SLPOtherAphasiology2021

Repeated word production is inconsistent in both aphasia and apraxia of speech.

Katarina L Haley, Kevin T Cunningham, Adam Jacks and 3 others

PMID 34924672

WHAT IT FOUND

When people with aphasia and apraxia of speech repeated words, their errors were not more consistent than in aphasia without apraxia.

After accounting for how often errors occurred, apraxia showed similar or less consistency, so high consistency is not a useful diagnostic marker.

Key findings

01After accounting for error frequency, speakers with AOS were not more consistent than speakers with aphasia without AOS; when significant, AOS or borderline groups were less consistent.

02Error frequency was a strong predictor of consistency: participants who produced more errors were more consistent in error location but less consistent in word variants.

03The sound-level consistency measures had poor reliability between transcribers, while the whole-word production consistency measure had good reliability.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The analysis used 137 of 171 recorded participants, after excluding speakers with no errors on the repeated words or output too limited to align, so the findings do not cover those speakers. Groups were formed with research cutoffs based on median syllable duration and distortion frequency, not with clinical diagnostic consensus, so everyday diagnosis may not match the study labels. The AOS group produced more errors than the comparison groups, and error frequency strongly predicted several consistency measures; even after statistical correction, severity imbalance remains a concern. The sound-level consistency measures had poor reliability between transcribers, so segment-level findings are less secure than the whole-word consistency results. The study reports diagnostic and speech measurement findings, not treatment outcomes, so it cannot show whether any therapy changes consistency or communication.

The easy way to misread this

Do not conclude that inconsistent repeated word errors diagnose apraxia of speech. In this study, inconsistency was also present in aphasia without apraxia, and consistency changed with how many errors the speaker produced.

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