1. Marshall, R. C. , Gandour, J. , & Windsor, J. (1988)
Marshall, R. C., Gandour, J., & Windsor, J. (1988). Selective impairment of phonation: A case study. Brain and Language, 35,

2. What to get from this case?
Methods of diagnosis
Use of sound displays - time-pressure waves and spectrograms
Components of speech production -- phonation in particular
Separation (dissociation) of elements in production
Interaction of processes in normal speech
Consequently, difficulty in diagnosis & treatment

3. Visual displays of DT speech
Time waveform p. 327
Fo trace (Fo plot) p.327
Spectrograms (many e.g. Fig. 7, p.325)
Relative peak Intensity or stress (Fig.8)
VOT (voice onset time)

4. Terms and concepts to know
Dissociation
Decorrelation between symptoms or processes; used to support autonomous functions or modules
Apraxia
Motor disorder- an impairment of selecting, planning, executing movements in normal fashion.
CVA
Cerebral vascular accident
Crainiotomy
Skull surgery

5. Dysarthria
A speech disorder due to weak and poorly coordinated speech muscles. Speech may be slow and imprecise. It is basically symptom of many problems including cerebral palsy, various degenerative diseases, poisons, and strokes.

6. Summary- apparent Broca's aphasia with speech apraxia
Verb shifted right, stressed syllables only
Abnormal fundamental frequency (Fo)
DT could whisper and use electrolarynx without error

7. Causal factors in patient's apraxia
Lesion
Efforts to compensate
Interaction among components

8. Various diagnostic procedures used
Brain scan
Various language tests (p.317) including the BDAE
Assessment of specific speech deficits (below)

9. Phonation Larynx - glottis, supraglottal, subglottal Whispering
Electrolarynx and its function
Whispering

10. Stroke Infarct (tissue death due to restricted circulation)
TIA- transient ischemic attack:

11. Apraxia (p.332)

12. Aphasia (Broca's, lesion)

13. Prosodics
Fundamental frequency, F0 pattern

14. Specific deficits Phonation
Articulation --phonological analysis of errors p.321
Syntax
Dissociation of phonology and articulation

15. Keys to diagnosis
Whispering, writing, and use of electrolarynx

16. H.E. 's TIA (transient ischemia attack)
Symptoms- depend on brain region with blockage
Evaluation - MRI, carotid arteries, heart, clinical exam
Cause -- generally uncertain
Treatment
Prognosis

18. Left temporal damage

19. Speech with electrolarynx

20. Writing sample

21. Treatment effect

22. Time-pressure wave showing disruptive effects on encoding thoughts

23. The spy fled from Greece

24. “Baseball player”

25. Conversation transcript

26. Rating scale profile from BDAE

27. Writing sample of DT (a- words, b- sentences)

29. How does phonation work? Evolve?

30. Schulz, G. M. , Varga, M. , Jeffires, K. , Ludlow, C. L. , & Braun, A
Schulz, G. M., Varga, M., Jeffires, K., Ludlow, C. L., & Braun, A. R. (2005). Functional neuroanatomy of human vocalization: An H215O PET study. Cerebral Cortex, 15(12),
Thus, when voiced speech (oral articulatory movements plus vocalization) is contrasted with whispered speech (oral articulatory movements alone) the differences should selectively reflect the demands associated with vocalization. We hypothesized that these would include activation of the midline visceromotor circuit — the set of regions that comprise the species specific call system in lower mammals — as well as neocortical motor areas.

31. Schulz 2
We also hypothesized that functional connections between these systems would be observed only the during voiced speech condition, suggesting a neural substrate for neocortical modulation of the midline circuit during human phonation.

32. Schulz 3
our results suggest that human vocalization is not exclusively regulated by neocortical or visceromotor mechanisms, but by a combination of both.

33. Schulz 4
The greater degree of voluntary control that humans have over phonation can be explained by neocortical regulation of these visceromotor structures.
(See Keith Hayes video bits- Vicki and voluntary vocalization?)

35. Vicki learns to talk!
Keith Hayes and his wife spent lots of time teaching Vicki.

36. Voluntary vocal control in chimps?
Chimps unlike some dogs and all children have little or no voluntary control over their vocal tracts.

37. Voluntary control in 17 month old Kate
She’s certainly vocalizing something!

38. Schulz 5
Finally, there are areas in the temporal lobe and cerebellum that are coactivated and functionally coupled to both visceromotor and neocortical systems during voiced speech production.
These regions may support vocal self- monitoring, providing crucial information for regulation of the motor areas, i.e. complex on-line adjustments of pitch and airflow that depend upon perception of one's vocal output.