DISCUSSION

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DISCUSSION •These new measures may have some clinical utility such as possible indices of severity (cf. Flipsen, Hammer, & Yost, 2005). •PMV may be of particular value given recent discussions of how increased variability may be of diagnostic value in disorders such as CAS (ASHA, 2007). •Additional study is clearly needed. The current findings should however be interpreted quite cautiously for at least two reasons: •1. The current analysis was based on all available words and sample size varied considerably – Ingram and Ingram suggested a consistent sample size (specifically 25 words). •2. The current analysis included both content and function words. Ingram and Ingram suggested only focusing on content words. REFERENCES •American Speech-Language-Hearing Association. (2007). Childhood Apraxia of Speech [Position Statement]. Available from www.asha.org/policy. •Flipsen, P., Jr., Hammer, J. B., & Yost, K. M. (2005). Measuring severity of involvement in speech delay: Segmental and whole-word measures. American Journal of Speech-Language Pathology, 14 (4), 298-312. •Ingram, D., & Ingram, K. D. (2001). A whole-word approach to phonological analysis and intervention. Language, Speech, and Hearing Services in Schools, 32, 271-283. •Shriberg, L. D., & Kent, R. D. (2003). Clinical Phonetics (Third Edition). Boston, MA: Allyn & Bacon. •Shriberg, L. D., Allen, C. T., McSweeny, J. L., & Whole Word Measures of Speech in Children with Cochlear Implants Peter Flipsen Jr., Ph.D. & Michelle Dykman, M.S. Idaho State University INTRODUCTION Ingram & Ingram (2001) proposed a change in focus from individual sounds to the whole word level and suggested several new measures for this purpose. The current study examined two of their proposed new measures (PWW, PWV) using data from two groups of children with cochlear implants. METHOD Participants Group 1 were six children from a longitudinal study who had been fitted with cochlear implants between 1;8 and 3;0 (Mn = 2;4). • Group 1 had 23 - 42 months of implant experience at initial testing (Mn = 32 months) and 36-61 months (Mn = 50 months) of implant experience at final testing. Group 2 included 17 children from a cross-sectional study who had been fitted with cochlear implants between 1;2 and 8;4 (Mn = 3;9). • Group 2 had 12-94 months of implant experience at time of testing (Mn = 51 months) . NOTE: 5 children were part of METHOD (cont’d) •For Group 1 samples were obtained every 3 months over periods of 12-21 months yielding 39 total samples (5-8 per child). For group 2 only a single sample was collected. •Samples were transcribed using narrow phonetic transcription (Shriberg & Kent, 2003) and analyzed using Programs to Evaluate Phonetic and Phonologic Evaluation Records (PEPPER; Shriberg et al., 2001). •Performance on consonant accuracy (PCC) and intelligibility were obtained using PEPPER software. Whole Word Analysis •The first occurrence of all available words were used for Proportion of Whole Word Accuracy (PWW). This is a measure of words containing no errors . Samples included from 38-229 unique words (Mn = 144 words). •All words attempted more than once were included in Proportion of Whole-Word Variability (PWV). This is a measure of the number of RESULTS Developmental Trends Significant correlations (p < .05) for each of the variables with both chronological age and amount of implant experience are shown in Table 2 (Note: ns = not significant). Only a few of the correlations were significant suggesting that the measures only weakly captured speech Acknowledgments Many thanks to Julie Beeler, Velvet Buehler, Molly Erickson, Mark Hedrick, Marge Hudson, Gayla Hutsell, Kim Jenkins, Leslie Jolles, and Saneta Thurman for their assistance with this study. Special thanks to Lana Colvard, Michelle LaGesse, and Rhonda Parker for participant testing and to Lisa Moss and Joel Blaiss for transcribing the conversational speech samples. Many thanks ASHA Convention, 2010 Philadelphia, PA RESULTS •Overall performance on each of the measures is shown in Table 1. •Considerable variability was in evidence on all of the measures for both groups. Inter-Correlations •Using data from groups separately and combined, analysis indicated that the measures were all significantly correlated with each other. •Of note (see for example Fig. 1) was that whole word variability was negatively correlated with the other Whole Word Accuracy PWW-b PWW-n Group 1 33-33-91.35 (Mn = 90.37) 31.82-89.73 (Mn = 65.40) Group 2 36.84-94.42 (Mn = 65.26) 30.71-92.89 (Mn = 54.68) Whole Word Variability PWV-b PWV-n Group 1 0.05-0.33 (Mn = 0.19) 0.08-0.39 (Mn = 0.22) Group 2 0.11-0.33 (Mn = 0.21) 0.13-0.40 (Mn = 0.26) PEPPER Variables Percentage Consonants Correct Intelligibility Group 1 47.01-94.43 (Mn = 81.80) 65.61-96.46 (Mn = 85.73) Group 2 51.30-95.58 (Mn = 74.43) 52.68-97.78 (Mn = 83.21) Table 1. Group Results for each variable Table 2. Significant correlations between speech production and developmental variables Age Implant Experience Group 1 Group 2 Group 1 Group 2 PWW-b .405 ns .340 ns PWW-n ns ns ns .493 PWV-b ns ns ns ns PWV-n ns ns ns ns PCC .492 ns .380 .573 Intelligibil ity .415 ns ns .634

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Whole Word Measures of Speech in Children with Cochlear Implants Peter Flipsen Jr., Ph.D. & Michelle Dykman, M.S. Idaho State University. ASHA Convention, 2010. Philadelphia, PA. INTRODUCTION - PowerPoint PPT Presentation

Transcript of DISCUSSION

Page 1: DISCUSSION

DISCUSSION

•These new measures may have some clinical utility such as possible indices of severity (cf. Flipsen, Hammer, & Yost, 2005).

•PMV may be of particular value given recent discussions of how increased variability may be of diagnostic value in disorders such as CAS (ASHA, 2007).

•Additional study is clearly needed. The current findings should however be interpreted quite cautiously for at least two reasons:•1. The current analysis was based on all available words and sample size varied considerably – Ingram and Ingram suggested a consistent sample size (specifically 25 words).

•2. The current analysis included both content and function words. Ingram and Ingram suggested only focusing on content words.

REFERENCES

•American Speech-Language-Hearing Association. (2007). Childhood Apraxia of Speech [Position Statement]. Available from www.asha.org/policy.

•Flipsen, P., Jr., Hammer, J. B., & Yost, K. M. (2005).  Measuring severity of involvement in speech delay: Segmental and whole-word measures.  American Journal of Speech-Language Pathology, 14(4), 298-312.

•Ingram, D., & Ingram, K. D. (2001). A whole-word approach to phonological analysis and intervention. Language, Speech, and Hearing Services in Schools, 32, 271-283.

•Shriberg, L. D., & Kent, R. D. (2003). Clinical Phonetics (Third Edition). Boston, MA: Allyn & Bacon.

•Shriberg, L. D., Allen, C. T., McSweeny, J. L., & Wilson, D. L. (2001). PEPPER: Programs to examine phonetic and phonologic evaluation records [Computer Program]. Madison, WI: University of Wisconsin.

Whole Word Measures of Speech in Children with Cochlear ImplantsPeter Flipsen Jr., Ph.D. & Michelle Dykman, M.S. Idaho State University

INTRODUCTION

• Ingram & Ingram (2001) proposed a change in focus from individual sounds to the whole word level and suggested several new measures for this purpose.

• The current study examined two of their proposed new measures (PWW, PWV) using data from two groups of children with cochlear implants.

METHOD

Participants

• Group 1 were six children from a longitudinal study who had been fitted with cochlear implants between 1;8 and 3;0 (Mn = 2;4).

• Group 1 had 23 - 42 months of implant experience at initial testing (Mn = 32 months) and 36-61 months (Mn = 50 months) of implant experience at final testing.

• Group 2 included 17 children from a cross-sectional study who had been fitted with cochlear implants between 1;2 and 8;4 (Mn = 3;9).

• Group 2 had 12-94 months of implant experience at time of testing (Mn = 51 months) .

• NOTE: 5 children were part of both groups.

Speech Samples

• Conversational speech samples were recorded in a sound booth using digital audiotape and a table-top microphone

METHOD (cont’d)

•For Group 1 samples were obtained every 3 months over periods of 12-21 months yielding 39 total samples (5-8 per child). For group 2 only a single sample was collected.

•Samples were transcribed using narrow phonetic transcription (Shriberg & Kent, 2003) and analyzed using Programs to Evaluate Phonetic and Phonologic Evaluation Records (PEPPER; Shriberg et al., 2001).

•Performance on consonant accuracy (PCC) and intelligibility were obtained using PEPPER software.

Whole Word Analysis

•The first occurrence of all available words were used for Proportion of Whole Word Accuracy (PWW). This is a measure of words containing no errors. Samples included from 38-229 unique words (Mn = 144 words).

•All words attempted more than once were included in Proportion of Whole-Word Variability (PWV). This is a measure of the number of different versions of each word that were produced. Samples were from 16-108 multiple attempt words (Mn = 66 words).

•PWW and PWV were calculated for each sample by the second author.

RESULTS

Developmental Trends

• Significant correlations (p < .05) for each of the variables with both chronological age and amount of implant experience are shown in Table 2 (Note: ns = not significant).

• Only a few of the correlations were significant suggesting that the measures only weakly captured speech development in this population.

• The variables were more likely to be correlated with implant experience than with age per se.

Acknowledgments

Many thanks to Julie Beeler, Velvet Buehler, Molly Erickson, Mark Hedrick, Marge Hudson, Gayla Hutsell, Kim Jenkins, Leslie Jolles, and Saneta Thurman for their assistance with this study. Special thanks to Lana Colvard, Michelle LaGesse, and Rhonda Parker for participant testing and to Lisa Moss and Joel Blaiss for transcribing the conversational speech samples. Many thanks also to the children who participated and their parents.

ASHA Convention, 2010 Philadelphia, PA

RESULTS

•Overall performance on each of the measures is shown in Table 1.

•Considerable variability was in evidence on all of the measures for both groups.

Inter-Correlations

•Using data from groups separately and combined, analysis indicated that the measures were all significantly correlated with each other.

•Of note (see for example Fig. 1) was that whole word variability was negatively correlated with the other measures. As the children became more intelligible and more accurate, they became less variable.

•Both PWW and PWV were most strongly correlated with PCC and least with intelligibility.

  Whole Word AccuracyPWW-b PWW-n

Group 1 33-33-91.35 (Mn = 90.37) 31.82-89.73 (Mn = 65.40)Group 2 36.84-94.42 (Mn = 65.26) 30.71-92.89 (Mn = 54.68)  Whole Word Variability

PWV-b PWV-nGroup 1 0.05-0.33 (Mn = 0.19) 0.08-0.39 (Mn = 0.22)Group 2 0.11-0.33 (Mn = 0.21) 0.13-0.40 (Mn = 0.26)  PEPPER Variables  Percentage Consonants Correct Intelligibility Group 1 47.01-94.43 (Mn = 81.80) 65.61-96.46 (Mn = 85.73)Group 2 51.30-95.58 (Mn = 74.43) 52.68-97.78 (Mn = 83.21)

Table 1. Group Results for each variable

Table 2. Significant correlations between speech production and developmental variables

  Age Implant ExperienceGroup 1 Group 2 Group 1 Group 2

PWW-b .405 ns .340 nsPWW-n ns ns ns .493PWV-b ns ns ns nsPWV-n ns ns ns nsPCC .492 ns .380 .573Intelligibility .415 ns ns .634