{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:39:10Z","timestamp":1791967150767,"version":"4.3.4"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,5,21]],"date-time":"2018-05-21T00:00:00Z","timestamp":1526860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp; Comm Disor"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Posterior nasal fricatives are a learned compensatory articulation error and commonly substituted for oral fricatives. Treatment of such articulation errors requires the modification or teaching of skilled movements. A motor\u2010based approach is designed to teach the complex motor skill movement sequences required in the production of sounds. Although motor learning research is well established, little has been done to determine how the approach changes the underlying physiology of articulatory movements. While the underlying anatomical configuration of the posterior nasal fricative has been described, no studies have quantified anatomic and physiological changes pre\u2010 and post\u2010treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To use magnetic resonance imaging (MRI) to visualize and quantify the results of motor\u2010based speech\u2010intervention approach on articulatory placement for the treatment of the posterior nasal fricative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>A 6\u2010year\u2010old male with a history of ear infections and posterior nasal fricative substitution for \/s\/ underwent six 1\u2010h sessions of a motor\u2010based treatment approach over the course of 2 weeks. Pre\u2010 and post\u2010treatment evaluation included perceptual and instrumental assessment of speech and resonance. Perceptual resonance was rated by two speech\u2013language therapists and articulation was assessed at the single\u2010word level. Instrumental assessment included the See\u2010Scape, Nasometer II and MRI during the sustained phonation of \/s\/. Amira v5.6 Visualization and Volume modelling software used the midsagittal and oblique coronal plane to measure dimensions of the articulatory anatomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>Interrater reliability was assessed using a Pearson product moment correlation (<jats:italic>\u03b1<\/jats:italic> = .05) and ranged from <jats:italic>r<\/jats:italic> = .91 to .95. Intra\u2010rater reliability was assessed using the intra\u2010class correlation coefficient (.976) demonstrating a high degree of reliability with a 95% confidence interval. Articulation improved from 0% accuracy for \/s\/ in isolation at baseline to 100% for \/s\/ at the word level and 95% accuracy during conversational speech by session 6. Post\u2010treatment results from this study revealed a greater shortening of the levator veli palatini (levator) muscle length during articulatory movements, more pronounced velar knee and dimple, decreased velar thickness, increased velar length and altered tongue position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>This study demonstrated the use of pre\u2010 and post\u2010treatment imaging methodology to quantify articulatory changes following an intensive motor\u2010based treatment approach. MRI demonstrated quantifiable changes in articulatory placement. Individuals who exhibit non\u2010developmental and phoneme\u2010specific articulation errors, such as the posterior nasal fricative, may be excellent candidates for short\u2010term, intensive and frequent speech therapy sessions to remediate the production of the posterior nasal fricative.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1460-6984.12393","type":"journal-article","created":{"date-parts":[[2018,5,21]],"date-time":"2018-05-21T10:02:16Z","timestamp":1526896936000},"page":"852-863","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effect of motor\u2010based speech intervention on articulatory placement in the treatment of a posterior nasal fricative: a preliminary MRI study on a single subject"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6839-9116","authenticated-orcid":false,"given":"Kazlin N.","family":"Mason","sequence":"first","affiliation":[{"name":"East Carolina University  Greenville NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshan","family":"Pua","sequence":"additional","affiliation":[{"name":"East Carolina University  Greenville NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie L.","family":"Perry","sequence":"additional","affiliation":[{"name":"East Carolina University  Greenville NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,21]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"246","volume-title":"Communicative Disorders Related to Cleft Lip and Palate","author":"Adams L.","year":"1989"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/13682828409007182"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3913(59)90111-8"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1597\/11-202"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/02687038.2012.676888"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1044\/0161-1461(2004\/033)"},{"key":"e_1_2_8_8_1","first-page":"327","article-title":"Treatment of articulation and resonance disorders associated with cleft palate and VPI","author":"Golding\u2010Kushner K. 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