Department of Speech, Language and Hearing Sciences, Boston University, MA.
Department of Communication Sciences and Disorders, University of Cincinnati, OH.
J Speech Lang Hear Res. 2023 Sep 13;66(9):3223-3241. doi: 10.1044/2023_JSLHR-22-00430. Epub 2023 Jul 31.
Children with residual speech sound disorders (RSSD) have shown differences in neural function for speech production, as compared to their typical peers; however, information about how these differences may change over time and relative to speech therapy is needed. To address this gap, we used functional magnetic resonance imaging (fMRI) to examine functional activation and connectivity on adaptations of the syllable repetition task (SRT-Early Sounds and SRT-Late Sounds) in children with RSSD before and after a speech therapy program.
Sixteen children with RSSD completed an fMRI experiment before (Time 1) and after (Time 2) a speech therapy program with ultrasound visual feedback for /ɹ/ misarticulation. Progress in therapy was measured via perceptual ratings of productions of untreated /ɹ/ word probes. To control for practice effects and developmental change in patterns of activation and connectivity, 17 children with typical speech development (TD) completed the fMRI at Time 1 and Time 2. Functional activation was analyzed using a region-of-interest approach and functional connectivity was analyzed using a seed-to-voxel approach.
Children with RSSD showed a range of responses to therapy. After correcting for multiple comparisons, we did not observe any statistically significant cross-sectional differences or longitudinal changes in functional activation. A negative relationship between therapy effect size and functional activation in the left visual association cortex was on the SRT-Late Sounds after therapy, but it did not survive correction for multiple comparisons. Significant longitudinal changes in functional connectivity were observed for the RSSD group on SRT-Early Sounds and SRT-Late Sounds, as well as for the TD group on the SRT-Early Sounds. RSSD and TD groups showed connectivity differences near the left insula on the SRT-Late Sounds at Time 2.
RSSD and treatment with ultrasound visual feedback may thus be associated with neural differences in speech motor and visual association processes recruited for speech production.
与典型同龄人相比，有残余语音障碍（RSSD）的儿童在言语产生方面的神经功能存在差异；然而，需要了解这些差异如何随时间变化，以及与言语治疗的关系。为了解决这一差距，我们使用功能磁共振成像（fMRI）来检查 RSSD 儿童在言语治疗计划前后对音节重复任务（SRT-Early Sounds 和 SRT-Late Sounds）的适应进行功能激活和连接。
16 名 RSSD 儿童在接受基于超声视觉反馈的 /ɹ/ 构音障碍言语治疗方案（治疗前）和治疗后（治疗后）完成了 fMRI 实验。通过对未经治疗的 /ɹ/ 单词探针产生的感知评估来衡量治疗的进展。为了控制练习效应和激活及连接模式的发育变化，17 名具有典型言语发育的儿童（TD）在时间 1 和时间 2 完成了 fMRI。使用感兴趣区方法分析功能激活，使用种子到体素方法分析功能连接。
RSSD 儿童对治疗的反应各不相同。在进行多次比较校正后，我们没有观察到功能激活的任何横向差异或纵向变化具有统计学意义。治疗效果大小与治疗后左视觉联合皮质的功能激活之间呈负相关，但在进行多次比较校正后，这种相关性并不存在。在 SRT-Early Sounds 和 SRT-Late Sounds 上，RSSD 组观察到功能连接的显著纵向变化，在 SRT-Early Sounds 上，TD 组也观察到功能连接的显著纵向变化。在 SRT-Late Sounds 上，RSSD 和 TD 组在左岛叶附近表现出连接差异，时间 2。
因此，RSSD 和基于超声视觉反馈的治疗可能与言语产生中言语运动和视觉联合过程的神经差异有关。
