QUANTIFICATION OF VOCAL TRACT CONFIGURATIONS OF CHILDREN WITH DOWN SYNDROME USING ACOUSTIC REFLECTIO - PowerPoint PPT Presentation

Loading...

PPT – QUANTIFICATION OF VOCAL TRACT CONFIGURATIONS OF CHILDREN WITH DOWN SYNDROME USING ACOUSTIC REFLECTIO PowerPoint presentation | free to view - id: 382aa-ZjRhY



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

QUANTIFICATION OF VOCAL TRACT CONFIGURATIONS OF CHILDREN WITH DOWN SYNDROME USING ACOUSTIC REFLECTIO

Description:

Caused by trisomy (extra) of chromosome 21; ... tract volume (F (1,18) =2.57, p = .13) for children in the Down syndrome group. ... – PowerPoint PPT presentation

Number of Views:215
Avg rating:3.0/5.0
Slides: 32
Provided by: Owne372
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: QUANTIFICATION OF VOCAL TRACT CONFIGURATIONS OF CHILDREN WITH DOWN SYNDROME USING ACOUSTIC REFLECTIO


1
QUANTIFICATION OF VOCAL TRACT CONFIGURATIONS OF
CHILDREN WITH DOWN SYNDROME USING ACOUSTIC
REFLECTION TECHNOLOGY A PILOT STUDY
2008 ASHA CONVENTION
Steve Xue, Ph.D., CCC-SLP, University of Hong
Kong Laura Kane, M.S., CCC-SLP, Portland State
University Manwa Ng Ph.D., CCC-SLP, University of
Hong Kong
2
Purpose of Study
  • Quantify the structures along the vocal tract of
    children with Down syndrome
  • Compare this data against those of typically
    developing children to determine if significant
    differences are observed
  • Locate specific structural differences along the
    vocal tract
  • Help establish standardized data of the vocal
    tract configuration for this population.

3
Down syndrome
  • Most common genetic disorder related to mental
    retardation
  • Occurs in approximately 1800-1,000 live births
  • Caused by trisomy (extra) of chromosome 21
  • Results in particular constellation of
    physiological and cognitive symptoms, including
  • Intellectual disability
  • Cranio-facial anomalies
  • Conductive hearing loss
  • Muscle hypotonia (flaccidity).
  • (McGrowther Marshall, 1990)

4
Literature Review Speech Language Development
  • Often have severe speech and language delays
  • Particular deficits in verbal processing relative
    to visuo-spatial processing
  • Expressive language and speech production skills
    are particularly impaired
  • Maintain expressive-receptive gap even when
    compared to mental-age matched peers or children
    with other intellectual disabilities.
  • (Buckley, 1992 Chapman Hesketh, 2000, Rondal,
    1993)

5
Study Rationale
  • Despite the widely documented physiological
    differences associated with DS, little is known
    about their potential impact on speech and
    swallowing production.
  • To date, there have been no studies using
    objective instrumentation to analyze vocal tract
    configuration as it relates to speech and
    swallowing difficulties associated with DS.

6
Study Participants
  • 10 children (n10), ages 9-17 years old,
    diagnosed with Down syndrome
  • 10 typically developing children (n10) matched
    for age, race, and gender obtained from a
    previous study (Xue et al. 2003b).
  • 4 male and 6 female in each group.

7
Demographic Data
  • One-way ANOVA revealed no statistical differences
    at the .05 level between the groups with regard
    to the following
  • Weight (F (1,18) 1.32, p .27)
  • Height (F (1,18) 4.21, p .06)
  • Body mass index (F (1,18) .004, p .95).
  • Within-group differences yielded
  • No statistical differences in vocal tract
    parameters for the control group.
  • Statistical difference for mean oral length and
    gender in the Down syndrome group (F (1,18)
    14.8, p lt .01).
  • p-value is significant at the .01 level, but not
    at the .05 level. This reflects a possible
    confounding variable.

8
(No Transcript)
9
Method
  • All participants were tested with pharyngometric
    acoustic programs.
  • Device consists of two microphones and one sound
    generator mounted on a wave tube.
  • Microphones capture the reflected acoustic data
    creating a curve of the area-distance
    relationship of the vocal tract lumen.

10
(No Transcript)
11
Acoustic Reflection (AR)
  • Objective diagnostic tool used to locate
    structural and functional abnormalities of upper
    airway.
  • Used in a variety of clinical applications
  • Location areas of obstruction for patients with
    sleep apnea
  • Determining endotracheal tube positioning
  • Documenting changes in vocal tract due to aging
    and
  • Determining patency of nasal airway.
  • (Bradley et al., 1986 Corey et al.,1998 Eckmann
    et al., 1996
  • Xue et al., 2003a)

12
Benefits of AR Technology
  • Compared to other objective diagnostic
    techniques, such as MRI, fluoroscopy, and
    ultrasound
  • Cost-effective and portable
  • Provides real-time display
  • Allows for simultaneous assessment of entire
    vocal tract lumen
  • Does not subject patients to radiation.
  • Studies have found reliability between results of
    AR and MRI and CT findings.
  • (DUrzo et al. 1987 Marshall et al., 1993)

13
Figure 2. Acoustic Rhinometer (1) and
Pharyngometer (2).
14
Study Variables
  • Independent variable presence or absence of Down
    syndrome.
  • Six Dependent Variables
  • Oral Length (OL)
  • Pharyngeal Length (PL)
  • Vocal Tract Length (VL)
  • Oral Volume (OV)
  • Pharyngeal Volume (PV)
  • Vocal Tract Volume (VV)

15
Results
P .43
P .44
P .25
Figure 2. Average oral length (OL), pharyngeal
length (PL), and vocal tract length (VL) for
children with Down syndrome (DS) and
typically-developing children (TD).
  • No significant differences between groups was
    observed for oral length, pharyngeal length, or
    vocal tract length.

16
Results
P .13
P .02
P .42
Figure 3. Average oral volume (OV), pharyngeal
volume (PV), and vocal tract volume (VV) for
children with Down syndrome (DS) and
typically-developing children (TD).
  • Significant differences observed between groups
    for oral volume (F (1,18) 6.62, p .02).
  • Observed a trend toward smaller vocal tract
    volume (F (1,18) 2.57, p .13) for children in
    the Down syndrome group.
  • No statistical differences between groups for
    pharyngeal volume (F (1,18) .67, p .42).

17
(No Transcript)
18
Discussion
  • Children with DS may express different vocal
    tract configurations from those of their
    typically-developing peers.
  • Data suggest that children with DS may have
    smaller oral cavity volumes.

19
Clinical Implications
  • Provides support for hypothesis that oral cavity
    size is smaller versus enlarged tongue size in
    children with DS.
  • Consequently, a reduction of lingual motility
    within the context of a reduced oral cavity may,
    to some extent, contribute to the speech
    difficulties associated with DS.

20
Clinical ImplicationsArticulation
  • Smaller oral cavity together with typical-sized
    articulators may inhibit coordination of rapid
    alternating movements required for speech,
    thereby reducing intelligibility
  • Structural differences are likely to influence
    speech-motor development of children with Down
    syndrome (Stoel-Gammon, 1997, p. 301).

21
Clinical ImplicationsVocal Quality
  • Changes in vocal tract volume have been
    correlated with changes in formant frequencies.
  • In a study by Xue et al. (2006) volumetric
    differences of the vocal tract among different
    racial groups were correlated with acoustical
    differences.
  • Morphological differences (especially vocal
    tract volumetric parameters) are partially
    responsible for formant frequency differences
    (Xue et al., 2006, p.698).

22
Clinical Implications Swallowing
  • Differences in oral cavity volume may also be
    related to feeding and swallowing difficulties.
  • May result in difficulties with sucking,
    swallowing, and salivation.
  • Reduced oral cavity may cause tongue to impinge
    upon the back of the mouth, thereby inhibiting
    coordinated movements required for feeding.
  • May contribute to characteristic open-mouth
    posture, which contributes to decreased sucking
    pressure.
  • Restrictions in lingual motility secondary to a
    smaller oral cavity may induce oral phase
    swallowing difficulties.
  • (Mizuno Ueda, 2001 Morris Klein, 2000 Wolf
    Glass, 1992)

23
Limitations of the study
  • The small sample size (n10) limits
    generalization of the study findings to larger
    populations.
  • Cannot make direct correlations between specific
    structures of vocal tract lumen and their
    functional impact on speech and swallow function.

24
Future Directions
  • Larger-scale studies needed to establish
    normative data on vocal tract configuration of
    special populations, such as DS.
  • Study investigating vocal tract configuration for
    this population with acoustical analysis of
    speech samples to elucidate effects of volumetric
    differences on vocal quality.

25
  • References
  • Baddeley, A.D. Hitch, G. (1974). Working
    memory. In G. Bower (Ed.), The Psychology of
    Learning and Motivation (pp. 47-90). New York
    Academic Press.
  • Barnes, E., Roberts, J., Mirrett, P., Sideris,
    J., Misenheimer, J. (2006). A comparison of
    oral structure and oral-motor function in young
    males with Fragile X syndrome and Down syndrome.
    Journal of Speech, Language, and Hearing
    Research, 49, 903-917.
  • Bradley, T., Brown, I., Grossman, R., Zamel, N.,
    Martinex, D., Phillipson, E., et al. (1986).
    Pharyngeal size in snorers, nonsnorers, and
    patients with obstructive sleep apnea. New
    England Journal of Medicine, 315, 1327-1331.
  • Buckley, S., (1992). The development of the child
    with Downs syndrome Implications for effective
    education. In P.T. Rogers (Ed.), Medical Care in
    Children with Downs Syndrome (pp. 29-46).
    Portsmouth, England Portsmouth Polytechnic
    Institute.
  • Bunn, L., Dominic, A.S., Welsh, T.N., Watson, C.,
    Elliott, D. (2002). Speech production errors in
    adults with and without Down syndrome following
    verbal, written, and pictorial cues.
    Developmental Neuropsychology, 21, 157-172.
  • Chapman, R., Hesketh, L. (2000). Behavioral
    phenotype of individuals with Down syndrome.
    Mental Retardation and Developmental Disabilities
    Research Reviews, 6, 84-95.

26
  • Corey, J., Gungor, A., Nelson, R., Liu, X.,
    Fredberg, J. (1998). Normative standards for
    nasal cross-sectional areas and volumes obtained
    with acoustic rhinometry. Otolaryngology-Head and
    Neck Surgery, 117, 349-354.
  • Dodd, B. (1976). A comparison of the phonological
    systems of mental matched, normal, severely
    subnormal and Downs syndrome children. British
    Journal of Communication, 11, 27-42.
  • Dodd, B. Thompson, L. (2001). Speech disorder
    in children with Downs syndrome. Journal of
    Intellectual Disability Research, 45, 308-316.
  • DUrzo, A., Lawson, V., Vassal, K., Rebuck, A.,
    Slutsky, S., Hoffstein, V. (1987). Airway area
    by acoustic response measurements and
    computerized tomography. American Review of
    Respiratory Diseases, 125, 392-398.
  • Eckmann, D., Glassenberg, R., Gavriely, N.
    (1996). Acoustic reflectometry and endotracheal
    intubation. Anesthesia and Analgesia, 83,
    1084-1089.
  • Elliott, D., Weeks, D., Chua, R. (1994).
    Anomalous cerebral lateralization and Down
    syndrome. Cortex, 29,103-113.

27
  • Field, D., Garland, M., Williams, K. (2003).
    Correlates of specific childhood feeding
    problems. Journal of Paediatrics and Child
    Health, 39, 299-304.
  • Florez, J. (1992). Neurobiological abnormalities.
    In S.M. Pueschel J.K. Pueshel (Eds.),
    Biomedical concerns in persons with Down
    syndrome. Baltimore, MD Paul H. Brookes
    Publishing Co.
  • Gravel, J. Wallace, I. (1995). Early otitis
    media, auditory abilities, and educational risk.
    American Journal of Speech-Language Pathology, 4,
    89-94.
  • Kile, J., Kuba, J., Neilis, R., Becker, T.
    (1990). Children with Down syndrome Hearing,
    language, and speech issues. Poster session
    presented at the American Speech-Language-Hearing
    Convention. Seattle, Washington.
  • Kumin, L. (1994). Intelligibility of speech in
    children with Down syndrome in natural settings
    Parents perspective. Perceptual Motor Skills,
    78, 307-313.
  • Kumin, L. (1996). Speech and language skills in
    children with Down syndrome. Metal Retardation
    and Developmental Disabilities Research Reviews,
    2, 109-115.

28
  • Laws, G. (2004). Contributions of phonological
    memory, language comprehension and hearing to the
    expressive language of adolescents and young
    adults with Down syndrome. Journal of Child
    Psychology and Psychiatry, 45, 1085-1095.
  • Leddy, M. (1996). The relations among select
    vocal function characteristics of adult males
    with Down syndrome. Unpublished doctoral
    dissertation, University of Wisconsin, Madison.
  • Marshall, I., Maran, N., Martin, S., Jan, M.,
    Rimmington, J., Best, J., Drummond, G.,
    Douglas, N. (1993). Acoustic reflectometry for
    airway measurements in man Implementation and
    validation. Physiological Measurements, 14,
    157-169.
  • McGrowther, C.W., Marshall, B. (1990). Recent
    trends in incidence, morbidity, and survival in
    Downs syndrome. Journal of Mental Deficiency
    Research, 34, 49-57.
  • Miller, J. (1999). Profiles of language
    development in children with Down syndrome. In
    J. Miller, M. Leddy, L. Leavitt (Eds.),
    Improving the Communication of People With Down
    Syndrome (pp. 9-39). Baltimore, MD Paul H.
    Brooks Publishing Co.
  • Miller, J. Leddy, M. (1998). Down syndrome The
    impact of speech production on language
    development. In R. Paul (Ed.), Exploring the
    Speech-Language Connection (pp. 163-177).
    Baltimore, MD Paul H. Brooks Publishing.

29
  • Mizuno, K. Ueda, A. (2001). Development of
    sucking behavior in infants with Down syndrome.
    Acta Paediatrica, 90, 1384-1388.
  • Moran, M. Gilbert, H. (1982). Selected acoustic
    characteristics and listener judgments of the
    voice of Down syndrome adults. American Journal
    of Mental Deficiency, 86, 553-556.
  • Morris, S., Klein, M. (2000). Pre-Feeding
    Skills Second Edition (pp. 356-444). San
    Antonio, Texas Therapy Skill Builders.
  • Novak (1972). The voice of children with Downs
    syndrome. Folia Phoniatrica, 24, 182-194.
  • Novak, A., Sedlackova, E., Klajman, S.,
    Betlejewski, S. (1967). Acoustic analysis of the
    voice of children suffering from the
    Down-syndrome. Czechoslovakian Otalaryngology,
    16, 26-31.
  • Rondal, J. (1993). Downs syndrome. In D. Bishop
    Mongford (Eds.), Language Development in
    Exceptional Circumstances (pp. 165-176). London,
    U.K Lawrence Earlbaum Associates.
  • Rosin, M., Swift, E., Khidr, A., Bless, D.,
    Vetter, D. (1988). Communication profiles of
    adolescents with Down syndrome. Journal of
    Childhood Communication Disorders, 12, 49-64.

30
  • Scott, B., Becker, L., Petit, T. (1983).
    Neurobiology of Down syndrome. Progress in
    Neurobiology, 21, 199-237.
  • Smith, B. (1997). Phonological development in
    Downs syndrome children. Communication presented
    at the 85th Annual Convention of the American
    Psychological Association August, 1997, San
    Francisco, CA.
  • Spender, Q., Stein, A., Dennis, J., Reilley, S.,
    Percy, E. Cave, D. (1996). An exploration of
    feeding difficulties in children with DS.
    Developmental Medicine and Child Neurology, 38,
    681-694.
  • Stoel-Gammon, C. (1980). Phonological analysis of
    four Down syndrome children. Applied
    Psycholinguistics, 1, 31-48.
  • Stoel-Gammon, C. (1981). Speech development of
    infants and children with Down syndrome. In J.
    Darby (Ed.), Speech Evaluation in Medicine (pp.
    341-360). New York, NY Grune Stratton.
  • Stoel-Gammon, C. (1997). Phonological development
    in Down syndrome. Mental Retardation and
    Developmental Disabilities Research Reviews, 3,
    300-306.

31
  • Wolf, L., Glass, R. (1992). Feeding and
    Swallowing Disorders in Infancy Assessment and
    Management (pp. 233-247). San Antonio, Texas
    Therapy Skill Builders.
  • Xue, A., Hao, G. (2003a). Changes in the human
    vocal tract due to aging and the acoustic
    correlates of speech production A pilot study.
    Journal of Speech, Language, and Hearing
    Research, 46, 689-701.
  • Xue, S. Hao, G. (2003b). Developmental changes
    in the young adolescents vocal tract dimensions.
    2003 American Speech-Language-Hearing Convention.
    Chicago, IL.
  • Xue, S., Hao, G., Mayo, R. (2006). Volumetric
    measurements of vocal tracts for male speakers
    from different races. Clinical Linguistics and
    Phonetics, 20, 691-702.
About PowerShow.com