A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: III. Theoretical Coherence of the Pause Marker with Speech Processing Deficits in Childhood Apraxia of Speech

Abstract

Purpose Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS. Method PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay. Results Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS–AAS similarities in the age–sex standardized percentages of occurrence of the most frequent type of inappropriate pauses ( abrupt ) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings. Conclusions Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM's pause-speech elements with these deficits.

A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: IV. The Pause Marker Index

“…In summary, construct validity and psychometric support for the PM was reported in the second article in this series (PM II; Shriberg et al, 2017b), and its theoretical coherence with speech processing deficits in CAS was addressed in the third article in this series (PM III; Shriberg et al, 2017c). The goal of the present research was to assess one feature of the generality of the PM (see PM I, Table 1; Shriberg et al, 2017a): its ability to scale severity of CAS.…”

“…As described and referenced in the three previous articles (Shriberg et al, 2017a(Shriberg et al, , 2017b(Shriberg et al, , 2017c, a PM score is the percentage of occurrence of four types of inappropriate between-words pauses in a continuous speech sample. A PM score is calculated by dividing the number of such pauses in a continuous speech sample by the number of between-words pause opportunities.…”

“…Severity findings for the 4 classifications and retrospective longitudinal findings from 8 participants with CAS supported the validity and stability of the PMI. Conclusion: Findings support research and clinical use of the PMI to scale the severity of CAS.A four-article series (Shriberg et al, 2017a(Shriberg et al, , 2017b(Shriberg et al, , 2017c, and the present article) to develop and assess the theoretical and clinical utility of a singlesign, behavioral marker of childhood apraxia of speech (CAS) poses the following three questions: …”

“…A four-article series (Shriberg et al, 2017a(Shriberg et al, , 2017b(Shriberg et al, , 2017c, and the present article) to develop and assess the theoretical and clinical utility of a singlesign, behavioral marker of childhood apraxia of speech (CAS) poses the following three questions:…”

A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: II. Validity Studies of the Pause Marker

“…Criterionreferenced Transcoding information is obtained from the Syllable Repetition Task (Shriberg et al, 2009;Shriberg & Lohmeier, 2008). A Phonology Project technical report (Tilkens et al, 2017) includes additional PM findings and audio exemplars of inappropriate between-words pauses, including examples of the primary type of inappropriate between-words pauses, termed an abrupt between-words pause (see PM III; Shriberg et al, 2017b).…”