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Case J, Hallin AE. The Relationship Between Speech Accuracy and Linguistic Measures in Narrative Retells of Children With Speech Sound Disorders. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3340-3358. [PMID: 37263015 DOI: 10.1044/2023_jslhr-22-00615] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Speech and language are interconnected systems, and language disorder often co-occurs with childhood apraxia of speech (CAS) and non-CAS speech sound disorders (SSDs). Potential trade-off effects between speech and language in connected speech in children without overt language disorder have been less explored. METHOD Story retell narratives from 24 children (aged 5;0-6;11 [years;months]) with CAS, non-CAS SSD, and typical development were analyzed in Systematic Analysis of Language Transcripts (SALT) regarding morphosyntactic complexity (mean length of C-unit in words [MLCU]), lexical diversity (moving-average type-token ratio [MATTR]), and linguistic accuracy (any linguistic error/bound morpheme omissions) and compared to 128 age-matched children from the SALT database. Linear and mixed-effects logistic regressions were performed with speech accuracy (percent phonemes correct [PPC]) and diagnostic group as predictors of the narrative variables. RESULTS PPC predicted all narrative variables. Poorer PPC was associated with lower MLCU and MATTR as well as a higher likelihood of linguistic errors. Group differences were only observed for the error variables. Comparison to the SALT database indicated that 13 of 16 children with CAS and SSD showed a higher-than-expected proportion of linguistic errors, with a small proportion explained by individual speech errors only. CONCLUSIONS The high occurrence of linguistic errors, combined with the relationship between PPC and linguistic errors in children with CAS/SSD, suggests a trade-off between speech accuracy and language output. Longitudinal studies are needed to investigate whether children with SSDs without language disorder show more language difficulties over time as linguistic demands increase.
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Affiliation(s)
- Julie Case
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY
| | - Anna Eva Hallin
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
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Hitchcock ER, Swartz MT, Cabbage KL. Preliminary Speech Perception Performance Profiles of School-Age Children With Childhood Apraxia of Speech, Speech Sound Disorder, and Typical Development. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3480-3494. [PMID: 37971542 DOI: 10.1044/2023_jslhr-22-00634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
PURPOSE Limited research exists assessing speech perception in school-age children with speech sound disorder (SSD) and childhood apraxia of speech (CAS); despite early evidence that speech perception may lead to error-prone motor planning/programming. In this study, we examine speech perception performance in school-age children with and without speech production deficits. METHOD Speech perception was assessed using the Wide Range Acoustic Accuracy Scale to determine the just-noticeable difference in discrimination for three consonant-vowel syllable contrasts (/bɑ/-/wɑ/, /dɑ/-/gɑ/, /ɹɑ/-/wɑ/), each varying along a single acoustic parameter for seven children with CAS with rhotic errors, seven children with SSD with rhotic errors, and seven typically developing (TD) children. RESULTS Findings revealed statistically significant mean differences between perceptual performance of children with CAS when compared to TD children for discrimination of /ɹɑ/-/wɑ/ contrasts. Large effect sizes were also observed for comparisons of /ɹɑ/-/wɑ/ contrasts between children with CAS, SSD, and TD peers. Additionally, large effect sizes were observed for /dɑ/-/gɑ/ contrasts between children with CAS and SSD and TD children despite nonsignificant mean differences in group performance. CONCLUSIONS Overall, mean outcome scores suggest that school-age children with CAS and persistent rhotic errors demonstrated less accurate speech perception skills relative to TD children for the /ɹɑ/-/wɑ/ contrasts. However, the relatively small sample sizes per group limit the extent to which these findings may be generalized to the broader population.
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Preston JL, Caballero NF, Leece MC, Wang D, Herbst BM, Benway NR. A Randomized Controlled Trial of Treatment Distribution and Biofeedback Effects on Speech Production in School-Age Children With Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3414-3436. [PMID: 37611182 DOI: 10.1044/2023_jslhr-22-00622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE This study examines how ultrasound biofeedback and intensive treatment distribution affect speech sound generalization during an evidence-based treatment, Speech Motor Chaining, for children with persisting speech errors associated with childhood apraxia of speech (CAS). METHOD In a 2 × 2 factorial randomized controlled trial, children ages 9-17 years meeting CAS criteria were randomized to receive (a) a distributed treatment (20 sessions twice weekly over 10 weeks) or intensive treatment (20 hr in 5 weeks, with 10 hr in Week 1) and (b) treatment with or without biofeedback. Due to the COVID pandemic, some participants were randomized to distributed/intensive telepractice treatment only. The primary outcome was percent target sounds correct on untreated phrases (i.e., generalization) at the 10-week time point. More than 50,000 narrow phonetic transcriptions were analyzed. RESULTS Forty-eight participants completed treatment. Intensive treatment significantly increased generalization at all time points. The effect of biofeedback was significant at 5 weeks from the start of treatment but not significant at the primary 10-week time point. However, when comparing each group immediately after their 20 hr of treatment finished, generalization was significantly greater in intensive over distributed treatment and greater in ultrasound over no-ultrasound treatment (with a significant interaction favoring intensive treatment with ultrasound). Only the advantage of intensive treatment remained significant 5 weeks after groups finished treatment. There was no significant difference between face-to-face and telepractice modalities. CONCLUSIONS When the number of treatment hours is fixed, an intensive schedule of Speech Motor Chaining facilitated greater improvement than a distributed schedule. Ultrasound biofeedback initially accelerated learning, but the benefits may dissipate as treatment continues or after it ends.
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van der Straten Waillet P, Crowe K, Charlier B, Colin C. Speech production skills of bilingual children using cochlear implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024:enae038. [PMID: 39301796 DOI: 10.1093/jdsade/enae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 07/16/2024] [Accepted: 09/09/2024] [Indexed: 09/22/2024]
Abstract
Evidence is lacking on the impact of bilingualism on the speech skills of children with cochlear implants (CIs). This study described the speech production of children with CIs acquiring French and one or more additional spoken languages. Four groups of children aged 4-11 were included: bilinguals (n = 15) and monolinguals (n = 14) with CIs and bilinguals (n = 14) and monolinguals (n = 20) with typical hearing. Data were collected about the percentage of consonant correct (PCC) and vowel correct (PVC) produced in French and intelligibility in all languages they spoke. Bilingual and monolingual children with CIs had comparable speech accuracy in French, but the pattern differed, impacting PCC for bilinguals and PVC for monolinguals. Most children with CIs had accurate and intelligible speech in French, but few bilingual children with CIs were highly intelligible in their home language. Therefore, bilingualism did not impede the speech production outcomes of bilingual children with CIs in the language of the wider community.
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Affiliation(s)
- Pauline van der Straten Waillet
- Center for Research in Cognition and Neurosciences, Université Libre de Bruxelles, Bruxelles, Belgium
- Centre Comprendre et Parler, Bruxelles, Belgium
| | - Kathryn Crowe
- School of Health Sciences, University of Iceland, Reykjavík, Iceland
- School of Education, Charles Sturt University, Bathurst, NSW, Australia
| | - Brigitte Charlier
- Center for Research in Cognition and Neurosciences, Université Libre de Bruxelles, Bruxelles, Belgium
- Centre Comprendre et Parler, Bruxelles, Belgium
| | - Cécile Colin
- Center for Research in Cognition and Neurosciences, Université Libre de Bruxelles, Bruxelles, Belgium
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Turner Swartz M, Hitchcock ER, Leece MC, Herbst BM, Preston JL. Caregiver and child perspectives of wellbeing in school-age children with childhood apraxia of speech. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-14. [PMID: 39148437 DOI: 10.1080/17549507.2024.2364808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
PURPOSE Childhood apraxia of speech (CAS) is a communication deficit that impacts a child's overall quality of life, including their academic and social interactions, yet few studies have investigated the impact from the child's perspective. Using The World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework, we examined the children's and caregivers' perspectives on the impact of CAS on their overall wellbeing. METHOD Survey data were collected from 32 child-caregiver dyads for children ages 9-17 years with CAS. Items elicited responses along a 5-point scale to examine the perceived impact of children's speech impairments using the framework, including impact on communication, interpersonal interactions/relationships, and major life events. RESULT Results from non-parametric statistical analyses revealed: (a) caregivers reported a significantly greater impact than children across individual ICF domains; (b) child responses were not significantly correlated with their caregiver's responses or with the child's age, gender, or severity indicators; and (c) both caregivers and children indicated the domain of communication was impacted more than other domains. CONCLUSION Results suggest a potential disconnect in the perceived impact of CAS between the caregiver and child. Recommendations include facilitating a dialogue between the child-caregiver dyad and considering treatment goals that address wellbeing.
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Affiliation(s)
- Michelle Turner Swartz
- Department of Speech-Language Pathology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Elaine R Hitchcock
- Department of Communication Sciences and Disorders, Montclair State University, Montclair, NJ, USA
| | - Megan C Leece
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, NY, USA
| | - Benedette M Herbst
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, NY, USA
| | - Jonathan L Preston
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, NY, USA
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Alighieri C, Hodges A, Verbeke J, Kestens K, Bettens K, Albite R, May Tan R, Van Lierde KM. Effects of Suspension Pharyngeal Flap on Speech in Filipino Individuals with Velopharyngeal Insufficiency. Folia Phoniatr Logop 2024:1-13. [PMID: 39106843 DOI: 10.1159/000540308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/04/2024] [Indexed: 08/09/2024] Open
Abstract
INTRODUCTION This study investigated the effects of suspension pharyngeal flap surgery for velopharyngeal insufficiency (VPI) due to cleft palate. METHODS Ten Filipino individuals (mean age = 20.63 years, range = 8.4-34.9 years) with a cleft palate who underwent suspension pharyngeal flap surgery for VPI were included in this study. Perceptual and instrumental speech assessments were conducted at two different time points: before surgery (data point 1) and after surgery (data point 2, range = 4-26 weeks postoperatively). Speech intelligibility in different contexts and satisfaction with speech were assessed by the participants themselves using a self-report questionnaire. Additionally, the risk for obstructive sleep apnea was assessed using the Berlin Questionnaire. RESULTS Velopharyngeal gap size significantly decreased after the surgery. Additionally, significant improvements in speech understandability and acceptability were observed following the suspension pharyngeal flap procedure. Besides, a significant reduction in hypernasality, nasal emission, and the occurrence of passive articulation errors was seen. No difference in the occurrence of active articulation errors was observed when comparing data pre- and post-surgery. The ten individuals reported to be significantly more intelligible in different contexts after surgery. CONCLUSION Improved speech was observed in individuals who received the suspension pharyngeal flap procedure. This procedure also positively influences an individual's intelligibility in different contexts in daily life. In individuals with persisting active articulation errors, post-surgery speech therapy will still be necessary.
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Affiliation(s)
- Cassandra Alighieri
- Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Ghent, Belgium
| | | | - Jolien Verbeke
- Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Ghent, Belgium
| | - Katrien Kestens
- Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Ghent, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Ghent, Belgium
| | - Rica Albite
- Tebow Cure Hospital, Agdao, Davao City, Philippines
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Collett BR, Gallagher ER, Johns AL, Trevino CO, Leroux BG, Shic F, Crerand CE, Baylis AL, Cummings CA, Santillan L. Book-Sharing for Toddlers with Clefts (BOOST): Protocol for a randomized controlled trial of a remote intervention to promote language development in children with cleft palate. PLoS One 2024; 19:e0304630. [PMID: 38870107 PMCID: PMC11175488 DOI: 10.1371/journal.pone.0304630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Children with cleft palate, with or without cleft lip (CP±L), exhibit language delays on average compared to children without clefts. Interventions to address these disparities are scarce. In this multi-center study, Book Sharing for Toddlers with Clefts (BOOST), we will test a remote, parent-focused intervention to promote language development in children with CP±L. OBJECTIVES The study will test two primary hypotheses. First, toddlers randomized to BOOST will exhibit better language outcomes than children receiving standard-of-care (SOC). Second, we hypothesize that the BOOST program's effect on language outcomes is mediated by the frequency and quality of parent-child reading interactions. METHODS The study is a randomized-controlled trial comparing the BOOST group to a SOC comparison group. We will enroll N = 320 English and/or Spanish-speaking children ages 24-32 months with isolated CP±L (n = 160 per group). Both groups will receive children's books, and parents will record and upload videos of themselves reading the books with their children using a smartphone app developed for the study. Parents will also complete surveys asking whether they read to their children on five randomly selected days each week. In addition, the BOOST group will participate in 3 remote dialogic book-sharing intervention sessions via Zoom. We will code book-sharing videos to assess parents' target skill usage and children's expressive language. End-of-study assessments will include measures of child language outcomes (e.g., clinician-administered measures, parent reports, and naturalistic child language samples). RESULTS Enrollment began in April 2024 and will continue through approximately April 2028. CONCLUSION The BOOST study will address a critical gap in the literature on interventions to improve language in children with CP±L. The results will inform the care for toddlers with oral clefts and have potential applications for other populations.
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Affiliation(s)
- Brent R. Collett
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington, United States of America
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Emily R. Gallagher
- Seattle Children’s Craniofacial Center, Seattle Children’s Hospital, Seattle, Washington, United States of America
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Alexis L. Johns
- Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, California, United States of America
| | - Cindy O. Trevino
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington, United States of America
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Brian G. Leroux
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
- Department of Oral Health Sciences, University of Washington, Seattle, Washington, United States of America
| | - Frederick Shic
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington, United States of America
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Canice E. Crerand
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- Center for Biobehavioral Health, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Adriane L. Baylis
- Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- Department of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Caitlin A. Cummings
- Department of Speech Pathology, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Lupita Santillan
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington, United States of America
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, United States of America
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Strömbergsson S, Fröjdh M, Pettersson M, Grósz T, Getman Y, Kurimo M. Listening like a speech-training app: Expert and non-expert listeners' goodness ratings of children's speech. CLINICAL LINGUISTICS & PHONETICS 2024:1-22. [PMID: 38853471 DOI: 10.1080/02699206.2024.2355470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 05/10/2024] [Indexed: 06/11/2024]
Abstract
Speech training apps are being developed that provide automatic feedback concerning children's production of known target words, as a score on a 1-5 scale. However, this 'goodness' scale is still poorly understood. We investigated listeners' ratings of 'how many stars the app should provide as feedback' on children's utterances, and whether listener agreement is affected by clinical experience and/or access to anchor stimuli. In addition, we explored the association between goodness ratings and clinical measures of speech accuracy; the Percentage of Consonants Correct (PCC) and the Percentage of Phonemes Correct (PPC). Twenty speech-language pathologists and 20 non-expert listeners participated; half of the listeners in each group had access to anchor stimuli. The listeners rated 120 words, collected from children with and without speech sound disorder. Concerning reliability, intra-rater agreement was generally high, whereas inter-rater agreement was moderate. Access to anchor stimuli was associated with higher agreement, but only for non-expert listeners. Concerning the association between goodness ratings and the PCC/PPC, correlations were moderate for both listener groups, under both conditions. The results indicate that the task of rating goodness is difficult, regardless of clinical experience, and that access to anchor stimuli is insufficient for achieving reliable ratings. This raises concerns regarding the 1-5 rating scale as the means of feedback in speech training apps. More specific listener instructions, particularly regarding the intended context for the app, are suggested in collection of human ratings underlying the development of speech training apps. Until then, alternative means of feedback should be preferred.
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Affiliation(s)
- Sofia Strömbergsson
- Division of Speech and Language Pathology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Molly Fröjdh
- Division of Speech and Language Pathology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Magdalena Pettersson
- Division of Speech and Language Pathology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Tamás Grósz
- Department of lnformation and Communications Engineering, Aalto University, Espoo, Finland
| | - Yaroslav Getman
- Department of lnformation and Communications Engineering, Aalto University, Espoo, Finland
| | - Mikko Kurimo
- Department of lnformation and Communications Engineering, Aalto University, Espoo, Finland
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Andersen HS, Jørgensen LD, Wilstrup C, Willadsen E. Multiple oppositions intervention: effective phonological treatment of two children with cleft lip and palate and severe speech sound disorder. CLINICAL LINGUISTICS & PHONETICS 2024:1-22. [PMID: 38770980 DOI: 10.1080/02699206.2024.2339308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/01/2024] [Indexed: 05/22/2024]
Abstract
The purpose of this study was to investigate if multiple oppositions intervention (MOI) generated widespread change in the phonological systems of two children with cleft lip and palate (CLP) and severe speech sound disorders (SSD). We treated two children (ages 5;4 and 5;6) with CLP and severe SSD using MOI for 24 and 29 sessions. We measured the percentage consonants correct (PCC) for target consonants and untreated consonants in non-treatment single words, as well as PCC for connected speech. Data points were collected in the baseline, intervention, and maintenance phase with post-tests conducted immediately after intervention and at 1, 3, 6 and 12 months. Two speech and language therapists (SLTs) unfamiliar with the children performed phonetic transcriptions, and we calculated intra- and inter-rater agreement. We graphed the data, and used permutation tests to analyse the probability that the observed increases in PCC were due to random chance. Both children experienced considerable improvements in PCC across all measures at the first post-test, supporting the impact of MOI on their entire phonological system. The PCC continued to increase during the maintenance phase. By the final post-test, the PCC in connected speech exceeded 90% for both children, reducing their SSD classification to mild. Our findings support that a phonological, contrastive intervention approach targeting multiple consonants simultaneously can create system-wide phonological change for children with CLP and severe SSD. Further research with more participants is needed to strengthen these findings.
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Affiliation(s)
- Helene Søgaard Andersen
- Copenhagen Cleft Palate Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- PPR, Rudersdal Municipality, Rudersdal, Denmark
| | - Line Dahl Jørgensen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark
- PPR, Roskilde Municipality, Roskilde, Denmark
| | | | - Elisabeth Willadsen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark
- PPR, Hillerød Municipality, Hillerød, Denmark
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Uberti LB, Keske-Soares M, Pagliarin KC. Development of the Digital Speech Assessment Instrument. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1317-1336. [PMID: 38359165 DOI: 10.1044/2024_ajslp-23-00155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE This study aimed to develop a Digital Speech Assessment Instrument to evaluate the phonological and motor speech skills of Brazilian Portuguese-speaking children and adolescents through six tasks: (a) word naming, (b) word imitation, (c) pseudoword imitation, (d) word repetition, (e) pseudoword repetition, and (f) diadochokinesis. METHOD The assessment instrument was developed and validated in a seven-step process, beginning with stimulus selection and ending with Pilot Study 1 (involving children and adolescents with typical speech development) and Pilot Study 2 (involving children and adolescents with speech sound disorders [SSDs]). Participants of the study included expert and nonexpert judges, children, and adolescents. RESULTS The Digital Speech Assessment Instrument contains 91 real words (61 in the naming task, 51 in the imitation task, and five in the repetition task), 26 pseudowords (26 in the imitation task and four in the repetition task), and six stimuli for diadochokinesis. The test contains stimuli in the form of images as well as audio and video recordings and allows for the analysis and storage of participant data in a virtual database. CONCLUSIONS This study described the development of the Digital Speech Assessment Instrument, available in Brazilian Portuguese for the evaluation of several aspects of speech production (including word and pseudoword naming, imitation, and repetition and diadochokinesis). The test was developed for children aged 2;0 (years;months) to 17;11 and is administered fully online. In the future, the instrument can be used to provide a timely and accurate diagnosis of SSDs.
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Affiliation(s)
- Letícia Bitencourt Uberti
- Postgraduate Program in Human Communication Disorders, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
| | - Marcia Keske-Soares
- Department of Speech, Language and Hearing, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
| | - Karina Carlesso Pagliarin
- Department of Speech, Language and Hearing, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
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Kim Y, Kim M, Kim J, Song TJ. Smartphone-Based Speech Therapy for Poststroke Dysarthria: Pilot Randomized Controlled Trial Evaluating Efficacy and Feasibility. J Med Internet Res 2024; 26:e56417. [PMID: 38509662 PMCID: PMC11082729 DOI: 10.2196/56417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/21/2024] [Accepted: 03/20/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Dysarthria is a common poststroke speech disorder affecting communication and psychological well-being. Traditional speech therapy is effective but often poses challenges in terms of accessibility and patient adherence. Emerging smartphone-based therapies may offer promising alternatives for the treatment of poststroke dysarthria. OBJECTIVE This study aimed to assess the efficacy and feasibility of smartphone-based speech therapy for improving speech intelligibility in patients with acute and early subacute poststroke dysarthria. This study also explored the impact of the intervention on psychological well-being, user experience, and overall feasibility in a clinical setting. METHODS Participants were divided into 2 groups for this randomized, evaluator-blinded trial. The intervention group used a smartphone-based speech therapy app for 1 hour per day, 5 days per week, for 4 weeks, with guideline-based standard stroke care. The control group received standard guideline-based stroke care and rehabilitation. Speech intelligibility, psychological well-being, quality of life, and user acceptance were assessed using repeated measures ANOVA. RESULTS In this study, 40 patients with poststroke dysarthria were enrolled, 32 of whom completed the trial (16 in each group). The intervention group showed significant improvements in speech intelligibility compared with the control group. This was evidenced by improvements from baseline (F1,30=34.35; P<.001), between-group differences (F1,30=6.18; P=.02), and notable time-by-group interactions (F1,30=6.91; P=.01). Regarding secondary outcomes, the intervention led to improvements in the percentage of correct consonants over time (F1,30=5.57; P=.03). In addition, significant reductions were noted in the severity of dysarthria in the intervention group over time (F1,30=21.18; P<.001), with a pronounced group effect (F1,30=5.52; P=.03) and time-by-group interaction (F1,30=5.29; P=.03). Regarding quality of life, significant improvements were observed as measured by the EQ-5D-3L questionnaire (F1,30=13.25; P<.001) and EQ-VAS (F1,30=7.74; P=.009) over time. The adherence rate to the smartphone-based app was 64%, with over half of the participants completing all the sessions. The usability of the app was rated high (system usability score 80.78). In addition, the intervention group reported increased self-efficacy in using the app compared with the control group (F1,30=10.81; P=.003). CONCLUSIONS The smartphone-based speech therapy app significantly improved speech intelligibility, articulation, and quality of life in patients with poststroke dysarthria. These findings indicate that smartphone-based speech therapy can be a useful assistant device in the management of poststroke dysarthria, particularly in the acute and early subacute stroke stages. TRIAL REGISTRATION ClinicalTrials.gov NCT05146765; https://clinicaltrials.gov/ct2/show/NCT05146765.
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Affiliation(s)
- Yuyoung Kim
- Human Computer Interaction Lab, Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
| | - Minjung Kim
- Human Computer Interaction Lab, Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
- HAII Corporation, Seoul, Republic of Korea
| | - Jinwoo Kim
- Human Computer Interaction Lab, Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
- HAII Corporation, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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Barrozo TF, Silva LAF, Matas CG, Wertzner HF. The Relationship between Speech Sound Disorder and Cortical Auditory Evoked Potential. Folia Phoniatr Logop 2024:1-15. [PMID: 38615664 DOI: 10.1159/000538849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/09/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION Speech sound disorder (SSD) is a speech and language disorder associated with difficulties in motor production, perception, and phonological representation of sounds and speech segments. Since auditory perception has a fundamental role in forming and organizing sound representation for its recognition, studies that evaluate the cortical processing of sounds are required. Thus, the present study aimed to verify the relation between SSD severity measured by the percentage of correct consonants (PCCs) with the cortical auditory evoked potentials (CAEPs) using speech stimulus. METHODS Twenty-nine children with normal hearing participated in this research and were grouped into three groups by SSD level measured by the PCC index. In addition, the groups were subdivided according to the children's age group: between 60-71 months, 72-83 months, and 83-94 months. The CAEP with speech stimulus was carried out in all children. RESULTS Older children had longer P1 and N1 latencies. In P2 latency, there was an interference of age only in the severe group. The N2 latency was affected by age, where older children had longer latency. CONCLUSION The amplitude of CAEP has not suffered any interference with the age, or severity of SSD. For the latency, older children generally presented longer averages than younger ones.
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Affiliation(s)
- Tatiane Faria Barrozo
- Department of Physiotherapy, Audiology and Speech Therapy, and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | | | - Carla Gentile Matas
- Department of Physiotherapy, Audiology and Speech Therapy, and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | - Haydée Fiszbein Wertzner
- Department of Physiotherapy, Audiology and Speech Therapy, and Occupational Therapy, University of São Paulo, São Paulo, Brazil
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Stefánsdóttir H, Crowe K, Magnússon E, Guiberson M, Másdóttir T, Ágústsdóttir I, Baldursdóttir ÖV. Measuring speech intelligibility with deaf and hard-of-hearing children: A systematic review. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:265-277. [PMID: 38079579 PMCID: PMC10950422 DOI: 10.1093/deafed/enad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/21/2023] [Accepted: 10/30/2023] [Indexed: 03/21/2024]
Abstract
There is great variability in the ways in which the speech intelligibility of d/Deaf and hard-of-hearing (DHH) children who use spoken language as part, or all, of their communication system is measured. This systematic review examined the measures and methods that have been used when examining the speech intelligibility of children who are DHH and the characteristics of these measures and methods. A systematic database search was conducted of CENTRAL; CINAHL; Cochrane; ERIC; Joanna Briggs; Linguistics, Language and Behavior Abstracts; Medline; Scopus; and Web of Science databases, as well as supplemental searches. A total of 204 included studies reported the use of many different measures/methods which measured segmental aspects of speech, with the most common being Allen et al.'s (2001, The reliability of a rating scale for measuring speech intelligibility following pediatric cochlear implantation. Otology and Neurotology, 22(5), 631-633. https://doi.org/10.1097/00129492-200109000-00012) Speech Intelligibility Rating scale. Many studies included insufficient details to determine the measure that was used. Future research should utilize methods/measures with known psychometric validity, provide clear descriptions of the methods/measures used, and consider using more than one measure to account for limitations inherent in different methods of measuring the speech intelligibility of children who are DHH, and consider and discuss the rationale for the measure/method chosen.
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Affiliation(s)
- Harpa Stefánsdóttir
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Kathryn Crowe
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- School of Education, Charles Sturt University, Bathurst, NSW, Australia
| | - Egill Magnússon
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Mark Guiberson
- Division of Communication Disorders, College of Health Sciences, University of Wyoming, United States
| | - Thora Másdóttir
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Inga Ágústsdóttir
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Ösp V Baldursdóttir
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
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Del Risco AC, Dunworth K, Sharif-Askary B, Suárez AH“B, Nyswonger J, Ford M, Kern J, Jones C, Raynor E, Allori AC. Exploration of the Utility of the Generic ICHOM Standard Set Measures in Evaluating the Speech of Patients with Cleft Lip/Palate. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5519. [PMID: 38250212 PMCID: PMC10798731 DOI: 10.1097/gox.0000000000005519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/08/2023] [Indexed: 01/23/2024]
Abstract
Background The International Consortium of Health Outcome Measurements (ICHOM) standard set for cleft care appraisal recommends clinicians assess articulation with percentage consonants correct (PCC) and velopharyngeal function with velopharyngeal competency rating (VPC-R). This study explores the utility and limitations of these generic measures in detecting cleft speech sound disorders by comparing them with two cleft-specific speech-rating systems, cleft audit protocol of speech-augmented Americleft modification (CAPS-A-AM) and Pittsburgh weighted speech scale (PWSS). Methods Consecutive children with repaired, nonsyndromic cleft lip/palate, aged 5 years or older (n = 27) underwent prospective speech evaluations conducted at a single academic institution. These evaluations were conducted, recorded, and evaluated by blinded speech-language pathologists experienced with all tools. Results When comparing measures of articulation, PCC scores correlated better with scores for relevant subcomponents of CAPS-A-AM than PWSS. When comparing measures of velopharyngeal function, VPC-R scores correlated well with relevant components of both scales. Using a "screening test versus diagnostic test" analogy, VPC-R ratings were 87.5% sensitive and 73.7% specific for detecting velopharyngeal dysfunction according to subcomponents of CAPS-A-AM, and 70.6% sensitive and 100% specific according to subcomponents of PWSS. Conclusions This exploratory study demonstrates that PCC and VPC-R perform moderately well in detecting articulatory and velopharyngeal dysfunction in patients with cleft lip/palate; however, these tools cannot describe nuances of cleft speech sound disorder. Thus, although PCC and VPC-R adequately track basic minimum outcomes, we encourage teams to consider extending the standard set by adopting a cleft-specific measurement system for further evaluation of the tools.
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Affiliation(s)
- Amanda C. Del Risco
- From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C
| | - Kristina Dunworth
- From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C
| | - Banafsheh Sharif-Askary
- From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C
| | - Arthur H. “Barron” Suárez
- Department of Otolaryngology, Head and Neck Surgery, & Communication Sciences, Duke University Health System, Durham, N.C
| | - Jillian Nyswonger
- Department of Otolaryngology, Head and Neck Surgery, & Communication Sciences, Duke University Health System, Durham, N.C
| | - Matthew Ford
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, N.C
| | - Jennifer Kern
- Department of Otolaryngology, Head and Neck Surgery, & Communication Sciences, Duke University Health System, Durham, N.C
| | - Carlee Jones
- Duke Cleft & Craniofacial Center, Duke Children’s Hospital, Durham, N.C
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, N.C
| | - Eileen Raynor
- From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C
- Department of Otolaryngology, Head and Neck Surgery, & Communication Sciences, Duke University Health System, Durham, N.C
- Duke Cleft & Craniofacial Center, Duke Children’s Hospital, Durham, N.C
| | - Alexander C. Allori
- From the Department of Otolaryngology, Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, N.C
- Duke Cleft & Craniofacial Center, Duke Children’s Hospital, Durham, N.C
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, N.C
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Korkalainen MJ, McCabe P, Smidt A, Morgan C. Outcomes of a novel single case study incorporating Rapid Syllable Transition treatment, AAC and blended intervention in children with cerebral palsy: a pilot study. Disabil Rehabil Assist Technol 2024; 19:167-176. [PMID: 35576498 DOI: 10.1080/17483107.2022.2071488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Motor speech and augmentative and alternative communication (AAC) interventions are commonly used with children with cerebral palsy (CP) but there is limited literature comparing the effectiveness of these interventions. The purpose of this study was to investigate the effectiveness of intensive AAC, Rapid Syllable Transition Treatment (ReST), and blended intervention, a combination of motor-speech and AAC, on speech accuracy and sentence length and complexity. METHODS A single case experimental design across participants with repeated measurements across phases (ABACADA design) was used. Four participants aged 8-14 years with CP who used a speech-generating device (SGD) received three 6-week intervention blocks that included ReST, AAC, and blended intervention. Measures were taken during intervention and baseline phases and at maintenance two and four weeks after the last intervention phase. Participants were randomized to starting with either ReST or AAC with the blended intervention delivered last. RESULTS All participants improved their speech accuracy and sentence length and complexity in speech and with their SGD in all three interventions. The data demonstrated overall immediacy of the effect with all interventions and retention of gains across the whole sequence of phases. The order of AAC or ReST interventions or the severity of CP did not impact the intervention gains. CONCLUSION This study suggests that intensive AAC, a multi-modal approach, and ReST improve speech accuracy and sentence length and complexity in children with moderate CP, but all require further investigation.Implications for rehabilitationIn this paper intensive AAC intervention with a speech generating device (SGD), ReST treatment and multimodal blended intervention were effective in improving speech accuracy and sentence length and complexity in both verbal speech and on communication with the SGD.ReST treatment has not been used with children with CP before. This study established a proof of concept for its effectiveness in children with CP. Further research is warranted.
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Affiliation(s)
- Marjut Johanna Korkalainen
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Patricia McCabe
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Andy Smidt
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Child and Adolescent Health, The University of Sydney, Sydney, Australia
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Phạm B, McLeod S. Considerations of dialect on the identification of speech sound disorder in Vietnamese-speaking children. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023. [PMID: 38105629 DOI: 10.1111/1460-6984.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 11/23/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The dialect spoken by children influences diagnostic decision-making regarding the identification and severity of speech sound disorder (SSD). AIMS The primary objective was to review papers that examined the influence of dialect on the identification of SSD in Vietnamese-speaking children. METHODS & PROCEDURES Five studies of mono- and multilingual Vietnamese-speaking children living in Vietnam and Australia were reviewed to examine the influence of dialect on the assessment and analysis children's speech. The main Vietnamese dialects (Standard, Northern, Central, Southern) differ in the production of consonants, vowels and tones. MAIN CONTRIBUTION Most speech assessments define correct production using the standard dialect of a language. Insights from recent studies of Vietnamese provide recommendations for also considering dialect in diagnostic decision-making. First, we recommend adding column(s) to the assessment score sheet that includes the dialectal variants spoken by adults in the child's family or community. Second, we calculate the accuracy of production twice, based on the standard form and dialectal form. Third, we report the percentage of consonants correct-standard (PCC-S) and percentage of consonants correct-dialect (PCC-D). CONCLUSIONS & IMPLICATIONS Diagnostic decision-making is influenced by dialectal variation in children's speech, so speech and language therapists need to compare standard and dialectal productions when undertaking assessments, analysis and diagnostic decision-making. WHAT THIS PAPER ADDS What is already known on the subject Most speech assessments use the standard form of a dialect as the correct production. The standard dialect is used for diagnosis of SSD and identification of intervention targets. What this paper adds to the existing knowledge This paper examines five research studies of Vietnamese to identify ways to consider dialect in speech and language therapy assessment and analysis. Vietnamese provides a complex environment for this examination since there are numerous Vietnamese dialects and they differ according to consonants, vowels and tones. What are the potential or actual clinical implications of this work? Speech and language therapists are encouraged to add column(s) to their assessment score sheet that includes the dialectal variants spoken by adults and to report the PCC-S and PCC-D.
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Affiliation(s)
- Ben Phạm
- Faculty of Special Education, Hanoi National University of Education, Hanoi, Vietnam
- School of Education, Charles Sturt University, Bathurst, NSW, Australia
| | - Sharynne McLeod
- School of Education, Charles Sturt University, Bathurst, NSW, Australia
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Washington KN, Karem RW, Kokotek LE, León M. Supporting Culturally Responsive Assessment Practices With Preschoolers: Guidance From Methods in the Jamaican Context. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4716-4738. [PMID: 37549376 PMCID: PMC11361786 DOI: 10.1044/2023_jslhr-23-00106] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/26/2023] [Accepted: 05/15/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE There is a shortage of available methods to accurately inform the developmental status of children whose cultural and linguistic backgrounds vary from the mainstream. The purpose of this review article was to describe different approaches used to support the accurate characterization of speech, language, and functional communication in children speaking Jamaican Creole and English, an understudied paradigm in the speech pathology research. METHOD Approaches used across four previously published studies in the Jamaican Creole Language Project are described. Participants included 3- to 6-year-old Jamaican children (n = 98-262) and adults (n = 15-33). Studies I and II described validation efforts about children's functional communication using the Intelligibility in Context Scale (ICS; speech) and the Focus on the Outcomes of Communication Under Six (FOCUS; speech and language). Study III described efforts to accurately characterize difference and disorder in children's expressive grammar using adapted scoring, along with adult models to contextualize child responses. Last, Study IV applied acoustic duration (e.g., whole word) and an adapted scoring protocol to inform variation in speech sound productions in the Jamaican context where a post-Creole continuum exists. RESULTS Studies I and II offered promising psychometric evidence about the utility of the ICS and the FOCUS. Study III revealed strong sensitivity and specificity in classifying difference and disorder using adult models. Last, in Study IV, linguistically informed acoustic analyses and an adapted protocol captured variation in speech productions better than a standard approach. CONCLUSIONS Applying culturally responsive methods can enhance the accurate characterization of speech, language, and functional communication in Jamaican children. The innovative methods used offer a model approach that could be applied to other linguistic contexts where a mismatch exists between speech-language pathologists and their clientele. PRESENTATION VIDEO https://doi.org/10.23641/asha.23929461.
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Affiliation(s)
- Karla N. Washington
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Rachel Wright Karem
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Leslie E. Kokotek
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Michelle León
- Department of Speech, Language, and Hearing Sciences, Mount St. Joseph University, Cincinnati, OH
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Van der Straeten C, Verbeke J, Alighieri C, Bettens K, Van Beveren E, Bruneel L, Van Lierde K. Treatment Outcomes of Interdisciplinary Care on Speech and Health-Related Quality of Life Outcomes in Adults With Cleft Palate. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2654-2675. [PMID: 37844623 DOI: 10.1044/2023_ajslp-23-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
PURPOSE Individuals born with a cleft palate with or without a cleft lip (CP ± L) often experience functional, aesthetic, and psychosocial consequences well into adulthood. This study aimed to investigate outcomes of speech and health-related quality of life (HRQoL) in adults with a CP ± L who received interdisciplinary cleft care at the Ghent University Hospital using valid, reliable, and condition-specific instruments. METHOD Thirteen Belgian Dutch-speaking participants with a CP ± L with a mean age of 25.4 years (SD = 5.1, range: 20-33 years) and an age- and gender-matched control group of 13 participants without a CP ± L with a mean age of 25.2 years (SD = 4.8, range: 20-32 years) were included in this study. Speech characteristics were evaluated perceptually and instrumentally. HRQoL was assessed through standardized patient-reported outcome measures. Outcomes were compared with those of the control group and to normative data where available. RESULTS Participants with a CP ± L in this sample demonstrated significantly lower speech acceptability (p < .001) and higher rates of hypernasality (p = .015) and nasal turbulence (p = .005) than the control group. They showed significantly higher satisfaction with appearance of the cleft scar compared with norms of adults with a CP ± L (p = .047). No other differences in speech characteristics, sociodemographics, or HRQoL were found between participants with and without a CP ± L. CONCLUSIONS The reduced speech acceptability and the presence of resonance and nasal airflow disorders may indicate the need for standardized long-term outcome measurement and interdisciplinary follow-up for speech characteristics and velopharyngeal insufficiency in young and middle adulthood in future clinical practice. Additional research is necessary to further substantiate these findings and to determine predictors for these continuing complications in adults with a CP ± L. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24243901.
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Affiliation(s)
- Charis Van der Straeten
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Belgium
| | - Jolien Verbeke
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Belgium
| | - Cassandra Alighieri
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Belgium
| | - Ellen Van Beveren
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Belgium
| | - Laura Bruneel
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Belgium
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
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Chen YJ, Yeh L. Dynamic association between phonemic awareness and disordered speech recognition moderated by transcription training. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:2178-2199. [PMID: 37462139 DOI: 10.1111/1460-6984.12933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/21/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Phonetic transcription of disordered speech samples is especially crucial for the assessment and treatment of functional or organic speech-sound disorders. Previous studies show that students who struggle with the identification and segmentation of speech sounds are more likely to encounter difficulties with clinical phonetic transcription. AIMS To clarify the connection between phonemic awareness and phonetic transcription in Mandarin-speaking undergraduate students, as well as the improvement of these skills after phonetic transcription training. METHODS & PROCEDURES A pretest-post-test design was adopted for this study. The experimental group (n = 38) consisted of students majoring in audiology and speech-language pathology who were given 12 weeks of transcription training. The control group (n = 33) consisted of audiology and speech-language pathology majors who completed the same module a year earlier without undergoing the transcription training. Two instruments were used to assess their skills: (1) the Phonemic Awareness Skill Test (PA test) and (2) the Phonetic Transcription Skill Test (PT test) designed for the purposes of the present study. OUTCOMES & RESULTS Performance on most subtests of the PT and PA tests improved significantly at post-test for the experiment group, although only PT training was provided. After phonetic transcription training, the relationship between phonemic addition abilities and phonetic transcription strengthened. Phonemic identification was found to be a predictor of undergraduate students' PT skills of disordered speech samples. CONCLUSIONS & IMPLICATIONS Results from this study provide insights into the role of phonetic transcription training in improving phonemic awareness and phonetic transcription skills. WHAT THIS PAPER ADDS What is already known on the subject Phonetic transcription of disordered speech samples is especially crucial for the assessment and treatment of functional or organic speech-sound disorders. Phonemic awareness is not only an essential ability for reading alphabetic language but also associated with acquiring phonetic transcription skills. What this paper adds to existing knowledge A dynamically changing association between phonemic transcription and phonetic transcription during transcription training was reported. Phonetic transcription training of disordered speech samples acted as a driving force for deeper relationships between the two skills. What are the potential or actual clinical implications of this work? Training phonetic recognition and transcription equips future and practising speech-language pathologists with better skills in managing speech-sound disorders. Implications for phonemic awareness training also have the potential to extend to the literacy skills of alphabetic language speakers.
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Affiliation(s)
- Yu-Ju Chen
- Department of Audiology and Speech-Language Pathology, MacKay Medical College, New Taipei City, Taiwan
| | - Lili Yeh
- Department of Audiology and Speech-Language Pathology, MacKay Medical College, New Taipei City, Taiwan
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De Ryck M, Van Lierde K, Alighieri C, Hens G, Bettens K. A protocol for a randomized-controlled trial to investigate the effect of infant sign training on the speech-language development in young children born with cleft palate. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:2212-2221. [PMID: 37376898 DOI: 10.1111/1460-6984.12920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Children born with a cleft palate with or without cleft lip (CP ± L) are known to be at risk for speech-language disorders that impact educational and social-emotional growth. It is hypothesized that speech-language intervention delivered before the age of 3 years could decrease the impact of CP ± L on speech-language development. Infant sign training in combination with verbal input expands the natural communication of young children including multimodal speech-language input (i.e., verbal and manual input) via caregivers who act as co-therapists. AIMS To determine the effectiveness of infant sign training in 1-year-old children with CP ± L by comparing different interventions. METHODS & PROCEDURES This is a two-centre, randomized, parallel-group, longitudinal, controlled trial. Children are randomized to either an infant sign training group (IST group), a verbal training group (VT group) or no intervention control group (C group). Caregivers of children who are assigned to the IST group or VT group will participate in three caregiver training meetings to practise knowledge and skills to stimulate speech-language development. Outcome measures include a combination of questionnaires, language tests and observational analyses of communicative acts. OUTCOMES & RESULTS It is hypothesized that speech-language development of children with CP ± L will benefit more from IST compared with VT and no intervention. Additionally, the number and quality of communicative acts of both children and caregivers are expected to be higher after IST. CONCLUSIONS & IMPLICATIONS This project will contribute to the development of evidence-based clinical practice guidelines regarding early speech-language intervention in children with CP ± L under the age of 3 years. WHAT THIS PAPER ADDS What is already known on the subject Children with CP ± L are known to be at risk for speech-language delays that impact educational and social emotional growth. Given the limited scientific prove of the impact of early speech-language intervention, no standardized clinical practice guidelines are available yet for children with CP ± L under the age of 3 years. Early intervention in this population mostly focuses on improving verbal input via caregivers or professionals without including a multimodal language input. A growing scientific interest has been seen in the use of infant signs to support speech-language development and caregiver-child interaction in typically developing children and children with developmental delays. What this study adds to existing knowledge No evidence is yet available for the effectiveness and feasibility of early intervention based on infant sign training in combination with verbal input to improve speech-language skills in young children with CP ± L. The current project will investigate the effect of infant sign training on the speech-language development in this population. Outcome measures are compared with those of two control groups: verbal training only and no intervention. It is hypothesized that infant signs may support the intelligibility of verbal utterances produced by children with CP ± L. Improving children's intelligibility may increase the opportunities for these children to engage in early, frequent and high-quality interactions with their caregivers resulting in a richer social and linguistic environment. As a result, infant sign training may result in better speech-language skills compared with the control interventions. What are the potential or actual clinical implications of this work? If providing early intervention based on infant sign training is effective, there is the potential for improved speech-language outcomes in early childhood, resulting in increased speech intelligibility, increased well-being of the child and family and less need for speech-language therapy on the long-term. This project will contribute to the development of evidence-based clinical practice guidelines regarding early speech-language intervention in children with CP ± L under the age of 3 years.
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Affiliation(s)
- Mira De Ryck
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
| | - Cassandra Alighieri
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
| | - Greet Hens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Multidisciplinary Cleft Lip and Palate Team, University Hospitals Leuven, Leuven, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
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Hayler R, Charters E, Coulson S, Hubert Low TH. Gender differences in perceived speech intelligibility in patients with facial nerve palsy. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-6. [PMID: 37907077 DOI: 10.1080/17549507.2023.2259136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
PURPOSE Facial nerve palsy (FNP) affects physical and social function, including speech. There exists discrepancy between professional and patient perception of appearance following FNP; however, speech differences remain unknown. We aimed to compare ratings of speech intelligibility by different listeners. METHOD Patients were identified through the Sydney Facial Nerve Service. FNP related scoring was obtained using the Sunnybrook Facial Grading System, Sydney Facial Grading Score, Facial Disability Index, and Speech Handicap Index. Intelligibility was scored by a speech-language pathologist, member of the public, and patient using a standardised passage. FNP scoring and intelligibility were compared using interclass coefficients (ICC). RESULT Forty patients were recruited (females = 20). There was no difference in FNP scoring, nor between the frequency or types of phonemic errors. Observers' rating of intelligibility had an ICC of 0.807, compared with 0.266 and 0.344 for patients compared to the member of the public and speech-language pathologist respectively. Observers rated males and females intelligibility similar (p > 0.05), but females rated their intelligibility lower than males (74.5 ± 12.8 vs. 82.5 ± 8.4, p = 0.025). CONCLUSION Patients, particularly females, perceive their speech to be less intelligible than observers. Clinicians should be aware of this discrepancy, which does not correlate with physical function.
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Affiliation(s)
- Raymond Hayler
- Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Sydney, Australia
- Department of Medicine, University of New South Wales, Sydney, Australia
- Faculty of Medicine and Health, Macquarie University, Sydney, Australia
| | - Emma Charters
- Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Sydney, Australia
- Head and Neck Department, Chris O'Brien Lifehouse, Sydney, Australia
| | - Susan Coulson
- Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Sydney, Australia
- School of Physiotherapy, and
| | - Tsu-Hui Hubert Low
- Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Sydney, Australia
- Faculty of Medicine and Health, Macquarie University, Sydney, Australia
- Head and Neck Department, Chris O'Brien Lifehouse, Sydney, Australia
- Sydney Medical School, The University of Sydney, Sydney, Australia
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Dunworth K, Sharif-Askary B, Grames L, Jones C, Kern J, Nyswonger-Sugg J, Suárez A, Thompson K, Ching J, Golden B, Merrill C, Nguyen P, Patel K, Rogers-Vizena CR, Rottgers SA, Skolnick GB, Allori AC. Using "Real-World Data" to Study Cleft Lip/Palate Care: An Exploration of Speech Outcomes from a Multi-Center US Learning Health Network. Cleft Palate Craniofac J 2023:10556656231207469. [PMID: 37844605 DOI: 10.1177/10556656231207469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To assess the ability of a cleft-specific multi-site learning health network registry to describe variations in cleft outcomes by cleft phenotypes, ages, and treatment centers. Observed variations were assessed for coherence with prior study findings. DESIGN Cross-sectional analysis of prospectively collected data from 2019-2022. SETTING Six cleft treatment centers collected data systematically during routine clinic appointments according to a standardized protocol. PARTICIPANTS 714 English-speaking children and adolescents with non-syndromic cleft lip/palate. INTERVENTION Routine multidisciplinary care and systematic outcomes measurement by cleft teams. OUTCOME MEASURES Speech outcomes included articulatory accuracy measured by Percent Consonants Correct (PCC), velopharyngeal function measured by Velopharyngeal Competence (VPC) Rating Scale (VPC-R), intelligibility measured by caregiver-reported Intelligibility in Context Scale (ICS), and two CLEFT-Q™ surveys, in which patients rate their own speech function and level of speech distress. RESULTS 12year-olds exhibited high median PCC scores (91-100%), high frequency of velopharyngeal competency (62.50-100%), and high median Speech Function (80-91) relative to younger peers parsed by phenotype. Patients with bilateral cleft lip, alveolus, and palate reported low PCC scores (51-91%) relative to peers at some ages and low frequency of velopharyngeal competency (26.67%) at 5 years. ICS scores ranged from 3.93-5.0 for all ages and phenotypes. Speech Function and Speech Distress were similar across phenotypes. CONCLUSIONS This exploration of speech outcomes demonstrates the current ability of the cleft-specific registry to support cleft research efforts as a source of "real-world" data. Further work is focused on developing robust methodology for hypothesis-driven research and causal inference.
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Affiliation(s)
- Kristina Dunworth
- Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Banafsheh Sharif-Askary
- Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Lynn Grames
- Cleft Palate and Craniofacial Institute, St. Louis Children's Hospital, St. Louis, USA
| | - Carlee Jones
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
| | - Jennifer Kern
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Department of Speech Pathology & Audiology, Duke University Hospital, Durham, NC, USA
| | - Jillian Nyswonger-Sugg
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Department of Speech Pathology & Audiology, Duke University Hospital, Durham, NC, USA
| | - Arthur Suárez
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Department of Speech Pathology & Audiology, Duke University Hospital, Durham, NC, USA
| | - Karen Thompson
- Cleft Lip and Palate Program/Craniofacial Program, Boston Children's Hospital, Boston, MA, USA
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Jessica Ching
- University of Florida Craniofacial Center, University of Florida, Gainesville, FL, USA
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Florida, Gainesville, FL, USA
| | - Brent Golden
- Pediatric Cleft Lip and Palate Surgery Program, Orlando Health Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Corinne Merrill
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, USA
| | - Phuong Nguyen
- Division of Plastic Surgery, Department of Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kamlesh Patel
- Cleft Palate and Craniofacial Institute, St. Louis Children's Hospital, St. Louis, USA
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, USA
| | - Carolyn R Rogers-Vizena
- Cleft Lip and Palate Program/Craniofacial Program, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - S Alex Rottgers
- Cleft and Craniofacial Center, Johns Hopkins Children's Center, Baltimore, MD, USA
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Gary B Skolnick
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, USA
| | - Alexander C Allori
- Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
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da Silva MH, Wertzner HF, Haynes C, Azoni CAS. Characterization of the phonological system in low-income Brazilian preschoolers. Codas 2023; 35:e20220189. [PMID: 37729319 PMCID: PMC10723580 DOI: 10.1590/2317-1782/20232022189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 05/23/2023] [Indexed: 09/22/2023] Open
Abstract
PURPOSE The purpose of this study is to characterize the phonological skills of low-income preschool children in a city in the Natal in the Northeast, Brazil. METHODS The researchers assessed the phonological skills of 90 children (from 5 to 6:11) in early childhood education in three public schools located in regions of social and economic vulnerability. The evaluators used the phonology subtests of the Test of Childhood language (ABFW) children's language test. In addition to performing the standard analysis they examined the following: Phonological Processes (PP), Percentage of Correct Consonants (PCC), Percentage of Correct Consonants Revised (PCC-R), and Process Density Index (PDI). The Spearman's Correlation Coefficient test was used to analyze for correlations among the PCC, PCC-R, and PDI. RESULTS According to the cutoff values of children who speak Brazilian Portuguese (BP), adequacy of the PCC and PCC-R values was observed in most participants (PCC: 82 children - 91.1%; PCC-R: 87 children - 94.6%). The processes of liquid simplification (LS), consonant clusters simplification (CCS), final consonant simplification (FCS) were productive of which the CCS (32.2%) and FCS (20%) are still expected for age and LS are not. There was a robust negative correlation between the variables PCC x PDI and PCC-R x PDI. CONCLUSION Most children showed adequate phonological development. Variations were observed in syllabic segments, especially in the coda, which reflect the influence of regional linguistic differences. The evidence obtained regarding the phonological performance of children within this region contributes to a more accurate speech-language diagnosis.
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Affiliation(s)
- Maria Helena da Silva
- Programa de Pós-graduação Associado em Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.
- Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil.
- Universidade Estadual de Ciências da Saúde de Alagoas - UNCISAL - Maceió (AL), Brasil.
- Laboratório LEIA - Linguagem Escrita, Interdisciplinaridade e Aprendizagem, Departamento de Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.
| | - Haydée Fiszbein Wertzner
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - FM, Universidade de São Paulo USP - São Paulo (SP), Brasil.
- Programa de Pós-graduação em Ciências da Reabilitação, Faculdade de Medicina - FM, Universidade de São Paulo USP - São Paulo (SP), Brasil.
- Laboratório de Investigação Fonoaudiológica em Fonologia, Faculdade de Medicina - FM, Universidade de São Paulo USP - São Paulo (SP), Brasil.
| | - Charles Haynes
- Department of Communication Sciences and Disorders, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston (MA), United States of America.
| | - Cíntia Alves Salgado Azoni
- Programa de Pós-graduação Associado em Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.
- Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil.
- Universidade Estadual de Ciências da Saúde de Alagoas - UNCISAL - Maceió (AL), Brasil.
- Laboratório LEIA - Linguagem Escrita, Interdisciplinaridade e Aprendizagem, Departamento de Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.
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Namasivayam AK, Shin H, Nisenbaum R, Pukonen M, van Lieshout P. Predictors of Functional Communication Outcomes in Children With Idiopathic Motor Speech Disorders. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-16. [PMID: 37672787 DOI: 10.1044/2023_jslhr-23-00070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE The purpose of the study was to investigate child- and intervention-level factors that predict improvements in functional communication outcomes in children with motor-based speech sound disorders. METHOD Eighty-five preschool-age children with childhood apraxia of speech (n = 37) and speech motor delay (n = 48) participated. Multivariable logistic regression models estimated odds ratios and 95% confidence intervals for the association between minimal clinically important difference in the Focus on the Outcomes of Communication Under Six scores and multiple child-level (e.g., age, sex, speech intelligibility, Kaufman Speech Praxis Test diagnostic rating scale) and intervention-level predictors (dose frequency and home practice duration). RESULTS Overall, 65% of participants demonstrated minimal clinically important difference changes in the functional communication outcomes. Kaufman Speech Praxis Test rating scale was significantly associated with higher odds of noticeable change in functional communication outcomes in children. There is some evidence that delivering the intervention for 2 times per week for 10 weeks provides benefit. CONCLUSION A rating scale based on task complexity has the potential for serving as a screening tool to triage children for intervention from waitlist and/or determining service delivery for this population.
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Affiliation(s)
- Aravind K Namasivayam
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Speech Research Centre, Toronto, Ontario, Canada
| | - Hyunji Shin
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Speech Research Centre, Toronto, Ontario, Canada
| | - Rosane Nisenbaum
- Applied Health Research Centre, MAP Centre for Urban Health Solutions, St. Michael's Hospital Li Ka Shing Knowledge Institute, Unity Health Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Margit Pukonen
- The Speech and Stuttering Institute, Toronto, Ontario, Canada
| | - Pascal van Lieshout
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
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25
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Case J, Wang EW, Grigos MI. The Multilevel Word Accuracy Composite Scale: A Novel Measure of Speech Production in Childhood Apraxia of Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1866-1883. [PMID: 37195724 PMCID: PMC10561970 DOI: 10.1044/2023_ajslp-22-00166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/23/2022] [Accepted: 03/02/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE The Multilevel word Accuracy Composite Scale (MACS) is a novel whole-word measure of speech production accuracy designed to evaluate behaviors commonly targeted in motor-based intervention for childhood apraxia of speech (CAS). The MACS yields a composite score generated through ratings of segmental accuracy, word structure maintenance, prosody, and movement transition. This study examined the validity of the MACS through comparison to established measures of speech accuracy. Reliability was also examined within and between practicing speech-language pathologists (SLPs). METHOD The MACS was used to rate 117 tokens produced by children with severe CAS. Ratings were performed in the laboratory setting by two expert raters and by practicing SLPs (N = 19). Concurrent validity was estimated through comparison of expert MACS ratings (i.e., MACS score and each component rating) to measures of speech accuracy (percent phoneme correct and the 3-point scale) using correlational analyses. Reliability was examined between expert raters and across SLP raters using the intraclass correlation coefficient to examine interrater reliability of expert ratings, in addition to inter- and intrarater reliability of SLP ratings. RESULTS Correlation analyses between MACS ratings (i.e., MACS score and component ratings) and existing measures of speech accuracy revealed small to large positive correlations between measures. Reliability analyses revealed moderate to excellent reliability for MACS ratings performed by expert raters and between (interrater) and within (intrarater) SLP raters. CONCLUSIONS Analyses of concurrent validity indicate that the MACS aligns with established measures, yet contributes novel elements for rating speech accuracy. Results further support the MACS as a reliable measure for rating speech accuracy in children with severe speech impairment for ratings performed by expert raters and practicing clinicians.
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Affiliation(s)
- Julie Case
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY
| | - Emily W. Wang
- Department of Communicative Sciences and Disorders, New York University, New York
| | - Maria I. Grigos
- Department of Communicative Sciences and Disorders, New York University, New York
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26
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Mues M, Zuk J, Norton ES, Gabrieli JDE, Hogan TP, Gaab N. Preliteracy Skills Mediate the Relation Between Early Speech Sound Production and Subsequent Reading Outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:2766-2782. [PMID: 37473736 PMCID: PMC10555467 DOI: 10.1044/2023_jslhr-22-00142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 10/14/2022] [Accepted: 04/19/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Learning to read is a complex, multifaceted process that relies on several speech and language-related subskills. Individual differences in word reading outcomes are indicated among children with inaccurate speech sound productions, with some of these children developing later reading difficulties. There are inconsistent reports as to whether phonological deficits and/or weaknesses in oral language explain these subsequent reading difficulties. Thus, it remains unclear how variability in speech production accuracy in early childhood may impact reading development. Therefore, the present longitudinal study seeks to clarify the relation between speech sound production accuracy in kindergarten and subsequent reading outcomes with a focus on additional potential mediating factors. METHOD Speech accuracy, core preliteracy skills (phonological awareness, rapid naming, and letter-name knowledge), and additional potential mediators (phonological memory and oral language abilities) were characterized at the start of formal reading instruction. Word reading, decoding, reading fluency, and comprehension were assessed at the end of second grade. Mediation analyses were conducted to examine factors that mediate the relation between speech accuracy in kindergarten and subsequent reading outcomes. RESULTS Initial associations between early speech sound production accuracy and subsequent reading outcomes were indicated; however, mediation effects of preliteracy skills (phonological awareness and letter-name knowledge) were identified for word reading, decoding, and reading fluency outcomes. For reading comprehension, mediation effects of preliteracy and vocabulary skills were observed. CONCLUSIONS The relation between speech sound production accuracy and subsequent word reading, decoding, reading fluency, and comprehension was observed to be mediated by preliteracy skills, specifically phonological awareness and letter-name knowledge. For reading comprehension only, vocabulary knowledge were of additional importance. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23671491.
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Affiliation(s)
| | - Jennifer Zuk
- Harvard Graduate School of Education, Cambridge, MA
- Department of Speech, Language & Hearing Sciences, Boston University, MA
| | - Elizabeth S. Norton
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - John D. E. Gabrieli
- McGovern Institute for Brain Research and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge
| | - Tiffany P. Hogan
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Nadine Gaab
- Harvard Graduate School of Education, Cambridge, MA
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Korkalainen J, McCabe P, Smidt A, Morgan C. The Effectiveness of Rapid Syllable Transition Treatment in Improving Communication in Children with Cerebral Palsy: A Randomized Controlled Trial. Dev Neurorehabil 2023; 26:309-319. [PMID: 37401894 DOI: 10.1080/17518423.2023.2218485] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 04/21/2023] [Accepted: 05/23/2023] [Indexed: 07/05/2023]
Abstract
Cerebral palsy (CP) is a movement disorder and majority of children with CP have communication impairments which impact participation with this population. Rapid Syllable Transition Treatment (ReST) is a motor speech intervention primarily for children with Childhood Apraxia of Speech (CAS). A recent pilot study in which ReST was trialed with children with CP showed improved speech performance. Therefore, a single blind randomized controlled trial to compare ReST to usual care with 14 children with moderate-to-severe CP and dysarthria was conducted. ReST was provided on telehealth. ANCOVA with 95% confidence intervals indicated significant group differences in favor of ReST in speech accuracy (F = 5.1, p = .001), intelligibility (F = 2.8, p = .02) and communicative participation on both the FOCUS (F = 2, p = .02) and Intelligibility in Context Scale (F = 2.4, p = .04). ReST was found to be more effective than usual care.
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Affiliation(s)
| | | | - Andy Smidt
- The University of Sydney, Camperdown, Sydney, Australia
| | - Catherine Morgan
- The University of Sydney, Cerebral Palsy Alliance Research Institute, Brain Mind Centre, Camperdown, Sydney, Australia
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28
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Potapova I, Combiths P, Pruitt-Lord S, Barlow J. Word-final complexity in speech sound intervention: two case studies. CLINICAL LINGUISTICS & PHONETICS 2023; 37:363-384. [PMID: 36121007 PMCID: PMC10024642 DOI: 10.1080/02699206.2022.2122082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 05/20/2023]
Abstract
In speech sound intervention, consonant clusters promote generalisation (i.e. improvement in untreated sounds and words), ostensibly due to their relative complexity compared to other phonological targets. However, our understanding of clusters as intervention targets is largely restricted to those in word-initial position (e.g. [fl-], flip). The present study extends available work to consider the effects of word-final consonant cluster targets (e.g. [-ks]). Phonologically complex word-final clusters may be morphologically simple (e.g. mix) or morphologically complex (e.g. packs, inflected with third-person singular) - yet this cross-domain complexity remains an understudied phenomenon. Presently, two case studies provide an initial investigation of word-final cluster intervention targets for children with phonologically based speech sound disorders. Intervention targets for both Anna (3;7 [years;months]) and David (4;1) featured the phonologically complex word-final cluster [-ks], with Anna's target being morphologically simple and David's being morphologically complex. Intervention was provided in 45-minute, individual sessions three times per week for a maximum of 18 sessions. Both children demonstrated high target accuracy by intervention's end. Following intervention, both children demonstrated progress in intelligibility and ability to produce word-final consonant clusters; David further demonstrated generalisation across multiple measures. Results are interpreted with consideration of individual differences and existing research on complexity in phonological intervention. Overall, present findings motivate continued research, as manipulation of word-final complexity allows for emphasis on a context that is relevant for children with speech sound disorders, for peers with difficulties in morphology (including word-final grammatical morphemes) and for the substantial proportion of children demonstrating weaknesses in both domains.
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29
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Warnier M, Maillart C, Rose Y, MacLeod AAN. Exploring word production in three-year-old monolingual French-speaking children. CLINICAL LINGUISTICS & PHONETICS 2023; 37:454-472. [PMID: 35801560 DOI: 10.1080/02699206.2022.2092424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 06/12/2022] [Accepted: 06/16/2022] [Indexed: 05/20/2023]
Abstract
There is a general need for more knowledge on the development of French phonology, and little information is currently available for typically developing French-speaking three-year-old children. This study took place in Belgium and explores the accuracy of speech production of 34 typically developing French-speaking children using a picture naming task. Measures of speech accuracy revealed lower performance than previously seen in the literature. We investigated speech accuracy across different phonological contexts in light of characteristics of target words that are known to have an influence on speech production, namely the condition of production (spontaneous vs. imitated), the length of the word (in number of syllables), syllable complexity (singleton vs. cluster) and positional complexity (onset vs. coda). Results indicate that the accuracy of words produced spontaneously did not differ from imitated words. The presence of consonant clusters in the target word was associated with lower performance on measures of Percentage of Consonants Correct and Whole Word Proximity for both 1- and 4-syllable words. Singleton codas were produced less accurately than onsets in 1-syllable words. Word-internal singleton codas were produced less accurately than final codas. In our sample, 1-syllable words showed surprisingly low levels of performance which we can explain by an over-representation of phonologically complex properties in the target words used in the present study. These results highlight the importance of assessing various aspects of phonological complexity in French speech tasks in order to detect developmental errors in typically developing children and, ultimately, help identify children with speech sound disorders.
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Affiliation(s)
- Morgane Warnier
- Département de Logopédie, Université de Liège, Liège, Belgique
| | | | - Yvan Rose
- Department of Linguistics, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Andrea A N MacLeod
- Communication Sciences & Disorders Department, University of Alberta, Edmonton, Alberta, Canada
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Iuzzini-Seigel J, Case J, Grigos MI, Velleman SL, Thomas D, Murray E. Dose frequency randomized controlled trial for Dynamic Temporal and Tactile Cueing (DTTC) treatment for childhood apraxia of speech: protocol paper. BMC Pediatr 2023; 23:263. [PMID: 37226208 PMCID: PMC10208915 DOI: 10.1186/s12887-023-04066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/10/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Childhood apraxia of speech (CAS) is a pediatric motor-based speech sound disorder that requires a specialized approach to intervention. The extant literature on the treatment of CAS commonly recommends intensive treatment using a motor-based approach, with some of the best evidence supporting the use of Dynamic Temporal and Tactile Cueing (DTTC). To date, a rigorous and systematic comparison of high and low dose frequency (i.e., frequency of therapy sessions) has not been undertaken for DTTC, resulting in a lack of evidence to guide decisions about the optimal treatment schedule for this intervention. The current study aims to fill this gap in knowledge by comparing treatment outcomes when dose frequency is varied. METHODS A randomized controlled trial will be conducted to examine the efficacy of low versus high dose frequency on DTTC treatment outcomes in children with CAS. A target of 60 children, 2;6-7;11 years of age, will be recruited to participate in this study. Treatment will be provided in the community setting by speech-language pathologists who have completed specialized training administering DTTC in a research reliable manner. True randomization with concealed allocation will be used to assign children to either the low or high dose frequency group. Treatment will be administered in 1-h sessions either 4 times per week over a 6-week period (high dose) or 2 times per week over a 12-week period (low dose). To measure treatment gains, probe data will be collected before treatment, during treatment, and 1 day, 1 week, 4 weeks, and 12 weeks post-treatment. Probe data will consist of customized treated words and a standard set of untreated words to assess generalization of treatment gains. The primary outcome variable will be whole word accuracy, encompassing segmental, phonotactic, and suprasegmental accuracy. DISCUSSION This will be the first randomized controlled trial to evaluate dose frequency for DTTC treatment in children with CAS. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT05675306, January 6, 2023.
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Affiliation(s)
- Jenya Iuzzini-Seigel
- Department of Speech Pathology and Audiology, Marquette University, PO Box 1881, Harriet Barker Cramer Hall, Milwaukee, WI, 53201, USA.
| | - Julie Case
- Speech-Language-Hearing Sciences, Hofstra University, Davison Hall 106B, 110, Hempstead, NY, 11549, USA
| | - Maria I Grigos
- Communicative Sciences and Disorders, New York University, 665 Broadway, 9th floor, New York, NY, 10012, USA
| | - Shelley L Velleman
- University of Vermont, Pomeroy Hall, 489 Main St, Burlington, VT, 05405, USA
| | - Donna Thomas
- University of Sydney, Susan Wakil Health Building, Western Avenue, Camperdown, NSW, 2006, Australia
| | - Elizabeth Murray
- University of Sydney, Susan Wakil Health Building, Western Avenue, Camperdown, NSW, 2006, Australia
- Remarkable Speech and Movement, 52 Anderson Avenue, Panania, NSW, 2213, Australia
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Cassar C, McCabe P, Cumming S. "I still have issues with pronunciation of words": A mixed methods investigation of the psychosocial and speech effects of Childhood Apraxia of Speech in adults. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:193-205. [PMID: 35034534 DOI: 10.1080/17549507.2021.2018496] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE Adolescents with Childhood Apraxia of Speech (CAS) are likely to have persistent speech errors compared to non-CAS peers (Lewis et al., 2018) and may have ongoing psychosocial issues (e.g. Carrigg, Parry, Baker, Shriberg, & Ballard, 2016). Beyond this, little is known about the long-term consequences of CAS in adulthood. This study explored whether adults who were reported to have had CAS as children have ongoing psychosocial or speech impacts. METHOD A cross-sectional descriptive design, with mixed-method analyses of demographic, psychosocial, and speech data was used. Data were collected via a four-part online survey. Part one consisted of questions about demographic information and participants' self-reported performance in speech, language and literacy. Parts two and three investigated the psychosocial impacts of CAS using the Brief Fear of Negative Evaluation Scale - Revised (BFNE- R) and The State-Trait Anxiety Inventory (STAI). Part four collected single word and connected speech data via an online audio recording, which was then transcribed following the Connected Speech Transcription Protocol (CoST-P). Analyses of speech characteristics reported in CAS was completed using Phon software. RESULT There were 17 participants in part one, 16 in parts two and three, and six in part four. Participants reported elevated levels of state (p = 0.01) and trait (p = 0.0001) anxiety compared to normative data. Ongoing segmental and suprasegmental speech errors were observed, with a significant difference between percent phonemes correct in single words versus connected speech (p = 0.03). Participants who provided a speech sample had difficulty with correct stress, use of juncture, and had increased intra- and inter-word segregation. Participants with better speech reported less anxiety. CONCLUSION Psychosocial effects and speech characteristics associated with CAS in childhood appear to persist into adulthood. Confirmation of these results and research to determine treatment and psychosocial support needs past early childhood is warranted.
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Affiliation(s)
- Courtney Cassar
- The University of Sydney, Camperdown, Australia
- Liverpool Hospital, South West Sydney Local Health District, Liverpool, Australia
| | - Patricia McCabe
- The University of Sydney, Camperdown, Australia
- Liverpool Hospital, South West Sydney Local Health District, Liverpool, Australia
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McCabe P, Preston JL, Evans P, Heard R. A Pilot Randomized Control Trial of Motor-Based Treatments for Childhood Apraxia of Speech: Rapid Syllable Transition Treatment and Ultrasound Biofeedback. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:629-644. [PMID: 36848673 PMCID: PMC10171856 DOI: 10.1044/2022_ajslp-22-00144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/08/2022] [Accepted: 11/29/2022] [Indexed: 05/12/2023]
Abstract
PURPOSE Both Rapid Syllable Transition Treatment (ReST) and ultrasound biofeedback are effective approaches to treating childhood apraxia of speech (CAS). The purpose of the study was to compare outcomes from these two motor-based treatment approaches for school-age children with CAS. METHOD In a single site, single blind randomized control trial, 14 children with CAS ages 6-13 years were randomly assigned to 12 sessions over 6 weeks of either of ultrasound biofeedback treatment (with a speech motor chaining practice structure) or ReST. Treatment was delivered at The University of Sydney by students trained and supervised by certified speech-language pathologists. Transcriptions from blinded assessors were used to compare the two groups on speech sound accuracy (percent phonemes correct) and prosodic severity (lexical stress errors and syllable segregation) in untreated words and sentences at three time points: pretreatment, immediately posttreatment, and 1-month posttreatment (i.e., retention). RESULTS Both groups showed significant improvement on treated items indicating a treatment effect. At no time was there a difference between groups. Both groups showed a significant improvement in speech sound accuracy on untreated words and sentences from pre to post and neither group showed an improvement in prosody pre-post. Changes to speech sound accuracy were retained by both groups at 1-month follow-up. Significant improvement in prosodic accuracy was reported at the 1-month follow-up. CONCLUSIONS ReST and ultrasound biofeedback were equally effective. Either ReST or ultrasound biofeedback may be viable treatment options for school-age children with CAS. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22114661.
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Affiliation(s)
| | | | - Pippa Evans
- The University of Sydney, New South Wales, Australia
- The University of Queensland, Brisbane, Australia
| | - Rob Heard
- The University of Sydney, New South Wales, Australia
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Chung H, Lemoine GE, Sanders JB, Schellinger SK. Effect of Speaker Age on Listener Perceptions of Word-Final /l/. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:916-930. [PMID: 36827509 DOI: 10.1044/2022_jslhr-22-00437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE This study investigated an effect of speaker age on listeners' perception of word-final /l/ produced by child and adult speakers of Southern White Vernacular English, a dialect that shows higher rates of word-final /l/ vocalization than other dialects of English. METHOD Stimuli included children and adults' word-final /l/ embedded in monosyllabic words in two vowel contexts (/i, ɪ/ and /ɔ, ɑ/). A total of 25 monolingual adult listeners listened to each word and were asked to judge the /l/-likeness using a visual analog scale. Average listener ratings and three acoustic measures (F2 transition rate [F2 TR] and F2-F1 [Hz] values at 20% and 80% time points along the vowel-/l/ duration) were analyzed. RESULTS Adult productions were rated more as correct /l/ than those of children in both vowel contexts, despite the similarity in their F2 TR and F2-F1 values at the 80% time point. Correlation between the acoustic measures and the average listener ratings were weak for all three measures for adults' productions. For children's productions, while the correlation with F2 TR values were weak, moderate significant correlations were found for F2-F1 values at the 20% and 80% time points. In terms of vowel context, word-final /l/ in the high front vowel context was rated more as /l/ than those in low back vowel context. CONCLUSIONS Findings suggest that listeners are more likely to accept word-final /l/ as being correct when produced by adult speakers, regardless of their acoustic characteristics, but more likely to perceive an error when produced by a child and attend more to acoustic information for their perceptual judgment. This highlights the importance of considering children's dialectal background when judging word-final /l/, which is more likely to be vocalized in certain dialects and certain vowel contexts, and thus can be misjudged without such consideration.
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Affiliation(s)
- Hyunju Chung
- Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge
| | - Grace E Lemoine
- Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge
| | - Julia B Sanders
- Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge
| | - Sarah K Schellinger
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
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Wren Y, Pagnamenta E, Orchard F, Peters TJ, Emond A, Northstone K, Miller LL, Roulstone S. Social, emotional and behavioural difficulties associated with persistent speech disorder in children: A prospective population study. JCPP ADVANCES 2023; 3:e12126. [PMID: 37431315 PMCID: PMC10241475 DOI: 10.1002/jcv2.12126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 11/28/2022] [Indexed: 01/18/2023] Open
Abstract
Purpose Social, emotional and behavioural difficulties (SEBD) in childhood are associated with negative consequences across the life course. Children with developmental language disorder have been identified as being at risk of developing SEBD but it is unclear whether a similar risk exists for children with speech sound disorder, a condition which impacts on children's ability to make themselves understood and has been shown to be associated with poor educational outcomes. Methods Participants were children who attended the 8-year-old clinic in the Avon Longitudinal Study of Parents and Children (N = 7390). Children with speech sound disorder that had persisted beyond the period of typical speech acquisition (persistent speech disorder [PSD]) at age 8 were identified from recordings and transcriptions of speech samples (N = 263). Parent-, teacher- and child-reported questionnaires and interviews including the Strengths and Difficulties Questionnaire, Short Moods and Feelings Questionnaire and measures for antisocial and risk-taking behaviour were used to provide outcome scores for SEBD at 10-14 years in a series of regression analyses. Results Following adjustment for biological sex, socio-economic status and Intelligence Quotient, children with PSD at age 8 were more likely to show peer problems at age 10-11 years compared with their peers, as reported by teachers and parents. Teachers were more likely to report problems with emotionality. Children with PSD were no more likely to report symptoms of depression than their peers. No associations were observed between PSD, risk of antisocial behaviour, trying alcohol at age 10 or smoking cigarettes at age 14. Conclusions Children with PSD may be at risk in terms of their peer relationships. This could impact on their wellbeing and, while not observed at this age, may lead to depressive symptoms in older childhood and adolescence. There is also the potential that these symptoms may impact on educational outcomes.
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Affiliation(s)
- Yvonne Wren
- Bristol Speech and Language Therapy Research UnitNorth Bristol NHS TrustBristolUK
- Bristol Dental SchoolUniversity of BristolBristolUK
| | - Emma Pagnamenta
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Faith Orchard
- School of PsychologyUniversity of SussexEast SussexUK
| | | | - Alan Emond
- Centre for Academic Child HealthBristol Medical SchoolBristolUK
| | - Kate Northstone
- Population Health SciencesBristol Medical SchoolOakfield HouseUniversity of BristolBristolUK
| | | | - Susan Roulstone
- Faculty of Health and Applied SciencesUniversity of the West of EnglandBristolUK
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Duan H, Xie Q, Zhang Z. Characteristics of Alveolo-palatal Affricates Produced by Mandarin-speaking Children with Repaired Cleft Palate. Am J Health Behav 2023; 47:13-20. [PMID: 36945094 DOI: 10.5993/ajhb.47.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Objectives: In this study, examined the acoustic properties of affricates /t/ and /th/ in Mandarin Chinese, and analyzed the differences of the acoustic characteristics of these affricates produced by children with repaired cleft palate and normally developing children. We also explored the relationship between the affricates and high-front vowel /i/. Methods: We analyzed 16 monosyllabic words with alveolo-palatal affricates as the initial consonants produced by children with repaired cleft palate (N=13, Mean=5.9 years) and normally developing children (N=6, Mean age=5.3 years). We used several acoustic parameters to investigate the characteristics of these affricates, such as the center of gravity, VOT and the formants of vowels. Results: Compared with normally developing children, children with cleft palate exhibited a lower center of gravity for the 2 affricates /t/ and /th/. Data from the control group showed that the affricate /th/ had a significantly greater center of gravity than that of /t/. The accuracy of /t , th/ produced by speakers of cleft palate was significantly correlated with that of /i/ (r=0.63). High-front vowel /i/ is a significant index in diagnosing speech intelligibility which is more valuable than /a/ and /u/. There was a significant difference in F2 of vowel /i/ between children with cleft palate without speech therapy (CS1) and after speech therapy (CS2). After speech intervention, the accuracy of affricates produced by children with cleft palate was improved, the acoustic properties "stop + noise segments" appeared. Conclusion: Children with cleft palate can be distinguished better from children with normal development by 2 significant acoustic characteristics: center of gravity and VOT. As alveolo-palatal affricates /t , th/ and high-front vowel /i/ have a similar place of articulation, front-tongue-blade, their production accuracy can be improved mutually. The analysis showed that the articulation of Chinese /i/ has a higher frontal lingual position and less variability, which is more conducive to articulation training and improves the effect of cleft palate training. These findings provide a potential relationship on affricates /t, th/ and vowel /i/. Children with cleft palate have difficulty pronouncing the /t, t h/ and /i/. It is better to start with a vowel /i/, resulting in improvement in overall speech intelligibility.
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Affiliation(s)
- Haifeng Duan
- Haifeng Duan, College of Chinese Minority Languages and Literature, Minzu University of China, Beijing, China
| | - Qingqing Xie
- Qingqing Xie, School of Communication Science, Beijing Language and Culture University, Beijing, China
| | - Zhifang Zhang
- Zhifang Zhang, School of Communication Science, Beijing Language and Culture University, Beijing, China;,
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Combiths P, Escobedo A, Barlow JA, Pruitt-Lord S. Complexity and cross-linguistic transfer in intervention for Spanish–English bilingual children with speech sound disorder. JOURNAL OF MONOLINGUAL AND BILINGUAL SPEECH 2023; 4:234-270. [PMID: 37035425 PMCID: PMC10081515 DOI: 10.1558/jmbs.23445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
With bilingual children, intervention for speech sound disorders must consider both of the child’s phonological systems, which are known to interact with each other in development. Further, cross-linguistic generalization following intervention for bilingual children with speech sound disorders (i.e. the impact of treatment in one language on the other) has been documented to varying degrees in some prior studies. However, none to date have documented the cross-linguistic impact of treatment with complex targets (e.g. consonant clusters) for bilingual children. Because complex phonological targets have been shown to induce system-wide generalization within a single language, the potential for bilingual children to generalize learning across languages could impact the efficiency of intervention in this population. This pilot intervention study examines the system-wide, cross-linguistic effects of treatment targeting consonant clusters in Spanish for two Spanish–English bilingual children with phonological disorder. Treatment was provided with 40-minute sessions in Spanish via teletherapy, three times per week for six weeks. Comprehensive phonological probes were administered in English and Spanish prior to intervention and across multiple baselines. Pre-intervention data were compared to data from probes administered during and after intervention to generate qualitative and quantitative measures of treatment outcomes and cross-linguistic generalization. Results indicate a medium effect size for system-wide generalization in Spanish (the language of treatment) and English (not targeted in treatment), for both participants (mean effect size in Spanish: 3.6; English 4.3). These findings have implications for across-language transfer and system-wide generalization in treatment for bilingual children.
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Affiliation(s)
- Philip Combiths
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, USA
- Correspondence concerning this article should be addressed to Philip Combiths, , Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Alicia Escobedo
- Language and Communicative Disorders, San Diego State University and University of California, San Diego, USA
| | - Jessica A. Barlow
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
| | - Sonja Pruitt-Lord
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
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Yasmin T, Hafeez H, Sadia A, Lubna M, Tarar SA, Raza MH, Basra MAR. Working memory span and receptive vocabulary assessment in Urdu speaking children with speech sound disorder. Acta Psychol (Amst) 2022; 231:103777. [PMID: 36356337 PMCID: PMC11318477 DOI: 10.1016/j.actpsy.2022.103777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
Emerging evidence suggests that impaired speech may be related to reduced working memory (WM). The current study aimed to validate and compare the influence of articulation, short-term memory (STM), WM, and receptive vocabulary abilities of Pakistani children with speech sound disorder (SSD; N = 50) versus typically developing (TD; N = 30) children aged 7-13 years. Assessments included the Test for Assessment of Articulation and Phonology in Urdu (TAAPU), Peabody Picture Vocabulary Test-4, translated to Urdu (U-PPVT-4), and Digit Memory Test (DMT) used to determine speech articulation, receptive vocabulary, and memory abilities respectively. The percentage correct consonants (PCC) score was used to divide the SSD group further into SSD severity groups. The TD and SSD groups significantly differed in performance on all tasks (p < 0.05). Moreover, the SSD severity groups showed significant differences (p < 0.0001) in performance on different components of TAAPU (total errors and substitution errors) and DMT tasks. However, the SSD severity groups did not show significant differences in performance on the U-PPVT-4. Correlational analyses indicate statistically significant correlations of PCC with STM, WM, and receptive vocabulary. Regression analyses suggested that both WM and STM contribute to speech intelligibility in children with SSD. Our findings in Urdu-speaking children support previous results in English-speaking children suggesting the articulation skills, receptive vocabulary, STM, and WM were less developed in children with SSD than in TD children.
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Affiliation(s)
- Tahira Yasmin
- Centre for Clinical and Nutritional Chemistry, School of Chemistry, University of the Punjab, New Campus, Lahore, Punjab, Pakistan
| | - Huma Hafeez
- Centre for Clinical and Nutritional Chemistry, School of Chemistry, University of the Punjab, New Campus, Lahore, Punjab, Pakistan
| | - Aatika Sadia
- Centre for Clinical and Nutritional Chemistry, School of Chemistry, University of the Punjab, New Campus, Lahore, Punjab, Pakistan
| | - Mubarak Lubna
- Department of Education, Govt. Graduate College for Women, Alipurchatha, Gujranwala, Pakistan; Department of Education, Virtual University, Lahore, Punjab, Pakistan
| | - Sharmeen Aslam Tarar
- Centre for Clinical Psychology, University of the Punjab, New Campus, Lahore, Punjab, Pakistan
| | | | - Muhammad Asim Raza Basra
- Centre for Clinical and Nutritional Chemistry, School of Chemistry, University of the Punjab, New Campus, Lahore, Punjab, Pakistan.
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Diepeveen S, Terband H, van Haaften L, van de Zande AM, Megens-Huigh C, de Swart B, Maassen B. Process-Oriented Profiling of Speech Sound Disorders. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1502. [PMID: 36291438 PMCID: PMC9600371 DOI: 10.3390/children9101502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022]
Abstract
The differentiation between subtypes of speech sound disorder (SSD) and the involvement of possible underlying deficits is part of ongoing research and debate. The present study adopted a data-driven approach and aimed to identify and describe deficits and subgroups within a sample of 150 four to seven-year-old Dutch children with SSD. Data collection comprised a broad test battery including the Computer Articulation Instrument (CAI). Its tasks Picture Naming (PN), NonWord Imitation (NWI), Word and NonWord Repetition (WR; NWR) and Maximum Repetition Rate (MRR) each render a variety of parameters (e.g., percentage of consonants correct) that together provide a profile of strengths and weaknesses of different processes involved in speech production. Principal Component Analysis on the CAI parameters revealed three speech domains: (1) all PN parameters plus three parameters of NWI; (2) the remaining parameters of NWI plus WR and NWR; (3) MRR. A subsequent cluster analysis revealed three subgroups, which differed significantly on intelligibility, receptive vocabulary, and auditory discrimination but not on age, gender and SLPs diagnosis. The clusters could be typified as three specific profiles: (1) phonological deficit; (2) phonological deficit with motoric deficit; (3) severe phonological and motoric deficit. These results indicate that there are different profiles of SSD, which cover a spectrum of degrees of involvement of different underlying problems.
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Affiliation(s)
- Sanne Diepeveen
- HAN University of Applied Sciences, 6524 TM Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud University Medical Center, 6525 AJ Nijmegen, The Netherlands
| | - Hayo Terband
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Leenke van Haaften
- Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud University Medical Center, 6525 AJ Nijmegen, The Netherlands
| | | | | | - Bert de Swart
- HAN University of Applied Sciences, 6524 TM Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud University Medical Center, 6525 AJ Nijmegen, The Netherlands
| | - Ben Maassen
- Centre for Language and Cognition, Groningen University, 9712 EK Groningen, The Netherlands
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León M, Washington KN, McKenna VS, Crowe K, Fritz K. Linguistically Informed Acoustic and Perceptual Analysis of Bilingual Children's Speech Productions: An Exploratory Study in the Jamaican Context. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2490-2509. [PMID: 35858256 PMCID: PMC9584129 DOI: 10.1044/2022_jslhr-21-00386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 12/17/2021] [Accepted: 04/08/2022] [Indexed: 05/03/2023]
Abstract
PURPOSE The aim of this study was to characterize speech acoustics in bilingual preschoolers who speak Jamaican Creole (JC) and English. We compared a standard approach with a culturally responsive approach for characterizing speech sound productions. Preschoolers' speech productions were compared to adult models from the same linguistic community as a means for providing confirmatory evidence of typical speech patterns specific to JC-English speakers. METHOD Two protocols were applied to the data collected using the Diagnostic Evaluation of Articulation and Phonology (DEAP) Articulation subtest: (a) the standardized DEAP protocol and (b) a culturally and linguistically adapted protocol reflective of the Jamaican post-Creole (English to Creole) continuum. The protocols were used to analyze responses from JC-English-speaking preschoolers (n = 119) and adults (n = 15). Responses were analyzed using acoustic (voice onset time, whole-word duration, and vowel duration) and perceptual (percentage of consonant correct-revised and response frequencies) measures. RESULTS The culturally responsive protocol captured variation in the frequency and acoustic differences produced in the post-Creole continuum, with higher amounts of "other" responses compared to "standard" target responses for both children and adults. Adults' whole-word durations were shorter and showed more consistent prevoicing during initial plosives compared to the children. CONCLUSIONS Applying culturally responsive methods, including knowledge of the variation produced in the post-Creole continuum and with adult models from the same linguistic community, improved the ecological validity of speech characterizations for JC-English preschoolers. Acoustic properties of speech should be investigated further as a means of describing bilingual development and distinguishing between difference and disorder. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20249382.
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Affiliation(s)
- Michelle León
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Karla N. Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Communicative Sciences and Disorders, New York University, New York
| | - Victoria S. McKenna
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Biomedical Engineering, University of Cincinnati, OH
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, OH
| | - Kathryn Crowe
- School of Education, Charles Sturt University, Bathurst, New South Wales, Australia
- School of Health Sciences, University of Iceland, Reykjavík
| | - Kristina Fritz
- Department of Psychology, California State University Northridge, Los Angeles
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Shooshtaryzadeh F, Stemberger JP. Idiosyncratic consonant clusters: a Farsi-speaking child with protracted phonological development. CLINICAL LINGUISTICS & PHONETICS 2022; 36:630-641. [PMID: 36005746 DOI: 10.1080/02699206.2022.2055495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 06/15/2023]
Abstract
This study presents a nonlinear phonological analysis of speech data from a Farsi-speaking child with protracted phonological development (aged 4;8) with very low accuracy on consonants. Results revealed some common phenomena (fricatives produced as stops; dorsals and non-anterior coronals produced as anterior coronals) and some uncommon phenomena (nasals produced as oral stops; voicing and devoicing of singleton obstruents in all word positions). These phenomena interacted in word-medial clusters to create an unusual sequence of two anterior-coronal or two bilabial stops, with C1 voiced and C2 voiceless, clusters which do not occur in the basic phonology of Farsi spoken by adults. We present a non-linear constraints-based analysis of the child's speech production and a plan for intervention targeting the child's special difficulties.
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Affiliation(s)
- Froogh Shooshtaryzadeh
- English Translation Department, Faculty of Literature and Humanity, Imam Khomeini International University (IKIU), Gazvin, Iran
| | - Joseph Paul Stemberger
- Department of Linguistics, University of British Columbia, Vancouver, British Columbia, Canada
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Malocclusion in children with speech sound disorders and motor speech involvement: a cross-sectional clinical study in Swedish children. Eur Arch Paediatr Dent 2022; 23:619-628. [PMID: 35776286 PMCID: PMC9338153 DOI: 10.1007/s40368-022-00728-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 06/10/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The objectives of this study were to investigate the occurrence, types and severity of malocclusions in children with speech sound disorder (SSD) persisting after 6 years of age, and to compare these findings to a control group of children with typical speech development (TSD). METHODS In total, 105 children were included: 61 with SSD and motor speech involvement (mean age 8:5 ± 2:8 years; range 6:0-16:7 years, 14 girls and 47 boys) and 44 children with TSD (mean age 8:8 ± 1:6; range 6:0-12:2 years, 19 girls and 25 boys). Extra-oral and intra-oral examinations were performed by an orthodontist. The severity of malocclusion was scored using the IOTN-DHC Index. RESULTS There were differences between the SSD and TSD groups with regard to the prevalence, type, and severity of malocclusions; 61% of the children in the SSD group had a malocclusion, as compared to 29% in the TSD group. In addition, the malocclusions in the SSD group were rated as more severe. Functional posterior crossbite and habitual lateral and/or anterior shift appeared more frequently in the SSD group. Class III malocclusion, anterior open bite and scissors bite were found only in the SSD group. CONCLUSION Children with SSD and motor speech involvement are more likely to have a higher prevalence of and more severe malocclusions than children with TSD.
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Mogren Å, Sand A, Havner C, Sjögreen L, Westerlund A, Agholme MB, Mcallister A. Children and adolescents with speech sound disorders are more likely to have orofacial dysfunction and malocclusion. Clin Exp Dent Res 2022; 8:1130-1141. [PMID: 35723352 PMCID: PMC9562821 DOI: 10.1002/cre2.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/08/2022] Open
Abstract
Background Children with speech sound disorders (SSD) form a heterogeneous group that differs in terms of underlying cause and severity of speech difficulties. Orofacial dysfunction and malocclusions have been reported in children with SSD. However, the association is not fully explored. Objectives Our aims were to describe differences in orofacial function and malocclusion between a group of children and adolescents with compared to without SSD and to explore associations between those parameters among the group with SSD. Methods A total of 105 participants were included, 61 children with SSD (6.0–16.7 years, mean age 8.5 ± 2.8, 14 girls and 47 boys) and 44 children with typical speech development (TSD) (6.0–12.2 years, mean age 8.8 ± 1.6, 19 girls and 25 boys). Assessments of orofacial function included an orofacial screening test and assessment of bite force, jaw stability, chewing efficiency, and intraoral sensory‐motor function. Possible malocclusions were also assessed. Result Children with SSD had both poorer orofacial function and a greater prevalence of malocclusion than children with TSD. Furthermore, children with SSD and poorer orofacial function had a greater risk of malocclusion. Conclusion Our result suggests that children with SSD are more prone to having poorer orofacial function and malocclusion than children with TSD. This illustrates the importance of assessing coexisting orofacial characteristics in children with SSD, especially since orofacial dysfunction may be linked to an increased risk of malocclusion. This result highlights the need for a multiprofessional approach.
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Affiliation(s)
- Åsa Mogren
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology Karolinska Institutet Stockholm Sweden
- Public Dental Service Mun‐H‐Center, Orofacial Resource Centre for Rare Diseases Gothenburg Sweden
| | - Anders Sand
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology Karolinska Institutet Stockholm Sweden
| | - Christina Havner
- Public Dental Service Mun‐H‐Center, Orofacial Resource Centre for Rare Diseases Gothenburg Sweden
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Lotta Sjögreen
- Public Dental Service Mun‐H‐Center, Orofacial Resource Centre for Rare Diseases Gothenburg Sweden
| | - Anna Westerlund
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Monica Barr Agholme
- Department of Dental Medicine, Division of Orthodontics and Pediatric Dentistry Karolinska Institutet Stockholm Sweden
| | - Anita Mcallister
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology Karolinska Institutet Stockholm Sweden
- Medical Unit Speech and Language Pathology, Women's Health and Allied Health Professionals Theme Karolinska University Hospital Stockholm Sweden
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Sayyahi F, Boulenger V. A temporal-based therapy for children with inconsistent phonological disorder: A case-series. CLINICAL LINGUISTICS & PHONETICS 2022:1-27. [PMID: 35694910 DOI: 10.1080/02699206.2022.2075792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 05/04/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
Deficits in temporal auditory processing, and in particular higher gap detection thresholds have been reported in children with inconsistent phonological disorder (IPD). Here we hypothesized that providing these children with extra time for phoneme identification may in turn enhance their phonological planning abilities for production, and accordingly improve not only consistency but also accuracy of their speech. We designed and tested a new temporal-based therapy, inspired by Core Vocabulary Therapy and called it T-CVT, where we digitally lengthened formant transitions between phonemes of words used for therapy. This allowed to target both temporal auditory processing and word phonological planning. Four preschool Persian native children with IPD received T-CVT for eight weeks. We measured changes in speech consistency (% inconsistency) and accuracy (percentage of consonants correct PCC) to assess the effects of the intervention. Therapy significantly improved both consistency and accuracy of word production in the four children: % inconsistency decreased from 59% on average before therapy to 2% post-T-CVT, and PCC increased from 61% to 92% on average. Consistency and accuracy were furthermore maintained or even still improved at three-month follow-up (2% inconsistency and 99% PCC). Results in a nonword repetition task showed the generalization of these effects to non-treated material: % inconsistency for nonwords decreased from 67% to 10% post-therapy, and PCC increased from 63% to 90%. These preliminary findings support the efficacy of the T-CVT intervention for children with IPD who show temporal auditory processing deficits as reflected by higher gap detection thresholds.
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Affiliation(s)
- Fateme Sayyahi
- School of Rehabilitation, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Véronique Boulenger
- Laboratoire Dynamique du Langage, UMR5596 CNRS/Université Lyon 2, Lyon, France
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Campbell DR, Goldstein H. Reliability of Scoring Telehealth Speech Sound Assessments Administered in Real-World Scenarios. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1338-1353. [PMID: 35442714 DOI: 10.1044/2022_ajslp-21-00219] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE COVID-19 caused a worldwide conversion from in-person therapy to telehealth; however, limited evidence to support the efficacy of remotely delivering standardized tests puts the future of widespread telehealth use at risk. The aim of this study is to investigate the reliability of scoring a speech sound assessment administered in real-world scenarios including two examples of telehealth technology. METHOD A total of thirty-nine 3- to 8-year-olds were administered the Goldman-Fristoe Test of Articulation-Third Edition. Licensed speech-language pathologists (SLPs) concurrently scored children's responses in person and in two telehealth conditions considered typical and enhanced. Mean standard scores and interrater reliability results were compared among the three conditions. Descriptive statistics were used to summarize the frequency of technology and behavior disruptions during administration and the results of an SLP telehealth perception survey. RESULTS All scoring conditions were found to be highly correlated, with mean differences revealing no systematic differences of one condition over- or underestimating another. Although response agreement was high (85%-87%), final sounds in words or sounds that are difficult to observe tended to attenuate reliability. Neither child nor technology disruptions affected SLPs' ability to score responses. Despite no significant differences between conditions on scoring reliability, SLP participants reported they continued to prefer in-person over a telehealth speech sound assessment. CONCLUSIONS This study supports the provision of a pediatric speech sound assessment using consumer-grade equipment, as in-person, typical telehealth, and enhanced telehealth scoring conditions produced similar results. However, SLP participants' skeptical attitudes toward remote delivery of standardized tests reveal an ongoing barrier to widespread telehealth use. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19593367.
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Affiliation(s)
- Deborah R Campbell
- Department of Communication Sciences and Disorders, University of South Florida, Tampa
| | - Howard Goldstein
- Department of Communication Sciences and Disorders, University of South Florida, Tampa
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Carl M, Levy ES, Icht M. Speech treatment for Hebrew-speaking adolescents and young adults with developmental dysarthria: A comparison of mSIT and Beatalk. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:660-679. [PMID: 35363414 DOI: 10.1111/1460-6984.12715] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/16/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Individuals with developmental dysarthria typically demonstrate reduced functioning of one or more of the speech subsystems, which negatively impacts speech intelligibility and communication within social contexts. A few treatment approaches are available for improving speech production and intelligibility among individuals with developmental dysarthria. However, these approaches have only limited application and research findings among adolescents and young adults. AIMS To determine and compare the effectiveness of two treatment approaches, the modified Speech Intelligibility Treatment (mSIT) and the Beatalk technique, on speech production and intelligibility among Hebrew-speaking adolescents and young adults with developmental dysarthria. METHODS & PROCEDURES Two matched groups of adolescents and young adults with developmental dysarthria participated in the study. Each received one of the two treatments, mSIT or Beatalk, over the course of 9 weeks. Measures of speech intelligibility, articulatory accuracy, voice and vowel acoustics were assessed both pre- and post-treatment. OUTCOMES & RESULTS Both the mSIT and Beatalk groups demonstrated gains in at least some of the outcome measures. Participants in the mSIT group exhibited improvement in speech intelligibility and voice measures, while participants in the Beatalk group demonstrated increased articulatory accuracy and gains in voice measures from pre- to post-treatment. Significant increases were noted post-treatment for first formant values for select vowels. CONCLUSIONS & IMPLICATIONS Results of this preliminary study are promising for both treatment approaches. The differentiated results indicate their distinct application to speech intelligibility deficits. The current findings also hold clinical significance for treatment among adolescents and young adults with motor speech disorders and application for a language other than English. WHAT THIS PAPER ADDS What is already known on the subject Developmental dysarthria (e.g., secondary to cerebral palsy) is a motor speech disorder that negatively impacts speech intelligibility, and thus communication participation. Select treatment approaches are available with the aim of improving speech intelligibility in individuals with developmental dysarthria; however, these approaches are limited in number and have only seldomly been applied specifically to adolescents and young adults. What this paper adds to existing knowledge The current study presents preliminary data regarding two treatment approaches, the mSIT and Beatalk technique, administered to Hebrew-speaking adolescents and young adults with developmental dysarthria in a group setting. Results demonstrate the initial effectiveness of the treatment approaches, with different gains noted for each approach across speech and voice domains. What are the potential or actual clinical implications of this work? The findings add to the existing literature on potential treatment approaches aiming to improve speech production and intelligibility among individuals with developmental dysarthria. The presented approaches also show promise for group-based treatments as well as the potential for improvement among adolescents and young adults with motor speech disorders.
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Affiliation(s)
- Micalle Carl
- Department of Communication Disorders, Ariel University, Ariel, Israel
| | - Erika S Levy
- Teachers College, Columbia University, New York, NY, USA
| | - Michal Icht
- Department of Communication Disorders, Ariel University, Ariel, Israel
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Oral and Laryngeal Articulation Control of Voicing in Children with and without Speech Sound Disorders. CHILDREN 2022; 9:children9050649. [PMID: 35626826 PMCID: PMC9139554 DOI: 10.3390/children9050649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/07/2022] [Accepted: 04/28/2022] [Indexed: 11/25/2022]
Abstract
Voicing contrast is hard to master during speech motor development, and the phonological process of consonant devoicing is very frequent in children with Speech Sound Disorders (SSD). Therefore, the aim of this study was to characterise the oral and laryngeal articulation control strategies used by children with and without SSD as a function of place of articulation. The articulation rate and relative oral airflow amplitude (flow) were used to analyse how children controlled oral articulation; fundamental frequency (fo), open quotient (OQ), and a classification of voicing were used to explore laryngeal behaviour. Data from detailed speech and language assessments, oral airflow and electroglottography signals were collected from 13 children with SSD and 17 children without SSD, aged 5; 0 to 7; 8, using picture naming tasks. Articulation rate and flow in children with and without SSD were not significantly different, but a statistically reliable effect of place on flow was found. Children with and without SSD used different relative fo (which captures changes in fo during the consonant-vowel transition) and OQ values, and place of articulation had an effect on the strength of voicing. All children used very similar oral articulation control of voicing, but children with SSD used less efficient laryngeal articulation strategies (higher subglottal damping and more air from the lungs expelled in each glottal cycle) than children without SSD.
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Beiting M. Diagnosis and Treatment of Childhood Apraxia of Speech Among Children With Autism: Narrative Review and Clinical Recommendations. Lang Speech Hear Serv Sch 2022; 53:947-968. [PMID: 35472263 DOI: 10.1044/2022_lshss-21-00162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Treatment for children with autism spectrum disorder (ASD) and low verbal ability is a largely neglected area of study. Existing research focuses on language abilities; however, a subset of children with ASD also has speech sound disorders (SSDs). The purpose of this tutorial is to provide clinicians with evidence-based recommendations to guide speech assessment and treatment among children with ASD, low verbal ability, and suspected childhood apraxia of speech (CAS). METHOD Multifaceted search procedures were used to identify studies that have assessed or treated speech sound production among children with ASD. A narrative review and synthesis of the literature is followed by practical clinical recommendations based on best available evidence. CONCLUSIONS It is critically important to consider all possible hindrances to the development of functional communication ability for children with ASD. Speech sound production has been identified as a key predictor of expressive language outcomes, yet there are very few studies that address assessment and treatment of SSDs among children with ASD. Less is known about the presentation of CAS among children with ASD and low verbal ability. More research is needed to determine whether existing speech assessment and treatment methods are appropriate for children with ASD, if modifications are needed, or if new methods should be designed.
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Affiliation(s)
- Molly Beiting
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
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Baker E, Masso S, Huynh K, Sugden E. Optimizing Outcomes for Children With Phonological Impairment: A Systematic Search and Review of Outcome and Experience Measures Reported in Intervention Research. Lang Speech Hear Serv Sch 2022; 53:732-748. [PMID: 35394819 DOI: 10.1044/2022_lshss-21-00132] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Reporting of outcome and experience measures is critical to our understanding of the effect of intervention for speech sound disorders (SSD) in children. There is currently no agreed-upon set of measures for reporting intervention outcomes and experiences. In this article, we introduce the Speech Outcome Reporting Taxonomy (SORT), a tool designed to assist with the classification of outcome and experience measures. In a systematic search and review using the SORT, we explore the type and frequency of these measures reported in intervention research addressing phonological impairment in children. Given the integral relationship between intervention fidelity and intervention outcomes, reporting of fidelity is also examined. METHOD Five literature databases were searched to identify articles written or translated into English published between 1975 and 2020. Using the SORT, outcome and experience measures were extracted and categorized. The number of intervention studies reporting fidelity was determined. RESULTS A total of 220 articles met inclusion criteria. The most frequently reported outcome domain was broad generalization measures (n = 142, 64.5%), followed by specific measures of generalization of an intervention target (n = 133, 60.5%). Eleven (5.0%) articles reported measures of the impact of the phonological impairment on children's activity, participation, quality of life, or others. Twenty articles (9.1%) reported on parent, child, or clinician experience or child engagement. Fidelity data were reported for 13.4% of studies of interventions. CONCLUSIONS The measurement of intervention outcomes is challenging yet important. No single type of measure was reported across all articles. Through using tailored measures closely related to intervention targets in combination with a universal set of measures of intelligibility, the impact of phonological impairment on children's lives, and the experience of receiving and providing intervention, researchers and clinicians could work together to progress insights and innovations in science and practice for children with SSD. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19497803.
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Affiliation(s)
- Elise Baker
- School of Health Sciences, Western Sydney University, New South Wales, Australia.,South Western Sydney Local Health District, Liverpool, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Sarah Masso
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.,Charles Sturt University, Bathurst, New South Wales, Australia
| | - Kylie Huynh
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Ellie Sugden
- School of Health Sciences, Western Sydney University, New South Wales, Australia
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van Noort-van der Spek IL, Dudink J, Reiss IK, Franken MCJP. Early Speech Sound Production and Its Trajectories in Very Preterm Children From 2 to 4 Years of Age. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1294-1310. [PMID: 35263167 DOI: 10.1044/2021_jslhr-21-00388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Very preterm (VPT) children are at risk for speech and language problems throughout school age. However, little is known about early speech sound production in these children. This study aims to present a detailed description of early speech sound production and its trajectories in VPT children from 2 to 4 years of age. In addition, this study aimed to determine if early speech sound production is associated with speech production and expressive language function at 4 years of age. METHOD In 63 VPT children (< 32 weeks of gestation, 41 boys, mean gestational age = 28.8 weeks, mean birth weight = 1,135 g), speech sound production was assessed by naturalistic speech analysis at 2 years of corrected age and speech and language function by standardized tests at 4 years of age. RESULTS Speech sound production was found to be abnormal in 49% of the VPT children at 2 years of age and in 19% at 4 years of age. Four different speech production trajectories from 2 to 4 years of age could be identified: a normal trajectory, an abnormal trajectory, a catch-up trajectory, and a growing-into-deficit trajectory. Early speech production, defined by the number of acquired consonants at 2 years of age, significantly predicted the word production score at 4 years of age and the sentence production score at 4 years of age. CONCLUSIONS Compared to the general population, an alarmingly high proportion of VPT children showed speech production problems at 2 years of age. About half of these children showed persistent speech problems at 4 years of age. Moreover, these problems were associated with expressive language problems at the age of 4 years. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19310822.
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Affiliation(s)
- Inge L van Noort-van der Spek
- Department of Otorhinolaryngology, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
| | - Jeroen Dudink
- Division of Neonatology, Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
- Division of Neonatology, Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, the Netherlands
| | - Irwin K Reiss
- Division of Neonatology, Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
| | - Marie-Christine J P Franken
- Department of Otorhinolaryngology, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
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Combiths P, Amberg R, Hedlund G, Rose Y, Barlow JA. Automated phonological analysis and treatment target selection using AutoPATT. CLINICAL LINGUISTICS & PHONETICS 2022; 36:203-218. [PMID: 34085574 PMCID: PMC8642465 DOI: 10.1080/02699206.2021.1896782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
Automated analyses of speech samples can offer improved accuracy and timesaving advantages that streamline clinical assessment for children with a suspected speech sound disorder. In this paper, we introduce AutoPATT, an automated tool for clinical analysis of speech samples. This free, open-source tool was developed as a plug-in for Phon and follows the procedures of the Phonological Analysis and Treatment Target Selection protocol, including extraction of a phonetic inventory, phonemic inventory with corresponding minimal pairs, and initial consonant cluster inventory. AutoPATT also provides suggestions for complex treatment targets using evidence-based guidelines. Automated analyses and target suggestions were compared to manual analyses of 25 speech samples from children with phonological disorder. Results indicate that AutoPATT inventory analyses are more accurate than manual analyses. However, treatment targets generated by AutoPATT should be viewed as suggestions and not used to substitute necessary clinical judgement in the target selection process.
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Affiliation(s)
- Philip Combiths
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
- Department of Cognitive Science, University of California, San Diego, USA
| | - R. Amberg
- Alta Loma School District, Rancho Cucamonga, USA
| | - G. Hedlund
- Department of Linguistics, Memorial University of Newfoundland, St. John’s, Canada
| | - Y. Rose
- Department of Linguistics, Memorial University of Newfoundland, St. John’s, Canada
| | - J. A. Barlow
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
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