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This chapter reviews the brain processes underlying human speech production, centered on the idea that a talker wants to communicate through to the execution of a motor plan. Cortical regions associated with motor control –including premotor cortex, supplemental motor area, and pre-supplemental motor area – are routinely implicated in speech planning and execution, complemented by the cerebellum. In addition to generating speech sound waves, speech production relies on somatosensory and auditory feedback, associated with additional regions of the superior temporal gyri and somatosensory cortex. A special point of emphasis is the contribution of the left inferior frontal gyrus (including the area traditionally defined as “Broca’s area”) to fluent speech production. Additional points include speech prosody and sensory-motor feedback. Finally, the chapter concludes by reviewing several common challenges to speech production, including dysarthria, apraxia of speech, and stuttering.
Childhood Apraxia of Speech (CAS) was declared as a motor speech disorder by ASHA (2007). The prevalence of CAS is yet to determined due to difficulties in reliable diagnosis, however 63.6% of children with ASD were found to Apraxic (Tierney et al, 2015), hence prevalence would be at least 1/100 (ASD prevalence is 1/54).
Objectives
The consequences of inability to speak in early and advanced developmental age are many and might include frustration, anger, depression, communication deficit, language delay, poor social skills and behavioural problems. Not only treating motor speech disorder is challenging enough, the external consequences make it far more difficult.
Methods
The VML method (Verbal Motor Learning) was designed to treat the motor aspect of speech. It uses manual techniques and motor learning principles in order to directly teach the basic milestones of speech for children with CAS. In addition, the importance of the manner of the practice was established over the years, extracting 16 unique treatment principles. These principles guide the therapist regarding HOW to perform the practice, while giving an answer to the external CAS consequences.
Results
The principles are the platform, managing energy levels, relationship, attention, goal-oriented thinking, emotional safety, treatment structure, rhythm, timing, threshold point, support, dynamic thinking, ecological treatment, proactivity, clarity and commitment.
Conclusions
The lecture will introduce the 16 principles briefly, and demonstrate the use of them via treatment videos.
Disclosure
I am the founder of the VML method and I teach it in various countries.
The VML method was developed and designed to treat Apraxia of speech focusing on the Autistic population. After experiencing over 2000 children in many countries around the world, we have developed an algorithm which represents the VML analysis process. The algorithm includes almost 1000 conditions and was found reliable with copying the in-person VML evaluation. The algorithm generates a treatment program with 95% accuracy of the elected treatment topics.
Objectives
The objective of the VML software is to enable the VML analysis and treatment at low cost to wide population around the world, at home. The program includes main treatment topics, detailed exercises, picture and videos demonstrating the proposed treatment and general guidelines. The software users are supported by the VML experts around the world.
Methods
Based on the algorithm, we have developed a software which can produce a highly detailed motor speech treatment program. The software is web based, available now in English, Mandarin and soon in other languages as well. The user is required to fill in the speech data using the software interface.
Results
The uniqe sofetware was tested and found to have 90% reliability rate in comparison to a VML expert treatment program. In addition it was found to have the ability to over come mild evaluation mistakes while producing an effective treatment program.
Conclusions
The MYVML evaluation software is innovation in the field of speech treatment, striving to share the knowledge and give the treatment tool to as many practitioners and families as possible.
Disclosure
I am the developer of the VML software described in the abstract
Childhood Apraxia of Speech (CAS) was declared as a motor speech disorder by ASHA (2007). Yet, until then it was mainly addressed as a phonological disorder and until these days, 14 years later, the treatment of CAS is yet to be motor based worldwide. Professionals finds it hard to diagnose it clearly due to comorbidity with communication and language disorders.
Objectives
This non clarity might lead to non-accurate treatment since the essence of the syndrome is not addressed. An accurate treatment will integrate knowledge from several domains: communication, Language, Sensory, behavioural, emotional, cognitive and, the most important one for CAS, motor learning.
Methods
Motor learning is an area of knowledge which is learnt usually in sport academy, while Its main practical purpose is to improve training methods in sport. The use of motor learning knowledge doesn’t belong to the world of sport primarily but rather to the world of movement wherever it exists. One of the fascinating areas of movement is speech.
Results
Speech in its basic form is motor based, before it being used as a motor tool for language and communication. It is the most complicated motor task in the human body since for every syllable we activate directly and indirectly over 100 muscles. The children who can’t acquire speech spontaneously due to severe deficit in motor planning, need to practice motor speech tasks repeatedly and accurately.
Conclusions
This lecture will present the use of 20 motor learning principles in the speech treatment via the VML method
Disclosure
I am the founder of the VML method while teaching it in various countries
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