MGH Institute of Health Professions, Boston, MA.
Harvard Medical School, Boston, MA.
J Speech Lang Hear Res. 2022 Mar 8;65(3):843-857. doi: 10.1044/2021_JSLHR-21-00213. Epub 2022 Feb 8.
The purpose of this study was to investigate the association between perceived single-word speech severity and intelligibility in children with childhood apraxia of speech (CAS), with and without comorbid language impairment (LI), and to investigate the contribution of different CAS signs to perceived single-word speech severity and single-word intelligibility.
Thirty children with CAS, 18 with comorbid LI, completed the Goldman-Fristoe Test of Articulation-Second Edition (GFTA-2). Trained judges coded children's responses for signs of CAS and percent phonemes correct. Nine listeners, blind to diagnoses, rated speech severity using a visual analog scale. Intelligibility was assessed by comparing listeners' orthographic transcriptions of children's responses to target responses.
Measures of speech severity (GFTA-2 standard score, number of unique CAS signs, total CAS signs, and mean severity rating) were significantly correlated with measures of intelligibility (GFTA-2 raw score, percent phonemes correct, and mean intelligibility score). Speech severity and intelligibility did not differ significantly between children with and without LI. Only consonant errors contributed significant variability to speech severity. Consonant errors and stress errors contributed significant variability to intelligibility.
Findings suggest that visual analog scale ratings are a valid and convenient measure of single-word speech severity and that GFTA-2 raw score is an equally convenient measure of single-word intelligibility. The result that consonant errors were by far the major contributor to single-word speech severity and intelligibility in children with CAS, with stress errors also making a small contribution to intelligibility, suggests that consonant accuracy and appropriate lexical stress should be prime therapeutic targets for these children in the context of treatment addressing motor planning/programming, self-monitoring, and self-correcting.
本研究旨在探讨儿童言语运动障碍（CAS）患儿，以及伴有或不伴有语言障碍（LI）的患儿感知的单词语音严重程度和可理解性之间的关系，并探讨不同 CAS 特征对感知单词语音严重程度和单词语音可理解性的贡献。
30 名 CAS 患儿，18 名伴有 LI 的患儿，完成了 Goldman-Fristoe 测试（第二版）（GFTA-2）。训练有素的评判员对儿童的反应进行 CAS 特征和正确音位百分比的编码。9 名听众对语音严重程度进行视觉模拟评分，他们对诊断结果不知情。可理解性通过比较听众对儿童反应的拼写字符转录与目标反应的结果来评估。
语音严重程度的测量指标（GFTA-2 标准分数、独特的 CAS 特征数、总 CAS 特征数和平均严重程度评分）与可理解性的测量指标（GFTA-2 原始分数、正确音位百分比和平均可理解性评分）显著相关。有和没有 LI 的儿童之间的语音严重程度和可理解性没有显著差异。只有辅音错误对语音严重程度有显著影响。辅音错误和重音错误对可理解性有显著影响。
研究结果表明，视觉模拟评分是一种有效的、方便的单词语音严重程度的测量方法，而 GFTA-2 原始分数是单词语音可理解性的一种同样方便的测量方法。在针对运动计划/编程、自我监控和自我纠错的治疗背景下，儿童 CAS 中单词语音严重程度和可理解性的主要影响因素是辅音错误，重音错误对可理解性也有一定影响，这表明辅音准确性和适当的词汇重音应是这些儿童治疗的主要目标。
