Lexical tone perception and production in Cantonese-speaking children with childhood apraxia of speech: a pilot study

Abstract

Introduction: Childhood apraxia of speech (CAS) is a paediatric motor speech disorder. We investigated the lexical tone perception and production abilities of children with CAS and the relationships between the two. Methods: Three children with CAS, aged between 3;7 and 5;8, were given the Cantonese Tone Identification Test (CANTIT) and the Hong Kong Cantonese Articulation Test (HKCAT) for assessment of tone perception and production, respectively. Accuracy and error patterns were investigated based on their performance on the two tests. Correlation analysis was performed on children's perception and production scores. Results: Two children scored at the lowest rank on the CANTIT, while one child obtained a Z score of 0. All children scored three standard deviations below the mean on the HKCAT. No statistical differences were found among the six tones with respect to perception accuracy, H(5) = 3.731, p = 0.589. Error analysis showed that children with CAS demonstrated more confusion on perceiving tones compared with TD peers. There were no main effects for task (F(1,2) = 0.040, p = 0.859) or tone (F(5,10 = 0.997, p = 0.467); nor were there task or tone interaction effects on perception versus production accuracy (F(5,10) = 1.772, p = 0.206). Tone perception and production accuracy were not significantly correlated (r 2 = 0.181, p = 0.078). Discussion: Tone perception deficits were evident in two out of three children with CAS, while all children had lexical tone production difficulties. In this small sample, tone production was more universally affected than tone perception.

The Use of Segmental and Suprasegmental Sequencing Skills to Differentiate Children With and Without Childhood Apraxia of Speech: Protocol for a Comparative Accuracy Study

“…The results will promote the standard of CAS diagnosis in Cantonese speakers from reliance on expert perceptual judgment based on a list of clinical features [ 41 ] to a combination of perceptual judgment and quantitative data. In addition, the short administration time of the measures proposed in this study (ie, approximately 15-20 minutes per measure) will provide clinicians with quick and accurate methods for CAS diagnosis in Cantonese speakers than approximately 2 hours of comprehensive assessment [ 18 , 41 , 42 ] of speech motor skills reported in the literature. Moreover, the results of this study will provide the basis for further investigations of pitch-variation skills in children with CAS who speak other tonal languages (eg, Mandarin, Vietnamese, and Thai) as well as in children with CAS who speak nontonal languages (eg, English).…”

“…A study has shown that an understanding of CAS in Cantonese speakers is lacking. Even experienced speech-language pathologists are not confident in using criteria for making a differential diagnosis of CAS in Cantonese-speaking children [ 44 ]. The challenge of making such an accurate diagnosis will be ameliorated through the dissemination of these results.…”

Clinical practice of childhood apraxia of speech in Hong Kong: A web-based survey study

“…The existing understanding of CAS is mainly based on English and Dutch speakers, but the literature about CAS in children who speak other languages is growing. For example, the genetic and neural bases of CAS have been investigated in Chinese [29] and Italian [30]; clinical features or speech performance have been explored in Arabic [31], Cantonese [32,33], Mandarin [34], and French [35]; assessment tests or diagnostic checklists have been developed for Arabic [36], Brazilian Portuguese [37], Danish [38], and Swedish speakers with CAS [39]; and the treatment efficacy of different approaches has been examined in speakers of Brazilian Portuguese [40,41], Cantonese [42], German [43], Italian [44], Korean [45], Mandarin [46], Spanish [47], and Turkish [48].…”

“…In particular, lexical tone errors and difficulty in perceiving tones were identified as clinical features that had never been reported for English speakers with CAS. Further investigation of tone perception and production skills, as well as the development of a potential diagnostic tool, were then carried out, resulting in an increased understanding of CAS in Cantonese, and probably other tonal languages [32,33].…”

“…In a recent scoping review, a total of four studies with a focus on Cantonese CAS were identified [58]. Wong [42] demonstrated the efficacy of a combined treatment approach of the syllable repetition method and modified DTTC therapy with two Cantonese speakers with CAS. A list of 29 clinical features that gained consensus among a group of experts for CAS diagnosis was proposed from a survey study [56].…”