Haley Katarina L, Richardson Jessica D, Harmon Tyson G, Turkeltaub Peter, Jacks Adam
Division of Speech and Hearing Sciences, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, New Mexico, USA.
Clin Linguist Phon. 2025 May 2:1-19. doi: 10.1080/02699206.2025.2498437.
There are varied reports about the extent to which people with apraxia of speech (AOS) simplify the phonemic complexity of utterances they attempt to produce and whether the degree to which they do so might inform differential diagnosis relative to aphasia with phonemic paraphasia (APP). Our study purpose was to determine whether either or both diagnostic groups simplify the phonemic content for words they repeat during a typical motor speech evaluation.
195 people with aphasia after stroke were assigned to four diagnostic groups based on quantitative metrics of core speech criteria for AOS and APP. In addition to the target groups, the sample was divided into a borderline group with equivocal feature combinations (BL) and a group with minimal sound production errors (MIN). Monosyllabic, disyllabic, and multisyllabic words were transcribed phonetically and scored for phonemic complexity. The ratio of produced complexity relative to target complexity - the word complexity measure (WCM) ratio - was compared across groups.
According to the WCM ratio, participants in all four groups, including the group with minimal speech sound involvement, simplified more productions than they complicated. Those who produced the most speech sound errors also displayed greater phonemic simplification.
People with stroke-induced aphasia sometimes produce words that are phonemic complications of targets, but more often they simplify the phonemic output. We conclude that phonemic simplification at the word level has limited value for differentiating clinically between AOS and APP. Future research should consider comparing alternative simplification measures.
关于言语失用症（AOS）患者在尝试发声时简化其话语音素复杂性的程度，以及这种简化程度是否有助于与音素性错语型失语症（APP）进行鉴别诊断，存在多种不同的报道。我们的研究目的是确定在典型的运动言语评估中，这两个诊断组在重复单词时是否都会简化音素内容。
根据AOS和APP的核心言语标准的定量指标，将195名中风后失语症患者分为四个诊断组。除目标组外，样本还分为特征组合不明确的临界组（BL）和发声错误极少的组（MIN）。对单音节、双音节和多音节单词进行语音转录，并对音素复杂性进行评分。比较各诊断组产出复杂性与目标复杂性的比率——单词复杂性测量（WCM）比率。
根据WCM比率，包括发声错误极少的组在内的所有四个诊断组的参与者，产出简化的情况多于复杂化的情况。发声错误最多的参与者也表现出更大程度的音素简化。
中风所致失语症患者有时会产出目标单词的音素复杂化形式，但更常见的是他们会简化音素产出。我们得出结论，单词层面的音素简化在临床上区分AOS和APP的价值有限。未来的研究应考虑比较其他简化测量方法。
