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

2017 ◽  
Vol 60 (4) ◽  
Author(s):  
Lawrence D. Shriberg ◽  
Edythe A. Strand ◽  
Marios Fourakis ◽  
Kathy J. Jakielski ◽  
Sheryl D. Hall ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Mayo Clinic ◽  
Diagnostic Marker ◽  
Adult Onset ◽  
Apraxia Of Speech ◽  
Speech Delay ◽  
Likelihood Ratios ◽  
Childhood Apraxia Of Speech ◽  
Acoustic Measures ◽  
Validity Studies

Purpose The purpose of this 2nd article in this supplement is to report validity support findings for the Pause Marker (PM), a proposed single-sign diagnostic marker of childhood apraxia of speech (CAS). Method PM scores and additional perceptual and acoustic measures were obtained from 296 participants in cohorts with idiopathic and neurogenetic CAS, adult-onset apraxia of speech and primary progressive apraxia of speech, and idiopathic speech delay. Results Adjusted for questionable specificity disagreements with a pediatric Mayo Clinic diagnostic standard, the estimated sensitivity and specificity, respectively, of the PM were 86.8% and 100% for the CAS cohort, yielding positive and negative likelihood ratios of 56.45 (95% confidence interval [CI]: [1.15, 2763.31]) and 0.13 (95% CI [0.06, 0.30]). Specificity of the PM for 4 cohorts totaling 205 participants with speech delay was 98.5%. Conclusion These findings are interpreted as providing support for the PM as a near-conclusive diagnostic marker of CAS.

Metrical Analysis of the Speech of Children With Suspected Developmental Apraxia of Speech

1999 ◽  
Vol 42 (6) ◽  
pp. 1444-1460 ◽  
Author(s):  
Shelley L. Velleman ◽  
Lawrence D. Shriberg
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Marker ◽  
Lexical Stress ◽  
Apraxia Of Speech ◽  
Speech Delay ◽  
Acoustic Measures ◽  
Metrical Phonology ◽  
Developmental Apraxia ◽  
Metrical Analysis ◽  
Better Than

Previous studies have shown that metrical analysis accounts for syllable omissions in young normally developing children better than prior perspectives. This approach has not yet been applied to children with disorders. Inappropriate sentential stress has been proposed as a diagnostic marker for a subgroup of children with suspected developmental apraxia of speech (SD-DAS), suggesting that the application of metrical perspectives to this population may be appropriate. This report extends the goal of identifying diagnostic markers for SD-DAS using analytic procedures from metrical phonology. The lexical metrical patterns of children with SD-DAS were compared to those of a group of children with speech delay (SD) to verify the applicability of metrical constructs to children with disorders while at the same time seeking lexical stress characteristics that might be useful for differential diagnosis. The lexical stress errors of children in both the SD and SD-DAS disorder groups were found to conform to patterns identified in metrical studies of younger normally developing children, confirming the applicability of this approach to children with disorders. Lexical metrical patterns did not differentiate the groups from each other. However, syllable omissions persisted to much later ages in the SD-DAS subjects, especially those children previously identified as having inappropriate phrasal stress. Further metrical studies of the speech of children with suspected SD-DAS are needed, both at the lexical and the sentential level, using both perceptual and acoustic measures.

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

2017 ◽  
Vol 60 (4) ◽  
Author(s):  
Lawrence D. Shriberg ◽  
Edythe A. Strand ◽  
Marios Fourakis ◽  
Kathy J. Jakielski ◽  
Sheryl D. Hall ◽  
...  
Keyword(s):  
Diagnostic Marker ◽  
Temporal Stability ◽  
Stability Study ◽  
Apraxia Of Speech ◽  
Speech Delay ◽  
Childhood Apraxia Of Speech ◽  
Retrospective Case ◽  
Marker Index ◽  
Speech Prosody ◽  
Stability Data

Purpose Three previous articles provided rationale, methods, and several forms of validity support for a diagnostic marker of childhood apraxia of speech (CAS), termed the pause marker (PM). Goals of the present article were to assess the validity and stability of the PM Index (PMI) to scale CAS severity. Method PM scores and speech, prosody, and voice precision-stability data were obtained for participants with CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech consequent to stroke and primary progressive apraxia; and idiopathic speech delay. Three studies were completed including criterion and concurrent validity studies of the PMI and a temporal stability study of the PMI using retrospective case studies. Results PM scores were significantly correlated with other signs of CAS precision and stability. The best fit of the distribution of PM scores to index CAS severity was obtained by dividing scores into 4 ordinal severity classifications: mild, mild-moderate, moderate-severe, and severe. 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.

scholarly journals A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: Introduction

2017 ◽  
Vol 60 (4) ◽  
Author(s):  
Lawrence D. Shriberg ◽  
Edythe A. Strand ◽  
Marios Fourakis ◽  
Kathy J. Jakielski ◽  
Sheryl D. Hall ◽  
...  
Keyword(s):  
Diagnostic Marker ◽  
Apraxia Of Speech ◽  
Speech Delay ◽  
Childhood Apraxia Of Speech

Purpose The goal of this article is to introduce the pause marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech (CAS) from speech delay.

scholarly journals A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker

2017 ◽  
Vol 60 (4) ◽  
Author(s):  
Lawrence D. Shriberg ◽  
Edythe A. Strand ◽  
Marios Fourakis ◽  
Kathy J. Jakielski ◽  
Sheryl D. Hall ◽  
...  
Keyword(s):  
Classification System ◽  
Diagnostic Marker ◽  
Speech Disorders ◽  
Apraxia Of Speech ◽  
Speech Delay ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Cross Classification ◽  
Classification Procedures

Purpose The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay. Method The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed. Results The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided. Conclusions The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay.

scholarly journals A diagnostic marker for childhood apraxia of speech: the coefficient of variation ratio

2003 ◽  
Vol 17 (7) ◽  
pp. 575-595 ◽  
Author(s):  
Lawrence D. Shriberg ◽  
Jordan R. Green ◽  
Thomas F. Campbell ◽  
Jane L. Mcsweeny ◽  
Alison R. Scheer
Keyword(s):  
Coefficient Of Variation ◽  
Diagnostic Marker ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech

scholarly journals Poor Speech Perception Is Not a Core Deficit of Childhood Apraxia of Speech: Preliminary Findings

2018 ◽  
Vol 61 (3) ◽  
pp. 583-592 ◽  
Author(s):  
Jennifer Zuk ◽  
Jenya Iuzzini-Seigel ◽  
Kathryn Cabbage ◽  
Jordan R. Green ◽  
Tiffany P. Hogan
Keyword(s):  
Speech Perception ◽  
Language Impairment ◽  
Motor Planning ◽  
Typically Developing ◽  
Apraxia Of Speech ◽  
Speech Delay ◽  
Childhood Apraxia Of Speech ◽  
Core Deficit ◽  
Language Assessments ◽  
Speech Motor

Purpose Childhood apraxia of speech (CAS) is hypothesized to arise from deficits in speech motor planning and programming, but the influence of abnormal speech perception in CAS on these processes is debated. This study examined speech perception abilities among children with CAS with and without language impairment compared to those with language impairment, speech delay, and typically developing peers. Method Speech perception was measured by discrimination of synthesized speech syllable continua that varied in frequency (/dɑ/–/ɡɑ/). Groups were classified by performance on speech and language assessments and compared on syllable discrimination thresholds. Within-group variability was also evaluated. Results Children with CAS without language impairment did not significantly differ in syllable discrimination compared to typically developing peers. In contrast, those with CAS and language impairment showed significantly poorer syllable discrimination abilities compared to children with CAS only and typically developing peers. Children with speech delay and language impairment also showed significantly poorer discrimination abilities, with appreciable within-group variability. Conclusions These findings suggest that speech perception deficits are not a core feature of CAS but rather occur with co-occurring language impairment in a subset of children with CAS. This study establishes the significance of accounting for language ability in children with CAS. Supplemental Materials https://doi.org/10.23641/asha.5848056

Comments Regarding the Investigation of Developmental Apraxia of Speech

1998 ◽  
Vol 41 (4) ◽  
pp. 958-960
Author(s):  
Claire M. Waldron
Keyword(s):  
Theoretical Model ◽  
Diagnostic Marker ◽  
Receptive Language ◽  
Speech Disorders ◽  
Written Language ◽  
Adult Onset ◽  
Apraxia Of Speech ◽  
Language Status ◽  
Developmental Apraxia ◽  
Strongly Agree

The conclusions and discussion were based on only 16 children who were identified based on clearly described criteria. Those subjects have widely varying ages, unspecified treatment histories, and varying receptive language status. The authors did not claim that these results are generalizable to a larger population of children, but I fear that their results will be interpreted that way by others. Identifying unusual phrasal stress deficits in 8 of 16 children with suspected DAS should not be construed or implied as evidence for a diagnostic marker for a subtype of DAS. I strongly agree with the authors that longitudinal studies of children with persistent and unusual speech disorders are needed. Studies concerning children's responses to treatment are also needed. Although models of adult onset apraxia (AOS) may provide useful procedures for measuring or describing speech and nonspeech characteristics of DAS, using AOS as a theoretical model or clinical analogy to DAS leads us to ask less relevant questions about children with unusual and persistent speech disorders. Children with suspected DAS are different from adults who have AOS. Children who have never spoken normally or used language normally are different from adults who have acquired a speech disorder after decades of using spoken and written language normally. In order to intervene efficiently and appropriately, we need to know whether and how children with DAS differ from other children, not how they might resemble adults with an acquired disorder.

Developmental Apraxia of Speech

1997 ◽  
Vol 40 (2) ◽  
pp. 313-337 ◽  
Author(s):  
Lawrence D. Shriberg ◽  
Dorothy M. Aram ◽  
Joan Kwiatkowski
Keyword(s):  
Diagnostic Marker ◽  
Unknown Origin ◽  
Conversational Speech ◽  
Apraxia Of Speech ◽  
Speech Delay ◽  
Motor Speech ◽  
Motor Speech Disorder ◽  
Developmental Apraxia ◽  
Working Hypotheses ◽  
Prior Stress

Two prior studies in this series (Shriberg, Aram, & Kwiatkowski, 1997a, 1997b) address the premise that children with developmental apraxia of speech (DAS) can be differentiated from children with speech delay (SD) on the basis of one or more reliable differences in their speech. The first study compared segmental and prosody-voice profiles of a group of 14 children with suspected DAS to profiles of 73 children with SD. Results suggest that the only linguistic domain that differentiates some children with suspected DAS from those with SD is inappropriate stress. The second study cross-validated these findings, using retrospective data from a sample of 20 children with suspected DAS evaluated in a university phonology clinic over a 10-year period. The present study is of particular interest because it cross-validates the prior stress findings, using conversational speech samples from 19 children with suspected DAS provided by five DAS researchers at geographically diverse diagnostic facilities in North America. Summed across the three studies, 52% of 48 eligible samples from 53 children with suspected DAS had inappropriate stress, compared to 10% of 71 eligible samples from 73 age-matched children with speech delay of unknown origin. Discussion first focuses on the implications of stress findings for theories of the origin and nature of DAS. Perspectives in psycholinguistics, neurolinguistics, and developmental biolinguistics lead to five working hypotheses pending validation in ongoing studies: (a) inappropriate stress is a diagnostic marker for at least one subtype of DAS, (b) the psycholinguistic loci of inappropriate stress in this subtype of DAS are in phonological representational processes, (c) the proximal origin of this subtype of DAS is a neurogenically specific deficit, (d) the distal origin of this form of DAS is an inherited genetic polymorphism, and (e) significant differences between acquired apraxia of speech in adults and findings for this subtype of DAS call into question the inference that it is an apractic, motor speech disorder. Concluding discussion considers implications of these findings for research in DAS and for clinical practice.

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