Overheard: An Apraxia Pioneer Talks Speech During her Fulbright experience at the University of Pretoria in South Africa, University of Washington Associate Professor Diane L. Kendall talked with speech motor control and apraxia expert Anita van der Merwe. The Leader was listening. Overheard
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Overheard  |   February 01, 2014
Overheard: An Apraxia Pioneer Talks Speech
Author Notes
  • Diane L. Kendall, PhD, CCC-SLP, is a research scientist with the U.S. Department of Veterans Affairs, and an associate professor in the Department of Speech and Hearing Sciences and director of the Aphasia Laboratory at the University of Washington. She is an affiliate of ASHA Special Interest Group 2, Neurophysiology and Neurogenic Speech and Language Disorders. ·dkendall@u.washington.edu
    Diane L. Kendall, PhD, CCC-SLP, is a research scientist with the U.S. Department of Veterans Affairs, and an associate professor in the Department of Speech and Hearing Sciences and director of the Aphasia Laboratory at the University of Washington. She is an affiliate of ASHA Special Interest Group 2, Neurophysiology and Neurogenic Speech and Language Disorders. ·dkendall@u.washington.edu×
Article Information
Professional Issues & Training / International & Global / Overheard
Overheard   |   February 01, 2014
Overheard: An Apraxia Pioneer Talks Speech
The ASHA Leader, February 2014, Vol. 19, 26-27. doi:10.1044/leader.OV.19022014.26
The ASHA Leader, February 2014, Vol. 19, 26-27. doi:10.1044/leader.OV.19022014.26
Anita van der Merwe, professor in the Department of Communication Pathology at the University of Pretoria, South Africa, has been training speech-language pathologists and conducting research since the 1970s. With a focus on models of speech motor control, apraxia of speech and treatment of apraxia of speech, her most significant contribution to date is the development of a brain-behavior model of speech sensorimotor control—one that explains neurological control of normal speech production, characterizes pathological speech sensorimotor control, and provides treatment guidelines. The foundation of Van der Merwe’s career is a rich and complex backdrop of cultural, political and linguistic diversity.
DIANE KENDALL: Tell me about your early clinical career as a speech-language pathologist in South Africa.
ANITA VAN DER MERWE: In South Africa, we complete a four-year undergraduate professional degree after high school. My aunt knew of a grant program offered by the Transvaal Education Department that provided financial assistance for university tuition in speech-language pathology and audiology. She helped me through this process, and I was accepted for the program at the University of Pretoria. Without [my aunt], I very likely would not have followed this degree. In those days we qualified as both speech-language therapists and audiologists.
I was 21 years old when I completed my studies in 1970. After graduating, I had to take on a post as school clinician in a town that was about 70 miles away from my home town. I drove alone each day through mountainous farm and rural areas. In South Africa, we have violent thunderstorms with rain and hail in the afternoons—I often encountered such storms. My only companions on those roads were groups of African children walking to the closest farm schools in the opposite direction than I was traveling. They were my friends, and we waved at each other every morning and afternoon as we traveled to school and work.
Eighteen months later, a new training hospital of the University of Pretoria was established on the outskirts of Pretoria. I applied for a post at this hospital, named Kalafong—meaning “place of healing.” At Kalafong, I started a Speech Therapy and Audiology Department. The three years spent there were wonderful and most educational. I loved my clients, who were mostly speakers of African languages such as Tswana, Sepedi and Zulu.

Anita van der Merwe

Anita van der Merwe

Anita van der Merwe

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KENDALL: What prompted you to transition to a career in academia? What was that experience like for you … getting a master’s degree and doctorate?
VAN DER MERWE: My aspirations toward an academic career started when I was about 5 years old. I overheard a discussion about doctoral degrees, and at that moment I knew that is what I wanted to pursue one day. I started my master’s degree in 1973, while still working at Kalafong. In 1979, I started my doctorate and decided to focus on apraxia of speech.
Attaining both degrees was a very lonely and isolated experience. There was very little on acquired dysarthria and apraxia of speech in the literature at the time. There were no other academics in this field in South Africa—and only three with doctoral degrees. However, during my doctoral studies I met a local neurophysiologist and he introduced me to the neurophysiology literature on the role of brain structures such as the basal ganglia and the cerebellum. This was an academic life-changing experience.
KENDALL: In the early 1970s, you started developing your model of speech motor planning and programming. Can you talk a little about what inspired you?
VAN DER MERWE: At Kalafong, I encountered clients—adults and children—who clearly did not present with aphasia or dysarthria, and I wanted to understand the nature of this disorder and give it a name. During my studies I became fascinated by the existing speech production models, but concluded that none of these explained the nature of this disorder.
I observed what kind of treatment had an effect on these clients’ speech signs and those observations—together with the readings on the neurophysiology of movement—gradually shaped the four-level model [which first delineated four levels in the speech production process]. The first attempts to formulate this model appeared in my doctoral thesis on apraxia of speech. I also read that Drs. Raymond D. Kent and Malcolm R. McNeil emphasised the need for a comprehensive model to explain the nature of neuromotor speech disorders. That served as an important impetus to persevere toward this end.
In 1992, I went overseas to the United States for the first time and showed my model to Malcolm McNeil. He contacted me soon after with the request to write a chapter on this model [published in “Clinical Management of Sensorimotor Speech Disorders,” Thieme Medical, 1997]. I will always remain indebted to him for giving me this opportunity.
KENDALL: Next year you will retire as professor at the University of Pretoria after 42 years. What do you envision for the department’s future … and yours?
VAN DER MERWE: Yes, in July 2014 I have to go on compulsory retirement, but I hop to continue being involved with staff and student research on a part-time basis. Most important, I am looking forward to having more time to dedicate to my own research My aim is to further understand speech motor control and apraxia of speech, and to distinguish between disorders at the motor planning versus programming levels. To this end, my current focus is on speech signs across languages and on motor awareness in typical speakers and individuals with apraxia of speech. I also will continue with treatment studies in which the speech motor learning approach—which was published for the first time internationally in 2011—is implemented.
In the department we are only two speech pathologists with a doctoral degree and we are both close to retirement. My concern is the continuation of good research and expert knowledge of the field of neuromotor speech disorders at this department and in the country. Currently, I am trying to address my concerns by involving international experts in post­graduate students’ studies.

Anita van der Merwe

Anita van der Merwe

Anita van der Merwe

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February 2014
Volume 19, Issue 2