By: Jill Vogt Eastern Illinois University Faculty Chairs: Rebecca Throneburg, PhD., CCC-SLP and Beth Bergstrom, M.S., CCC-SLP Auditory Discrimination/Image for /r/ ◦ Poor auditory discrimination skills between /r/, /w/, and /l/ (Aungst & Frick, 1964). ◦ Poor auditory image for how a correct /r/ should sound (Aungst & Frick, 1964; Shuster, 1998; Hoffman, Stager, & Daniloff, 1983). Sub-Types of Errors ◦ Possible subtypes based on the nature of speech sound errors – Shriberg Type 1 or Type 2 (Shriberg, 1980). ◦ Clinical implications from Marshalla (2007) suggested some children misarticulate /r/ due to incorrect articulator placement of the tongue, lips, and/or jaw. Foundational motor skills require stabilization/isolation. McNutt (1977) investigated oral-sensory motor skills of children who misarticulate /r/ compared to children with normal articulation. ◦ The investigator reported that children who misarticulated /r/ had: fewer syllables produced per second on syllable repetition tasks revealing deficient oral alternate motion rates sensory discrimination deficits that resulted in sensory motor difficulties McNutt suggested that /r/ articulation disorders may not simply be a functional articulation disorder. 1) Is there a difference in oral-motor skills and discrimination skills between children with typical articulation, children with /r/ errors who are stimulable for correct /r/, and children with /r/ errors who are not stimulable for /r/? 2) Is a difference in the number and type of other speech errors between children who are and are not stimulable for /r/ production? Typical (T) N=9 R-Errors but Stimulable (RS) N=8 R-ErrorsNonstimulable (RNS) N=13 Significant Difference Age 9.51 yrs 7.92-12.00 9.69 yrs 7.00-11.50 8.59 yrs 7.33-12.33 NS Past Speech Therapy None 4.75 yrs 1-6 yrs 3.08 yrs 1-7 yrs Peabody Picture Vocabulary Test 117.50 94-135 113.38 96-130 102.67 93-135 NS Goldman-Fristoe Test of Articulation 105.33 101-108 85.89 65-103 78.54 52-87 p<.001 T>RS & RNS R-Accuracy on World of R Word Level Screening All 100% 44% 3-100% 3% 0-7% p<.001 T>RS & RNS RS>RNS R-Accuracy in Conversational All 100% 35% 0-76% 2% 0-7% Speech Sound Discrimination and Awareness for /r/ ◦ An informal discrimination task was administered to evaluate the participants ability to discriminate /r/ presence in words Word placement of /r/ (I,M,F) Correctness of /r/ from recordings of investigator Shriberg’s (1980) liquids, glides, vowel assessment ◦ (Type 1/Type 2 Errors)Number and type of additional speech sound errors (Shriberg’s 1980 speech tasks) Structure and Function of the Oral Mechanism ◦ The Marshalla Oral Sensorimotor Test (MOST) was administered, along with informal supplementary tasks developed by the current investigator. Tongue Tasks Jaw Tasks Lip Tasks Oscillation Tasks A protocol for obtaining Maximum Performance Tasks developed by Thoonen et al. (1999) was administered to evaluate maximum duration tasks and rate of syllable repetition tasks. Maximum Duration (ah, mama) Maximum Fricative Duration (f,s,z) Monosyllable Repetition Rate (papapapa, tatatata, kakaka) Trisyllable Repetition Rate and Accuracy (pataka- at least 5 with accurate place) Accurate /pataka/ Inaccurate /pataka/ 100 95 Typical 90 R-Stimulable 85 R-Nonstimulable 80 75 70 Total /r/ /r/ Word /r/ Discrim Presence Place Task Accuracy Test Task Task 100 /r/ Stimulable 95 /r/ Nonstimulable 90 85 80 75 70 Shriberg Shriberg Shriberg Shriberg /l/ /w/ /j/ Vowel accruacy accuracy accuracy accuracy • Children in the Stimulable Group produced 0-3 (M= 1.00) additional phonemes in error on the GFTA • Children in the Nonstimulable Group produced 07 (M= 1.67) additional phonemes in error on the GFTA Typical 100 95 90 85 80 75 70 65 60 55 50 Total MOST plus Supplemental Accuracy /r/ Stimulable Tongue Tasks Jaw Tasks /r/ Nonstimulable Lip Tasks Oscillation Tasks 5 Typical /r/ Stimulable Seconds 4 2 1 /r/ Nonstimulable 0 5 Monosyllable Trisyllable 4 Rep Rate 3 2 1 0 Maximum Maximum Phonation Fricative Duration Duration Percent Accuracy Seconds 3 Rep Rate 100 90 80 70 60 50 40 30 20 10 0 PaTaKa Accuracy 80 Typical 70 Stimulable/r/ 60 Nonstimulable/r/ 50 40 30 20 10 0 No Oral Motor Difficulty 1 Indication More than 1 O-M Difficulty Indication O-M Difficulty The data supports previous research. ◦ Shriberg (1980) & Marshalla (2007) suggested some children with /r/ errors used exaggerated jaw movements and had trouble holding the jaw stable. ◦ McNutt (1977) & Marshalla (2007) suggested that children with /r/ articulation difficulties were different based on their oral-motor skills. (Slower syllable repetition rate) ◦ Shriberg (1980) suggested children are either Type 1 or Type 2 based on type of speech sound errors. The data suggest The main suggestion is that a thorough assessment should be administered to a child with /r/ difficulties. ◦ Some children with /r/ errors have subtle oral-motor deficits (planning/accuracy ptk, stabilization, tongue movements) ◦ There may be subgroups of children with /r/ errors who have different patterns of strengths and weaknesses. ◦ The assessor should be aware of those foundational skills (stabilization, isolation, and disassociation). ◦ The assessor should look for patterns of strengths and weaknesses for each individual /r/ client. Also, make sure the assessor is aware of the child’s oral-motor skills. For example does the child have difficulties with discrimination of /r/, planning control for articulators, tongue and jaw disassociation. Further research on the impact of oral-motor skills on children’s abilities to produce a correct /r/ is needed. Aungst, L. F. & Frick, J. V. (1964). Auditory discrimination ability and consistency of articulation of /r/. Journal of Speech and Hearing Disorders, 29, 76-84. Dunn., L, & Dunn., D. (2007). Peabody Picture Vocabulary Test, Fourth Edition (PPVT-4). Minneapolis, MN: Pearson, Inc. Goldman, R., & Fristoe, M. (2000). Goldman-Fristoe Test of Articulation, Second Edition (GFTA-2). Circle Pines, MN: American Guidance Service, Inc. Hoffman, P. R., Stager, S., & Daniloff, R. G. (1983). Perception and production of misarticulated /r/. Journal of Speech and Hearing Disorders, 48, 210-215. Marshalla, P. (2004). Oral-motor techniques in articulation & phonological therapy. Kirkland, WA: Marshalla Speech and Language. Marshalla, P. (2007). Successful /r/ therapy. Kirkland, WA: Marshalla Speech and Language. Marshalla, P. (2007). Marshalla Oral Sensorimotor Test. Greenville, SC: Super Duper Publications. McNutt, J. C. (1977). Oral sensory of motor behaviors of children with /s/ or /r/ misarticulations. Journal of Speech and Hearing Research, 20, 694-703. Ristuccia, C. (2006). The Entire World of R Advanced Screening. Tybee Island, GA: Say It Right. Secord, W., & Shine, R. (1997). Secord Contextual Articulation Test (S-CAT) Storytelling Probes of Articulation Competence. Sedona, AZ: Red Rock Educational Publications. Shriberg, L. D. (1980). An intervention procedure for children with persistent /r/ errors. Language Speech Hearing Services in Schools, 11, 102-110. Shuster, L. I. (1998). The perception of correctly and incorrectly produced /r/. Journal of Speech, Language, and Hearing Research, 41, 941-950. Thoonen, G., Maassen, B., Gabreels, F., Schreuder, R. (1999). Validity of maximum performance tasks to diagnose motor speech disorders in children. Journal of Clinical Linguistics and Phonetics, 13, 1-23.