Case Study of the Redevelopment of Motor Speech Control Following Acquired Brain Damage in Early Childhood This article presents retrospective longitudinal perceptual and acoustic analyses of the recovery of motor speech control in a right-handed 5-year-old male in the 46 weeks following acquired brain damage. The primary lesion site involved the left fronto-parietal cortex. Correlative descriptions of some aspects of linguistic recovery up to 29 months ... Clinical Focus: Case Study
Clinical Focus: Case Study  |   May 01, 1994
Case Study of the Redevelopment of Motor Speech Control Following Acquired Brain Damage in Early Childhood
 
Author Affiliations & Notes
  • Paula A. Square, PhD
    Graduate Department of Speech Pathology, University of Toronto, 6 Queen’s Park Crescent, Toronto, Ontario M5S 1A8, Canada
    Chair
  • Arnold E. Aronson
    Mayo Clinic and Mayo Foundation, Rochester, MN
  • Ellen Hyman
    Private Practice, Ottawa, Ontario
Article Information
Speech, Voice & Prosodic Disorders / Attention, Memory & Executive Functions / Traumatic Brain Injury / Speech, Voice & Prosody / Clinical Focus / Case Study
Clinical Focus: Case Study   |   May 01, 1994
Case Study of the Redevelopment of Motor Speech Control Following Acquired Brain Damage in Early Childhood
American Journal of Speech-Language Pathology, May 1994, Vol. 3, 67-80. doi:10.1044/1058-0360.0302.67
History: Received February 24, 1992 , Accepted January 26, 1994
 
American Journal of Speech-Language Pathology, May 1994, Vol. 3, 67-80. doi:10.1044/1058-0360.0302.67
History: Received February 24, 1992; Accepted January 26, 1994

This article presents retrospective longitudinal perceptual and acoustic analyses of the recovery of motor speech control in a right-handed 5-year-old male in the 46 weeks following acquired brain damage. The primary lesion site involved the left fronto-parietal cortex. Correlative descriptions of some aspects of linguistic recovery up to 29 months post-onset are also presented. A mute period of 8 days followed a 2-day comatose period. Spontaneous undifferentiated central vowel-like utterances emerged at 11 days post-injury. Intelligible purposeful utterances emerged at 26 weeks post-onset with the motor speech impairment resolving almost completely within the first year post-onset. The motor speech deficit following the mute period was more consistent with the diagnosis of apraxia of speech than dysarthria. Further, the seemingly lateralized damage associated with the communication disorder may indicate that lateralized hemispheric control of motor speech occurs in early childhood. Finally, the redevelopment of motor speech abilities indicates that the young child’s brain is able to reestablish parameters of motor control underlying speech following acquired brain damage.

Acknowledgments
Data collection was undertaken at and supported by Mayo Clinic and Mayo Foundation while the first author held a predoctoral fellowship at that institution. Portions of this study were completed by the third author in partial fulfillment of the requirements of Master of Health Science, Graduate Department of Speech Pathology, University of Toronto, and was partially supported by a grant to the third author from the Speech Pathology Alumni Association, University of Toronto. Preparation of the manuscript was supported by a grant to the first author from a Dean’s Research Grant, Faculty of Medicine, University of Toronto, and through partial support of the Department of Rehabilitation Medicine, University of Toronto. Preparation of some graphics was supported by Mayo Clinic and Mayo Foundation. Special gratitude is extended to Kevin Munhall and Patricia Osborne for their assistance in interpreting the acoustic data and to Sharon Cohen, and Kevin Kearns, associate editor of AJSLP, and his reviewers for their comments on a previous version of this manuscript. Portions of this study were presented at the Motor Speech Disorders Conference, Boulder, Colorado, in April of 1992.
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