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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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van der Goes PAJ, Ombashi S, van Roey V, Hakelius M, Mathijssen IMJ, Mink van der Molen AB, Versnel SL. The Development of a European Multidisciplinary Cleft Lip and Palate Registry by the European Reference Network CRANIO: Experiences, Barriers, And Facilitators. J Craniofac Surg 2024:00001665-990000000-01626. [PMID: 38781427 DOI: 10.1097/scs.0000000000010314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/15/2024] [Indexed: 05/25/2024] Open
Abstract
The European Reference Network for Rare Craniofacial Aanomalies and Ear-Nose-Throat disorders aims to improve care for patients with such afflictions, including cleft lip and palate (CL/P) across Europe. Cleft treatment remains varied throughout European centers, inhibiting meaningful comparison of treatment outcomes. To overcome these issues, a European-wide common CL/P dataset and registry was developed, facilitating standardized treatment endpoints and outcome measures for international comparison and benchmarking of CL/P centers. Questionnaires and semi-structured interviews were used to determine the set-up of the registry. Previous CL/P initiatives were analyzed to create an initial dataset, refined through consensus meetings. In total, 87 cleft specialists working in specialized CL/P centers from 16 European nations participated. Consensus on a common dataset was reached. A "Level 1" dataset, with mandatory clinical and patient-reported outcome measures, and "Level 2" dataset with additional outcome measures. Finally, 2 dashboards were developed for data dissemination. The development of the European CL/P common dataset and registry tackled challenges with resource disparities, variations in specialists within CL/P teams, regulatory differences in patient data usage, patient-reported outcome measures availability in European languages, and use of assessment tools. This study described the successful development of the European Reference Network for Rare Craniofacial Aanomalies and Ear-Nose-Throat disorders CL/P common dataset and registry. This achievement will help improve patient care and outcomes for patients with CL/P in Europe. Furthermore, this study provides useful information for initiatives with similar aims.
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Affiliation(s)
| | - Saranda Ombashi
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center, Rotterdam
| | - Victor van Roey
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center, Rotterdam
| | - Malin Hakelius
- Department of Plastic Surgery and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Irene M J Mathijssen
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center, Rotterdam
| | | | - Sarah L Versnel
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center, Rotterdam
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Tahmasebi N, Zarifian T, Ashtari A, Biglarian A. Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e54426. [PMID: 38640014 PMCID: PMC11069098 DOI: 10.2196/54426] [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: 11/09/2023] [Revised: 02/14/2024] [Accepted: 02/22/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents' role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders. OBJECTIVE This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention. METHODS A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants' speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants). RESULTS The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received. CONCLUSIONS The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54426.
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Affiliation(s)
- Neda Tahmasebi
- Department of Speech Therapy, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Talieh Zarifian
- Department of Speech Therapy, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Atieh Ashtari
- Department of Speech Therapy, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Akbar Biglarian
- Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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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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Ombashi S, Kurniawan MS, Allori A, Sharif-Askary B, Rogers-Vizena C, Koudstaal M, Franken MC, Mink van der Molen AB, Mathijssen I, Klassen A, Versnel SL. What is the optimal assessment of speech? A multicentre, international evaluation of speech assessment in 2500 patients with a cleft. BMJ Open 2023; 13:e071571. [PMID: 38154881 PMCID: PMC10759067 DOI: 10.1136/bmjopen-2023-071571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 10/23/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVES Speech problems in patients with a cleft palate are often complex and multifactorial. Finding the optimal way of monitoring these problems is challenging. The International Consortium of Health Outcomes Measurement (ICHOM) has developed a set of standardised outcome measures at specific ages for patients with a cleft lip and/or palate, including measures of speech assessment. This study evaluates the type and timing of speech outcome measures currently included in this ICHOM Standard Set. Additionally, speech assessments in other cleft protocols and initiatives are discussed. DESIGN, SETTING AND PARTICIPANTS An international, multicentre study was set up including centres from the USA and the Netherlands. Outcomes of clinical measures and Patient Reported Outcome Measures (PROMs) were collected retrospectively according to the ICHOM set. PROM data from a field test of the CLEFT-Q, a questionnaire developed and validated for patients with a cleft, were collected, including participants from countries with all sorts of income statuses, to examine the value of additional moments of measurement that are used in other cleft initiatives.Data from 2500 patients were included. Measured outcomes contained univariate regression analyses, trend analyses, t-tests, correlations and floor and ceiling effects. RESULTS PROMs correlated low to moderate with clinical outcome measures. Clinical outcome measures correlated low to moderate with each other too. In contrast, two CLEFT-Q Scales correlated strongly with each other. All PROMs and the Percent Consonants Correct (PCC) showed an effect of age. In patients with an isolated cleft palate, a ceiling effect was found in the Intelligibility in Context Scale. CONCLUSION Recommendations for an optimal speech outcome assessment in cleft patients are made. Measurement moments of different cleft protocols and initiatives are considered in this proposition. Concerning the type of measures, adjustment of the current PCC score outcome seems appropriate. For centres with adequate resources and specific interest in research, translation and validation of an upcoming tool, the Cleft Audit Protocol for Speech Augmented, is recommended.
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Affiliation(s)
- Saranda Ombashi
- Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Alexander Allori
- Plastic, Maxillofacial and Oral Surgery, Duke University Hospital and Children's Health Center, Durham, North Carolina, USA
| | - Banafsheh Sharif-Askary
- Plastic, Maxillofacial and Oral Surgery, Duke University Hospital and Children's Health Center, Durham, North Carolina, USA
| | | | - Maarten Koudstaal
- Department of Oral and Maxillofacial Surgery, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands
| | | | | | - Irene Mathijssen
- Department of Plastic and Reconstructive Surgery, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands
| | - Anne Klassen
- Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Lisa Versnel
- Plastic and Reconstructive Surgery, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands
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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 DOI: 10.1044/2023_jslhr-23-00106] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [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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Soriano JU, Mahr TJ, Rathouz PJ, Hustad KC. Intelligibility in Context Scale: Growth Curves for Typically Developing English-Speaking Children Between Ages 2;6 and 9;11. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2021-2039. [PMID: 37390405 PMCID: PMC10561968 DOI: 10.1044/2023_ajslp-22-00392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE The aim of this study was to quantify the clinical utility of the Intelligibility in Context Scale (ICS) English version by characterizing the growth patterns of the ICS composite scores and seven ICS individual item scores of typically developing American English-speaking children. METHOD Parents of 545 typically developing children aged 2;6-9;11 (years;months) completed the ICS. Using a proportional odds model, we regressed ICS composite scores on age and computed for model-estimated mean and lower quantile ICS composite scores. Logistic regression and proportional odds modeling were utilized to quantify the relationship of individual ICS items and age. RESULTS ICS composite scores of typically developing children changed with age, but change was small and incremental, with scores compressed between 3 and 5 across the range of ages. An average child (i.e., on the 50th percentile) is expected to have an ICS composite score of 4 beginning at 3;0 and an ICS composite score of 5 by 6;6. On average, parents gave different intelligibility ratings based on communicative partners, and the rating differences between communicative partners decreased with age. CONCLUSIONS Given that ICS scores increase with age, the expected score for average children also increases. A child's age is a main factor for interpreting ICS scores.
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Affiliation(s)
- Jennifer U. Soriano
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
- Waisman Center, University of Wisconsin–Madison
| | | | - Paul J. Rathouz
- Department of Population Health, Dell Medical School, The University of Texas at Austin
| | - Katherine C. Hustad
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
- Waisman Center, University of Wisconsin–Madison
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van Tellingen M, Hurkmans J, Terband H, van de Zande AM, Maassen B, Jonkers R. Speech and Music Therapy in the Treatment of Childhood Apraxia of Speech: An Introduction and a Case Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-19. [PMID: 37625142 DOI: 10.1044/2023_jslhr-22-00619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
PURPOSE Speech-Music Therapy for Aphasia (SMTA), a method that combines speech therapy and music therapy, is introduced as a treatment method for childhood apraxia of speech (CAS). SMTA will be evaluated in a proof-of-principle study. The first case study is presented herein. METHOD SMTA was evaluated in a study with a single-subject experimental design comparing 10 weeks of treatment with 2 months of no treatment. The research protocol included a pretest, baseline phase, treatment phase, posttest, no-treatment phase, and follow-up test. The participant was a boy with CAS aged 5;8 (years;months). Outcome measures were selected to reflect both intelligibility in daily communication as well as features of CAS and speech motor planning and programming. RESULTS Results on the Intelligibility in Context Scale-Dutch (ICS-Dutch) and in the analysis of a spontaneous speech sample suggest generalization of treatment effects. Improvements were found in measures that reflect complex speech motor skills, that is, the production of consonant clusters and consistency. CONCLUSIONS This case study showed that speech production of the participant improved after treatment with SMTA. Although intelligibility as measured with the ICS-Dutch improved over the study period, objectifying changes at the level of intelligibility in daily communication proved to be difficult. Additional measures may be necessary to gain more insight into treatment effects at this level. Overall, the results of this first case study provide sufficient support and important leads for further evaluation of SMTA in the treatment of CAS in a proof-of-principle study.
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Affiliation(s)
- Mirjam van Tellingen
- Rehabilitation Centre "Revalidatie Friesland," Beetsterzwaag, the Netherlands
- University of Groningen, the Netherlands
| | - Joost Hurkmans
- Rehabilitation Centre "Revalidatie Friesland," Beetsterzwaag, the Netherlands
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McLeod S, Verdon S, Margetson K, Tran VH, Wang C, Phạm B, To L, Huynh K. Multilingual Speech Acquisition by Vietnamese-English-Speaking Children and Adult Family Members. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-46. [PMID: 37379225 DOI: 10.1044/2023_jslhr-21-00669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
PURPOSE This article presents a large-scale example of culturally responsive assessment and analysis of multilingual Vietnamese-English-speaking children and their family members using the VietSpeech Protocol involving (a) examining all spoken languages, (b) comparing ambient phonology produced by family members, (c) including dialectal variants in the definition of accuracy, and (d) clustering participants with similar language experience. METHOD The VietSpeech participants (N = 154) comprised 69 children (2;0-8;10 [years;months]) and 85 adult family members with Vietnamese heritage living in Australia. Speech was sampled using the Vietnamese Speech Assessment (Vietnamese) and the Diagnostic Evaluation of Articulation and Phonology (English). RESULTS Children's Vietnamese consonant accuracy was significantly higher when dialectal variants were accepted (percentage of consonants correct-dialect [PCC-D]: M = 87.76, SD = 8.18), compared to when only Standard Vietnamese was accepted as the correct production (percentage of consonants correct-standard [PCC-S]: M = 70.34, SD = 8.78), Cohen's d = 3.55 (large effect). Vietnamese voiced plosives, nasals, semivowels, vowels, and tones were more often correct than voiceless plosives and fricatives. Children's Standard Australian English consonant accuracy (PCC-S) was 82.51 (SD = 15.57). English plosives, nasals, glides, and vowels were more often correct than fricatives and affricates. Vietnamese word-initial consonants had lower accuracy than word-final consonants, whereas English consonant accuracy was rarely influenced by word position. Consonant accuracy and intelligibility were highest for children with high proficiency in both Vietnamese and English. Children's consonant productions were most similar to their mothers' than other adults or siblings' productions. Adults' Vietnamese consonants, vowels, and tones were more likely to match Vietnamese targets than their children's productions. CONCLUSIONS Children's speech acquisition was influenced by cross-linguistic, dialectal, maturational, language experience, and environmental (ambient phonology) factors. Adults' pronunciation was influenced by dialectal and cross-linguistic factors. This study highlights the importance of including all spoken languages, adult family members, dialectal variants, and language proficiency to inform differential diagnosis of speech sound disorders and identify clinical markers in multilingual populations. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23290055.
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Affiliation(s)
- Sharynne McLeod
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Sarah Verdon
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Kate Margetson
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Van H Tran
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Cen Wang
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Ben Phạm
- Charles Sturt University, Bathurst, New South Wales, Australia
- Hanoi National University of Education, Viet Nam
| | - Lily To
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Kylie Huynh
- Charles Sturt University, Bathurst, New South Wales, Australia
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Mirihagalla Kankanamalage I, Cleland J, Cohen W. Translation and validation of the Intelligibility in Context Scale into Sinhala for adolescents in Sri Lanka with cleft lip and palate. CLINICAL LINGUISTICS & PHONETICS 2023; 37:398-414. [PMID: 36093956 DOI: 10.1080/02699206.2022.2120417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 07/29/2022] [Accepted: 08/22/2022] [Indexed: 05/20/2023]
Abstract
The Intelligibility in Context Scale (ICS) is a parent-report screening tool used to measure parents' perceptions of children's functional intelligibility. This tool has been translated into over 60 languages and found to have a good reliability and validity. The purpose of the current study was to translate the ICS into Sinhala (the ICS-SIN), the main language spoken by the Sinhalese people in Sri Lanka, and to validate it with both typically developing (TD) children and children with repaired cleft lip and/or palate (CLP). The translation process followed the forward-backward-forward method. A total of 88 parents of TD children and children with CLP aged 12-15 years old (TD n = 50, CLP n = 38) completed the ICS-SIN questionnaire. Parents of TD and CLP children reported their children's speech as most intelligible to parents and least intelligible to strangers. The ICS-SIN had high internal consistency for both groups (TD α = 0.87, p < 0.05, CLP α = 0.97, p < 0.05). The ICS-SIN total scores and item scores showed significant correlations, indicating a good construct validity. TD participant group's ICS-SIN average mean scores (M = 4.88, SD = 0.29) were significantly higher compared to the CLP ICS-SIN average mean scores (M = 4.64, SD = 0.67) and varied according to gender in both groups, suggesting good discriminant validity. The ICS-SIN has overall good psychometric properties. Therefore, this tool has the potential to be used as a valid parent-rating screening tool for clinical and research purposes in Sri Lanka.
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Affiliation(s)
| | - Joanne Cleland
- Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Wendy Cohen
- Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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12
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Kokotek LE, Washington KN. Characterizing Communicative Participation in Multilingual Jamaican Preschoolers. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:658-674. [PMID: 36827540 PMCID: PMC10171857 DOI: 10.1044/2022_ajslp-22-00138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/07/2022] [Accepted: 12/02/2022] [Indexed: 05/12/2023]
Abstract
PURPOSE This study characterized communicative participation and related aspects of functional communication for Jamaican Creole (JC)-English-speaking preschoolers with and without functionally defined speech sound disorders (fSSDs). This study included parent reports and direct assessment measures from an existing corpus of baseline data collected prior to the COVID-19 pandemic. METHOD The communicative participation of typically developing (TD; n = 226) bilingual JC-English-speaking preschoolers and those with fSSDs (n = 39) was documented using the Focus on the Outcomes of Communication Under Six (FOCUS). Functional speech intelligibility was recorded using the Intelligibility in Context Scale (ICS) in English and JC (ICS-JC). Objective measures of speech production were collected through direct child assessment in both languages and then transcribed and calculated for percent of consonants (PCC), vowels (PVC), and phonemes correct (PPC). Within-group relationships were explored using association testing, and differences between groups were explored through multivariate analyses. RESULTS FOCUS scores and ICS and ICS-JC scores were found to be minimally to moderately related for Jamaican preschoolers in the TD group (r = .28-.34, p < .002) and strongly related in the fSSD group (r = .56-.60, p < .002). No relations were observed between the FOCUS scores and PCC/PVC/PPC in either language. There was a statistically significant difference between all FOCUS scores for Jamaican preschoolers in the TD and fSSD groups (p ≤ .002). CONCLUSIONS These findings provide additional evidence for using the FOCUS beyond documenting change in communicative participation to support clinical decision-making in planning and developing speech-language interventions. This study also documents an important characterization of JC-English-speaking children with and without fSSDs, offering data on children's abilities that can be used in future comparisons of communicative participation and speech functioning observed during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Leslie E. Kokotek
- 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 Speech-Language Pathology, University of Toronto, Ontario, Canada
- Department of Communicative Sciences and Disorders, New York University, NY
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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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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 2022; 9:children9101502. [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
- Correspondence: (S.D.); (H.T.)
| | - Hayo Terband
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
- Correspondence: (S.D.); (H.T.)
| | - 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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PROMPT to improve speech motor abilities in children with cerebral palsy: a wait-list control group trial protocol. BMC Neurol 2022; 22:246. [PMID: 35794522 PMCID: PMC9258135 DOI: 10.1186/s12883-022-02771-6] [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: 05/11/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Children with cerebral palsy (CP) often have communication impairments, including speech altered intelligibility. Multiple levels of disrupted speech have been reported in CP, which negatively impact on participation and quality of life, with increase of care needs. Augmentative Alternative Communication (AAC) is an option, with debated benefits and limitations, in particular for its functional use. This is supported by a substantial lack of defined evidences in favor of direct speech articulation intervention in CP. Motor learning-based interventions are effective in CP and are the basis of speech motor interventions such as PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets). The PROMPT speech motor treatment provides tactile-kinesthetic inputs to facilitate articulatory movements by dynamic modelling, resulting in more efficient motor patterns that can be integrated into speech and communication. In CP, exploratory evidences support the feasibility and preliminarily advantages on intelligibility of motor speech treatments, such as PROMPT, with increased speech motor control, also documented by kinematic analyses. Methods A randomized waitlist-control trial will be conducted in children aged between 3- and 10-years having CP and dysarthria (estimated sample size = 60 children). Children will be allocated in the immediate intervention or in the waitlist control group. The intervention consists of an intensive 3 weeks period of twice-a-day administration of PROMPT. Standard care will be administered in the control (waitlist) group. After repeated baseline assessments (T0), the PROMPT treated group will undergo the experimental 3-week intervention period, with T1 assessment at the end. A further T2 assessment will be provided at medium term (3 months after the end of the intervention) for evaluating the stability of intervention. Primary and secondary speech clinical and kinematics outcome measures will be collected at T0, T1 and T2. Discussion This paper describes the study protocol consisting of a RCT with two main objectives: (1) to evaluate the or short-term benefits of an intensive speech motor intervention on speech and intelligibility in children with CP and the stability of the intervention at medium term; (2) to describe the kinematic correlates of speech motor control modifications. Trial registration Trial registration date 06/12/2019; ClinicalTrials.gov Identifier: NCT04189159.
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16
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To CKS, McLeod S, Sam KL, Law T. Predicting Which Children Will Normalize Without Intervention for Speech Sound Disorders. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1724-1741. [PMID: 35381182 DOI: 10.1044/2022_jslhr-21-00444] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The speech of some children does not follow a typical normalization trajectory, and they develop speech sound disorders (SSD). This study investigated predictive correlates of speech sound normalization in children who were at risk of SSD. METHOD A prospective population cohort study of 845 Cantonese-speaking preschoolers was conducted over 2.5 years to examine (a) children who resolved nonadult realizations of consonants (normalized) and (b) those who had persisting speech sound difficulties (did not normalize). From these 845, a sample of 82 participants characterized as having SSD (1.25 SDs below the mean in a standardized speech assessment, with a delay in initial consonant acquisition or with one or more atypical errors) was followed for 2 years at 6-month intervals or until the completion of their initial consonant inventory. Data from 43 children who did not receive speech-language pathology services were analyzed with survival analysis to model time to normalization while controlling for covariates. The target event (outcome) was the completion of their initial consonant inventory. RESULTS Under the no-intervention condition, the estimated median time to normalization was 6.59 years of age. Children who were more likely to normalize or normalized in a shorter time were stimulable to all errors and more intelligible as rated by caregivers using the Intelligibility in Context Scale. Those who showed atypical error patterns did not necessarily take longer to normalize. Similarly, expressive language ability was not significantly associated with speech normalization. CONCLUSIONS Stimulability and intelligibility were more useful prognostic factors of speech normalization when compared to (a)typicality of error patterns and expressive language ability. Children with low intelligibility and poor stimulability should be prioritized for speech-language pathology services given that their speech errors are less likely to resolve naturally.
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Affiliation(s)
| | - Sharynne McLeod
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Ka Lam Sam
- The University of Hong Kong, Hong Kong SAR, China
| | - Thomas Law
- The Chinese University of Hong Kong, Hong Kong SAR, China
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17
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Combiths P, Pruitt-Lord S, Escobedo A, Barlow JA. Phonological complexity in intervention for Spanish-speaking children with speech sound disorder. CLINICAL LINGUISTICS & PHONETICS 2022; 36:219-240. [PMID: 34112044 PMCID: PMC8660952 DOI: 10.1080/02699206.2021.1936186] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The efficiency of intervention for children with speech sound disorder may be influenced by linguistic complexity of the phonological intervention target. Complex targets, particularly, later-acquired, less-known consonants and consonant clusters, have been linked to greater post-intervention generalization to untargeted phonological structures. Yet there is little direct evidence to support target selection based on linguistic complexity for Spanish-speaking children with speech sound disorder. This intervention study utilizes an experimental single-case design to examine the efficacy of intervention in Spanish using different complex targets (i.e. /ɡɾ/, /bɾ/, and /l/). For each of the four Spanish-speaking children with speech sound disorder, sounds at 0% accuracy during baseline were monitored across the baseline period, during and post-intervention, and at one- and two-month follow-up visits. Over the course of intervention, only one participant achieved mastery of the targeted structure in practiced words. However, all participants demonstrated some amount of broad phonological generalization to untargeted consonants or clusters. Variable learning trajectories and broad phonological generalization are discussed as they relate to participant characteristics and linguistic complexity.
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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
- Correspondence concerning this article should be addressed to Philip Combiths, , School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA 92182, USA
| | - S. Pruitt-Lord
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
| | - A. Escobedo
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
- Department of Cognitive Science, University of California, San Diego, USA
| | - J. A. Barlow
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, USA
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18
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McLeod S, Verdon S, Tran VH, Margetson K, Wang C. SuperSpeech: Multilingual Speech and Language Maintenance Intervention for Vietnamese-Australian Children and Families via Telepractice. Lang Speech Hear Serv Sch 2022; 53:675-697. [PMID: 35245081 DOI: 10.1044/2021_lshss-21-00146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The aim of this pilot feasibility study was to evaluate the effectiveness of the group VietSpeech SuperSpeech program targeting speech skills and home language maintenance via telepractice. METHOD In Stage 1, using a case-control design, 30 Vietnamese-English-speaking children were assessed in English and Vietnamese, and parents completed questionnaires about speech and language competency and practices. During Stage 2, children were allocated to intervention (n = 14) or control (n = 16) conditions. COVID-19 restrictions resulted in changes including nonrandom allocation. Online group intervention targeting speech, home language maintenance, and multilingualism as a superpower was delivered 1 hr/week for 8 weeks. For Stage 3, assessments were undertaken approximately 10 weeks after the pre-intervention assessment. RESULTS Parents in the intervention group significantly increased encouragement of their children to speak Vietnamese. The intervention group significantly increased intelligibility in English. Growth of Vietnamese vocabulary was faster for the control group. There was a moderate effect of intervention for children's perception of being happy talking in Vietnamese and English. There was no significant mean change from pre- to post-intervention compared with the control group for measures of speech sound accuracy in Vietnamese or English, Vietnamese intelligibility, English vocabulary, or hours of Vietnamese spoken each week. CONCLUSIONS This study presents preliminary evidence that this 8-hr online group program targeting speech skills and home language maintenance had some impact on Vietnamese-Australian children's speech and home language maintenance. Further research involving a randomized trial is warranted.
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Affiliation(s)
- Sharynne McLeod
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Sarah Verdon
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Van H Tran
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Kate Margetson
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Cen Wang
- Charles Sturt University, Bathurst, New South Wales, Australia
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Scherer NJ, Yamashita R, de Oliveira DN, DiLallo J, Trindade I, Fukushiro AP, Richards K. Early speech and language intervention in Brazilian-Portuguese toddlers with cleft lip and/or palate. CLINICAL LINGUISTICS & PHONETICS 2022; 36:34-53. [PMID: 33899624 PMCID: PMC8858428 DOI: 10.1080/02699206.2021.1912187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 03/27/2021] [Accepted: 03/30/2021] [Indexed: 05/30/2023]
Abstract
Young children with cleft palate with or without cleft lip (CL/P) are at risk for early vocabulary and speech sound production delays. Early intervention studies have shown some promising findings to promote early speech and vocabulary development following palate repair; however, we know little about how these interventions can be used in other international contexts. This study adapted an early speech and language intervention developed in the US, Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE), to the Brazilian context at the Hospital for Rehabilitation of Craniofacial Anomalies at the University of São Paulo-Bauru. The purpose of this study was to compare the speech and language performance of 24 toddlers with CL/P randomized into an EMT+PE intervention group and a business-as-usual (BAU) comparison group over three time points: prior to, immediately following, and three months after intervention. Results immediately following intervention indicate gains in multiple measures of language. Three months following intervention, participants showed gains in both language and speech measures.
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Affiliation(s)
- Nancy J Scherer
- Department of Speech and Hearing Science, Arizona State University, Tempe, Arizona, USA
| | - Renata Yamashita
- Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | - Debora Natalia de Oliveira
- Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | - Jennifer DiLallo
- Department of Speech and Hearing Science, Arizona State University, Tempe, Arizona, USA
| | - Inge Trindade
- Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Ana Paula Fukushiro
- Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Kacey Richards
- Department of Speech and Hearing Science, Arizona State University, Tempe, Arizona, USA
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Soriano JU, Olivieri A, Hustad KC. Utility of the Intelligibility in Context Scale for Predicting Speech Intelligibility of Children with Cerebral Palsy. Brain Sci 2021; 11:1540. [PMID: 34827539 PMCID: PMC8615948 DOI: 10.3390/brainsci11111540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 11/22/2022] Open
Abstract
The Intelligibility in Context Scale (ICS) is a widely used, efficient tool for describing a child's speech intelligibility. Few studies have explored the relationship between ICS scores and transcription intelligibility scores, which are the gold standard for clinical measurement. This study examined how well ICS composite scores predicted transcription intelligibility scores among children with cerebral palsy (CP), how well individual questions from the ICS differentially predicted transcription intelligibility scores, and how well the ICS composite scores differentiated between children with and without speech motor impairment. Parents of 48 children with CP, who were approximately 13 years of age, completed the ICS. Ninety-six adult naïve listeners provided orthographic transcriptions of children's speech. Transcription intelligibility scores were regressed on ICS composite scores and individual item scores. Dysarthria status was regressed on ICS composite scores. Results indicated that ICS composite scores were moderately strong predictors of transcription intelligibility scores. One individual ICS item differentially predicted transcription intelligibility scores, and dysarthria severity influenced how well ICS composite scores differentiated between children with and without speech motor impairment. Findings suggest that the ICS has potential clinical utility for children with CP, especially when used with other objective measures of speech intelligibility.
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Affiliation(s)
- Jennifer U. Soriano
- Waisman Center, University of Wisconsin–Madison, Madison, WI 53705, USA;
- Department of Communication Sciences & Disorders, University of Wisconsin–Madison, Madison, WI 53706, USA;
| | - Abby Olivieri
- Department of Communication Sciences & Disorders, University of Wisconsin–Madison, Madison, WI 53706, USA;
| | - Katherine C. Hustad
- Waisman Center, University of Wisconsin–Madison, Madison, WI 53705, USA;
- Department of Communication Sciences & Disorders, University of Wisconsin–Madison, Madison, WI 53706, USA;
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21
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Lagerberg TB, Anrep-Nordin E, Emanuelsson H, Strömbergsson S. Parent rating of intelligibility: A discussion of the construct validity of the Intelligibility in Context Scale (ICS) and normative data of the Swedish version of the ICS. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:873-886. [PMID: 34125476 DOI: 10.1111/1460-6984.12634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/25/2021] [Accepted: 05/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Intelligibility can be defined as the speakers' ability to convey a message to the listener and it is considered the key functional measure of speech. The Intelligibility in Context Scale (ICS) is a parent rating scale used to assess intelligibility in children. AIMS To describe normative and validation data on the ICS in Swedish and to investigate how these are related to age, gender and multilingualism. METHODS & PROCEDURES Two studies were included. Study 1 included ICS forms from 319 Swedish-speaking children (3:2-9:2 years:months). Study 2 included video recordings and ICS forms from 14 children with speech sound disorder (SSD) and two with typical speech. The video recordings were transcribed in the validation process, resulting in intelligibility reference scores to which ICS scores were correlated. OUTCOMES & RESULTS Study 1: The mean value of the ICS for the 319 children was 4.73. There were no differences in ICS score related to age or gender. The children in the multilingual group were significantly older than the monolingual group and had significantly lower ICS scores than the group of monolinguals. Study 2: There was a moderate correlation between the ICS score and the transcription-based intelligibility score, with the two children with typical speech excluded; however, this correlation was not significant. CONCLUSIONS & IMPLICATIONS We contribute mean scores and percentiles on the ICS for Swedish-speaking children. The finding that the ICS does not provide valid measures of intelligibility for the included children with SSD suggests that the instrument measures a different construct. WHAT THIS PAPER ADDS What is already known on the subject The ICS has been translated to numerous languages and validated against articulation measures in several previous studies. The validity of the Swedish version has been investigated against intelligibility based on transcription of single words. What this paper adds to existing knowledge The study provides normative values of the Swedish version of the ICS for children aged 3-9 years. This is the first study to use a gold standard measure of intelligibility in continuous speech to validate the ICS. The results show a somewhat dubious validity regarding ICS for the group of children with SSD included in the study. What are the potential or actual clinical implications of this work? The ICS's suitability as a measure of intelligibility is questionable; however, it might be of use for speech and language pathologists to give an overview of the parents' view of their child's ability to communicate, in order to make a decision on possible further assessment and intervention. The normative values of the Swedish version of the ICS could be of use in this decision process.
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Affiliation(s)
- Tove B Lagerberg
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elin Anrep-Nordin
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helena Emanuelsson
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sofia Strömbergsson
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet (KI), Stockholm, Sweden
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22
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Seifert M, Davies A, Harding S, McLeod S, Wren Y. Intelligibility in 3-Year-Olds With Cleft Lip and/or Palate Using the Intelligibility in Context Scale: Findings from the Cleft Collective Cohort Study. Cleft Palate Craniofac J 2021; 58:1178-1189. [DOI: 10.1177/1055665620985747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type. Design: Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children’s cleft type and syndromic status. Participants: A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old. Main Outcome Measure(s): Mothers’ rating of their children’s intelligibility using the ICS. Results: The average ICS score for the total sample was 3.75 ( sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 ( always intelligible). Children’s speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence ( P < .001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81). Conclusions: These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement.
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Affiliation(s)
- Miriam Seifert
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, United Kingdom
| | - Amy Davies
- University of Bristol, Bristol, United Kingdom
| | - Sam Harding
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - Sharynne McLeod
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Yvonne Wren
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
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Leon M, Washington KN, Fritz KA, Leon M, Basinger M, Crowe K. Intelligibility in Context Scale: Sensitivity and specificity in the Jamaican context. CLINICAL LINGUISTICS & PHONETICS 2021; 35:154-171. [PMID: 32462946 PMCID: PMC7704795 DOI: 10.1080/02699206.2020.1766574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The present study investigated the sensitivity and specificity of the English Intelligibility in Context Scale (ICS) and the ICS-Jamaican Creole (ICS-JC) translation with bilingual preschool-aged Jamaican children. Participants in this study were 262 English-Jamaican Creole simultaneous bilingual children (aged 3;3 to 6;3, M = 4;11, SD = 7.8). The ICS and ICS-JC were administered to parents in auditory form, rather than written form. Although recent evidence has demonstrated the validity and reliability of the ICS as an assessment tool in various languages, further data are needed to determine diagnostic accuracy of the ICS and ICS-JC in Jamaican children. The sensitivity and specificity of both tools were high in this cohort of children, indicating that in the Jamaican context, these versions of the ICS could be used as screening tools to identify children who require further assessment of speech sound disorders. A cut-off score of 4.12 was used for both tools to achieve high sensitivity (0.84) and specificity (0.70) values for the ICS, as well as high sensitivity (0.84) and specificity (0.71) for the ICS-JC. The results of this study also demonstrate that administration of the auditory ICS is a valid way of collecting parent reports about children's speech intelligibility, which has implications for use of the ICS in languages with no written form or with parents who have a low level of literacy in the languages they use. This investigation is relevant not only to this underserved population but broadens knowledge of research-based tools for working with bilingual children.
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Affiliation(s)
- Michelle Leon
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, USA
| | - Karla N. Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, USA
| | - Kristina A. Fritz
- Department of Psychiatry, School of Medicine, The University of Sydney, Sydney, Australia
| | - Marco Leon
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, USA
| | - Melanie Basinger
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, USA
| | - Kathryn Crowe
- School of Teacher Education, Charles Sturt University, Bathurst, Australia
- School of Education and School of Health Sciences, University of Iceland, Reykjavík, Iceland
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Crowe K, McLeod S. Children's English Consonant Acquisition in the United States: A Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2155-2169. [PMID: 33181047 DOI: 10.1044/2020_ajslp-19-00168] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Speech-language pathologists' clinical decision making and consideration of eligibility for services rely on quality evidence, including information about consonant acquisition (developmental norms). The purpose of this review article is to describe the typical age and pattern of acquisition of English consonants by children in the United States. Method Data were identified from published journal articles and assessments reporting English consonant acquisition by typically developing children living in the United States. Sources were identified through searching 11 electronic databases, review articles, the Buros database, and contacting experts. Data describing studies, participants, methodology, and age of consonant acquisition were extracted. Results Fifteen studies (six articles and nine assessments) were included, reporting consonant acquisition of 18,907 children acquiring English in the United States. These cross-sectional studies primarily used single-word elicitation. Most consonants were acquired by 5;0 (years;months). The consonants /b, n, m, p, h, w, d/ were acquired by 2;0-2;11; /ɡ, k, f, t, ŋ, j/ were acquired by 3;0-3;11; /v, ʤ, s, ʧ, l, ʃ, z/ were acquired by 4;0-4;11; /ɹ, ð, ʒ/ were acquired by 5;0-5;11; and /θ/ was acquired by 6;0-6;11 (ordered by mean age of acquisition, 90% criterion). Variation was evident across studies resulting from different assessments, criteria, and cohorts of children. Conclusions These findings echo the cross-linguistic findings of McLeod and Crowe (2018) across 27 languages that children had acquired most consonants by 5;0. On average, all plosives, nasals, and glides were acquired by 3;11; all affricates were acquired by 4;11; all liquids were acquired by 5;11; and all fricatives were acquired by 6;11 (90% criterion). As speech-language pathologists apply this information to clinical decision making and eligibility decisions, synthesis of knowledge from multiple sources is recommended.
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Affiliation(s)
- Kathryn Crowe
- Charles Sturt University, Bathurst, New South Wales, Australia
- University of Iceland, Reykjavik
| | - Sharynne McLeod
- Charles Sturt University, Bathurst, New South Wales, Australia
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Strömbergsson S, Holm K, Edlund J, Lagerberg T, McAllister A. Audience Response System-Based Evaluation of Intelligibility of Children's Connected Speech - Validity, Reliability and Listener Differences. JOURNAL OF COMMUNICATION DISORDERS 2020; 87:106037. [PMID: 32846287 DOI: 10.1016/j.jcomdis.2020.106037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 07/18/2020] [Accepted: 07/23/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE We assessed audience response systems (ARS)-based evaluation of intelligibility, with a view to find a valid and reliable intelligibility measure that is accessible to non-trained participants. In addition, we investigated potential listener differences between pediatric speech and language pathologists (SLPs) and untrained adults. METHOD Sixteen one-minute samples of connected speech were compiled, collected from 14 children with a speech sound disorder (SSD) and two children with typical speech. 16 SLPs and 13 untrained adults participated in a series of ARS listening sessions, where they were fitted with headphones and hand controls, and instructed to click a button whenever they did not understand the child speaking. Listeners' button clicks were registered and, for each speech sample, totaled into an (un)intelligibility index. The proportion of syllables perceived correctly - based on orthographic listener transcripts - was used as a reference score of intelligibility. RESULTS The ARS-based intelligibility scores correlated strongly with the intelligibility reference score. Reliability was high across listener groups and weaker for single listeners. No significant difference was found between the evaluations of SLPs and untrained adults. CONCLUSIONS ARS-based evaluation offers a valid and reliable measure of intelligibility of particular value in research as a practical tool for collecting input from listeners without experience or knowledge of SSDs. We stress that the ARS design presupposes a listener panel, and that evaluations obtained from individual listeners are predictably inadequate in terms of reliability.
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Affiliation(s)
- Sofia Strömbergsson
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet (KI), SE-141 86 Stockholm, Sweden.
| | - Katarina Holm
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet (KI), SE-141 86 Stockholm, Sweden
| | - Jens Edlund
- Speech Music & Hearing/Språkbanken Tal, KTH Royal Institute of Technology, SE-100 44 Stockholm, Sweden
| | - Tove Lagerberg
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, University of Gothenburg, The Sahlgrenska Academy, Box 452, SE-405 30 Gothenburg, Sweden
| | - Anita McAllister
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet (KI), SE-141 86 Stockholm, Sweden; Functional Area Speech and Language Pathology, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
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26
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Cronin A, McLeod S, Verdon S. Holistic Communication Assessment for Young Children With Cleft Palate Using the International Classification of Functioning, Disability and Health:Children and Youth. Lang Speech Hear Serv Sch 2020; 51:914-938. [PMID: 32697920 DOI: 10.1044/2020_lshss-19-00122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Children with a cleft palate (± cleft lip; CP±L) can have difficulties communicating and participating in daily life, yet speech-language pathologists typically focus on speech production during routine assessments. The International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY; World Health Organization, 2007) provides a framework for holistic assessment. This tutorial describes holistic assessment of children with CP±L illustrated by data collected from a nonclinical sample of seven 2- to 3-year-old children, 13 parents, and 12 significant others (e.g., educators and grandparents). Method Data were collected during visits to participants' homes and early childhood education and care centers. Assessment tools applicable to domains of the ICF-CY were used to collect and analyze data. Child participants' Body Functions including speech, language, and cognitive development were assessed using screening and standardized assessments. Participants' Body Structures were assessed via oral motor examination, case history questionnaires, and observation. Participants' Activities and Participation as well as Environmental and Personal Factors were examined through case history questionnaires, interviews with significant others, parent report measures, and observations. Results Valuable insights can be gained from undertaking holistic speech-language pathology assessments with children with CP±L. Using multiple tools allowed for triangulation of data and privileging different viewpoints, to better understand the children and their contexts. Several children demonstrated speech error patterns outside of what are considered cleft speech characteristics, which underscores the importance of a broader assessment. Conclusion Speech-language pathologists can consider incorporating evaluation of all components and contextual factors of the ICF-CY when assessing and working with young children with CP±L to inform intervention and management practices.
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Affiliation(s)
- Anna Cronin
- School of Teacher Education, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Sharynne McLeod
- School of Teacher Education, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Sarah Verdon
- School of Community Health, Charles Sturt University, Albury, New South Wales, Australia
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