Nature of Error Consistency in Apraxia of Speech and Aphasia with Phonemic Paraph

描述(申请人提供)：有效治疗中风后的沟通障碍需要准确的鉴别诊断。然而，在某些情况下，我们缺乏可靠、有效的方法来鉴别诊断具有相似行为特征的疾病。这对于获得性言语失用症(AOS)和以音素失语症(PP)频繁发生为特征的失语症尤其如此。AOS和PP的鉴别诊断具有挑战性，因为这两种疾病都是由左半球卒中引起的，并且具有相同的临床特征。因此，识别每种疾病特有的特征是很重要的。加强当前诊断过程的一种方法是检查用于提供鉴别诊断信息的诊断标准的有效性。目前提出的区分AOS和PP的标准包括：1)语速慢，表现为段和段间持续时间延长，2)声音失真，3)声音替换失真，4)韵律异常，5)错误位置和错误类型方面的相对一致的错误。因为错误一致性被描述为“相对的”，所以错误一致性是区分这两种疾病的一个特征。错误一致性指的是关于错误在单词内的位置(例如，顺序首字母)和产生的错误的类型(例如，扭曲与替换)，从一次试验到另一次试验的错误是否相对一致。比较AOS和PP中错误一致性的性质的调查显示，结果相互矛盾。然而，这些研究在重要的方法领域有所不同，因此很难得出关于这两个群体中错误一致性的性质的结论。此外，文献表明错误一致性可能受到许多变量的影响，例如刺激呈现条件、错误率和损伤的严重程度。因此，本研究的目的是进一步考察10名AOS伴失语症患者和10名PP失语症患者的错误一致性。具体地说，本研究将探讨在双音节、三音节和五音节单词重复过程中，错误位置和错误类型一致性的群体差异。还将检查刺激呈现条件、错误率和损伤严重程度对组内和组间错误一致性的影响。最后，为了进一步检验产生的错误类型的组别差异，将比较特定错误类型的出现情况和频率。这项研究将做出重大贡献，作为一系列计划研究的第一步，该研究的重点是通过检查左半球中风引起的获得性沟通障碍患者的具体临床特征和特征模式，提高AOS与其临床邻居的鉴别诊断。

DESCRIPTION (provided by applicant): Effectively treating communication disorders after stroke requires accurate differential diagnosis. In some cases, however, we lack reliable, valid methods of differentially diagnosing disorders with similar behavioral profiles. This is particulary true of acquired apraxia of speech (AOS) and aphasia characterized by frequent occurrences of phonemic paraphasia (PP). The differential diagnosis of AOS and PP is challenging because both disorders result from left hemisphere stroke and share clinical characteristics. Therefore, the identification of characteristics that pattern uniquely to each disorder is important. One way in which to strengthen the current diagnostic process is to examine the validity of diagnostic criteria used to inform differential diagnosis. The current criteria proposed to differentiate AOS from PP include: 1) slow speech rate characterized by prolonged segment and intersegment durations, 2) sound distortions, 3) distorted sound substitutions, 4) prosodic abnormalities, and 5) relatively consistent errors in regard to error location and error type. Because it has been described as being "relative", error consistency is one characteristic that holds promise for the differentiation of these two disorders. Error consistency refers to whether or not errors are relatively consistent from trial to trial in regard to the location of errors within a word (e.g., ord initial) and the type of errors produced (e.g., distortions vs. substitutions). Investigations comparing the nature of error consistency in AOS and PP have revealed conflicting results. However, these studies differ in important methodological areas, making it difficult to draw conclusions about the nature of error consistency in these two populations. Furthermore, the literature suggests that error consistency may be influenced by a number of variables, such as stimulus presentation condition, error rate, and severity of impairment. Therefore, the purpose of this proposal, is to further examine the nature of error consistency in a group of 10 individuals with AOS and concomitant aphasia and a group of 10 individuals with aphasia with PP. Specifically, this study will explore group differences in the consistency of error location and error type during the repetition of two-, three-, and five-syllable words. The influence of stimulu presentation condition, error rate, and severity of impairment on error consistency, within and between groups, will also be examined. Lastly, to further examine group differences in the types of errors produced the occurrence and frequency of specified error types will be compared. This study will make a significant contribution as the first step in a programmatic line of research focused on improving the differential diagnosis of AOS from its clinical neighbors by examining specific clinical characteristics and patterns of characteristics in individuals with acquired communication impairments resulting from left hemisphere stroke.