Aim The purpose of this study was to create and validate a Communication Function Classification System (CFCS) for children with cerebral palsy (CP) that can be used by a wide variety of individuals who are interested in CP. This paper reports the content validity, interrater reliability, and test–retest reliability of the CFCS for children with CP. Method An 11-member development team created comprehensive descriptions of the CFCS levels, and four nominal groups comprising 27 participants critiqued these levels. Within a Delphi survey, 112 participants commented on the clarity and usefulness of the CFCS. Interrater reliability was completed by 61 professionals and 68 parents/relatives who classified 69 children with CP aged 2 to 18 years. Test–retest reliability was completed by 48 professionals who allowed at least 2 weeks between classifications. The participants who assessed the CFCS were all relevant stakeholders: adults with CP, parents of children with CP, educators, occupational therapists, physical therapists, physicians, and speech–language pathologists. Results The interrater reliability of the CFCS was 0.66 between two professionals and 0.49 between a parent and a professional. Professional interrater reliability improved to 0.77 for classification of children older than 4 years. The test–retest reliability was 0.82. Interpretation The CFCS demonstrates content validity and shows very good test–retest reliability, good professional interrater reliability, and moderate parent–professional interrater reliability. Combining the CFCS with the Gross Motor Function Classification System and the Manual Ability Classification System contributes to a functional performance view of daily life for individuals with CP, in accordance with the World Health Organization’s International Classification of Functioning, Disability and Health.
Recordings were obtained of the comfort-state vocalizations of infants at 3, 6, and 9 months of age during a session of play and vocal interaction with the infant's mother and the experimenter. Acoustic analysis, primarily spectrography, was used to determine utterance durations, formant frequencies of vocalic utterances, patterns of f0 frequency change during vocalizations, variations in source excitation of the vocal tract, and general properties of the utterances. Most utterances had durations of less than 400 ms although occasional sounds lasted 2 s or more. An increase in the ranges of both the F1 and F2 frequencies was observed across both periods of age increase, but the center of the F1-F2 plot for the group vowels appeared to change very little. Phonatory characteristics were at least generally compatible with published descriptions of infant cry. The f0 frequency averaged 445 Hz for 3-month-olds, 450 Hz for 6-month-olds, and 415 Hz for 9-month-olds. As has been previously reported for infant cry, the vocalizations frequently were associated with tremor (vibrato), harmonic doubling, abrupt f0 shift, vocal fry (or roll), and noise segments. Thus, from a strictly acoustic perspective, early cry and the later vocalizations of cooing and babbling appear to be vocal performances in continuity. Implications of the acoustic analyses are discussed for phonetic development and speech acquisition.
This paper surveys acoustic studies of speech development and discusses the data with respect to the anatomical and neuromuscular maturation of the speech mechanism. The acoustic data on various aspects of speech production indicate that the accuracy of motor control improves with age until adult-like performance is achieved at about 11 or 12 years, somewhat after the age at which speech sound acquisition usually is judged to be complete. Other topics of discussion are (1) problems in the spectrographic analysis of children’s speech, (2) formant scale factors that relate children’s and adults' data, and (3) identification and diagnosis of developmental disorders through acoustic analyses of speech sounds.
A broad review of literature describing lingual function during speech shows that speaker samples per study are typically small (N<3 in more than 80% of all cases), and that speech samples, and representational and analysis conventions are highly variable. Similar conclusions can be drawn for other articulators. Thus it is fair to argue that there is still not available any valid, statistically-defensible sense of normal speech motor behavior, against which disordered articulatory behavior can be compared. Accordingly, a large-sample, 50-speaker x-ray microbeam speech database will be developed at the University of Wisconsin, incorporating point-parametrized representations of lingual, labial, mandibular, and velar movements in association with the resulting acoustic sound pressure wave, for a rich set of utterances and oral motor tasks, and lengthy recording interval (circa 18 min/speaker). The database is intended to be uniform across speakers in task inventory and descriptive kinematic framework; sufficiently accurate and deep to withstand scrutiny of variance, within and across speakers, and perhaps most importantly, an open source available for unlimited inspection and use by other speech scientists. Descriptions of the proposed speech inventory, experimental protocol, speaker sample, and timetable for database development will be provided. [Work supported by NIH DC00820.]
Apraxia of speech (or verbal apraxia) is a controversial disorder, considered by some to be an impairment of the motor programming of speech. Because the disorder is characterized by "higher orderrdquo; errors such as metathesis and segment addition as well as by errors of apparent dyscoordination of articulation, it seems to reflect a relatively high level of damage to the nervous system. This report presents acoustic descriptions of the speech of seven persons diagnosed as having apraxia of speech but without severe aphasic impairmaent, especially agrammatism. The acoustic results indicate a variety of segmental and prosodic atmormalities, including slow speaking rate with prolongations of transitions, steady states, and intersyllable pauses; reduced intensity variation across syllables; slow and inaccurate movements of the articulators; incoordination of voicing with other articulations; initiation difficulties; and errors of selection or sequencing of segments. These error patterns are discussed with respect to a theory of motor control based on spatial-temporal schemata. In addition, consideration is given to the controversy about phonologic versus motor programming impairment in apraxia of speech.
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