Intelligibility in Context Scale: Growth Curves for Typically Developing English-Speaking Children Between Ages 2;6 and 9;11.

PURPOSE: The aim of this study was to quantify the clinical utility of the Intelligibility in Context Scale (ICS) English version by characterizing the growth patterns of the ICS composite scores and seven ICS individual item scores of typically developing American English-speaking children. METHOD: Parents of 545 typically developing children aged 2;6-9;11 (years;months) completed the ICS. Using a proportional odds model, we regressed ICS composite scores on age and computed for model-estimated mean and lower quantile ICS composite scores. Logistic regression and proportional odds modeling were utilized to quantify the relationship of individual ICS items and age. RESULTS: ICS composite scores of typically developing children changed with age, but change was small and incremental, with scores compressed between 3 and 5 across the range of ages. An average child (i.e., on the 50th percentile) is expected to have an ICS composite score of 4 beginning at 3;0 and an ICS composite score of 5 by 6;6. On average, parents gave different intelligibility ratings based on communicative partners, and the rating differences between communicative partners decreased with age. CONCLUSIONS: Given that ICS scores increase with age, the expected score for average children also increases. A child's age is a main factor for interpreting ICS scores.

Developmental Cut-Points for Atypical Speech Intelligibility in Children With Cerebral Palsy.

PURPOSE: Early identification of speech motor involvement (SMI) in children with cerebral palsy (CP) is difficult because of overlapping features with many aspects of typical speech development. Quantitative measures of speech intelligibility have the potential to differentiate between children with SMI and those with no SMI (NSMI). We examined thresholds for speech intelligibility development in children with CP relative to the low end of age-specific typical developmental expectations. We sought to determine whether there were intelligibility differences between children with CP and NSMI versus typically developing (TD) age-mates across the range of development and whether there were differences between children with CP who have NSMI and those with CP who have SMI across the range of development based on speech intelligibility. METHOD: We used two large existing data sets that included speech samples from children between the ages of 2.5 and 8 years. One data set included 511 longitudinal speech samples from children with CP; the other included 505 cross-sectional speech samples from TD children. We examined receiver operating characteristic curves and sensitivity/specificity results by age for differentiating among groups of children. RESULTS: TD children versus those with CP and NSMI showed differentiation in their speech intelligibility across all ages, but the strength of differentiation was only marginally above chance. Children with CP and NSMI showed clear differentiation in their speech intelligibility from those with CP and SMI beginning at the earliest age point. Children with CP who have intelligibility below 40% at the age of 3 years have a very high probability of having SMI. CONCLUSIONS: Early intelligibility screening should be performed in children diagnosed with CP. Those with intelligibility below 40% at 3 years of age should be referred immediately for speech assessment and treatment.

Functional Communication Abilities in Youth With Cerebral Palsy: Association With Impairment Profiles and School-Based Therapy Goals.

PURPOSE: The aim of this study was to examine the relationship between functional communication skills, underlying speech, language, and cognitive impairments and school-based speech pathology services in students with cerebral palsy (CP). METHOD: Thirty-five participants with CP who had Individualized Education Programs (IEPs) were classified according to the Communication Function Classification System (CFCS). Participants completed laboratory assessments of speech, receptive language, executive functioning, and nonverbal cognition. Each participant's speech and language IEP goals were coded into treatment units and then categorized into seven, mutually exclusive target goal areas. Nonparametric analyses were employed to examine differences among CFCS groups in the number of deficit areas and the number of goal areas from the IEP. Descriptive analyses were used to evaluate the extent to which deficit and goal areas in the IEP co-occurred by CFCS level. RESULTS: Those in more involved CFCS levels demonstrated more severe speech, receptive language, and cognitive impairments. However, there were no significant differences in the number of deficit areas across CFCS groups. Regardless of CFCS level, there were no differences in the number of treatment goals specified in the IEP. Literacy was the only goal area addressed across all CFCS levels. Those in the most involved CFCS levels had augmentative and alternative communication (AAC) goals, but those with more moderate restrictions in functional communication who also had markedly reduced speech intelligibility did not typically have speech or AAC goals. INTERPRETATION: Individuals with CP across CFCS levels demonstrate variability in underlying deficit profiles, suggesting that measures of both functional communication and of underlying deficits are necessary to provide a complete picture of communication needs. Literacy goals were common across all CFCS levels, but AAC goals were limited to the most severely involved individuals, suggesting that continuing education may be necessary to support speech-language pathologists in developing treatments involving the integration of AAC and speech to foster functional communication at school. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.16968073.

Utility of the Intelligibility in Context Scale for Predicting Speech Intelligibility of Children with Cerebral Palsy.

The Intelligibility in Context Scale (ICS) is a widely used, efficient tool for describing a child's speech intelligibility. Few studies have explored the relationship between ICS scores and transcription intelligibility scores, which are the gold standard for clinical measurement. This study examined how well ICS composite scores predicted transcription intelligibility scores among children with cerebral palsy (CP), how well individual questions from the ICS differentially predicted transcription intelligibility scores, and how well the ICS composite scores differentiated between children with and without speech motor impairment. Parents of 48 children with CP, who were approximately 13 years of age, completed the ICS. Ninety-six adult naïve listeners provided orthographic transcriptions of children's speech. Transcription intelligibility scores were regressed on ICS composite scores and individual item scores. Dysarthria status was regressed on ICS composite scores. Results indicated that ICS composite scores were moderately strong predictors of transcription intelligibility scores. One individual ICS item differentially predicted transcription intelligibility scores, and dysarthria severity influenced how well ICS composite scores differentiated between children with and without speech motor impairment. Findings suggest that the ICS has potential clinical utility for children with CP, especially when used with other objective measures of speech intelligibility.

Speech Development Between 30 and 119 Months in Typical Children II: Articulation Rate Growth Curves.

Purpose We aimed to develop normative growth curves for articulation rate during sentence repetition for typically developing children. Our primary goal was the development of quantile/percentile growth curves so that typical variation in articulation rate with age could be estimated. We also estimated when children became adultlike in their articulation rate, and we examined the contributions of age and utterance length to articulation rate. Method This cross-sectional study involved collection of in-person speech samples from 570 typically developing children (297 girls; 273 boys) who passed speech, language, and hearing screening measures. Pauses greater than 150 ms in duration were removed from the samples, and articulation rate was measured in syllables per second (sps). Results Articulation rate reliably increased with age and utterance length. Rate in all key percentiles increased with age. The median rate (50th percentile) increased from 2.7 sps at 36 months to 3.3 sps at 96 months. The 5th percentile increased from 2.3 to 3.1 sps over the same age range. Using 3.2 sps as a benchmark for adultlike speech, we found the 25th, 50th, and 75th percentiles reached adultlike rates at 99, 75, and 53 months, respectively. Conclusions Articulation rate increases from early childhood into middle childhood, and it is generally adultlike by 10 years of age. Variability in articulation rate among typical children was substantial. Implications for prior research and for clinical usage are discussed.

Speech-Language Profile Groups in School Aged Children with Cerebral Palsy: Nonverbal Cognition, Receptive Language, Speech Intelligibility, and Motor Function.

Purpose: To explore the relationship of intelligibility, receptive language, executive functioning, and motor skills to nonverbal cognitive skills among children with cerebral palsy (CP) in different speech-language profile groups. Method: Twenty-seven children with CP aged 10-12 years old participated in the study. They completed a battery of standard clinical assessments. The relationship of various skillsets with nonverbal cognitive ability was explored using correlational procedures. Additionally, we examined pairwise differences in nonverbal cognitive skills among profile groups. Cohen's Kappa and Chi-square tests were used to study the consistency of receptive language and nonverbal cognitive performance. Results: Children who showed better nonverbal cognitive abilities demonstrated better motor, receptive language, and intelligibility skills. Nonverbal cognition was generally consistent with receptive language. Conclusion: Nonverbal cognitive impairment often co-occurs with language and speech motor impairment among children with CP. Speech-language profile groups are a useful framework for describing both communication and cognitive abilities.

[Food environment and space accessibility evaluation to perform physical activity in 3 socially contrasting neighbourhoods of Buenos Aires city]. / Evaluación del ambiente construido en barrios de diferente nivel socioeconómico de la CABA.

Due to the environmental influences on health, the goal of this study was to describe and compare the built environment in 3 socially contrasting neighbourhoods of Buenos Aires city.In 2011 a cross-sectional study was conducted in 3 socially contrasting neighbourhoods of Buenos Aires city: Recoleta (upper class), Almagro (middle class) and Constitución (lower class). Grocery stores and food stands were surveyed as well as all suitable spaces to perform physical activity. An analysis was conducted to assess the density of every food outlet per Km2 of each neighbourhood's area and per 10000 inhabitants. 2778 food stores and 149 outdoor physical activity facilities were surveyed. A higher density was observed in Constitución for fast food restaurants (Recoleta 3.6; Almagro 2.4; Constitución 6.7) and food stands (Recoleta 4.2; Almagro 1.2; Constitución 25.7) and a lower density for outdoor physical activity facilities. Population density and area density proved to be analogous. Statistically relevant differences were observed regarding the dimension of each food outlet: grocery stores, fruit stands, pubs, restaurants and food stands, as well as in the number of food stores and outdoor physical activity facilities. The information gathered in this study could be highly useful for public health policies on healthy lifestyles, and could eventually redefine the built environment in order to improve the city's equality regarding outdoor physical activity facilities and food stores.

Debido a que el ambiente influye sobre la salud de la población, nuestro objetivo fue describir y comparar el ambiente construido (alimentario y de actividad física) en tres barrios representativos de diferente nivel socioeconómico (NSE) de la Ciudad Autónoma de Buenos Aires (CABA). Se realizó un estudio de corte transversal durante 2011 en tres barrios de la CABA representantes de diferente NSE: Recoleta (alto), Almagro (medio) y Constitución (bajo). Se relevaron todos los locales estables y puestos ambulantes de venta de alimentos (LA) y los espacios destinados a la realización de actividad física (AF). Se estimaron las densidades de cada tipo de local por Km2 de superficie del barrio y por cada 10.000 habitantes.Se relevaron 2778 LA y 149 AF. Se observó una mayor densidad en el barrio de Constitución para locales de comidas rápidas (Recoleta 3.6; Almagro 2.4; Constitución 6.7) y Puestos ambulantes (Recoleta 4.2; Almagro 1.2; Constitución 25.7) y menor en AF. Las densidades por habitantes fueron concordantes con las densidades por superficie. Se observaron diferencias estadísticamente significativas en las proporciones de despensas, kioscos, verdulerías, bares, restaurantes, puestos ambulantes y en las cantidades totales de LA y AF.La información generada en este estudio podría ser muy útil en la gestión de salud pública para promoción de estilo de vida saludable modificando el ambiente construido para mejorar la equidad en la CABA.

Evaluación del ambiente construido en barrios de diferente nivel socioeconómico de la CABA / [Food environment and space accessibility evaluation to perform physical activity in 3 socially contrasting neighbourhoods of Buenos Aires city].

Due to the environmental influences on health, the goal of this study was to describe and compare the built environment in 3 socially contrasting neighbourhoods of Buenos Aires city.In 2011 a cross-sectional study was conducted in 3 socially contrasting neighbourhoods of Buenos Aires city: Recoleta (upper class), Almagro (middle class) and Constitución (lower class). Grocery stores and food stands were surveyed as well as all suitable spaces to perform physical activity. An analysis was conducted to assess the density of every food outlet per Km2 of each neighbourhood’s area and per 10000 inhabitants. 2778 food stores and 149 outdoor physical activity facilities were surveyed. A higher density was observed in Constitución for fast food restaurants (Recoleta 3.6; Almagro 2.4; Constitución 6.7) and food stands (Recoleta 4.2; Almagro 1.2; Constitución 25.7) and a lower density for outdoor physical activity facilities. Population density and area density proved to be analogous. Statistically relevant differences were observed regarding the dimension of each food outlet: grocery stores, fruit stands, pubs, restaurants and food stands, as well as in the number of food stores and outdoor physical activity facilities. The information gathered in this study could be highly useful for public health policies on healthy lifestyles, and could eventually redefine the built environment in order to improve the city’s equality regarding outdoor physical activity facilities and food stores.

Evaluación del ambiente construido en barrios de diferente nivel socioeconómico de la CABA. / [Food environment and space accessibility evaluation to perform physical activity in 3 socially contrasting neighbourhoods of Buenos Aires city].

Due to the environmental influences on health, the goal of this study was to describe and compare the built environment in 3 socially contrasting neighbourhoods of Buenos Aires city.In 2011 a cross-sectional study was conducted in 3 socially contrasting neighbourhoods of Buenos Aires city: Recoleta (upper class), Almagro (middle class) and Constitución (lower class). Grocery stores and food stands were surveyed as well as all suitable spaces to perform physical activity. An analysis was conducted to assess the density of every food outlet per Km2 of each neighbourhoods area and per 10000 inhabitants. 2778 food stores and 149 outdoor physical activity facilities were surveyed. A higher density was observed in Constitución for fast food restaurants (Recoleta 3.6; Almagro 2.4; Constitución 6.7) and food stands (Recoleta 4.2; Almagro 1.2; Constitución 25.7) and a lower density for outdoor physical activity facilities. Population density and area density proved to be analogous. Statistically relevant differences were observed regarding the dimension of each food outlet: grocery stores, fruit stands, pubs, restaurants and food stands, as well as in the number of food stores and outdoor physical activity facilities. The information gathered in this study could be highly useful for public health policies on healthy lifestyles, and could eventually redefine the built environment in order to improve the citys equality regarding outdoor physical activity facilities and food stores.