Perceptual measurement of articulatory goodness in young children: Relationships with age, speech sound acquisition, and intelligibility.

Speech language pathologists regularly use perceptual methods in clinical practice to assess children's speech. In this study, we examined relationships between measures of speech intelligibility, clinical articulation test results, age, and perceptual ratings of articulatory goodness for children. We also examined the extent to which established measures of intelligibility and clinical articulation test results predicted articulatory goodness ratings, and whether goodness ratings were influenced by intelligibility. A sample of 164 (30-47 months) typically developing children provided speech samples and completed a standardised articulation test. Single word intelligibility scores and ratings of articulatory goodness were gathered from 328 naïve listeners; scores on a standardised articulation test were obtained from each child. Bivariate Pearson correlation, linear regression, and linear mixed effects modelling were used for analysis. Results showed that articulatory goodness ratings had the highest correlation with intelligibility, followed by age, followed by articulation score. Age and clinical articulation scores were both significant predictors of goodness ratings, but articulation scores made only a small contribution to prediction. Articulatory goodness ratings were substantially lower for unintelligible words compared to intelligible words, but articulatory goodness scores increased with age at the same rate for unintelligible and intelligible words. Perceptual ratings of articulatory goodness are sensitive to developmental changes in speech production (regardless of intelligibility) and yield a different kind of information than clinical articulation scores from standardised measures.

Longitudinal change in speech classification between 4 and 10 years in children with cerebral palsy.

AIM: To examine speech impairment severity classification over time in a longitudinal cohort of children with cerebral palsy (CP). METHOD: A total of 101 children (58 males, 43 females) between the ages of 4 and 10 years with CP participated in this longitudinal study. Speech severity was rated using the Viking Speech Scale (VSS), a four-level classification rating scale, at 4, 6, 8, and 10 years (age 4 years: mean = 52 months [3 SD]; age 6 years: mean = 75 months [2 SD]; age 8 years: mean = 100 months [4 SD]; age 10 years: mean = 125 months [5 SD]). We used Bayesian mixed-effects ordinal logistic regression to model (1) the extent to which speech severity changed over time and (2) patterns of change across age groups and classification rating group levels. RESULTS: VSS ratings decreased (speech severity became less severe) between 4 and 10 years of age. Children who were first classified in VSS levels I, II, or III at age 4 years had a high probability of staying at, or improving to, VSS level I by 10 years. Children who were first classified in VSS level IV at 4 years had a high probability of remaining in VSS level IV at 10 years. INTERPRETATION: Early speech performance is highly predictive of later childhood speech abilities. Children with any level of speech impairment at age 4 years should be receiving speech therapy. Those with more severe speech impairments should be introduced to augmentative and alternative communication as soon as possible. WHAT THIS PAPER ADDS: Children with early Viking Speech Scale (VSS) ratings below level IV have a good prognosis for speech improvement. Children with early VSS level IV ratings are likely to remain at VSS level IV over time. Children did not show worsening of VSS level between the ages of 4 and 10 years.

Cambio longitudinal en la clasificación del habla entre los 4 y 10 años en niños con parálisis cerebral OBJETIVO: Examinar la clasificación de la gravedad del deterioro del habla a lo largo del tiempo en una cohorte longitudinal de niños con parálisis cerebral (PC) entre las edades de 4 y 10 años. MÉTODO: Un total de 101 niños (58 varones, 43 mujeres) con PC participaron en este estudio longitudinal. La gravedad del habla se evaluó utilizando la Viking Speech Scale (VSS), una escala de calificación de clasificación de cuatro niveles, a los 4, 6, 8 y 10 años (edad 4 años: media = 52 meses [3 DE]; edad 6 años: media = 75 meses [2 DE]; edad 8 años: media = 100 meses [4 DE]; edad 10 años: media = 125 meses [5 DE]). Utilizamos la regresión logística ordinal de efectos mixtos bayesianos para modelar (1) la medida en que la severidad del habla cambió con el tiempo y (2) los patrones de cambio entre los grupos de edad y los niveles de clasificación de los grupos. RESULTADOS: Las calificaciones de VSS disminuyeron (la severidad del habla se volvió menos severa) entre los 4 y los 10 años de edad. Los niños que fueron clasificados por primera vez en los niveles I, II o III de VSS a los 4 años tenían una alta probabilidad de permanecer en el nivel I de VSS o mejorar al nivel I de VSS a los 10 años. Los niños que fueron clasificados por primera vez en el nivel IV de VSS a los 4 años tenían una alta probabilidad de permanecer en el nivel IV de VSS a los 10 años. INTERPRETACIÓN: El desempeño temprano del habla es altamente predictivo de las habilidades del habla en la niñez posterior. Los niños con cualquier nivel de discapacidad del habla a la edad de 4 años deben recibir terapia del habla. Aquellos con impedimentos del habla más severos deben ser introducidos a la comunicación aumentativa y alternativa tan pronto como sea posible.

Mudança longitudinal na classificação da fala entre 4 e 10 anos em crianças com paralisia cerebral OBJETIVO: Analisar a classificação da gravidade do comprometimento da fala ao longo do tempo em uma coorte longitudinal de crianças com paralisia cerebral (PC) entre 4 e 10 anos. MÉTODO: Um total de 101 crianças (58 meninos, 43 meninas) com PC participaram deste estudo longitudinal. A gravidade da fala foi avaliada usando a Viking Speech Scale (VSS), uma escala de classificação de quatro níveis, aos 4, 6, 8 e 10 anos (idade 4 anos: média = 52 meses [3 DP]; idade 6 anos: média = 75 meses [2 DP]; idade 8 anos: média = 100 meses [4 DP]; idade 10 anos: média = 125 meses [5 DP]). Usamos a regressão logística ordinal Bayesiana de efeitos mistos para modelar (1) a extensão em que a gravidade da fala mudou ao longo do tempo e (2) padrões de mudança entre as faixas etárias e os níveis de classificação do grupo. RESULTADOS: As classificações de VSS diminuíram (a gravidade da fala tornou-se menos grave) entre 4 e 10 anos de idade. As crianças que foram classificadas pela primeira vez nos níveis VSS I, II ou III aos 4 anos de idade tiveram uma alta probabilidade de permanecer ou melhorar para o nível VSS I em 10 anos. As crianças que foram classificadas pela primeira vez em VSS nível IV aos 4 anos tiveram alta probabilidade de permanecer no VSS nível IV aos 10 anos. INTERPRETAÇÃO: O desempenho precoce da fala é altamente preditivo de habilidades de fala na infância posteriormente. Crianças com qualquer nível de deficiência de fala aos 4 anos de idade devem receber terapia da fala. Aqueles com deficiências de fala mais graves devem ser introduzidos à comunicação aumentativa e alternativa o mais rápido possível.

Construct Validity of the Viking Speech Scale.

OBJECTIVE: The Viking Speech Scale (VSS) reliably classifies the speech performance of children with cerebral palsy. This paper aims to establish the construct validity of the VSS by testing the extent to which percentage intelligibility in single word speech and connected speech predicts VSS rating. PATIENTS AND METHODS: This is a secondary analysis of two sets of anonymised data collected for previous research. The full data set comprised 79 children with cerebral palsy from the US (n = 43) and the UK (n = 36): (43 boys, 36 girls); mean age 7.2 years (SD 3.3). Single word intelligibility was measured using the TOCS+ words for US children and Children's Speech Intelligibility Measure for the UK children. Connected speech intelligibility was measured from a subset of repeated sentences in TOCS+ for US children and picture description for the UK children. We used ordinal logistic regression to examine prediction of VSS rating by percentage single word and connected speech intelligibility scores in both samples. RESULTS: Percentage single word intelligibility and connected speech intelligibility predicted VSS rating in univariate and multivariate regression models for both the US and UK samples. CONCLUSION: Intelligibility predicts VSS for both single words and connected speech, establishing the construct validity of VSS.

Longitudinal growth of receptive language in children with cerebral palsy between 18 months and 54 months of age.

AIM: We examined receptive language developmental trajectories between 18 months and 54 months for three clinical speech-language profile groups of children with cerebral palsy (those with speech motor involvement, without speech motor involvement, and with anarthria) and quantified differences from age-level expectations. We identified latent classes of comprehension development, related these classes to clinical profile groups, and examined how well early receptive language predicted outcomes. METHOD: We used a prospective longitudinal design. Eighty-five children with cerebral palsy (43 females, 42 males) were followed longitudinally from 18 to 54 months of age. Children were seen two to eight times (322 data points). Children were classified into clinical profile groups. Language comprehension age-equivalent scores were the primary measures of interest. RESULTS: Children with anarthria had significant language delays, limited developmental change over time, and comprised their own latent class. Children with speech motor impairment had slight receptive language delays over time. Children with no speech motor impairment had age-appropriate receptive language over time. Early language comprehension scores were highly predictive of later latent profile group membership. INTERPRETATION: Early language comprehension abilities are highly predictive of language comprehension growth trajectory and suggest that children with early language delay, particularly those who are non-speaking, should receive language intervention to support development. WHAT THIS PAPER ADDS: There are two growth trajectories for language comprehension among children with cerebral palsy. Children with speech motor impairment had a constant 6-month receptive language delay. Children without speech motor impairment had age-appropriate receptive language. Non-speaking children had significant receptive language delay. Early language comprehension change was highly predictive of later trajectory group.

Alignment of classification paradigms for communication abilities in children with cerebral palsy.

AIM: We examined three communication ability classification paradigms for children with cerebral palsy (CP): the Communication Function Classification System (CFCS), the Viking Speech Scale (VSS), and the Speech Language Profile Groups (SLPG). Questions addressed interjudge reliability, whether the VSS and the CFCS captured impairments in speech and language, and whether there were differences in speech intelligibility among levels within each classification paradigm. METHOD: Eighty children (42 males, 38 females) with a range of types and severity levels of CP participated (mean age 60mo, range 50-72mo [SD 5mo]). Two speech-language pathologists classified each child via parent-child interaction samples and previous experience with the children for the CFCS and VSS, and using quantitative speech and language assessment data for the SLPG. Intelligibility scores were obtained using standard clinical intelligibility measurement. RESULTS: Kappa values were 0.67 (95% confidence interval [CI] 0.55-0.79) for the CFCS, 0.82 (95% CI 0.72-0.92) for the VSS, and 0.95 (95% CI 0.72-0.92) for the SLPG. Descriptively, reliability within levels of each paradigm varied, with the lowest agreement occurring within the CFCS at levels II (42%), III (40%), and IV (61%). Neither the CFCS nor the VSS were sensitive to language impairments captured by the SLPG. Significant differences in speech intelligibility were found among levels for all classification paradigms. INTERPRETATION: Multiple tools are necessary to understand speech, language, and communication profiles in children with CP. Characterization of abilities at all levels of the International Classification of Functioning, Disability and Health will advance our understanding of the ways that speech, language, and communication abilities present in children with CP.

AAC and Early Intervention for Children with Cerebral Palsy: Parent Perceptions and Child Risk Factors.

The current study examined parent perceptions of communication, the focus of early intervention goals and strategies, and factors predicting the implementation of augmentative and alternative communication (AAC) for 26 two-year-old children with cerebral palsy. Parents completed a communication questionnaire and provided early intervention plans detailing child speech and language goals. Results indicated that receptive language had the strongest association with parent perceptions of communication. Children who were not talking received a greater number of intervention goals, had a greater variety of goals, and had more AAC goals than children who were emerging and established talkers. Finally, expressive language had the strongest influence on AAC decisions. Results are discussed in terms of the relationship between parent perceptions and language skills, communication as an emphasis in early intervention, AAC intervention decisions, and the importance of receptive language.

A preliminary investigation of longitudinal changes in speech production over 18 months in young children with cerebral palsy.

OBJECTIVE: This study examined longitudinal change in speech intelligibility, vowel space, and word duration over 18 months among children with cerebral palsy (CP) who varied in the severity of their speech motor involvement. The study also examined relationships among variables at each time point. METHOD: Twenty-two children with CP participated in the study (mean age = 50 months at the first time point). Speech samples were collected at four time points that were 6 months apart. Children were separated into four severity groups based on intelligibility scores. RESULTS: Change over time varied by severity. Children with CP who did not have speech motor involvement and children in the mild group showed gains in intelligibility, but no changes in vowel space area or word duration. Children in the moderate group showed no significant change, and children in the severe group showed increased vowel space and decreased word durations. Significant positive correlations between intelligibility and vowel space were noted at each time point for data pooled across all children. CONCLUSION: Children showed different patterns of change over time in intelligibility, vowel space, and word duration based on their speech motor abilities. The relationship between intelligibility and vowel space across severity groups was constant, suggesting a robust relationship between these variables.

Lexical Predictors of Intelligibility in Young Children's Speech.

PURPOSE: Speech perception is a probabilistic process, integrating bottom-up and top-down sources of information, and the frequency and phonological neighborhood of a word can predict how well it is perceived. In addition to asking how intelligible speakers are, it is important to ask how intelligible individual words are. We examined whether lexical features of words influenced intelligibility in young children. In particular, we applied the neighborhood activation model, which posits that a word's frequency and the overall frequency of a word's phonological competitors jointly affect the intelligibility of a word. METHOD: We measured the intelligibility of 165 children between 30 and 47 months in age on 38 different single words. We performed an item response analysis using generalized mixed-effects logistic regression, adding word-level characteristics (target frequency, neighborhood competition, motor complexity, and phonotactic probability) as predictors of intelligibility. RESULTS: There was considerable variation among the words and the children, but between-word variability was larger in magnitude than between-child variability. There was a clear positive effect of target word frequency and a negative effect of neighborhood competition. We did not find a clear negative effect of motor complexity, and phonotactic probability did not have any effect on intelligibility. CONCLUSION: Word frequency and neighborhood competition both had an effect on intelligibility in young children's speech, so listener expectations are an important factor in the selection of items for children's intelligibility assessment.

Marginal and Canonical Babbling in 10 Infants at Risk for Cerebral Palsy.

PURPOSE: This study is a preliminary quantification and characterization of the development of marginal and canonical syllable patterns in 10 infants at risk for cerebral palsy (CP). METHOD: We calculated marginal and canonical babbling ratios from parent-infant laboratory recordings of 10 infants at two time points, approximately 13 and 16 months of age. The frequency and diversity of labial, coronal, and velar types of marginal and canonical syllables were also examined. Differences across three outcome groups were compared: infants later diagnosed with CP (n = 3, CP group), risk of CP due to ongoing gross motor delays (n = 4, risk group), and current typically developing status with resolved gross motor delays (n = 3, TDx group). Performance on the Mullen Scales was included for perspective on cognitive development. RESULTS: Higher marginal syllable ratios were observed in the CP and risk groups than the TDx group. An increasing canonical syllable ratio across the two ages was consistently observed in the TDx group. The TDx group produced a greater frequency and diversity of canonical syllable types than the risk and CP groups, and of marginal syllable types than the CP group. CONCLUSIONS: This study offers preliminary support for the possibility that speech motor impairment in infants with CP have the potential to be observed and quantified early in vocal development prior to the expected onset of first words. Prolonged rates of marginal syllable forms may be suggestive of speech motor impairment; however, additional longitudinal outcome data over a longer time course and a larger sample of infants are needed to provide further support for this possibility.

Intelligibility in Context Scale: Growth Curves for Typically Developing English-Speaking Children Between Ages 2;6 and 9;11.

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.

Developmental Cut-Points for Atypical Speech Intelligibility in Children With Cerebral Palsy.

PURPOSE: Early identification of speech motor involvement (SMI) in children with cerebral palsy (CP) is difficult because of overlapping features with many aspects of typical speech development. Quantitative measures of speech intelligibility have the potential to differentiate between children with SMI and those with no SMI (NSMI). We examined thresholds for speech intelligibility development in children with CP relative to the low end of age-specific typical developmental expectations. We sought to determine whether there were intelligibility differences between children with CP and NSMI versus typically developing (TD) age-mates across the range of development and whether there were differences between children with CP who have NSMI and those with CP who have SMI across the range of development based on speech intelligibility. METHOD: We used two large existing data sets that included speech samples from children between the ages of 2.5 and 8 years. One data set included 511 longitudinal speech samples from children with CP; the other included 505 cross-sectional speech samples from TD children. We examined receiver operating characteristic curves and sensitivity/specificity results by age for differentiating among groups of children. RESULTS: TD children versus those with CP and NSMI showed differentiation in their speech intelligibility across all ages, but the strength of differentiation was only marginally above chance. Children with CP and NSMI showed clear differentiation in their speech intelligibility from those with CP and SMI beginning at the earliest age point. Children with CP who have intelligibility below 40% at the age of 3 years have a very high probability of having SMI. CONCLUSIONS: Early intelligibility screening should be performed in children diagnosed with CP. Those with intelligibility below 40% at 3 years of age should be referred immediately for speech assessment and treatment.

Vocal Characteristics of Infants at Risk for Speech Motor Involvement: A Scoping Review.

PURPOSE: The purpose of this scoping review was to (a) summarize methodological characteristics of studies examining vocal characteristics of infants at high risk for neurological speech motor involvement and (b) report the state of the high-quality evidence on vocal characteristic trends of infants diagnosed or at high risk for cerebral palsy (CP). METHOD: The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) extension for scoping reviews was followed for reporting our review. Studies measured prelinguistic vocal characteristics of infants under 24 months with birth risk or genetic conditions known to commonly present with speech motor involvement. Fifty-five studies met criteria for Part 1. Eleven studies met criteria for synthesis in Part 2. RESULTS: A smaller percentage of studies examined infants with or at risk for CP compared to studies examining genetic conditions such as Down syndrome. The median year of publication was 1999, with a median sample size of nine participants. Most studies were conducted in laboratory settings and used human coding of vocalizations produced during caregiver-child interactions. Substantial methodological differences were noted across all studies. A small number of high-quality studies of infants with or at risk for CP revealed high rates of marginal babbling, low rates of canonical babbling, and limited consonant diversity under 24 months. Mixed findings were noted across studies of general birth risk factors. CONCLUSIONS: There is limited evidence available to support the early detection of speech motor involvement. Large methodological differences currently impact the ability to synthesize findings across studies. There is a critical need to conduct longitudinal research with larger sample sizes and advanced, modern technologies to detect vocal precursors of speech impairment to support the accurate diagnosis and prognosis of speech development in infants with CP and other clinical populations.

Perceptual Learning of Dysarthria in Adolescence.

PURPOSE: As evidenced by perceptual learning studies involving adult listeners and speakers with dysarthria, adaptation to dysarthric speech is driven by signal predictability (speaker property) and a flexible speech perception system (listener property). Here, we extend adaptation investigations to adolescent populations and examine whether adult and adolescent listeners can learn to better understand an adolescent speaker with dysarthria. METHOD: Classified by developmental stage, adult (n = 42) and adolescent (n = 40) listeners completed a three-phase perceptual learning protocol (pretest, familiarization, and posttest). During pretest and posttest, all listeners transcribed speech produced by a 13-year-old adolescent with spastic dysarthria associated with cerebral palsy. During familiarization, half of the adult and adolescent listeners engaged in structured familiarization (audio and lexical feedback) with the speech of the adolescent speaker with dysarthria; and the other half, with the speech of a neurotypical adolescent speaker (control). RESULTS: Intelligibility scores increased from pretest to posttest for all listeners. However, listeners who received dysarthria familiarization achieved greater intelligibility improvements than those who received control familiarization. Furthermore, there was a significant effect of developmental stage, where the adults achieved greater intelligibility improvements relative to the adolescents. CONCLUSIONS: This study provides the first tranche of evidence that adolescent dysarthric speech is learnable-a finding that holds even for adolescent listeners whose speech perception systems are not yet fully developed. Given the formative role that social interactions play during adolescence, these findings of improved intelligibility afford important clinical implications.

Contributors to Intelligibility in Preschool- Aged Children with Cerebral Palsy.

PURPOSE: We investigated the contribution of vowel space, articulation rate, maximum utterance length, and language skills to intelligibility in 30-36 month old children with CP. We also examined differences among variables for 3 subgroups of children with CP and a small group of typically developing (TD) children. METHOD: Nineteen children with CP and 5 TD children provided speech samples, and 120 listeners transcribed the speech samples. Acoustic analysis of temporal and vowel spectral measures was completed on single-word productions. RESULTS: Vowel space was the only variable that made a significant and independent contribution to intelligibility, though all variables collectively accounted for 74% of the variance in intelligibility scores. TD children tended to have larger vowel spaces, than children with CP, even among children with CP who had intelligibility scores within the range of TD children. CONCLUSIONS: Of children with CP who were able to talk at 30-36 months of age, 60% had clinical speech or language deficits. Production of vowels appears to make an important contribution to intelligibility; and for many children with CP, considerable deficits in intelligibility may be evident by the age of 3. Early interventions targeting both speech and language may improve intelligibility and functional communication skills.

Relationship Between Prosody and Intelligibility in Children with Dysarthria.

Exaggerated and redundant prosodic cue use has been noted among adults with dysarthria secondary to cerebral palsy (CP) (Patel, 2004; van Doorn & Sheard, 2001). A possible explanation may be that speakers heighten prosodic contrasts to increase intelligibility. The current work examined whether children with dysarthria due to CP also produce exaggerated prosodic contours and if so, how prosodic cue use in these speakers impacts intelligibility. Acoustic analyses were conducted on a previously collected dataset of 2-7 word utterances produced by fourteen children with CP (7 with dysarthria and 7 without) (Hustad, Gorton & Lee, 2010). The dataset also included sentence-level transcriptions obtained from five listeners per speaker. Word intelligibility scores were derived from these transcripts and used to determine whether prosodic modulation differed for words with high versus low intelligibility. Although mean fundamental frequency (F0) and intensity range were similar across groups, words produced by children with dysarthria were slower and more variable in F0 than the group without dysarthria. Moreover, intelligibility decreased when children with dysarthria increased F0 and duration beyond the range used by children without dysarthria. Thus findings suggest that interventions targeting appropriate prosody may be beneficial in improving intelligibility in children with dysarthria and CP.

Functional Communication Abilities in Youth With Cerebral Palsy: Association With Impairment Profiles and School-Based Therapy Goals.

PURPOSE: The aim of this study was to examine the relationship between functional communication skills, underlying speech, language, and cognitive impairments and school-based speech pathology services in students with cerebral palsy (CP). METHOD: Thirty-five participants with CP who had Individualized Education Programs (IEPs) were classified according to the Communication Function Classification System (CFCS). Participants completed laboratory assessments of speech, receptive language, executive functioning, and nonverbal cognition. Each participant's speech and language IEP goals were coded into treatment units and then categorized into seven, mutually exclusive target goal areas. Nonparametric analyses were employed to examine differences among CFCS groups in the number of deficit areas and the number of goal areas from the IEP. Descriptive analyses were used to evaluate the extent to which deficit and goal areas in the IEP co-occurred by CFCS level. RESULTS: Those in more involved CFCS levels demonstrated more severe speech, receptive language, and cognitive impairments. However, there were no significant differences in the number of deficit areas across CFCS groups. Regardless of CFCS level, there were no differences in the number of treatment goals specified in the IEP. Literacy was the only goal area addressed across all CFCS levels. Those in the most involved CFCS levels had augmentative and alternative communication (AAC) goals, but those with more moderate restrictions in functional communication who also had markedly reduced speech intelligibility did not typically have speech or AAC goals. INTERPRETATION: Individuals with CP across CFCS levels demonstrate variability in underlying deficit profiles, suggesting that measures of both functional communication and of underlying deficits are necessary to provide a complete picture of communication needs. Literacy goals were common across all CFCS levels, but AAC goals were limited to the most severely involved individuals, suggesting that continuing education may be necessary to support speech-language pathologists in developing treatments involving the integration of AAC and speech to foster functional communication at school. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.16968073.

Use of listening strategies for the speech of individuals with dysarthria and cerebral palsy.

This study examined listeners' endorsement of cognitive, linguistic, segmental, and suprasegmental strategies employed when listening to speakers with dysarthria. The study also examined whether strategy endorsement differed between listeners who earned the highest and lowest intelligibility scores. Speakers were eight individuals with dysarthria and cerebral palsy. Listeners were 80 individuals who transcribed speech stimuli and rated their use of each of 24 listening strategies on a 4-point scale. Results showed that cognitive and linguistic strategies were most highly endorsed. Use of listening strategies did not differ between listeners with the highest and lowest intelligibility scores. Results suggest that there may be a core of strategies common to listeners of speakers with dysarthria that may be supplemented by additional strategies, based on characteristics of the speaker and speech signal.

Speech-Language Profile Groups in School Aged Children with Cerebral Palsy: Nonverbal Cognition, Receptive Language, Speech Intelligibility, and Motor Function.

Purpose: To explore the relationship of intelligibility, receptive language, executive functioning, and motor skills to nonverbal cognitive skills among children with cerebral palsy (CP) in different speech-language profile groups. Method: Twenty-seven children with CP aged 10-12 years old participated in the study. They completed a battery of standard clinical assessments. The relationship of various skillsets with nonverbal cognitive ability was explored using correlational procedures. Additionally, we examined pairwise differences in nonverbal cognitive skills among profile groups. Cohen's Kappa and Chi-square tests were used to study the consistency of receptive language and nonverbal cognitive performance. Results: Children who showed better nonverbal cognitive abilities demonstrated better motor, receptive language, and intelligibility skills. Nonverbal cognition was generally consistent with receptive language. Conclusion: Nonverbal cognitive impairment often co-occurs with language and speech motor impairment among children with CP. Speech-language profile groups are a useful framework for describing both communication and cognitive abilities.

Validity of Parent Ratings of Speech Intelligibility for Children with Cerebral Palsy.

Aim: To examine the relationship between subjective parent ratings of intelligibility and objectively measured intelligibility scores for children with cerebral palsy (CP) with differing levels of speech severity. Method: Fifty children (84-96 months) with CP were classified into groups based on intelligibility scores during a speech elicitation task - high intelligibility (90% or higher), mild-moderate intelligibility reduction (61-89%), and severe intelligibility reduction (60% or lower). Parent ratings of understandability (on a 7-point scale) were compared to intelligibility scores gathered from 100 naïve listeners. Results: For children with mild-moderate and severe intelligibility reduction, there was a large range of variability in parent ratings. For children with high intelligibility, ratings were consistent with intelligibility scores. There was a range of intelligibility scores within each rating, especially in the middle of the scale. Conclusions: For children with mild-moderate intelligibility deficits, parent ratings may best be used in conjunction with objective measurement of intelligibility.