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Dementia
Published in Henry J. Woodford, Essential Geriatrics, 2022
The dominant hemisphere encodes language. This is the left side of the brain in all right-handed and most left-handed people. The language centres are more diffuse and less well defined than traditionally thought. They include Broca's area in the frontal lobe and Wernicke's area at the margin of the temporal and parietal lobes. There is also a network of connections between these areas, called the arcuate fasciculus (seeFigure 6.2). Paraphrasia is a term for the use of abnormal or incorrect words. These can be semantic (similar categories – e.g. dog for cat), phonemic (similar sounds – e.g. jar for car) or neologistic (made up words – e.g. flut for car). Prosody is a term for the melodic characteristics of speech including intonation, stress and cadence (rhythm). Anomia is a term for a naming deficit (e.g. cannot say the name for a pen). Anomic aphasia is also called ‘word block'. With this disorder, people typically stop mid-sentence. Its presence is associated with space occupying lesions within the dominant lobe. Progressive aphasia is a term for a slowly worsening non-fluent aphasia secondary to left frontotemporal degeneration (plus apraxia). Dysgraphia (impaired writing) and dyslexia (impaired reading) are often associated with aphasia.
Developmental disorders, Part 3: Speech and language 1
Published in Quentin Spender, Judith Barnsley, Alison Davies, Jenny Murphy, Primary Child and Adolescent Mental Health, 2018
Quentin Spender, Judith Barnsley, Alison Davies, Jenny Murphy
Pragmatics refers to the development of skill in communicating (pragma means deed and pragmatikos means practical). Conversation has implicit rules, such as turn-taking, topic maintenance and conversational repair. There are also unspoken rules about politeness, storytelling, talking for a long time, and signalling what you intend to say. This also includes the child’s ability to understand how the meaning of any word may vary with context and in relation to the speaker’s intention. Prosody refers to the use of stress (on a word or a syllable) and tone of voice — and the interpretation of the meaning this adds to what is said (prosoidia means a song sung to music or the tone of a syllable).
Signs and Symptoms in Psychiatry
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Prosody refers to intonation, stress pattern, loudness variations, pausing, and rhythm. We express prosody mainly by varying pitch, loudness, and duration. We also may use greater articulatory force to emphasize a word or phrase.
Music and musical elements in the treatment of childhood speech sound disorders: A systematic review of the literature
Published in International Journal of Speech-Language Pathology, 2023
Mirjam van Tellingen, Joost Hurkmans, Hayo Terband, Roel Jonkers, Ben Maassen
Six studies in this review included participants with CAS, suggesting that music-based interventions are mostly applied in the treatment of speech disorders at the level of planning and programming. This use is supported by evidence that the music-based intervention SMTA improved accuracy, consistency and fluency of articulation in adults with AoS (Hurkmans et al., 2015), since CAS and AoS share characteristics such as inconsistency and inappropriate prosody. Speech and music are highly associated in prosody, e.g. stress is expressed by a combination of pitch, loudness and duration (Terband, Namasivayam, et al., 2019) that relate to the musical elements melody, dynamics (volume) and rhythm, respectively (Hurkmans et al., 2015). While there is debate on how these associations support speech rehabilitation, there is growing evidence that these associations contribute to the effect of music-based interventions (Merrett et al., 2014).
Evidence from a systematic review suggests a motor-speech mechanism for music-based interventions in aphasia treatment
Published in Evidence-Based Communication Assessment and Intervention, 2020
Zumbansen and Tremblay (2019) suggest a motor-based mechanism for music-based interventions to interpret these positive findings, which is compatible with the neurobiological, cognitive, and emotional mechanisms in MIT as described by Merrett et al. (2014). Hurkmans (2016) proposed that these interventions use various musical parameters to enhance a fluent speech production. Fluency characteristics refer to the flow and melody of articulation and their relationship to speech motor planning and programming in the dynamic process of speech motor control. Thus, the next step in understanding working mechanisms of music-based interventions is to study how various musical parameters are related to speech prosody in the context of speech motor control. As Zumbansen and Tremblay (2019) emphasized, various studies have been conducted to determine the relative contribution of musical elements to connected speech after music-based intervention with a specific focus on rhythm and melody (e.g. Stahl et al., 2013). The methodology of most studies is to compare a rhythm-based therapy with a singing-based therapy in order to explain which musical denominator (rhythm or melody) is most effective in music-based interventions. Apart from the fact that findings of these studies are ambiguous, it remains a matter of debate on how these musical parameters are related to various levels of speech processing, in particular aspects of speech prosody, such as stress, tempo, and intonation. Therefore, we need deeper insight into the process of prosody: the rhythm and melody of speech and music.
Lexical stress in childhood apraxia of speech: acoustic and kinematic findings
Published in International Journal of Speech-Language Pathology, 2020
Hailey C. Kopera, Maria I. Grigos
Prosodic deficits, including stress errors, have been noted as a characteristic of CAS since some of the earliest descriptions of this disorder (e.g. Rosenbek & Wertz, 1972; Yoss & Darley, 1974), and there has been much interest in atypical prosody as a potential indicator of CAS. For instance, a series of studies by Shriberg et al. (1997a, 1997b) compared the speech and prosody-voice profiles of three separate samples of children with suspected CAS to children with speech delay and found that only stress significantly differentiated a portion of children in these groups. The most common stress error pattern was described as excessive/equal phrasal stress, but lexical stress errors were also noted. While the present study further investigates stress in CAS, we note that recent work within the prosodic domain has also focussed on phrasing errors (i.e. inappropriate pauses) to develop a Pause Marker for differentiating CAS from speech delay (e.g. Shriberg et al., 2017).