Measuring Speech Production Development in Children With Cerebral Palsy Between 6 and 8 Years of Age: Relationships Among Measures
Publication: Language, Speech, and Hearing Services in Schools
Volume 51, Number 3
Pages 882-896
Abstract
Purpose
Accurate measurement of speech intelligibility is essential for children with speech production deficits, but wide variability exists in the measures and protocols used. The current study sought to examine relationships among measures of speech intelligibility and the capacity of different measures to capture change over time.
Method
Forty-five children with cerebral palsy (CP) with and without speech motor impairment were observed at ages 6, 7, and 8 years. The speech performance of each child was rated using four measures at each time point: standardized articulation test scores, multiword intelligibility scores obtained from naïve listeners, parent ratings of intelligibility, and percent intelligible utterances obtained from language transcripts. We analyzed the correlations of measures within each age and within three different severity groups, and we analyzed how these measures changed year over year in each severity group.
Results
For children with CP who have mild and moderate speech deficits, different measures of speech production were weakly associated, and for children with CP with severe speech impairment, these measures showed stronger associations. The four measures also differed in their ability to capture change over time. Finally, results from standardized assessments of articulation were not found to inform overall speech intelligibility for children with mild and moderate speech deficits.
Conclusions
Results suggest that speech production is not fully described by any single clinical measure. In order to adequately describe functional speaking abilities and to capture change over time, multiple levels of measurement are required.
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References
Allison, K. M., & Hustad, K. C. (2018). Acoustic predictors of pediatric dysarthria in cerebral palsy. Journal of Speech, Language, and Hearing Research, 61(3), 462–478.
Bickham, R. S., Ranganathan, K., Wombacher, N. R., Shapiro, D. N., Carlozzi, N. E., Baker, M. K., Vercler, C. J., Warschausky, S. A., Buchman, S. R., & Waljee, J. F. (2017). Speech perceptions and health-related quality of life among children with cleft lip and palate. Journal of Craniofacial Surgery, 28(5), 1264–1268.
Binger, C., Ragsdale, J., & Bustos, A. (2016). Language sampling for preschoolers with severe speech impairments. American Journal of Speech-Language Pathology, 25(4), 493–507.
Connolly, J. H. (1986). Intelligibility: A linguistic view. International Journal of Language & Communication Disorders, 21(3), 371–376.
Darley, F. L., Aronson, A. E., & Brown, J. R. (1969). Differential diagnostic patterns of dysarthria. Journal of Speech and Hearing Research, 12(2), 246–269.
Dickinson, H. O., Parkinson, K. N., Ravens-Sieberer, U., Schirripa, G., Thyen, U., Arnaud, C., Beckung, E., Fauconnier, J., McManus, V., Michelsen, S. I., Parkes, J., & Colver, A. F. (2007). Self-reported quality of life of 8–12 year old children with cerebral palsy: A cross-sectional European study. The Lancet, 369(9580), 2171–2178.
Ertmer, D. J. (2010). Relationships between speech intelligibility and word articulation scores in children with hearing loss. Journal of Speech, Language, and Hearing Research, 53(5), 1075–1086.
Ertmer, D. J., & Goffman, L. A. (2011). Speech production accuracy and variability in young cochlear implant recipients: Comparisons with typically developing age-peers. Journal of Speech, Language, and Hearing Research, 54(1), 177–189.
Fox, C. M., & Boliek, C. A. (2012). Intensive voice treatment (LSVT LOUD) for children with spastic cerebral palsy and dysarthria. Journal of Speech, Language, and Hearing Research, 55(3), 930–945.
Fudala, J. B. (2001). Arizona Articulation Proficiency Scale–Third Edition. Western Psychological Services.
Gamer, M., Lemon, J., Fellows, I., & Singh, P. (2019). irr: Various coefficients of interrater reliability and agreement. https://CRAN.R-project.org/package=irr
Goldman, R., & Fristoe, M. (2015). Goldman-Fristoe Test of Articulation–Third Edition. PsychCorp.
Heilmann, J., Nockerts, A., & Miller, J. F. (2010). Language sampling: Does the length of the transcript matter? Language, Speech, and Hearing Services in Schools, 41(4), 393–404.
Hodge, M., & Daniels, J. (2007). TOCS+ intelligibility measures. University of Alberta.
Hodge, M., & Gotzke, C. L. (2014). Criterion-related validity of the Test of Children's Speech sentence intelligibility measure for children with cerebral palsy and dysarthria. International Journal of Speech-Language Pathology, 16(4), 417–426.
Hustad, K. C., Allison, K., McFadd, E., & Riehle, K. (2014). Speech and language development in 2-year-old children with cerebral palsy. Developmental Neurorehabilitation, 17(3), 167–175.
Hustad, K. C., Gorton, K., & Lee, J. (2010). Classification of speech and language profiles in 4-year-old children with cerebral palsy: A prospective preliminary study. Journal of Speech, Language, and Hearing Research, 53(6), 1496–1513.
Hustad, K. C., Oakes, A., & Allison, K. (2015). Variability and diagnostic accuracy of speech intelligibility scores in children. Journal of Speech, Language, and Hearing Research, 58(6), 1695–1707.
Hustad, K. C., Sakash, A., Broman, A. T., & Rathouz, P. J. (2019). Differentiating typical from atypical speech production in 5-year-old children with cerebral palsy: A comparative analysis. American Journal of Speech Language Pathology, 28(2S), 807–817.
Hustad, K. C., Sakash, A., Natzke, P. E. M., Broman, A. T., & Rathouz, P. J. (2019). Longitudinal growth in single word intelligibility among children with cerebral palsy from 24 to 96 months of age: Predicting later outcomes from early speech production. Journal of Speech, Language, and Hearing Research, 62(6), 1599–1613.
Hustad, K. C., Schueler, B., Schultz, L., & DuHadway, C. (2012). Intelligibility of 4-year-old children with and without cerebral palsy. Journal of Speech, Language, and Hearing Research, 55(4), 1177–1189.
Kent, R. D. (1993). Speech intelligibility and communicative competence in children. In A. P. Kaiser & D. B. Gray (Eds.), Enhancing children's communication: Foundations for intervention (Vol. 2, pp. 223–239). Brookes.
Kent, R. D., Miolo, G., & Bloedel, S. (1994). The intelligibility of children's speech: A review of evaluation procedures. American Journal of Speech-Language Pathology, 3(2), 81–95.
Kent, R. D., Weismer, G., Kent, J. F., & Rosenbek, J. C. (1989). Toward phonetic intelligibility testing in dysarthria. Journal of Speech and Hearing Disorders, 54(4), 482–499.
Lagerberg, T. B., Åsberg, J., Hartelius, L., & Persson, C. (2014). Assessment of intelligibility using children's spontaneous speech: Methodological aspects. International Journal of Language & Communication Disorders, 49(2), 228–239.
Landa, S., Pennington, L., Miller, N., Robson, S., Thompson, V., & Steen, N. (2014). Association between objective measurement of the speech intelligibility of young people with dysarthria and listener ratings of ease of understanding. International Journal of Speech-Language Pathology, 16(4), 408–416.
Lee, J., Hustad, K. C., & Weismer, G. (2014). Predicting speech intelligibility with a multiple speech subsystems approach in children with cerebral palsy. Journal of Speech, Language, and Hearing Research, 57(5), 1666–1678.
Loban, W. (1976). Language development: Kindergarten through grade twelve. NCTE Committee on Research Report No. 18.
Malmenholt, A., McAllister, A., & Lohmander, A. (2019). Orofacial function, articulation proficiency, and intelligibility in 5-year-old children born with cleft lip and palate. The Cleft Palate–Craniofacial Journal, 56(3), 321–330.
McLeod, S., Crowe, K., & Shahaeian, A. (2015). Intelligibility in Context Scale: Normative and validation data for English-speaking preschoolers. Language, Speech, and Hearing Services in Schools, 46(3), 266–276.
McLeod, S., Harrison, L. J., & McCormack, J. (2012). The Intelligibility in Context Scale: Validity and reliability of a subjective rating measure. Journal of Speech, Language, and Hearing Research, 55(2), 648–656.
Miller, J. F., Andriacchi, K., & Nockerts, A. (2011). Assessing language production using SALT software: A clinician's guide to language sample analysis. SALT Software.
Namasivayam, A. K., Pukonen, M., Goshulak, D., Yu, V. Y., Kadis, D. S., Kroll, R., Pang, E. W., & De Nil, L. F. (2013). Relationship between speech motor control and speech intelligibility in children with speech sound disorders. Journal of Communication Disorders, 46(3), 264–280.
Nordberg, A., Miniscalco, C., Lohmander, A., & Himmelmann, K. (2013). Speech problems affect more than one in two children with cerebral palsy: Swedish population-based study. Acta Paediatrica, 102(2), 161–166.
Palisano, R. J., Rosenbaum, P., Bartlett, D., & Livingston, M. H. (2008). Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine & Child Neurology, 50(10), 744–750.
Pennington, L., Virella, D., Mjøen, T., da Graça Andradad, M., Murray, J., Colver, A., Himmelmann, K., Rackauskaite, G., Greitane, A., Prasauskiene, A., Andersen, G., & de la Cruz, J. (2013). Development of the Viking Speech Scale to classify the speech of children with cerebral palsy. Research in Developmental Disabilities, 34(10), 3202–3210.
Rice, M. L., Smolik, F., Perpich, D., Thompson, T., Rytting, N., & Blossom, M. (2010). Mean length of utterance levels in 6-month intervals for children 3 to 9 years with and without language impairments. Journal of Speech, Language, and Hearing Research, 53(2), 333–349.
Weismer, G., & Martin, R. E. (1992). Acoustic and perceptual approaches to the study of intelligibility. In R. D. Kent (Ed.), Intelligibility in speech disorders: Theory, measurement and management (pp. 67–118). John Benjamins.
Whitehill, T. L. (2002). Assessing intelligibility in speakers with cleft palate: A critical review of the literature. The Cleft Palate–Craniofacial Journal, 39(1), 50–58.
Williams, A. L., McLeod, S., & McCauley, R. J. (2010). Interventions for speech sound disorders in children. Brookes.
Yoder, P. J., Woynaroski, T., & Camarata, S. (2016). Measuring speech comprehensibility in students with Down syndrome. Journal of Speech, Language, and Hearing Research, 59(3), 460–467.
Yorkston, K. M., & Beukelman, D. R. (1980). A clinician-judged technique for quantifying dysarthric speech based on single-word intelligibility. Journal of Communication Disorders, 13(1), 15–31.
Yorkston, K. M., Beukelman, D. R., Strand, E. A., & Bell, K. (1999). Management of motor speech disorders in children and adults (2nd ed.). Pro-Ed.
Yorkston, K. M., Strand, E. A., & Kennedy, M. R. T. (1996). Comprehensibility of dysarthric speech: Implications for assessment and treatment planning. American Journal of Speech-Language Pathology, 5(1), 55–66.
Information & Authors
Information
Published In
Language, Speech, and Hearing Services in Schools
Volume 51 • Number 3 • July 2020
Pages: 882-896
PubMed: 32574125
Copyright
Copyright © 2020 American Speech-Language-Hearing Association.
History
- Received: Nov 4, 2019
- Revised: Jan 28, 2020
- Accepted: Apr 6, 2020
- Published online: Jun 23, 2020
- Published in issue: Jul 15, 2020
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