Development and Validation of a Probe Word List to Assess Speech Motor Skills in Children.

Purpose The aim of the study was to develop and validate a probe word list and scoring system to assess speech motor skills in preschool and school-age children with motor speech disorders. Method This article describes the development of a probe word list and scoring system using a modified word complexity measure and principles based on the hierarchical development of speech motor control known as the Motor Speech Hierarchy (MSH). The probe word list development accounted for factors related to word (i.e., motoric) complexity, linguistic variables, and content familiarity. The probe word list and scoring system was administered to 48 preschool and school-age children with moderate-to-severe speech motor delay at clinical centers in Ontario, Canada, and then evaluated for reliability and validity. Results One-way analyses of variance revealed that the motor complexity of the probe words increased significantly for each MSH stage, while no significant differences in the linguistic complexity were found for neighborhood density, mean biphone frequency, or log word frequency. The probe word list and scoring system yielded high reliability on measures of internal consistency and intrarater reliability. Interrater reliability indicated moderate agreement across the MSH stages, with the exception of MSH Stage V, which yielded substantial agreement. The probe word list and scoring system demonstrated high content, construct (unidimensionality, convergent validity, and discriminant validity), and criterion-related (concurrent and predictive) validity. Conclusions The probe word list and scoring system described in the current study provide a standardized method that speech-language pathologists can use in the assessment of speech motor control. It can support clinicians in identifying speech motor difficulties in preschool and school-age children, set appropriate goals, and potentially measure changes in these goals across time and/or after intervention.

Treatment intensity and childhood apraxia of speech.

BACKGROUND: Intensive treatment has been repeatedly recommended for the treatment of speech deficits in childhood apraxia of speech (CAS). However, differences in treatment outcomes as a function of treatment intensity have not been systematically studied in this population. AIM: To investigate the effects of treatment intensity on outcome measures related to articulation, functional communication and speech intelligibility for children with CAS undergoing individual motor speech intervention. METHODS & PROCEDURES: A total of 37 children (32-54 months of age) with CAS received 1×/week (lower intensity) or 2×/week (higher intensity) individual motor speech treatment for 10 weeks. Assessments were carried out before and after a 10-week treatment block to study the effects of variations in treatment intensity on the outcome measures. OUTCOMES & RESULTS: The results indicated that only higher intensity treatment (2×/week) led to significantly better outcomes for articulation and functional communication compared with 1×/week (lower intensity) intervention. Further, neither lower nor higher intensity treatment yielded a significant change for speech intelligibility at the word or sentence level. In general, effect sizes for the higher intensity treatment groups were larger for most variables compared with the lower intensity treatment group. CONCLUSIONS & IMPLICATIONS: Overall, the results of the current study may allow for modification of service delivery and facilitate the development of an evidence-based care pathway for children with CAS.

Motor speech treatment protocol for developmental motor speech disorders.

OBJECTIVE: This study examines the effect of the Motor Speech Treatment Protocol (MSTP), a multi-sensory hybrid treatment approach on five children (mean: 3;3 years; S.D. 0;1) with severe to profound speech sound disorders with motor speech difficulties. METHODS: A multiple probe design, replicated over five participants, was used to evaluate the effects of treatment on improving listeners' auditory and visual judgements of speech accuracy. RESULTS: All participants demonstrated significant change between baseline and maintenance conditions, with the exception of KM, who may have had underlying psychosocial, regulation and/or attention difficulties. The training- (practiced in treatment) and test-words (not practiced in treatment) both demonstrated positive change in all participants, indicating generalization of target features to untrained words. CONCLUSION: These results provide preliminary evidence that the MSTP, which integrates multi-sensory information and utilizes hierarchical goal selection, may positively impact speech sound production by improving speech motor control in this population.

Peripheral auditory tuning for vowels.

In this study, 35 young, healthy adults were tested on whether speech-like stimuli evoke a unique response in the auditory efferent system. To this end, descending cortical influences on medial olivocochlear (MOC) activity were indirectly evaluated by studying the effects of contralateral suppression on distortion product otoacoustic emissions (DPOAEs) under four conditions: (a) in the absence of any contralateral noise (Baseline), (b) presence of contralateral broadband noise (Noise Baseline), (c) vowel discrimination-in-noise task (VDN) and (d) tone discrimination-in-noise (TDN) task. A statistically significant release from suppression was evident across all tested DPOAE frequencies (1, 1.5 and 2 kHz) only for the VDN task (p < 0.05), which yielded greater release from suppression than the TDN task. These findings indicate that during active listening in the presence of noise, the MOC activity may be differentially modulated depending on the type of stimulus (vowel vs. tone). Specifically, in the presence of background noise, vowels may show a greater release from suppression in the cochlea than frequency, intensity and duration matched tones.