Articulatory consistency and variability in  apraxia of speech. In R.H. Brookshire (Ed.), Clinical aphasiology conference proceedings (pp. 235-238). Minneapolis, MN: BRK.    Odell, K., McNeil, M.R., Rosenbek, J.C., & Hunter, L. (1990). Perceptual  characteristics of consonant production by apraxic speakers. Journal of Speech and Hearing Disorders, 55, 345-359. Odell, K., McNeil, M.R., Rosenbek, J.C., & Hunter, L. (1991). Perceptual characteristics  of vowel and prosody production by apraxic, aphasic and dysarthric speakers. Journal of Speech and Hearing Research, 34, 67-80. Raven, J., Raven, J.C., & Court, J. H. (1998). Coloured progressive matrices. Oxford,  England: Oxford Psychologist Press, Ltd.   Shuster, L., & Wambaugh, J. L. (2003). Consistency of speech sound errors in apraxia  of speech accompanied by aphasia. Presentation at the annual Clinical Aphasiology Conference, Orcas Island, WA.   Wambaugh, J.L., Nessler, C., Bennett, J., & Mauszycki, S. C. (2004) Variability in  apraxia of speech: A perceptual and VOT analysis of stop consonants. Journal of Medical Speech-Language Pathology, 12, 221-227. Wertz, R.T., LaPointe, L.L., & Rosenbek, J.C. (1984). Apraxia of speech in adults: The  disorder and its management. Orlando, FL: Grune & Stratton.   Yorkston, K.M., & Beukelman, D.R. (1981). Assessment of Intelligibility of  Dysarthric Speech. Austin, TX: Pro-Ed.                                                                                                     AOS: Perceptual Analysis                                                           5 Table 1  Participant Characteristics      Characteristic   P-1   P-2   P-3   P-4   P-5   P-6   P-7   P-8   P-9    P-10     P-11  Age  35  56  46  47  56  25  41  62  63  58  52  Gender   Male  Female   Female  Male  Female  Female  Male  Female  Female  Male  Male  Years of  Education  18  14  12  13  10  12  14  15  13  20  11  Etiology  CVA  CVA  CVA  CVA  CVA  CVA    TBI  CVA  CVA  CVA  CVA  Yrs/Mos Post-onset   1 yr  9 mos  2 yrs 9 mos   1 yr 2 mos   15 yrs 7 mos    9 mos    9 mos   6 yrs 1 mos    4 mos   9 yrs 4 mos   4 yrs 10 mos   8 mos                                                                                                        AOS: Perceptual Analysis                                                           6  Table 2 Assessment Results   Assessment Tool  P-1  P-2  P-3  P-4  P-5  P-6  P-7  P-8  P-9   P-10   P-11  Apraxia Battery for Adults-2 (Dabul, 2000) Level of Impairment  Mild  AOS Mild-Mod AOS Mod-Severe AOS Mod-Severe AOS Mod-Severe AOS Severe AOS Mod-Severe AOS Mild AOS Mild AOS Mod-Severe AOS Severe  AOS   Western Aphasia Battery (Kertesz, 1982) Aphasia Quotient 94.0 71.2 45.1 83.6 76.7 42.7 36.9 92.5 97.3 47.0 52.6  Classifi- cation   Anomic  Broca’s  Broca’s  Broca’s  Broca’s  Broca’s  Broca’s  Anomic  Anomic  Broca’s  Broca’s   Assessment of Intelligibility of Dysarthric Speech (Yorkston & Beukelman, 1981) Word Level    92%  94% 98% 84% 78% 82% 90% 98% 100% 92% 90%  Coloured Progressive Matrices (Raven, Raven, & Court, 1998) (36 Possible)   Total Score   33 30 28 30 30 35 32 33 31 36 28                                                                                                    AOS: Perceptual Analysis                                                           7 Table 3  Number of Errors and Error Types (Percentage) for Each Target Phoneme at Each Sampling Occasion in the Blocked Condition with Predominant Error Type in Bold   Phoneme Sampling Time Number of Errors Distortion Substitution Distorted Substitution Omission /h/        Time 1 22 5% 23% 63% 9%  Time 2 27 11% 44% 30% 15%  Time 3 7 14% 14% 72% NA        /m/        Time 1 30 57%               30% 10% 3%  Time 2 22 59% 36% 5% NA  Time 3 20 30% 60% 10% NA        /n/        Time 1 47 4% 51% 43% 2%  Time 2 43 14% 65% 7% 14%  Time 3 35 23% 68% 9% NA        /r/        Time 1 60 66% 12% 22% NA  Time 2 58 79% 16% 3% 2%  Time 3 76 87% 9% 4% NA        /d/        Time 1 59 42% 34% 19% 5%  Time 2 60 42% 22% 36% NA  Time 3 77 60% 13% 27% NA        /f/        Time 1 98 70% 17% 11% 1%  Time 2 81 91% 4% 5% NA  Time 3 68 72% 24% 4% NA        /s/        Time 1 129 77% 11% 12% NA  Time 2 129 94% 5% 1% NA  Time 3 120 75% 18% 6% 1%  NA = No Errors                                                                                                             AOS: Perceptual Analysis                                                           8 Table 4  Number of Errors and Error Types (Percentage) for Each Target Phoneme at Each Sampling Occasion in the Random Condition with Predominant Error Type in Bold   Phoneme Sampling Time Number of Errors Distortion Substitution Distorted Substitution Omission /h/        Time 1 25 20% 24% 24% 32%  Time 2 21 19% 43% 29% 9%  Time 3 19 21% 26% 42% 11%        /m/        Time 1 42 60% 26% 12% 2%  Time 2 38 66% 29% 5% NA  Time 3 37 59% 30% 11% NA        /n/        Time 1 55 15% 65% 15% 15%  Time 2 57 21% 49% 28% 2%  Time 3 55 15% 63% 20% 2%        /r/        Time 1 73 60% 29% 10% 1%  Time 2 71 69% 14% 17% NA  Time 3 63 81% 15% 2% 2%        /d/        Time 1 68 37% 29% 34% NA  Time 2 74 47% 20% 30% 3%  Time 3 65 43% 32% 23% 2%        /f/        Time 1 67 64% 24% 10% 2%  Time 2 66 69% 14% 14% 3%  Time 3 50 70% 22% 6% 2%        /s/        Time 1 130 67% 20% 13% NA  Time 2 119 72% 22% 6% NA  Time 3 129 79% 16% 4% 1%  NA = No Errors                                                                                                             AOS: Perceptual Analysis                                                           9     Figure 1. The overall mean percentage of errors and standard deviation (error bars) in the blocked and random conditions across the three sampling occasions                                                                                                                      AOS: Perceptual Analysis                                                           10                       Figure 2. The mean percentage of error and standard deviation (error bars) for the group for each target phoneme across conditions and sampling occasions   Blocked Condition                             Random Condition Percentage of Error Types0102030405060708090100DistortionsSubstitutionsDistorted Substitutions Omissions Figure 3. The overall percentage of error types in the blocked and random conditions for the group.   0 10 20 30 40 50 60 70 80 90 100 110Initial /s/Initial /f/Initial /d/Initial /r/Initial /n/Initial /m/Initial /h/Time 3-RandomTime 3-BlockedTime 2-RandomTime 2-BlockedTime 1-RandomTime 1-Blocked

Apraxia of Speech: Perceptual Analysis of Trisyllabic Words Across Repeated Sampling Occasions

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