Age Norms for Auditory-Perceptual Neurophonetic Parameters: A Prerequisite for the Assessment of Childhood Dysarthria

Abstract

Purpose The aim of this study was to collect auditory-perceptual data on established symptom categories of dysarthria from typically developing children between 3 and 9 years of age, for the purpose of creating age norms for dysarthria assessment. Method One hundred forty-four typically developing children (3;0–9;11 [years;months], 72 girls and 72 boys) participated. We used a computer-based game specifically designed for this study to elicit sentence repetitions and spontaneous speech samples. Speech recordings were analyzed using the auditory-perceptual criteria of the Bogenhausen Dysarthria Scales, a standardized German assessment tool for dysarthria in adults. The Bogenhausen Dysarthria Scales (scales and features) cover clinically relevant dimensions of speech and allow for an evaluation of well-established symptom categories of dysarthria. Results The typically developing children exhibited a number of speech characteristics overlapping with established symptom categories of dysarthria (e.g., breathy voice, frequent inspirations, reduced articulatory precision, decreased articulation rate). Substantial progress was observed between 3 and 9 years of age, but with different developmental trajectories across different dimensions. In several areas (e.g., respiration, voice quality), 9-year-olds still presented with salient developmental speech characteristics, while in other dimensions (e.g., prosodic modulation), features typically associated with dysarthria occurred only exceptionally, even in the 3-year-olds. Conclusions The acquisition of speech motor functions is a prolonged process not yet completed with 9 years. Various developmental influences (e.g., anatomic–physiological changes) shape children's speech specifically. Our findings are a first step toward establishing auditory-perceptual norms for dysarthria in children of kindergarten and elementary school age. Supplemental Material https://doi.org/10.23641/asha.12133380

Dysarthria syndromes in children with cerebral palsy

“…The ratings were completed by either TS or EH, who were blind for the motor type of CP at the time of the speech evaluation. For details of construction, reliability, and validity of the original BoDyS protocol see Ziegler et al, 25 and for analyses of interrater reliability in children see Schölderle et al 21 In the variables chosen as classifiers, the observed frequency of occurrence of a feature was weighted by the severity score of its corresponding scale, using the formula:: 4 À ðrelative frequency of occurrence  4 À mean score on corresponding scale ½ Þ :…”

“…For example, the articulation rate scale comprises the two features reduced rate and increased rate, and the voice quality scale comprises the features breathy voice, strained-strangled voice, rough/harsh voice, and fluctuating voice quality. 21,25 Following the original BoDyS protocol, we documented the presence of each feature in each speech sample, from which we calculated the relative frequency of occurrence (ranging from 0=not observed to 1=observed in each of the six samples). The nine scales were rated for severity on a five-point equal-appearing interval scale (0=very severe; 4=no disorder) for each speech sample separately.…”

“…In a previous study, we showed that speech motor development is reflected in speech characteristics that may overlap or interfere with symptoms of childhood dysarthria. 21 Many typically developing children of a certain age present with hyponasality and breathy voice quality due to anatomical-physiological configurations, which may mask dysarthric symptoms in neurological conditions; the restricted dimensions of children's nasal cavities, for instance, attenuate nasal resonance and can therefore mask hypernasality resulting from velar insufficiency. Similarly, irregular glottal cycles caused by the vocal fold tissue characteristics of the developing larynx 22 may counteract spastic glottal hyperadduction and thereby mitigate the strained-strangled voice quality typical of adult spastic dysarthria.…”

Dysarthriediagnostik mit Kindern – das Testmaterial der BoDyS-KiD

“…Die typisch entwickelten Kinder wurden zur Erhebung auditiver Normdaten untersucht (vgl. [14]). Alle Kinder waren muttersprachlich deutsch, wiesen keine organischen Erkrankungen der Atemwege oder Sprechorgane und keine Hörstörungen auf.…”

“…Das Untersuchungsmaterial stellt somit die Basis für eine gezielte auditive Analyse dysarthrischer Störungen bei Kindern dar. Dazu liegen altersbezogene Normdaten für 3-bis 9-Jährige vor [14], die in Zukunft für Kinder bis ins Alter der Pubertät ausgeweitet werden sollen.…”