Speech feature profiles in Swedish 5-year-olds with speech sound disorder related to suspected childhood apraxia of speech or cleft palate

Figures & data

Table I. Background information on concomitant impairment for all participants.

Table II. Operational definitions for the 12-feature checklist of CAS proposed by Iuzzini-Seigel and Murray (2017) and assessment procedure used in this study.

ASHA’s three primary criteria (2007)	Speech features commonly associated with CAS	Operational definition according to Iuzzini-Seigel and Murray (2017)	Assessment procedure*
(a) Inconsistent errors on consonants and vowels in repeated productions of syllables or words	Vowel error	Both vowel substitutions and distortions are considered incorrect	Yes / no
	Consonant distortion	The speech sound is recognisable as a specific consonant but not produced accurately	Yes / no
	Speech sound inconsistency	Variable production of phonemes (i.e. phonemic inconsistency) words or phrases (i.e. token-to-token inconsistency across multiple opportunities)	Yes / no calculation of the Inconsistency Severity Percentage for consonants (ISPc) and vowels (ISPv), based on semi-narrow phonetic transcription
	Nasal resonance	Hypo- or hypernasal resonance	Yes / no
(b) Lengthened and disrupted coarticulatory transitions between sounds and syllables	Intrusive schwa	Addition of a schwa between consonants	Yes / no
	Voicing error	A sound produced between voicing categories or as its voicing cognate	Yes / no
	Groping	Prevocalic, silent articulatory searching prior onset of phonation and speech production	Yes / no visually judged video recordings*
	Difficulty achieving initial articulatory configurations or transitionary movement gestures	Lengthened or disrupted, hence uncoordinated, movements or coarticulatory gestures at word start or between sounds within words	Yes / no observation of visual speech behaviour* and/or perceptual output (e.g. diphthongisation)
	Increased difficulty with multisyllabic words	The number of errors increases disproportionately if number of syllables increase	Yes / no calculation of the Magnitude of Change Score based on semi-narrow phonetic transcription
(c) Inappropriate prosody, especially in the realisation of lexical or phrasal stress	Stress errors	Appropriate stress is not correctly produced at the word or sentence level	Yes / no
	Syllable segregation	Inappropriate pauses between sounds, syllables or words leading to segregation and lack of smooth transitions within words	Yes / no
	Slow rate	Atypically slow speech rate	Yes / no

*Differences in assessment procedure between included patient groups due to missing video recordings, i.e. visual speech bahaviours were available for 32% of participants with CP ± L.

Table III. Speech features assessed according to the checklist and operational definitions proposed by Iuzzini-Seigel and Murray (2017) presented individually

Participants group sCAS (n = 15)	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15
Vowel error
Inconsistency Severity Percentage for vowels (ISPv)
Consonant distortion
Inconsistency Severity Percentage (ISPc)
Nasal Resonance
Intrusive schwa
Voicing error
Groping
Diff articulatory configurations & transitions
Increased difficulties with multisyllabic words
Stress errors
Syllable segregation
Slow rate
Sum CAS features + Inconsistency measures ISP**	7 + 2	7 + 2	8 + 2	1 + 1	6 + 2	5 + 2	5 + 2	5 + 2	5 + 2	3 + 1	7 + 2	3 + 1	2 + 1	8 + 2	2 + 0
Participants group CP ± L (n = 19)	16	17	18	19	20	21	22	23	24	25	26	27	28	29	30	31	32	33	34
Vowel error
Inconsistency Severity Percentage for vowels (ISPv)
Consonant distortion
Inconsistency Severity Percentage (ISPc)
Nasal Resonance
Intrusive schwa
Voicing error
Groping									*	*	*	*	*	*	*	*	*	*	*
Diff articulatory configurations & transitions
Increased difficulties with multisyllabic words
Stress errors
Syllable segregation
Slow rate
Sum CAS features + Inconsistency measures ISP**	3 + 1	4 + 1	4 + 1	1 + 1	2 + 1	6 + 2	5 + 2	3 + 1	1 + 0	2 + 0	2 + 1	3 + 1	2 + 1	1 + 1	3 + 0	2 + 1	1 + 0	3 + 1	3 + 2

*missing data; Inconsistency measures ISP** +0 = no phonemic inconsistency; +1 = phonemic inconsistency for consonants; +2= phonemic inconsistency for both consonants and vowels

Figure 1. Distribution of CAS features in percentage across the two compared groups. CAS ± CP ± L: Childhood apraxia of speech with/without cleft palate with/without cleft lip; non-CAS CP ± L: speech sound disorder other than CAS and cleft palate with/without cleft lip, *Groping could not be assessed for all participants from patient group CP ± L.

Iuzzini-Seigel, J., & Murray, E. (2017). Speech assessment in children with childhood apraxia of speech. Perspectives of the ASHA Special Interest Groups, 2, 47–60. doi:https://doi.org/10.1044/persp2.SIG2.47

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American Speech-Language-Hearing Association, Ad Hoc Committee on Apraxia of Speech in Children. (2007). Childhood Apraxia of Speech [Technical Report]. Rockville (MD): ASHA, Retrieved from: http://www.asha.org/policy/TR2007-00278/

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