Haley Katarina L, Shafer Jennifer N, Harmon Tyson G, Jacks Adam
Department of Allied Health Sciences, University of North Carolina at Chapel Hill.
Am J Speech Lang Pathol. 2016 Dec 1;25(4S):S687-S696. doi: 10.1044/2016_AJSLP-15-0143.
This study was intended to document speech recovery for 1 person with acquired apraxia of speech quantitatively and on the basis of her lived experience.
The second author sustained a traumatic brain injury that resulted in acquired apraxia of speech. Over a 2-year period, she documented her recovery through 22 video-recorded monologues. We analyzed these monologues using a combination of auditory perceptual, acoustic, and qualitative methods.
Recovery was evident for all quantitative variables examined. For speech sound production, the recovery was most prominent during the first 3 months, but slower improvement was evident for many months. Measures of speaking rate, fluency, and prosody changed more gradually throughout the entire period. A qualitative analysis of topics addressed in the monologues was consistent with the quantitative speech recovery and indicated a subjective dynamic relationship between accuracy and rate, an observation that several factors made speech sound production variable, and a persisting need for cognitive effort while speaking.
Speech features improved over an extended time, but the recovery trajectories differed, indicating dynamic reorganization of the underlying speech production system. The relationship among speech dimensions should be examined in other cases and in population samples. The combination of quantitative and qualitative analysis methods offers advantages for understanding clinically relevant aspects of recovery.
本研究旨在对1名获得性言语失用症患者的言语恢复情况进行定量记录，并基于其生活经历进行分析。
第二作者因创伤性脑损伤导致获得性言语失用症。在两年时间里，她通过22段视频记录的独白记录了自己的恢复过程。我们结合听觉感知、声学和定性方法对这些独白进行了分析。
在所检查的所有定量变量中，恢复情况明显。对于语音产生，恢复在最初3个月最为显著，但在随后的许多个月里改善较为缓慢。语速、流畅性和韵律的测量在整个期间变化更为渐进。对独白中涉及主题的定性分析与定量言语恢复情况一致，表明准确性和语速之间存在主观动态关系，观察到几个因素使语音产生存在差异，并且说话时持续需要认知努力。
言语特征在较长时间内得到改善，但恢复轨迹不同，表明潜在言语产生系统的动态重组。应在其他病例和人群样本中研究言语维度之间的关系。定量和定性分析方法的结合为理解恢复的临床相关方面提供了优势。
