The purpose of this investigation was to compare the effects of two specific treatment protocols for acquired apraxia of speech (AOS): Sound Production Treatment (SPT) and Metrical Pacing Therapy (MPT), and to examine changes in communicative participation.
Four speakers with chronic AOS and aphasia were each administered SPT and MPT in a replicated crossover design (ABACA/ACABA) with nonconcurrent multiple baselines across participants and behaviors. Treatment outcomes were compared with respect to whole word correctness (WWC) for treated and untreated multisyllabic word targets. Speech intelligibility was assessed using the Chapel Hill Multilingual Intelligibility Test, and communicative participation was measured using the Communicative Participation Item Bank at baseline, washout, and follow-up phases.
Three of the four participants experienced statistically significant improvements in WWC with SPT, and three of the four participants with MPT. Based on a priori criteria, three participants demonstrated relatively greater benefit from SPT and one participant demonstrated relatively greater benefit from MPT. There were measurable improvements in intelligibility following SPT for three of the four participants. Only one participant in this investigation reported a significant change in communicative participation, and only following MPT.
This study demonstrated that individuals in the chronic stages of AOS can benefit from both SPT and MPT, corroborating prior research on articulatory kinematic and rate and/or rhythm control treatment approaches. It contributes a comparison of two protocols for AOS with respect to whole word targets, intelligibility, and individual self-report of communicative participation changes. More participants showed a relative advantage of SPT over MPT. One individual reported communicative participation improvement after MPT.
https://doi.org/10.23641/asha.23971929.

Rudimentary otocyst (RO) is characterized by an otic capsule without an internal auditory canal, which is considered a contraindication to cochlear implantation (CI). In this study, we were the first to report two patients with ROs who underwent CI.
Two patients (18 months old and 2 years old) presenting with bilateral congenital hearing loss were diagnosed with ROs.
CI was performed. The transmastoid slotted labyrinthotomy approach was used with customized MED-EL electrode arrays.
Categorical auditory performance, infant-toddler meaningful auditory integration of sound, the speech intelligibility rating, and meaningful use of speech scale.
Both children could understand common phrases and had intelligible, connected speech 2 years after CI.
With proper indication, surgical approach and postoperative training, a child with an RO may benefit from CI.

Gunshot wounds in the maxillofacial region may cause serious defects that result in functional and esthetic disabilities. A 14-year-old male patient was referred to the prosthodontics clinic for provisional prosthetic restoration 5 months after an injury involving the midline midfacial region. An interim extraoral silicone maxillofacial prosthesis (MFP), also known as an epithesis, replacing the nose and upper lip, was fabricated to enhance appearance and speech intelligibility. The effect of the prosthesis insertion on speech outcome was assessed over 6 months. Blood pulse oxygen saturation levels and heart rate were monitored to assess ventilation following the prosthesis insertion. Results of the Assessment of Articulation Subtest revealed the patient produced the target speech sounds of 31 more words correctly at 6 months follow-up. Bilabial, labiodental, and postalveolar speech sounds in the phonetic inventory improved. Fabrication of an extraoral silicone MFP, modifying substructure design, and prosthesis usage over time contributed to the significant enhancement of speech intelligibility and did not significantly change the blood pulse oxygen saturation levels and heart rate. It led to an improvement in overall aesthetic outcomes and was a useful tool for the patient\'s social integration.

Auditory brainstem implantation (ABI) is a relative recent development in paediatric hearing restoration. Consequently, young-implanted children\'s productive language has not received much attention. This study investigated speech intelligibility of children with ABI (N = 3) in comparison to children with cochlear implants (CI) and children with typical hearing (TH). Spontaneous speech samples were recorded from children representing the three groups matched on cumulative vocabulary level. Untrained listeners (N = 101) rated the intelligibility of one-word utterances on a continuous scale and transcribed each utterance. The rating task yielded a numerical score between 0 and 100, and similarities and differences between the listeners\' transcriptions were captured by a relative entropy score. The speech intelligibility of children with CI and children with TH was similar. Speech intelligibility of children with ABI was well below that of the children with CI and TH. But whereas one child with ABI\'s intelligibility approached that of the control groups with increasing lexicon size, the intelligibility of the two other children with ABI did not develop in a similar direction. Overall, speech intelligibility was only moderate in the three groups of children, with quite low ratings and considerable differences in the listeners\' transcriptions, resulting in high relative entropy scores.

UNASSIGNED: To assess and describe the involvement of all speech subsystems, including respiration, phonation, articulation, resonance, and prosody, in an individual with cervical spinal cord injury.
UNASSIGNED: Detailed speech and voice assessment was performed that included Frenchay Dysarthria Assessment, cranial nerve examination, voice (per-ceptual and instrumental) and nasometric evalua-tion, and intelligibility and communicative effecti-veness.
UNASSIGNED: Impaired respiratory and phonatory con-trol correlated with the physical impairment of C4 and C5 prolapsed intervertebral disc. Cranial nerve examination indicated nerve IX and XI pathology. Phonatory deficits such as imprecise consonants and mild sibilant distortions were apparent. Voice analysis revealed a hoarse, breathy voice with re-duced loudness and no problems with resonance. Reading and speaking rate was reduced, and over-all a mild reduction in communicative effectiveness was perceived.
UNASSIGNED: Assessment of the speech subsystems produced a comprehensive picture of the patient\'s condition and impairments in one or more areas was identified. Treatment options to improve speech outcomes were provided.

OBJECTIVE: Wearing a sports mouthguard is not only recommended in collision sports, such as American football, boxing, and rugby football, but also in low-contact sports, such as basketball, handball, and soccer. It is recommended to remove oral prosthetic devices while playing sports to avoid the risk of fracturing the device. However, players with maxillectomy must wear obturator-type prosthetic devices for speech, breathing, and deglutition even while playing sports. Therefore, there is a need for an oral appliance to prevent dental injury while playing sports without the risk of fracturing the device for players who have undergone maxillectomy.In this case, we fabricated and proposed overlay-type and obturator-type customized sports mouthguards for a patient who had undergone maxillectomy and assessments of satisfaction, speech intelligibility, nasopharyngeal closure function, and swallowing function while playing soccer.
RESULTS: The patient was only satisfied with the obturator-type mouthguard, and the results of the speech intelligibility, nasopharyngeal closure function, and swallowing tests using the obturator-type mouthguard showed no differences compared to those associated with the previously used prosthetic device.
CONCLUSIONS: This case may help highlight the importance of providing obturator-type mouthguards for players who have undergone maxillectomy to prevent dental injury and physical and mental discomfort.

Progressive multifocal leukoencephalopathy (PML) is a life-threatening central nervous system (CNS) disorder, most commonly described in patients infected with the human immunodeficiency virus (HIV). Limited data exist on its natural history and treatment in solid organ transplant (SOT) recipients. A complication of PML is the immune reconstitution inflammatory syndrome (IRIS), which develops after T cell reconstitution and can have severe consequences when it occurs in the CNS. While well described in HIV-infected individuals, its clinical features, diagnosis, and treatment after SOT are largely unknown. We report a case of a kidney transplant recipient who was diagnosed with PML and developed significant worsening of her symptoms upon reduction of immunosuppression. Thallium SPECT showed avid uptake suggestive of lymphoma, but the diagnosis of PML-IRIS was ultimately established by brain biopsy. She survived with nearly complete restoration of her functional status after a prolonged steroid taper.

People with Down syndrome (DS) can experience difficulties with speech production that can impact on speech intelligibility. In previous research, both perceptual and acoustic analysis has shown that people with DS can have difficulties with speech production in the areas of respiration, phonation, articulation, resonance and prosody. However, these studies have investigated various aspects of speech production separately. No study has examined all components of speech production in one single study and considered how these components, if impaired, may impact on speech intelligibility in DS. This paper presents the data of three male speakers with DS and three age- and gender-matched controls as a case series. The participants\' speech samples were analysed using a number of perceptual and acoustic parameters, across the major components of speech production - respiration, phonation, articulation, resonance, and prosody. Results showed that different areas of speech production were affected in each participant, to different extents. The main perceptual difficulties included poor voice quality, monopitch, and monoloudness. Acoustic findings showed a higher mean F0, lower harmonics-to-noise ratio and longer voice onset times. These preliminary findings show that people with DS can present with mixed profiles of speech production that can affect speech intelligibility. When assessing speech production in DS, clinicians need to evaluate all components of speech production and consider how they may be impacting intelligibility.

Speech-language pathologists (SLPs) may be approached by multilingual speakers wishing to improve their intelligibility in English. Intelligibility is an essential element of spoken language proficiency and is particularly important for multilingual international students given their need to express complex ideas in an additional language. Intelligibility Enhancement aims to improve the intelligibility and acceptability of consonants, vowels and prosody with multilingual speakers who are learning to speak English. This study aimed to describe the Intelligibility Enhancement Assessment and Intervention Protocols and determine whether the intervention changed multilingual university students\' English intelligibility. A multiple-baseline single-case experimental design was applied with direct inter-subject replication across two female participants whose home languages were Vietnamese and Putonghua (Mandarin). English intelligibility was assessed at multiple intervals pre, post and during intervention. The intervention protocol consisted of 11 weekly 1-h sessions with an SLP targeting English consonants, vowels and prosody. Following intervention, both participants displayed increased performance across most measures. For example, the Vietnamese participant\'s percentage of consonants correct (PCC) increased from 62.5% to 85.0% in probe keywords. Effect sizes, when comparing baseline and withdrawal phases, were 5.5 for PCC, 4.6 for final consonants, 2.3 for consonant clusters and 1.6 for syllables indicating improvements in all variables measured. Her speech rate reduced, word stress increased in accuracy and she perceived less difficulty communicating in English. These promising results suggest further testing of the Intelligibility Enhancement Protocols is warranted to determine effectiveness as an intervention for multilingual speakers.

Purpose Facial transplantation involves partial or total replacement of neuromuscular and skeletal structures of the face, head, and neck using donor tissues and is among the most extensive facial reconstructive procedures. This case report compares changes in speech production and articulator movement in a 44-year-old man from pretransplant to a 13-month posttransplant period. Method Speech production and articulator movement data were examined at 5 time points, once pretransplant and 4 times posttransplant (4, 7, 10, and 13 months), and compared to 4 healthy controls. A motion capture system was used to track jaw and vertical/horizontal lip movement during nonspeech and speech tasks. Speech intelligibility, jaw displacement, lip aperture, and movement variability were measured. Results Speech intelligibility varied across the study period and was restored to control status by 7 months posttransplant. Jaw displacement and lip aperture in the vertical plane significantly increased over time for nonspeech and speech tasks. Changes in horizontal lip movements over time were minimal. Jaw and lip movement variability fluctuated over time and was greater than the controls by 13 months posttransplant. Discussion Findings quantify changes in articulator movement and contributions to improved speech production following facial transplant. Changes reflect the adaptability of the speech motor system and are discussed in relation to pretransplant speech motor control patterns.