呻吟之王

Dr Adam Brown

Job: Senior Lecturer, Speech and Language Therapy

Faculty: Health and Life Sciences

School/department: School of Allied Health Sciences

Address: Hawthorn, The Gateway, Leicester UK

T: +44(0)116 207 8809

E: abrown02@dmu.ac.uk

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Personal profile

Adam works in the area of speech and language therapy, specifically in the field of motor speech disorders. His research interests are communication and social capital in Parkinson’s disease: social participation, social activity, social networks and social anxiety. He is also interested in the discourse of speech and language therapy, and teaches motor speech disorders, cognitive psychology, clinical reasoning, acquired dyslexia and dysgraphia, research methods

Publications and outputs

dc.title: Children and young adults with profound and multiple learning disabilities: Evidence of intelligible subvocal language dc.contributor.author: Woods, Rosemary H.; Kerr, David; Woods, L. F.; Raghavan, Ragu; Cornelius, Pip; Brown, Adam dc.description.abstract: Introduction Literature to date describes people with Profound and Multiple Learning Disabilities (PMLD) as pre-linguistic. In contrast, this study explores the existence and use of meaningful sub vocal (SV) language by twenty PMLD participants. Method The SV utterances of 20 PMLD participants were recorded and amplified. Recordings were investigated for evidence of language content and structure, listener intelligibility, and acoustic and phonetic features relative to normal speech and whisper. Results Language content and structure was identified. Listener intelligibility was demonstrated. Acoustic and phonetic features relative to normal speech and whisper were evident. Conclusion Twenty PMLD participants produced meaningful SV language intelligible to listeners. This study requires further robust research to fully confirm its findings but highlights implications for clinical practice and for understanding of PMLD communication competencies. This paper is accompanied by audio samples and transcriptions of recorded utterances to demonstrate the SV language produced by the participants. The quality of the samples varies due to the difficulties in recording SV utterances and the difficulties for participants in articulating clearly. This is not normal speech, but it is normal language. The listener may need to replay samples where the quality of the recording is poor. dc.description: open access article
dc.title: Social Aspects of Communication in Parkinson's Disease dc.contributor.author: Brown, Adam dc.description.abstract: Parkinson鈥檚 disease is a degenerative neurological condition which affects motor control, in almost all cases involving speech, and is frequently of many years duration. Much is known about speech production but less of the psychosocial consequences of the speech impairment (dysarthria). Accounts of people with dysarthria have shown that its impact on quality of social participation can be varied and profound. However, level of participation has not been investigated. Reduction in social activity and social networks has been found following onset of other neurogenic communication disorders. In Parkinson鈥檚 disease there is some evidence of social activity reduction but this has not been studied in relation to severity of dysarthria. Social anxiety has been found to be raised in speakers with other speech production impairments and this may be a contributor to reduction in social engagement. Investigation of social variables is of importance in understanding relationships within a biopsychosocial model of health which underpins intervention for therapies for communication disorders. Aims The study aimed to investigate the impact of dysarthria on social participation and whether presence of dysarthria in Parkinson鈥檚 disease (PD) resulted in changes to social anxiety, social networks and social activity. It further sought to investigate whether severity of dysarthria resulted in changes to the same variables. Method A group of 43 mild-moderately dysarthric speakers with PD were recruited. Exclusion criteria were applied to control for cognitive impairment, depression, apathy, movement disability and co-occurring neurological and communication impairment. A group of 30 non-neurologically impaired participants were recruited matched for age, sex, socioeconomic status and educational attainment. Participants with PD were further grouped using measures of sentence intelligibility and motor speech impairment into higher and lower functioning groups. All participants completed a social anxiety questionnaire, a social activity checklist and detailed their social network. Group data were compared to address the research questions. Semi-structured interviews were carried out with all participants to explore change to social life and perceptions of causes of change. Results Participants reported a range of changes to interaction and social engagement arising from speech and other impairments and also from intra and interpersonal contextual factors. Quantitative data showed that presence of dysarthria was associated with social anxiety and avoidance but not changes to social activity level or social network size. Greater severity of dysarthria was associated with deterioration in social activities and social network. There was wide individual variation on these variables. Outcomes Impact of dysarthria may be significant and unrelated to severity of impairment and satisfaction with level of activity is low in dysarthric speakers. Mild - moderately dysarthric speakers with PD may experience social anxiety in particular types of social situation. Moderately dysarthric speakers may experience loss of social capital in terms of quantitative changes in social networks and social activities. Motor speech impairment was a better predictor of social functioning than intelligibility in this sample. It is possible that a threshold for change lies at a more severe level of speech involvement. How speakers with PD perceive and experience their social interactions is discussed and limitations to the research are considered. The implications of the findings are discussed in relation to the ICF framework and the concept of social capital
dc.title: Social participation and speech impairment in Parkinson's disease dc.contributor.author: Brown, Adam; Rowley, David T.; Brown, Brian J. dc.description.abstract: Background: although speech impairment and intelligibility have been investigated in some detail in Parkinson鈥檚 disease, relatively little is known about the specific impact of these factors on social functioning. Aims: the aims of this study were to investigate the effect of level of intelligibility on social communication. Method and Procedure: two groups of speakers with Parkinson鈥檚 disease, differentiated by level of intelligibility as mildly and moderately impaired, and a matched, non-neurologically involved control group were compared using measures of social anxiety, social activity type and frequency and social network size and composition. Results and Outcome: social anxiety and frequency of engagement in social situations did not differ significantly between groups. Overall range of social activities did not differ between groups. Unimpaired speakers reported more leisure activities and greater frequency of activity. Speakers with PD reported more organised activities. Satisfaction with number of social activities was significantly worse among PD speakers. Size of social network did not differ significantly by group but severity of speech involvement affected network composition. Conclusion: poorer intelligibility in this population was not significantly associated with negative changes to patterns of social activity. Social anxiety and social network size were not affected by speech impairment.
dc.title: Phonetic variation in dysarthric speech as a function of sampling task. dc.contributor.author: Brown, Adam; Docherty, G. dc.description.abstract: Previous studies have demonstrated a number of ways in which normal speakers' phonetic performance varies across reading and spontaneous speech tasks. This study set out to investigate whether similar differences across speech sampling tasks were found in a mixed group of dysarthric subjects. A selection of segmental and prosodic parameters were investigated acoustically in the performance of five mild dysarthric speakers and five matched control subjects. The results demonstrated that breath鈥損ause position, unstressed vowel duration and voice-onset time were subject to variation across sampling task in the speech produced by different types of dysarthric speaker. The results suggest that read material produced by dysarthric speakers may not be wholly representative of those speakers' spontaneous speech. Preliminary implications for clinical practice are discussed. The findings point to the need for further research to investigate the extent of such differences and their implications for dysarthria assessment, which up to the present has relied predominantly on read material
dc.title: Using conversation analysis to investigate the efficacy of the Hanen Parent Programme for parents of preschool children with learning disabilities/language disorder. dc.contributor.author: Hickin, J.; Cunningham, R.; Flanagan, J.; Brown, Adam dc.description.abstract: The Hanen Training Programme, (Manolson, 1975)1 was devised to empower parents and caregivers to help children to communicate to the best of their abilities. In line with moves within the speech and language therapy profession towards an enabling model, the programme has been used widely by speech and language therapists with parents of children who have delayed language development. Conversation analysis is a qualitative methodology which allows evaluation of interactional aspects of language from naturally-occurring data and which thus has strong ecological validity. Whilst it has been used in speech and language therapy research to analyse interaction and motivate therapy with adults with aphasia, there is limited data published to date using conversation analysis with children. However studies are now emerging which demonstrate the utility of this methodology in relation to this client group (e.g. Volden, 2004)2. This study investigated the interactions between children and parents before, during and after participation in a Hanen programme, using video tapes which were subjected to conversation analysis. Five children aged between 2陆 and 4 years with severe/moderate learning difficulties and their parents who were selected for Hanen intervention by their speech and language therapist in a child development centre participated. Videos were transcribed (including nonverbal behaviour) following standard conventions. The three principles advocated by Hanen (allowing, adapting and adding) were investigated by using conversation analysis focussing on: initiation within the parent-child interaction, facilitation used to enable the child to participate, the balance between parent and child turns, and patterns of repair. The researchers analysing the videos were blind to the order of recording. The results of the study will be discussed in terms of their implications for evaluating the effectiveness of the widely used Hanen training techniques, and will provide direction for further research.
dc.title: Linguistic and social aspects of communication in Parkinson鈥檚 Disease. dc.contributor.author: Brown, Adam dc.description.abstract: Descriptions of speech characteristics and speech impairments in speakers with Parkinson鈥檚 disease are well advanced. Recent literature has also begun to describe the experience of Parkinson鈥檚 disease from the patient鈥檚 perspective and to analyse it from social as well as psychological viewpoints. A key finding is that in many cases the struggle to adapt to physical limitations including speech impairment leads to social withdrawal. The presence of primary PD is associated with deterioration in activity and social functioning which is marked by lowered likelihood of fulfilling certain social roles (e.g. paid employment) and increased likelihood of spending time in solitary activity (e.g. watching TV). This has been described as evidence of premature social ageing since the social profile of those with PD is that of more elderly groups in the general population. However, existing studies have relied on relatively simple measures of activity and social networks and have not explored relationships between other communication measures, such as motor speech functioning and intelligibility, and measures of social participation. This is an ongoing study which aims to investigate social aspects of communication in speakers with Parkinson鈥檚 disease of differing intelligibility and to understand relationships between measures of speech impairment and social participation. Possible outcomes of the study include informing and enhancing current assessment procedures for people with hypokinetic dysarthria in particular and motor speech disorders in general. The study uses a between subjects design to compare groups of mildly, moderately and severely speech-impaired speakers using measures of social network, social participation and social anxiety. Speech measures include the Frenchay Dysarthria Assessment (Enderby, 1983), the Assessment of Intelligibility of Dysarthric Speech (Yorkston and Beukelman, 1981) and the Phonetic Intelligibility Test (Kent, Weismer et al, 1989). Social network size and density are measured using the convoy model (Antonucci and Akiyama, 1987), social activity using the Social Activities Checklist (SOCAT) (Cruice, 2001) and social anxiety using the Inventory of Interpersonal Situations (Van Dam Baagen and Kraaimaat, 1999). Participants are screened for physical functioning, depression, apathy and cognitive impairment. Preliminary results suggest no differences in measures of social participation and social anxiety between groups of speakers of differing severity of motor speech impairment. There are implications for the timing of speech and language therapy intervention for people with Parkinson鈥檚 disease as it would appear that social withdrawal may be quantified before speech impairments emerge

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Areas of teaching

Motor speech disorders
Cognitive psychology
Clinical reasoning
Acquired dyslexia
Dysgraphia, research methods

Qualifications

PhD in Motor Speech Disorders
MA English Language and Literature
BSc Speech and Psychology

呻吟之王 taught

Psychology for Speech and Language Therapists
Medical Sciences for Intervention.

Membership of external committees

External examiner University of Ulster 1997-2001
External examiner University of Wales 2000-2003
External Examiner University College London 2007-2011
Member of Committee of Representatives of Speech and Language Therapists in Higher Education (CREST)

Membership of professional associations and societies

Registered member Royal College of Speech and Language Therapists
Member British Aphasiology Society.

Professional licences and certificates

Registered with Health Professions Council as Speech and Language Therapist.

Conference attendance

International Motor Speech Conference, Santa Rosa CA, 2012
Royal College of Speech and Language Therapists Scientific Conference, London, 2009
International Dysarthria Conference, Sheffield UK, 2007.

Consultancy work

Effectiveness of intervention in motor speech disorders for Parkinson’s UK - External advisor on validation of degree programme in speech and language therapy, Attica College, Athens for University College of St Mark and St John, Plymouth.

Current research students

Karen Hayden, MSc Advanced Speech and Language Therapy, 1st dissertation supervisor.

Internally funded research project information

Linguistic and social aspects of communication in Parkinson’s disease. Internally funded Phd Started Jan 2006. Lead investigator.

Professional esteem indicators

International Journal of Language and Communication Disorders, 2011 – present, reviewer
Journal of Fluency Disorders, 2011 – present, reviewer.

Adam Brown