Megan Hodge

Stability of serial assessments of motor and communication abilities in typically developing infants-implications for screening

BACKGROUND Neuromaturational theory and dynamic systems theory make different assumptions about the rate of development of motor and communication skills. AIMS The stability of fine motor, gross motor, and communication scores of infants was evaluated to test these assumptions. STUDY DESIGN This longitudinal descriptive study evaluated infants in their homes at 9, 11, 13, 16, and 21 months of age. PARTICIPANTS One hundred and two Canadian children of English-speaking parents classified as typically developing at 23 months of age using the Diagnostic Inventory for Screening Children Preschool Screen were included. OUTCOME MEASURES The Peabody Developmental Motor Scales and the Communication Symbolic Behavior Scales-Developmental Profile were used to assess development at each time. Scores were stable if the 95% confidence intervals around the scores overlapped across all assessments. Correlations evaluated the relationship of scores in a domain over time (normative stability) as well as the relationship of scores between domains (ipsative stability). RESULTS There was large variability in scores within an infant, among infants and across developmental domains. Typical development is nonlinear rather than occurring at a constant rate. Fine motor, gross motor, and communication skills appear to develop independently. CONCLUSIONS These results have implications both for developmental screening policies and for early intervention programs. Screening should include multiple domains and multiple time points before referrals are made to early intervention programs.

Preliminary Results of an Intelligibility Measure for English-Speaking Children With Cleft Palate

Objective: This study describes a preliminary evaluation of the construct and concurrent validity of the Speech Intelligibility Probe for Children With Cleft Palate. Design: The study used a prospective between-groups design with convenience samples. Participants: Participants (ages 39 to 82 months) included 5 children with cleft palate and 10 children with typical speech development and no history of craniofacial abnormalities. All children had age-appropriate language skills. Interventions: Each child completed the Speech Intelligibility Probe for Children With Cleft Palate by imitating single words. Each childs word productions were recorded and played back to listeners who completed open-set and closed-set response tasks. Recorded utterances that represented a contiguous 100-word sample of each childs spontaneous speech also were played back to listeners for completion of an open-set word identification task. Main Outcome Measures: Measures reported include group means for (1) intelligibility scores for the open-set Speech Intelligibility Probe for Children With Cleft Palate and spontaneous speech sample conditions, and (2) percentage of phonetic contrasts correct and correct-distorted from the Speech Intelligibility Probe for Children With Cleft Palate closed-set response task. Results: The group of children with cleft palate had significantly lower intelligibility scores, lower percentage of correct phonetic contrasts, and higher percentage of correct distorted items (construct validity). A strong positive correlation (r = .88, p < .01) was found between intelligibility scores from the Speech Intelligibility Probe for Children With Cleft Palate and the spontaneous sample (concurrent validity). Conclusions: The results provide preliminary support for the construct and concurrent validities of the Speech Intelligibility Probe for Children With Cleft Palate as a measure of childrens speech intelligibility.

Scores of Typically Developing Children on the Peabody Developmental Motor Scales-Infancy to Preschool

Norms for the Peabody Developmental Motor Scales (PDMS) and the Peabody Developmental Motor Scales, second edition (PDMS-2) are based on cross-sectional data that do not provide information on how the scores of individual children vary over time. This study examined intra-individual variability of PDMS fine and gross motor scores of 77 typically developing children at 9, 11, 13, 16, and 21 months of age and PDMS and PDMS-2 fine and gross motor scores at 4 years. Correlations between scores over time ranged from .13 to .45. PDMS and PDMS-2 scores were correlated at .71 and .75 with significantly different means, indicating that the two versions are not equivalent for 4-year-old children. Most children scored above the 16th percentile, the suggested cut-off on the PDMS, at both 21-month and 4-year assessments, but their percentile ranks fluctuated considerably. Use of confidence intervals contributes to accurate interpretation of scores by differentiating true change in a childs score from change due to measurement error.

Effects of supplemental linguistic cues on the intelligibility of severely dysarthric speakers

Severely dysarthric speakers who are considering an augmentative form of communication may think this option precludes use of their residual speech. Current procedures used to assess speech intelligibility have not addressed how natural speech might be incorporated into a total communication system for an individual with severe dysarthria. The purpose of this investigation was to determine if any of three types of linguistic cues (first letter, word class, combined first letter and word class) aided listeners in their ability to understand three speakers with different severity levels of dysarthria. Speech intelligibility was judged by four panels of 10 unfamiliar listeners (N = 40) using a word transcription task. A two-factor (4 × 3) mixed design was used to determine the effects of cuing conditions and severity of dysarthria on speech intelligibility scores expressed as the number of correctly transcribed single words. The two factors were linguistic cue, having four levels (no cue, first-letter cue, w...

Criterion-related validity of the Test of Children's Speech sentence intelligibility measure for children with cerebral palsy and dysarthria.

Abstract Purpose: To evaluate the criterion-related validity of the TOCS+ sentence measure (TOCS+, 11) for children with dysarthria and CP by comparing intelligibility and rate scores obtained concurrently from the TOCS+ and from a conversational sample. Method: Twenty children (3 to 10 years old) diagnosed with spastic cerebral palsy (CP) participated. Nineteen children also had a confirmed diagnosis of dysarthria. Childrens intelligibility and speaking rate scores obtained from the TOCS+, which uses imitation of sets of randomly selected items ranging from 2–7 words (80 words in total) and from a contiguous 100-word conversational speech were compared. Results: Mean intelligibility scores were 46.5% (SD = 26.4%) and 50.9% (SD = 19.1%) and mean rates in words per minute (WPM) were 90.2 (SD = 22.3) and 94.1 (SD = 25.6), respectively, for the TOCS+ and conversational samples. No significant differences were found between the two conditions for intelligibility or rate scores. Strong correlations were found between the TOCS+ and conversational samples for intelligibility (r = 0.86; p < 0.001) and WPM (r = 0.77; p < 0.001), supporting the criterion validity of the TOCS+ sentence task as a time efficient procedure for measuring intelligibility and rate in children with CP, with and without confirmed dysarthria. Conclusion: The results support the criterion validity of the TOCS+ sentence task as a time efficient procedure for measuring intelligibility and rate in children with CP, with and without confirmed dysarthria. Children varied in their relative performance on the two speaking tasks, reflecting the complexity of factors that influence intelligibility and rate scores.

Construct-related validity of the TOCS measures: comparison of intelligibility and speaking rate scores in children with and without speech disorders.

UNLABELLED This study evaluated construct-related validity of the Test of Childrens Speech (TOCS). Intelligibility scores obtained using open-set word identification tasks (orthographic transcription) for the TOCS word and sentence tests and rate scores for the TOCS sentence test (words per minute or WPM and intelligible words per minute or IWPM) were compared for a group of 15 adults (18-30 years of age) with normal speech production and three groups of children: 48 3-6 year-olds with typical speech development and neurological histories (TDS), 48 3-6 year-olds with a speech sound disorder of unknown origin and no identified neurological impairment (SSD-UNK), and 22 3-10 year-olds with dysarthria and cerebral palsy (DYS). As expected, mean intelligibility scores and rates increased with age in the TDS group. However, word test intelligibility, WPM and IWPM scores for the 6 year-olds in the TDS group were significantly lower than those for the adults. The DYS group had significantly lower word and sentence test intelligibility and WPM and IWPM scores than the TDS and SSD-UNK groups. Compared to the TDS group, the SSD-UNK group also had significantly lower intelligibility scores for the word and sentence tests, and significantly lower IWPM, but not WPM scores on the sentence test. The results support the construct-related validity of TOCS as a tool for obtaining intelligibility and rate scores that are sensitive to group differences in 3-6 year-old children, with and without speech sound disorders, and to 3+ year-old children with speech disorders, with and without dysarthria. LEARNING OUTCOMES Readers will describe the word and sentence intelligibility and speaking rate performance of children with typically developing speech at age levels of 3, 4, 5 and 6 years, as measured by the Test of Childrens Speech, and how these compare with adult speakers and two groups of children with speech disorders. They will also recognize what measures on this test differentiate children with speech sound disorders of unknown origin from children with cerebral palsy and dysarthria.

Scientific forum topic: Translating knowledge to practice in childhood dysarthria

Dysarthria can have profound effects on childrens quality-of-life and social participation (Dickinson et al., 2007; Fauconnier et al., 2009). Despite such impacts, there has been a critical lack o...

Effect of age and context on vowel area

Vowel quadrilateral area, based on first and second formant measures of the corner vowels, has been shown to be correlated positively with intelligibility scores in studies of adults with and without dysarthria [Weismer et al., 2001] and children with and without dysarthria [Higgins and Hodge, 2002]. This study compared vowel areas of three groups of typical talkers (3 year‐olds, 5‐year‐olds, and women) using a log Hz scale in two different speaking conditions. The first speaking condition was production of multiple tokens of isolated /hV/ syllables for each corner vowel, and the second was production of single word items containing the four corner vowels taken from a childrens’ test of intelligibility [Hodge, 1996]. An interaction of age with phonetic context was found. Vowel areas for the 3‐year‐olds did not differ between the two conditions and were the largest of the three groups. The 5‐year‐olds’ and women’s vowel areas were of similar size and both were smaller in the word condition. The women showe...

Influence of /r/ on burst spectra for stop place

Bilabial and lingua‐alveolar stops in 20 minimally contrastive word pairs in both singleton and stop /r/ (cluster) contexts were recorded from two girls, one with facial paralysis (CFP) and one with normal facial movement (CNM). Auditory identification of these productions by 12 listeners revealed a significant place by context interaction for CFP. Identification scores were high for her lingua‐alveolar stops (99.3% singletons; 94.8% clusters). Identification scores for her bilabial stops were lower, with singletons being significantly lower (57.8%) than clusters (77.8%). Acoustic cues for stop place (F2 onset frequency, VOT, mean and skewness of burst spectra) were measured for all word productions. For both girls, F2 onset and VOT measures were lower for bilabial than lingua alveolar stops in singletons and clusters. CFP’s burst spectra for bilabials had a higher mean and more negative skewness than lingua alveolars in singletons and clusters. CNM’s burst spectra for bilabials had a lower mean and more ...

Effects of frequency scale on inter‐age comparisons of first and second formant transitions

Comparison of spectral measures from a wide age range of talkers, to draw inferences about inter‐age differences in articulatory behavior, is confounded by the absolute resonant frequency differences that result from vocal tract size differences. Normalization procedures are required so that spectral differences due to vocal tract size differences are not misinterpreted as age differences in speech production behavior. Based on vowel (steady‐state) data, the log Hz scale has been favored over several other frequency scales that have been used to normalize spectra for analysis of production data [T. M. Nearey, Proc. Int. Conf. Spok. Lang. Process. 1, 583–586 (1992)]. The magnitudes of first and second formant transition extents of male talkers, who ranged from infancy to adulthood, were compared under three different normalization conditions (log Hz, ERB, and Bark scales). Each formant was measured in Hz at the onset and offset of the consonant–vowel transition in wideband spectrographic displays of the sy...