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Vol. 61, No. 1, 2009
Issue release date: April 2009
Section title: Original Paper
Free Access
Folia Phoniatr Logop 2009;61:1–11
(DOI:10.1159/000184539)

Analysis of Diadochokinesis in Ataxic Dysarthria Using the Motor Speech Profile Program™

Wang Y.-T.a · Kent R.D.b · Duffy J.R.c · Thomas J.E.c
aSchool of Dentistry, National Yang-Ming University, Taipei, Taiwan; bWaisman Center, University of Wisconsin-Madison, Madison, Wisc., and cMayo Clinic, Rochester, Minn., USA
email Corresponding Author

Abstract

Aims: The Diadochokinetic Rate Analysis (DRA) in the KayPENTAX Motor Speech Profile is a computer program for the analysis of diadochokinesis (DDK). The objective of this study is to evaluate the suitability, reliability, and concurrent validity of the results from the DRA protocol and hand measurement for individuals with ataxic dysarthria, which is characteristically associated with dysdiadochokinesis. Methods: Twenty-one participants with ataxic dysarthria were recorded as they repeated various syllables as quickly and steadily as possible. The DDK samples were executed by the DRA protocol at different thresholds and were also hand-measured. Analyses were based on the percentage of nonexecutable DDK samples, defined as samples in which the lowest peak intensity during CV syllables is lower than the highest peak intensity during intersyllable pauses, and the comparisons of the results between repeated analyses at different thresholds and between automatic and manual measuring methods. Results: (1) More than one third of the DDK samples were nonexecutable; (2) the reliability at different thresholds and concurrent validity between different measuring methods were both satisfactory, and (3) temporal variation parameters were more inconsistent between different measuring methods than intensity variation parameters. Conclusion: DRA has notable limitations in its clinical application but there is a considerable potential for improving its performance.

© 2008 S. Karger AG, Basel


  

Key Words

  • Diadochokinesis
  • Reliability
  • Validity

References

  1. Fimbel EJ, Domingo PP, Lamoureux D, Beuter A: Automatic detection of movement disorders using recordings of rapid alternating movements. J Neurosci Methods 2005;146:183–190.
  2. Taylor Tavares AL, Jefferis GS, Koop M, Hill BC, Hastie T, Heit G, Bronte-Stewart HM: Quantitative measurements of alternating finger tapping in Parkinson’s disease correlate with UPDRS motor disability and reveal the improvement in fine motor control from medication and deep brain stimulation. Mov Disord 2005;20:1286–1298.
  3. Lundy DS, Roy S, Xue JW, Casiano RR, Jassir D: Spastic/spasmodic vs. tremulous vocal quality: motor speech profile analysis. J Voice 2004;18:146–152.
  4. Meurer EM, Wender MC, von Eye CH, Capp E: Phono-articulatory variations of women in reproductive age and postmenopausal. J Voice 2004;18:369–374.
  5. Duffy JR: Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. St. Louis, Mosby, 2005.
  6. Kent RD, Kent JF, Rosenbek JC: Maximum performance tests of speech production. J Speech Hear Disord 1987;52:367–387.
  7. Renout KA, Leeper HA, Bandur DL: Vocal fold diadochokinetic function of individuals with amyotrophic lateral sclerosis. Am J Speech Lang Pathol 1995;4:73–80.
  8. Kent RD, Kent JF, Duffy JR, Thomas JE, Weismer G, Stuntebeck S: Ataxic dysarthria. J Speech Lang Hear Res 2000;43:1275–1289.
  9. Darley FL, Aronson AE, Brown JR: Motor Speech Disorders. Philadelphia, Saunders, 1975.
  10. Hale ST, Kellum GD, Richardson JF, Messer SC, Gross AM, Sisakun S: Oral motor control, posturing, and myofunctional variables in 8-year-olds. J Speech Hear Res 1992;35:1203–1218.
  11. Henry CE: The development of oral diadochokinesia and non-linguistic rhythmic skills in normal and speech-disordered young children. Clin Linguist Phonet 1990;4:121–137.
  12. Potter NL: Oral/Speech and Manual Motor Development in Preschool Children; unpublished PhD diss University of Wisconsin-Madison, 2005.
  13. Thoonen G, Maassen B, Wit J, Gabreels F, Schreuder R: The integrated use of maximum performance tasks in differential diagnostic evaluations among children with motor speech disorders. Clin Linguist Phonet 1996;10:311–336.
  14. Williams P, Stackhouse J: Rate, accuracy and consistency: diadochokinetic performance of young, normally developing children. Clin Linguist Phonet 2000;14:267–293.
  15. Kent RD, Sufit RL, Rosenbek JC, Kent JF, Weismer G, Martin RE, Brooks BR: Speech deterioration in amyotrophic lateral sclerosis: a case study. J Speech Hear Res 1991;34:1269–1275.
  16. Samlan RA, Weismer G: The relationship of selected perceptual measures of diadochokinesis to speech intelligibility in dysarthric speakers with amyotrophic lateral sclerosis. Am J Speech Lang Pathol 1995;4:9–13.
  17. Nishio M, Niimi S: Changes over time in dysarthric patients with amyotrophic lateral sclerosis (ALS): a study of changes in speaking rate and maximum repetition rate (MRR). Clin Linguist Phonet 2000;14:485–497.
  18. Wessel K, Ziegler W: Speech timing in ataxic disorders: sentence production and rapid repetitive articulation. Neurology 1996;47:208–214.
  19. Ackermann H, Hertrich I, Hehr T: Oral diadochokinesis in neurological dysarthrias. Folia Phoniatr Logop 1995;47:15–23.
  20. Ozawa Y, Shiromoto O, Ishizaki F, Watamori T: Symptomatic differences in decreased alternating motion rates between individuals with spastic and with ataxic dysarthria: an acoustic analysis. Folia Phoniatr Logop 2001;53:67–72.
  21. Kent RD, Kent JF, Rosenbek JC, Vorperian HK, Weismer G: A speaking task analysis of the dysarthria in cerebellar disease. Folia Phoniatr Logop 1997;49:63–82.
  22. Schalling E, Hartelius L: Acoustic analysis of speech tasks performed by three individuals with spinocerebellar ataxia. Folia Phoniatr Logop 2004;56:367–380.
  23. Gentil M: Dysarthria in Friedreich disease. Brain Lang 1990;38:438–448.
  24. Hartelius L, Lillvik M: Lip and tongue function differently affected in individuals with multiple sclerosis. Folia Phoniatr Logop 2003;55:1–9.
  25. Tjaden K, Watling E: Characteristics of diadochokinesis in multiple sclerosis and Parkinson’s disease. Folia Phoniatr Logop 2003;55:241–259.
  26. Rosen KM, Kent RD, Duffy JR: Task-based profile of vocal intensity decline in Parkinson’s disease. Folia Phoniatr Logop 2005;57:28–37.
  27. Kent RD, Duffy JR, Kent JF, Vorperian HK, Thomas JE: Quantification of motor speech abilities in stroke: time-energy analyses of syllable and word repetition. J Med Speech Lang Pathol 1999;7:83–90.
  28. Wang YT, Kent RD, Duffy JR, Thomas JE, Weismer G: Alternating motion rate as an index of speech motor disorder in traumatic brain injury. Clin Linguist Phonet 2004;18:57–84.
  29. Ziegler W: Task-related factors in oral motor control: speech and oral diadochokinesis in dysarthria and apraxia of speech. Brain Lang 2002;80:556–575.
  30. Wang YT, Kent RD, Duffy JR, Thomas JE, Fredericks GV: Dysarthria following cerebellar mutism secondary to resection of a fourth ventricle medulloblastoma: a case study. J Med Speech Lang Pathol 2006;14:109–122.

    External Resources

  31. Nishio M, Niimi S: Comparison of speaking rate, articulation rate and alternating motion rate in dysarthric speakers. Folia Phoniatr Logop 2006;58:114–131.
  32. Weismer G: Motor speech disorders; in Hardcastle WJ, Laver J (eds): The Handbook of Phonetic Science. Cambridge, Blackwell, 1997, pp 191–219.
  33. Brown JR, Darley FL, Aronson AE: Ataxic dysarthria. Int J Neurol 1970;7:302–309.
  34. Nunnally JC, Bernstein I: Psychometric Theory. St. Louis, McGraw-Hill, 1994.
  35. Guilford JP: Fundamental Statistics in Psychology and Education. St Louis, McGraw-Hill, 1973.
  36. Milenkovic P: Time-Frequency Analysis for 32-Bit Windows. Madison, Wisconsin, 2001.
  37. Auzou P, Özsancak C, Morris RJ, Jan M, Eustache F, Hannequin D: Voice onset time in aphasia, apraxia of speech and dysarthria: a review. Clin Linguist Phonet 2000;14:131–150.
  38. Davis K: Phonetic and phonological contrasts in the acquisition of voicing: voice onset time production in Hindi and English. J Child Lang 1995;22:275–305.
  39. Özsancak C, Auzou P, Jan M, Hannequin D: Measurement of voice onset time in dysarthric patients: methodological considerations. Folia Phoniatr Logop 2001;53:48–57.
  40. Wang YT, Kent RD, Duffy JR, Thomas JE: Dysarthria associated with traumatic brain injury: speaking rate and emphatic stress. J Commun Disord 2005;38:231–260.
  41. Cohen W, Waters D, Hewlett N: DDK rates in the paediatric clinic: a methodological minefield. Int J Lang Commun Disord 1998;33:428–433.
  42. Yaruss JS, Logan KJ: Evaluating rate, accuracy, and fluency of young children’s diadochokinetic productions: a preliminary investigation. J Fluency Disord 2002;27:65–85.

  

Author Contacts

Yu-Tsai Wang
School of Dentistry, Rm. 411, National Yang-Ming University
No. 155, Sec. 2, Li-Nong St. Beitou District
Taipei, 11211 (Taiwan)
Tel. +886 2 2826 7237, Fax +886 2 2826 4053, E-Mail yutsaiwang@ym.edu.tw

  

Article Information

Published online: December 17, 2008
Number of Print Pages : 11
Number of Figures : 3, Number of Tables : 4, Number of References : 42

  

Publication Details

Folia Phoniatrica et Logopaedica (International Journal of Phoniatrics, Speech Therapy and Communication Pathology)

Vol. 61, No. 1, Year 2009 (Cover Date: April 2009)

Journal Editor: Schutte H.K. (Groningen)
ISSN: 1021-7762 (Print), eISSN: 1421-9972 (Online)

For additional information: http://www.karger.com/FPL


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Aims: The Diadochokinetic Rate Analysis (DRA) in the KayPENTAX Motor Speech Profile is a computer program for the analysis of diadochokinesis (DDK). The objective of this study is to evaluate the suitability, reliability, and concurrent validity of the results from the DRA protocol and hand measurement for individuals with ataxic dysarthria, which is characteristically associated with dysdiadochokinesis. Methods: Twenty-one participants with ataxic dysarthria were recorded as they repeated various syllables as quickly and steadily as possible. The DDK samples were executed by the DRA protocol at different thresholds and were also hand-measured. Analyses were based on the percentage of nonexecutable DDK samples, defined as samples in which the lowest peak intensity during CV syllables is lower than the highest peak intensity during intersyllable pauses, and the comparisons of the results between repeated analyses at different thresholds and between automatic and manual measuring methods. Results: (1) More than one third of the DDK samples were nonexecutable; (2) the reliability at different thresholds and concurrent validity between different measuring methods were both satisfactory, and (3) temporal variation parameters were more inconsistent between different measuring methods than intensity variation parameters. Conclusion: DRA has notable limitations in its clinical application but there is a considerable potential for improving its performance.

© 2008 S. Karger AG, Basel


  

Author Contacts

Yu-Tsai Wang
School of Dentistry, Rm. 411, National Yang-Ming University
No. 155, Sec. 2, Li-Nong St. Beitou District
Taipei, 11211 (Taiwan)
Tel. +886 2 2826 7237, Fax +886 2 2826 4053, E-Mail yutsaiwang@ym.edu.tw

  

Article Information

Published online: December 17, 2008
Number of Print Pages : 11
Number of Figures : 3, Number of Tables : 4, Number of References : 42

  

Publication Details

Folia Phoniatrica et Logopaedica (International Journal of Phoniatrics, Speech Therapy and Communication Pathology)

Vol. 61, No. 1, Year 2009 (Cover Date: April 2009)

Journal Editor: Schutte H.K. (Groningen)
ISSN: 1021-7762 (Print), eISSN: 1421-9972 (Online)

For additional information: http://www.karger.com/FPL


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 12/17/2008
Issue release date: April 2009

Number of Print Pages: 11
Number of Figures: 3
Number of Tables: 4

ISSN: 1021-7762 (Print)
eISSN: 1421-9972 (Online)

For additional information: http://www.karger.com/FPL


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Fimbel EJ, Domingo PP, Lamoureux D, Beuter A: Automatic detection of movement disorders using recordings of rapid alternating movements. J Neurosci Methods 2005;146:183–190.
  2. Taylor Tavares AL, Jefferis GS, Koop M, Hill BC, Hastie T, Heit G, Bronte-Stewart HM: Quantitative measurements of alternating finger tapping in Parkinson’s disease correlate with UPDRS motor disability and reveal the improvement in fine motor control from medication and deep brain stimulation. Mov Disord 2005;20:1286–1298.
  3. Lundy DS, Roy S, Xue JW, Casiano RR, Jassir D: Spastic/spasmodic vs. tremulous vocal quality: motor speech profile analysis. J Voice 2004;18:146–152.
  4. Meurer EM, Wender MC, von Eye CH, Capp E: Phono-articulatory variations of women in reproductive age and postmenopausal. J Voice 2004;18:369–374.
  5. Duffy JR: Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. St. Louis, Mosby, 2005.
  6. Kent RD, Kent JF, Rosenbek JC: Maximum performance tests of speech production. J Speech Hear Disord 1987;52:367–387.
  7. Renout KA, Leeper HA, Bandur DL: Vocal fold diadochokinetic function of individuals with amyotrophic lateral sclerosis. Am J Speech Lang Pathol 1995;4:73–80.
  8. Kent RD, Kent JF, Duffy JR, Thomas JE, Weismer G, Stuntebeck S: Ataxic dysarthria. J Speech Lang Hear Res 2000;43:1275–1289.
  9. Darley FL, Aronson AE, Brown JR: Motor Speech Disorders. Philadelphia, Saunders, 1975.
  10. Hale ST, Kellum GD, Richardson JF, Messer SC, Gross AM, Sisakun S: Oral motor control, posturing, and myofunctional variables in 8-year-olds. J Speech Hear Res 1992;35:1203–1218.
  11. Henry CE: The development of oral diadochokinesia and non-linguistic rhythmic skills in normal and speech-disordered young children. Clin Linguist Phonet 1990;4:121–137.
  12. Potter NL: Oral/Speech and Manual Motor Development in Preschool Children; unpublished PhD diss University of Wisconsin-Madison, 2005.
  13. Thoonen G, Maassen B, Wit J, Gabreels F, Schreuder R: The integrated use of maximum performance tasks in differential diagnostic evaluations among children with motor speech disorders. Clin Linguist Phonet 1996;10:311–336.
  14. Williams P, Stackhouse J: Rate, accuracy and consistency: diadochokinetic performance of young, normally developing children. Clin Linguist Phonet 2000;14:267–293.
  15. Kent RD, Sufit RL, Rosenbek JC, Kent JF, Weismer G, Martin RE, Brooks BR: Speech deterioration in amyotrophic lateral sclerosis: a case study. J Speech Hear Res 1991;34:1269–1275.
  16. Samlan RA, Weismer G: The relationship of selected perceptual measures of diadochokinesis to speech intelligibility in dysarthric speakers with amyotrophic lateral sclerosis. Am J Speech Lang Pathol 1995;4:9–13.
  17. Nishio M, Niimi S: Changes over time in dysarthric patients with amyotrophic lateral sclerosis (ALS): a study of changes in speaking rate and maximum repetition rate (MRR). Clin Linguist Phonet 2000;14:485–497.
  18. Wessel K, Ziegler W: Speech timing in ataxic disorders: sentence production and rapid repetitive articulation. Neurology 1996;47:208–214.
  19. Ackermann H, Hertrich I, Hehr T: Oral diadochokinesis in neurological dysarthrias. Folia Phoniatr Logop 1995;47:15–23.
  20. Ozawa Y, Shiromoto O, Ishizaki F, Watamori T: Symptomatic differences in decreased alternating motion rates between individuals with spastic and with ataxic dysarthria: an acoustic analysis. Folia Phoniatr Logop 2001;53:67–72.
  21. Kent RD, Kent JF, Rosenbek JC, Vorperian HK, Weismer G: A speaking task analysis of the dysarthria in cerebellar disease. Folia Phoniatr Logop 1997;49:63–82.
  22. Schalling E, Hartelius L: Acoustic analysis of speech tasks performed by three individuals with spinocerebellar ataxia. Folia Phoniatr Logop 2004;56:367–380.
  23. Gentil M: Dysarthria in Friedreich disease. Brain Lang 1990;38:438–448.
  24. Hartelius L, Lillvik M: Lip and tongue function differently affected in individuals with multiple sclerosis. Folia Phoniatr Logop 2003;55:1–9.
  25. Tjaden K, Watling E: Characteristics of diadochokinesis in multiple sclerosis and Parkinson’s disease. Folia Phoniatr Logop 2003;55:241–259.
  26. Rosen KM, Kent RD, Duffy JR: Task-based profile of vocal intensity decline in Parkinson’s disease. Folia Phoniatr Logop 2005;57:28–37.
  27. Kent RD, Duffy JR, Kent JF, Vorperian HK, Thomas JE: Quantification of motor speech abilities in stroke: time-energy analyses of syllable and word repetition. J Med Speech Lang Pathol 1999;7:83–90.
  28. Wang YT, Kent RD, Duffy JR, Thomas JE, Weismer G: Alternating motion rate as an index of speech motor disorder in traumatic brain injury. Clin Linguist Phonet 2004;18:57–84.
  29. Ziegler W: Task-related factors in oral motor control: speech and oral diadochokinesis in dysarthria and apraxia of speech. Brain Lang 2002;80:556–575.
  30. Wang YT, Kent RD, Duffy JR, Thomas JE, Fredericks GV: Dysarthria following cerebellar mutism secondary to resection of a fourth ventricle medulloblastoma: a case study. J Med Speech Lang Pathol 2006;14:109–122.

    External Resources

  31. Nishio M, Niimi S: Comparison of speaking rate, articulation rate and alternating motion rate in dysarthric speakers. Folia Phoniatr Logop 2006;58:114–131.
  32. Weismer G: Motor speech disorders; in Hardcastle WJ, Laver J (eds): The Handbook of Phonetic Science. Cambridge, Blackwell, 1997, pp 191–219.
  33. Brown JR, Darley FL, Aronson AE: Ataxic dysarthria. Int J Neurol 1970;7:302–309.
  34. Nunnally JC, Bernstein I: Psychometric Theory. St. Louis, McGraw-Hill, 1994.
  35. Guilford JP: Fundamental Statistics in Psychology and Education. St Louis, McGraw-Hill, 1973.
  36. Milenkovic P: Time-Frequency Analysis for 32-Bit Windows. Madison, Wisconsin, 2001.
  37. Auzou P, Özsancak C, Morris RJ, Jan M, Eustache F, Hannequin D: Voice onset time in aphasia, apraxia of speech and dysarthria: a review. Clin Linguist Phonet 2000;14:131–150.
  38. Davis K: Phonetic and phonological contrasts in the acquisition of voicing: voice onset time production in Hindi and English. J Child Lang 1995;22:275–305.
  39. Özsancak C, Auzou P, Jan M, Hannequin D: Measurement of voice onset time in dysarthric patients: methodological considerations. Folia Phoniatr Logop 2001;53:48–57.
  40. Wang YT, Kent RD, Duffy JR, Thomas JE: Dysarthria associated with traumatic brain injury: speaking rate and emphatic stress. J Commun Disord 2005;38:231–260.
  41. Cohen W, Waters D, Hewlett N: DDK rates in the paediatric clinic: a methodological minefield. Int J Lang Commun Disord 1998;33:428–433.
  42. Yaruss JS, Logan KJ: Evaluating rate, accuracy, and fluency of young children’s diadochokinetic productions: a preliminary investigation. J Fluency Disord 2002;27:65–85.