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Abstract

The Diagnostic Evaluation of Articulation and Phonology, (DEAP) is a comprehensive, individually administered, norm-referenced battery designed to provide differential diagnoses of speech disorders in children ages 3.0-8.11 years. Five tests (two screens and three assessments) comprise the DEAP assessment process. Although you are not required to administer all test components, each screen can be administered in 5 minutes and each assessment in 15 minutes. From the Diagnostic Screen results, you can determine if additional testing is needed and, if so, the appropriate DEAP test to administer. The Articulation, Phonology, and Word Inconsistency Assessments then help clinicians differentiate between disorders of articulation; delayed phonological development and consistent phonological disorders; and inconsistent phonological disorders, respectively. If there are concerns about a possible oral motor disorder, the Oral Motor Screen may be administered to determine if an in-depth assessment of oral motor skills is warranted.
How to Administer, Score and Interpret
the ‘Diagnostic Evaluation of Articulation and Phonology(DEAP)
Screen, Articulation, Oromotor, Phonology, and Inconsistency.
Note: Not all assessments are given to any one child.
*Screening Assessment: 


How to administer the Screen:
  ! "
!#$
   % !watch 
&'()*&+(,-..!*/&+0+0+(,1
23.
  .! 


How to score the Screen using the scoresheet
 -#44
$
 -  ,.)
.    
 
 -  . ,.)
 .  !#.,.
 .$ .
How to interpret the Screen:
" 5

 .
" 6%
 .
3"

.. !
  . .
" ! % ,
..  !0
,
Do Activity A to ensure understanding of how the DEAP Screen is scored.
7Screen  6 #
 $23
.#    .
Activity 1. Lucy, aged 3;7, referred by mother, initial assessment: Scoring example.
Target IPA Transcription 1 Transcription 2 not
 '+ ' '
. 8+89 no response 88 +
. :;< ;< ;<
   8= 8= 8=
) >?9)@ ? ? >
 8<=< 8<=< 8<=<
  A)' = 8'= A'=
. 8B no response 8 !B
 ;A= A= A=
  A== A= A=
Inconsistency calculation 2 #$ CD
2 #$ CE
"#F$% C25%
Normative Data
Age
Band
Articulation:
All sounds except:
Acceptable error patterns Inconsistency
GH0GH I+!B!+!B!J!K!I ::
:
 :)
L6
GHM0GH I+!B!B!J!K!I ::
:
)
L6
NH0NH I+!J!K!I :: L6
H0H IJ!K!I :: L6
MH0MH IJ!KI  L6
Lucy’s:
(i) Articulation is age appropriate  .
There is therefore no need to do the Articulation Subtest.
(ii) Inconsistency score (25%), below the criterion of 50%. There is therefore no need to
do the Inconsistency Subtest.
(iii) There is no need to do the Oromotor Subtest  #
)$ #) %
$
(iv) Phonological error patterns were acceptable % II. &(
gloves .van, TV,  five II!
... .  
Clinical Decision: 4, . .  O
 !. 
 )4, NH
Articulation Assessment: 7.
  .!
.
0
How to administer the Articulation Assessment:
 .1,5P!
)!).#$- 
     
 .
*"..",Q
 !.. ! .
"-R!  !.!
 % !)II* 
 !)2!,HII*IIQ2II!
,HI+I*4, .  S.
  !)4.!@
T5,
How to score the Articulation Assessment:
O)!UV % 
2.  
" O T -RI
R-
 D G "  D G
 . :  U
 + 8  V V V V U
D ð8  V V V V V V
G) ' ) . V V U U
W. 8 9 . V V V V V V
X.. !
.  % !.
!W6I9I.DH!
W6Ið/ at 6;11
How to interpret the Articulation Assessment:
"!.  
!
0 . 
#- D$" ..,
!)S
  G!N!!Y!W$ 
7 
 -R--R!
!.. 
The Oromotor Assessment: .)#Z$!
%. 00)S.! H
.#.$S..#.!)
$.
0
How to administer the Oromotor Assessment:
O.
0 !).#.!. $
How to score the Oromotor Assessment:
[ 
..3
How to interpret the Oromotor Assessment:
Z) ... GHMH
 patacake !
0 "S
%    
@.0 
3.  
 .
 ! .#
!DW$
- MY%  
 % 
The Phonological Assessment: !
.. #.
,. .$ .
 .quantitative
#--$
#R-$
 #-$
.0 #-$
 qualitatively  .
#$direct intervention#  .
.$
0D
How to administer the Phonological Assessment:
-) "..!,)
! !!!S#).
$ T  )!%
  H)S!.
 !) 
How to score the Phonological Assessment:
 )quantitative severity
Percent Consonants Correct
- N#
$minus. NOT
 #.!)!
!!$ 
.100135 #N0M$CYN%--CYN6
Percent Vowels Correct
- YE# $
minus. NOT
 #.!)$O 
.7476 #YE0D$CWY%R-CWY6
Percent Phonemes Correct.
YNIDCED%-CED6
Single words versus continuous speech
-  ..#DNGM$
 )- )!
 )#\$
.IDCEG%-CEG6
Look up the normative data to determine the child standard score for the four measures.
D )qualitative 
 - #$)% 
% &8(five!) ..H&A=(square
)#$
.#.% $ .#
 % $! !

). #..!
!!.!)! .!#$.$
 #!!).$
)other% !&+ (sheep  
.H&.A.(egg otherH&];<(gloves
otherbilabial fricative
 -%  !.
Total #)% $"
other!) ) 
!
Typical Errors")five     
#..!!!.! .!#$.$!two% 
)!. 

.6.  
.0 ).,  . #!DD$
./ GH0GH GHM0GH NH0NH H0H
 
Q. 7 7 7 7
 7 7 7
-[ 7 7 ^
T. 7 7
1) 7 7
 . 7
^0#! !)!9J! $
Atypical Errors . W6
 .GHMH-S!
  
  I#.!H
% !)$3
 %#.!II)$-
@.#...% 
,$
How to interpret the Phonological Assessment:
Severity: 
 ...
.    
 . " !
!, .
Single words vs Continuous Speech: ) 
 . % 
 . . DEAP
. !
%...! .
4)  . 
 . 
Types of Errors: 1.   
 DEAP..
!,.   H
#..   $H! 
 ..
.
 ".  ! .
  %  H
#/_!DH- _$
 . .. HI .
 
   .  
) )
  
. ##/_!DH- _$
The Consistency Assessment: .
 L6.
-D 
! 
0
How to administer the Consistency Assessment:
 )D !. 
 #.!!.!$
 .)D !

 
 
 .)D !

 
2/".
  
O  
 P
 !)!).)
 "N6 !
!.,) 
How to score the Consistency Assessment:
T!!
 %  .
#.IDCN%CN6$
N6.".#.
  .6
G6$
" . 
I ! . 
" )  .
%!.! 
How to interpret the Consistency Assessment:
-6  
% % 
# -"$". ,.
  .! .!.! .!%
)#!.%$)!)
 .).! . .S
 ... .  -
! 
  #- D!!D$
.- .#"$
Childhood Apraxia of Speech Inconsistent Phonological Disorder
Inconsistent errors Inconsistent errors
Increasing errors with increasing length Increasing errors with increasing length
Poor sequencing of sounds (eg. metathesis);
marked syllable segregation.
Wrong choice of phoneme rather than order
errors; no syllable segregation.
Poor oro-motor skills Oro-motor skills within normal limits
Groping; silent posturing No groping, no silent posturing
Prolongations and repetitions of speech
sounds
No prolongations and no repetitions of
speech sounds
Poorer in imitation than spontaneous
production
Better in imitation than spontaneous
production
Dysfluent, short utterance length,
prosodic disturbance, slow speech rate
Fluent, normal utterance length, normal
affect, normal-rapid speech rate
Best therapy focuses on phonetic gesture Best therapy focuses on word production
[
/!`_!/#D$" 4.. 
 I.. 5 [-International Journal of
Language and Communication Disorder, NM#M$!MDE0N
!/!X!-!O"!/#D$-R
 "1!O4!_[O-"
 - Y0GM2a)/)
!/!O"!/!4!O_O !2#DW$  "-
".`- _4..!Y
N0DN
!/!bX!-!!X!!_3<!#DD$Diagnostic Evaluation of
Articulation and Phonology.4.- 
Activity A: Interpreting Diagnostic Screening Data
DEAP . William 5;4
Instructions
 Naming.2#$
D Sound stimulability- ")
#$
G Naming[ .)D-
Target IPA Transcription 1 Transcription 2  
not
 '+ 'c 'c
. 8+89 8c89 8c8
. :;< ];c ];c
   8= ]8c= ]8c=
) J?9)@ ?9] ?9] J
 8<=< 8]= 8]=
  A)' = 'c= 'c=
. 8B ]8c ]8c
 ;A= ]Ac= ]Ac=
  A== Ad=d= Ad=d=
Inconsistency calculation 2 #$ Ceeeee
2 #$ Ceeeee
"#F$% Ceeeee
Normative Data
Age
Band
Articulation:
All sounds except:
Acceptable error patterns Inconsistency
GH0GH I+!B!+!B!J!K!I ::
.
 :)
L6
GHM0GH I+!B!B!J!K!I ::
:
)
L6
NH0NH I+!J!K!I :: L6
H0H IJ!K!I :: L6
MH0MH IJ!KI  L6
Results (Is further assessment needed? If so, what subtests does the screen indicate?)
.   )
T 0f
3
.
"
DEAP . Kelly 4;8
Instructions
 Naming.2#$
D Sound stimulability- ")
#$
G Naming[ .)D-
Target IPA Transcription 1 Transcription 2  
not
 '+ lɒp jɒl
. 8+89 sɪbʌʃ -
. :;< dʌd dʌbʌdə
   8= daɪdə Jaɪbə
) J?9)@ gæn ju tæŋk tu
 8<=< tɪdə tɪdə
  A)' = hɛlikɒptə hɛjikɒptə
. 8B brɪdʒ brɪdʒ
 ;A= ʌmrɛlə ʌbɛjə
  A== ɛlitɪtənt lɛlifənt
Inconsistency calculation 2 #$ Ceeeee
2 #$ Ceeeee
"#F$% Ceeeee
Normative Data
Age
Band
Articulation:
All sounds except:
Acceptable error patterns Inconsistency
GH0GH I+!B!+!B!J!K!I ::
.
 :)
L6
GHM0GH I+!B!B!J!K!I ::
:
)
L6
NH0NH I+!J!K!I :: L6
H0H IJ!K!I :: L6
MH0MH IJ!KI  L6
Results (Is further assessment needed? If so, what subtests does the screen indicate?)
.   )
T 0f
3
.
"
DEAP . Ellen 5;3
Instructions
 Naming.2#$
D Sound stimulability- ")
#$
G Naming[ .)D-
Target IPA Transcription 1 Transcription 2  
not
 '+ ' '
. 8+89 88 88
. :;< :;< :;<
   8= paɪdə paɪdə
) J?9)@ tæn ju tæn ju
 8<=< 8<=< 8<=<
  A)' = kɒptə he8kɒptə
. 8B bɪdz bɪdz
 ;A= ʌmbɛlə bɛjə
  A== ɛfənt ɛlifənt
Inconsistency calculation 2 #$ Ceeeee
2 #$ Ceeeee
"#F$% Ceeeee
Normative Data
Age
Band
Articulation:
All sounds except:
Acceptable error patterns Inconsistency
GH0GH I+!B!+!B!>!K!I ::
.
 :)
L6
GHM0GH I+!B!B!>!K!I ::
:
)
L6
NH0NH I+!>!K!I :: L6
H0H I>!K!I :: L6
MH0MH I>!KI  L6
Results (Is further assessment needed? If so, what subtests does the screen indicate?)
.   )
T 0f
3
.
"
DEAP . Declan 4;0
Instructions
 Naming.2#$
D Sound stimulability- ")
#$
G Naming[ .)D-
Target IPA Transcription 1 Transcription 2  
not
 '+ ' ' +
. 8+89 88 88 !+!9
. :;< ; ; .!!<
   8= paɪdə paɪdə
) J?9)@ n tu tæn tu J!)
 8<=< 8= 8=
  A)' = 'g= 'g=
. 8B bɪd bɪd !B
 ;A= ʌmbə ʌmbə
  A== ɛpən ɛpən
Inconsistency calculation 2 #$ Ceeeee
2 #$ Ceeeee
"#F$% Ceeeee
Normative Data
Age
Band
Articulation:
All sounds except:
Acceptable error patterns Inconsistency
GH0GH I+!B!+!B!J!K!I ::
.
 :)
L6
GHM0GH I+!B!B!J!K!I ::
:
)
L6
NH0NH I+!J!K!I :: L6
H0H IJ!K!I :: L6
MH0MH IJ!KI  L6
Results (Is further assessment needed? If so, what subtests does the screen indicate?)
.   )
T 0f
3
.
"
... Inclusion criteria included (a) consensus diagnosis of CAS (see below), (b) normal receptive vocabulary (Peabody Picture Vocabulary Test-Fourth Edition; Dunn & Dunn, 2007), (c) normal oral structure (oral and speech motor protocol; Robbins & Klee, 1987), and (d) passed pure-tone audiometry at 20 dB at 500, 1, 2, and 4 kHz. The diagnosis of CAS was made independently by the first and last authors, based on the perception of all three core perceptual features of CAS (ASHA, 2007; see below) and the presence of at least four of the 10 speech features described in Shriberg et al. (2011) during a battery of speech production tests: Diagnostic Evaluation of Articulation and Phonology (DEAP; Dodd et al., 2006), Goldman-Fristoe Test of Articulation-Third Edition (GFTA-3, Goldman & Fristoe, 2015), Single Word Test of Polysyllables (SWTP; Gozzard et al., 2006), and a 10-min connected speech sample. The core perceptual features (ASHA, 2007) were operationalized as (a) more than 40% lexical inconsistency on the Inconsistency subtest of the DEAP (Dodd et al., 2006) for children < 11 years old or on three repetitions of 25 words from the SWTP (Gozzard et al., 2006) for children ≥ 11 years old; (b) a minimum of three words exhibiting perceptually identifiable syllable segregation during the Test of Polysyllables (Gozzard et al., 2006), indicating difficulty transitioning between syllables; and (c) both less than 85% stress pattern match on the SWTP (Gozzard et al., 2006) as measured by perceptual coding of primary and secondary stress within Phon (Hedlund & Rose, 2020) by trained examiners as well as perceptual judgment by the assessing SLP of abnormal prosody in connected speech. ...
... The diagnosis of CAS was made independently by the first and last authors, based on the perception of all three core perceptual features of CAS (ASHA, 2007; see below) and the presence of at least four of the 10 speech features described in Shriberg et al. (2011) during a battery of speech production tests: Diagnostic Evaluation of Articulation and Phonology (DEAP; Dodd et al., 2006), Goldman-Fristoe Test of Articulation-Third Edition (GFTA-3, Goldman & Fristoe, 2015), Single Word Test of Polysyllables (SWTP; Gozzard et al., 2006), and a 10-min connected speech sample. The core perceptual features (ASHA, 2007) were operationalized as (a) more than 40% lexical inconsistency on the Inconsistency subtest of the DEAP (Dodd et al., 2006) for children < 11 years old or on three repetitions of 25 words from the SWTP (Gozzard et al., 2006) for children ≥ 11 years old; (b) a minimum of three words exhibiting perceptually identifiable syllable segregation during the Test of Polysyllables (Gozzard et al., 2006), indicating difficulty transitioning between syllables; and (c) both less than 85% stress pattern match on the SWTP (Gozzard et al., 2006) as measured by perceptual coding of primary and secondary stress within Phon (Hedlund & Rose, 2020) by trained examiners as well as perceptual judgment by the assessing SLP of abnormal prosody in connected speech. Children were excluded from the study if they had a comorbid neurodevelopmental disorder (e.g., global developmental delay, autism). ...
... = moderate. (Dodd et al., 2006), and those ≥ 11 years did repeated productions of 25 words from the Single Word Test of Polysyllables (Gozzard et al., 2006). c Test of Polysyllables (Gozzard et al., 2006). ...
Article
Purpose The aim of this study was to pilot the efficacy of rapid syllable transition (ReST) treatment when provided once per week for a 50-min treatment session for 12 weeks with five children with childhood apraxia of speech. Of central importance was the children's retention and generalization of gains from treatment as indicators of speech motor learning. Method A multiple-baseline across-participant design was employed to investigate (a) treatment effect on the 20 treated pseudowords, (b) generalization to 40 untreated real words and 10 untreated polysyllabic word sentences, and (c) maintenance of any treatment and generalization goals to up to 4 months posttreatment. To investigate any difference between in-session performance and retention, a comparison was made between data collected during treatment and probe sessions. Results Treatment data collected during therapy showed all children improving across their 12 treatment sessions. Three of the five children showed a treatment effect on treated pseudowords in the probe sessions, but only one child showed generalization to untreated real words, and no children showed generalization to sentences. Conclusions ReST treatment delivered at a dose frequency of once per week was efficacious for only one of the five children. In-session treatment data were not a reliable indicator of children's learning. One session per week of ReST therapy is therefore not recommended. Supplemental Material https://doi.org/10.23641/asha.23751018
... Inconsistent errors were calculated using a modification of procedures described in the Diagnostic Evaluation of Articulation and Phonology (DEAP) Word Inconsistency subtest (Dodd et al., 2006). We phonemically transcribed all words a participant produced at least 3 times across the two narrative generation tasks to calculate a word inconsistency score. ...
... A word was coded as inconsistent if it was produced with at least two different tokens. Variations between a correct and incorrect production that were age appropriate (e.g., gliding for liquids under the age of 5;5) were not scored as inconsistent (Dodd et al., 2006). Furthermore, typical variations that occur in conversational/ connected speech such as occasionally producing a centralized vowel (e.g., "to" as [tu] and as [tʌ]) were not counted as inconsistent errors. ...
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Purpose: Rhythm is one procedural mechanism that underlies language and motor skill acquisition and has been implicated in children with childhood apraxia of speech (CAS). The purpose of this study is to investigate manual rhythmic sequencing skills in children with a history of or current CAS (hx/CAS) compared to children with typical development (TD). Method: Thirty-eight children (18 with hx/CAS, 20 with TD), ages 5;0-12;8 (years;months), from across the United States participated in an online study. Participants imitated two rhythms in two different conditions, clapping and tapping. We assessed overall accuracy, mean number of beats, pause marking, and rhythmic sequence variability using the Mann-Whitney U test. Effect sizes were calculated to examine the influence of coordinative complexity on performance. Results: Compared to children with TD, children with hx/CAS marked fewer trials with a pause in both conditions of the easier rhythm and showed lower overall accuracy and more variable rhythmic sequences in both rhythms and conditions. The mean number of beats produced by children with hx/CAS and children with TD did not differ in three out of four rhythms/conditions. Unlike children with TD, children with hx/CAS showed little improvement from clapping to tapping across most dependent measures; reducing coordination demands did not improve performance in children with hx/CAS. Conclusions: We found that children with hx/CAS show manual rhythmic deficits that are similar to the deficits they display in speech. These findings provide support for a domain-general cognitive mechanisms account of the rhythmic deficits observed across linguistic and nonlinguistic tasks in children with hx/CAS. Supplemental material: https://doi.org/10.23641/asha.24052821.
... Next, the Diagnostic Evaluation of Articulation and Phonology (DEAP) was administered to the participant to provide an additional measure for suspected speech disorders (Dodd et al., 2002). This is a comprehensive, norm-referenced assessment that was created to provide a differential diagnosis for a speech disorder. ...
... The pretest and posttest assessment measures were collected on the first and last days of camp, respectively. Scores were collected on the DEMSS (Strand & McCauley, 2019), DEAP (Dodd et al., 2002), SRT (Shriberg & Lohmeier, 2008), and a speech sample (Gill, 2009). ...
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This single participant, AB design was used to examine the effects of Dynamic Temporal and Tactile Cueing (DTTC) for a 10-year-old, English-speaking female of White-European descent who was diagnosed with severe, idiopathic childhood apraxia of speech (CAS). Treatment was administered in a summer camp that ran Monday-Friday with a focus on the participant's short-term goals of /ð, θ, ɹ/ in all positions of words for one hour each day over a three-week period. The efficacy of the DTTC approach demonstrated that there was an increase in the independent, accurate productions of target words for a client with severe CAS.
... In all, 19 instruments were used by the studies included in this research to assess CAS. Among them, 4 were the most frequent: Goldman-Fristoe Test of Articulation -Second Edition (41) and Diagnostic Evaluation of Articulation and Phonology -DEAP (42) , both used in 55% of the selected studies; Test of Polysyllables (43) , cited in 30% of the included studies, and also the Oral and Speech Motor Control Protocol (44) , used by 25% of the selected studies. ...
... It is also noteworthy that some tests evaluated more than one dimension, such as the Diagnostic Evaluation of Articulation and Phonology-DEAP (42) and the Kaufman Speech Praxis Test for Children (9) , which took into account both motor and/ or articulatory aspects, as well as segmental aspects. Other 3 protocols analyzed all three dimensions listed in this study: Dynamic Evaluation of Motor Speech Skills (DEMSS) (11) and its adaptation to Brazilian Portuguese (50) ; Multisyllabic Word (12) and Strand's 10-point Checklist (51) . ...
Article
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Purpose: Systematically review the protocols and/or assessments that contribute to the diagnosis of CAS and classify them according to the clinical dimension evaluated Research strategy: Study of systematic literature review in the databases MEDLINE (accessed via PubMed), LILACS, Scopus and SciELO with the descriptors Apraxias, Childhood apraxia of speech, Evaluation, Assessment, Validation Studies, Evaluation Studies, Language Therapy, Rehabilitation of Speech and Language Disorders, Child and Child, Preschool. Selection criteria: The search for scientific articles in the databases was conducted by three independent researchers. Studies that clearly assessed subjects with suspected or diagnosed PIA were included. The reviewers performed data collection with regard to methodological characteristics, interventions and study outcomes using standardized forms. The main data collected was related to the assessment procedures of CAS. Results: Most studies (14 of the 21 included) made an association between the assessment of motor and/or articulatory and segmental skills. Five performed an evaluation of all listed aspects: motor and/or articulatory, segmental and suprasegmental; and two underwent only motor and/or articulatory assessment. The age of the subjects in the present study ranged from 3 to 12 years. Conclusion: The assessment of CAS generally involves the association between the assessment of motor and/or articulatory and segmental skills. It is suggested that further studies in order to evidence validity for the assessment of CAS. RESUMO Objetivos: Revisar sistematicamente os protocolos e/ou avaliações que contribuem para o diagnóstico de apraxia de fala na infância (AFI) e classificá-los de acordo com a dimensão clínica avaliada. Estratégia de pesquisa: Estudo de revisão sistemática da literatura nas bases de dados MEDLINE (acessado via PubMed), LILACS, Scopus e SciELO, com os descritores Apraxias, Childhood apraxia of speech, Evaluation, Assessment, Validation Studies, Evaluation Studies, Language Therapy, Rehabilitation of Speech and Language Disorders, Child e Child, Preschool. Critérios de seleção: A busca nas bases de dados foi conduzida por três pesquisadores independentes. Foram incluídos estudos que avaliavam, de forma clara, sujeitos com suspeita ou diagnóstico de AFI. Os revisores realizaram a coleta de dados no que diz respeito às características metodológicas, intervenções e desfechos dos estudos, por meio de planilhas previamente elaboradas especificamente para o presente estudo. O dado principal coletado foi referente aos procedimentos de avaliação da AFI para crianças. Resultados: A maior parte dos estudos (14 dos 21 incluídos) realizou a associação entre a avaliação de habilidades motoras e/ou articulatórias e segmentais. Cinco realizaram avaliação de todos os aspectos elencados: motor e/ou articulatória, segmental e suprassegmental e dois realizaram apenas avaliação motora e/ou articulatória. A idade dos sujeitos variou de 3 a 12 anos. Conclusão: A maioria das pesquisas considerou a associação entre habilidades motoras e/ou articulatórias e segmentais para avaliação da apraxia de fala na infância. Sugere-se a realização de mais estudos, a fim de buscar evidências de validade. Descritores: Reabilitação dos transtornos da fala e da linguagem; Fala; Inteligibilidade da fala; Apraxias; Criança Study carried out at
... Of these parent referrals, 89 children had a SSD (i.e. performed >1 standard deviation below the mean on the phonology subtest of the Diagnostic Evaluation of Articulation and Phonology, DEAP, Dodd et al., 2002). All children were monolingual English-speakers, had age-appropriate language comprehension, and no hearing, neurological or cognitive impairments. ...
... Appendix 1. DEAP normative data* (Dodd et al., 2002): speech sounds articulated at least once, and phonological error patterns used in ≥ 5 different lexical items by ≥ 10% of children in each age group. ...
Article
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Studies of children's consistency of word production allow identification of speech sound disorder. Inconsistent errors are reported for two groups of children: childhood apraxia of speech (CAS) due to difficulty with the motoric precision and consistency of speech movements; and inconsistent phonological disorder (IPD) attributed to impaired phonological planning. This paper describes the inconsistent productions of children with IPD in comparison to typically developing children. In two studies of suspected SSD (N = 135), 22 children pronounced ≥40% of 25 words inconsistently on three repeated trials. No participant had symptoms of CAS. They were monolingual and spoke Australian- or Irish-English. Assessment determined the proportions of words said consistently (i.e. the same across productions: all correct or with the same error) or inconsistently (i.e. differently across productions: at least one correct and one error or different errors in productions). Qualitative analyses examined error types and explored the effect of target words' characteristics on inconsistency. Children with IPD produced 52% of words with different errors. While 56% of all phoneme errors were developmental (age appropriate or delayed), atypical errors typified inconsistency: default sounds and word structure errors. Words with more phonemes, syllables and consonant clusters were vulnerable to inconsistency, but their frequency of occurrence had no effect. TD children and those with IPD had different quantitative and qualitative error profiles, confirming IPD as a diagnostic category of SSD. Qualitative analyses supported the hypothesised deficit in phonological planning of words' production for children with IPD.
... All participants had Scottish accents. One participant had a 91 percentage consonants correct score on the Diagnostic Evaluation of Articulation and Phonology (DEAP) diagnostic screen (Dodd et al., 2006) because of several labialized productions for /ɹ/ and /ʃ/ fronting. The participant's data were excluded from the analysis, leaving a total of 29 typically developing participants (15 girls, 14 boys), aged between 5;8 and 12;10 (M = 9;8, SD = 2). ...
... The participant's data were excluded from the analysis, leaving a total of 29 typically developing participants (15 girls, 14 boys), aged between 5;8 and 12;10 (M = 9;8, SD = 2). The other participants all scored within normal limits on the DEAP diagnostic screen (Dodd et al., 2006). With two exceptions (with standard scores of 72 and 76), all participants had British Picture Vocabulary Scale (Dunn, 2009) standard scores within normal limits (overall mean = 103, SD = 14). ...
Article
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Purpose: This study investigates the hypothesis that younger speakers and speakers with more severe speech sound disorders are more likely to use simpler (undifferentiated) tongue gestures due to difficulties with, or immaturity of, lingual motor control. Method: The hypothesis is tested using cross-sectional secondary data analysis of synchronous audio and high-speed ultrasound recordings from children with idiopathic speech sound disorders (n = 30, aged 5;0-12;11 [years;months]) and typically developing children (n = 29, aged 5;8-12;10), producing /a/, /t/, /ɹ/, /l/, /s/, and /ʃ/ in an intervocalic /aCa/ environment. Tongue shape complexity is measured using NINFL (Number of INFLections) and modified curvature index (MCI) from splines fitted to ultrasound images at the point of maximal lingual gesture. Age, perceived accuracy, and consonant are used as predictors. Results: The results suggest that as age increases, children with speech sound disorders have lower MCI compared to typically developing children. Increase in age also led to decrease of MCI for the typically developing group. In the group of children with speech sound disorders, perceptually incorrect /ɹ/ productions have lower MCI than correct productions, relative to /a/. Conclusions: There is some evidence of systematic tongue shape complexity differences between typically developing children and children with speech sound disorders when accounting for increase in age. Among children with speech sound disorders, increase in age and perceptually incorrect consonant realizations are associated with decreasing tongue shape complexity.
Article
Purpose: There is a shortage of available methods to accurately inform the developmental status of children whose cultural and linguistic backgrounds vary from the mainstream. The purpose of this review article was to describe different approaches used to support the accurate characterization of speech, language, and functional communication in children speaking Jamaican Creole and English, an understudied paradigm in the speech pathology research. Method: Approaches used across four previously published studies in the Jamaican Creole Language Project are described. Participants included 3- to 6-year-old Jamaican children (n = 98-262) and adults (n = 15-33). Studies I and II described validation efforts about children's functional communication using the Intelligibility in Context Scale (ICS; speech) and the Focus on the Outcomes of Communication Under Six (FOCUS; speech and language). Study III described efforts to accurately characterize difference and disorder in children's expressive grammar using adapted scoring, along with adult models to contextualize child responses. Last, Study IV applied acoustic duration (e.g., whole word) and an adapted scoring protocol to inform variation in speech sound productions in the Jamaican context where a post-Creole continuum exists. Results: Studies I and II offered promising psychometric evidence about the utility of the ICS and the FOCUS. Study III revealed strong sensitivity and specificity in classifying difference and disorder using adult models. Last, in Study IV, linguistically informed acoustic analyses and an adapted protocol captured variation in speech productions better than a standard approach. Conclusions: Applying culturally responsive methods can enhance the accurate characterization of speech, language, and functional communication in Jamaican children. The innovative methods used offer a model approach that could be applied to other linguistic contexts where a mismatch exists between speech-language pathologists and their clientele.
Article
Purpose: This article presents a large-scale example of culturally responsive assessment and analysis of multilingual Vietnamese-English-speaking children and their family members using the VietSpeech Protocol involving (a) examining all spoken languages, (b) comparing ambient phonology produced by family members, (c) including dialectal variants in the definition of accuracy, and (d) clustering participants with similar language experience. Method: The VietSpeech participants (N = 154) comprised 69 children (2;0-8;10 [years;months]) and 85 adult family members with Vietnamese heritage living in Australia. Speech was sampled using the Vietnamese Speech Assessment (Vietnamese) and the Diagnostic Evaluation of Articulation and Phonology (English). Results: Children's Vietnamese consonant accuracy was significantly higher when dialectal variants were accepted (percentage of consonants correct-dialect [PCC-D]: M = 87.76, SD = 8.18), compared to when only Standard Vietnamese was accepted as the correct production (percentage of consonants correct-standard [PCC-S]: M = 70.34, SD = 8.78), Cohen's d = 3.55 (large effect). Vietnamese voiced plosives, nasals, semivowels, vowels, and tones were more often correct than voiceless plosives and fricatives. Children's Standard Australian English consonant accuracy (PCC-S) was 82.51 (SD = 15.57). English plosives, nasals, glides, and vowels were more often correct than fricatives and affricates. Vietnamese word-initial consonants had lower accuracy than word-final consonants, whereas English consonant accuracy was rarely influenced by word position. Consonant accuracy and intelligibility were highest for children with high proficiency in both Vietnamese and English. Children's consonant productions were most similar to their mothers' than other adults or siblings' productions. Adults' Vietnamese consonants, vowels, and tones were more likely to match Vietnamese targets than their children's productions. Conclusions: Children's speech acquisition was influenced by cross-linguistic, dialectal, maturational, language experience, and environmental (ambient phonology) factors. Adults' pronunciation was influenced by dialectal and cross-linguistic factors. This study highlights the importance of including all spoken languages, adult family members, dialectal variants, and language proficiency to inform differential diagnosis of speech sound disorders and identify clinical markers in multilingual populations. Supplemental material: https://doi.org/10.23641/asha.23290055.
Article
Purpose This study investigated native Cantonese-speaking preschool children's diadochokinetic performance, including rate, accuracy, and regularity. The second aim of this study was to examine whether language-specific patterns exist by comparing diadochokinetic rates with the average DKK rate for native English speakers. Method Sixty-four typically developing preschool children who were native Cantonese speakers participated. The diadochokinetic task administered to the children involved repetitions of monosyllabic, disyllabic, and trisyllabic words and nonsense words. The maximum performance of the children was compared by diadochokinetic rate (number of syllables per second), accuracy (percentage of matched production), and regularity (pairwise variability indexes, known as PVIs). Results Monosyllabic units were produced faster, more accurately, and more regularly than multisyllabic units. Word repetition showed higher accuracy and generally lower regularity than nonsense words but similar rates. Older children were faster and more regular (higher raw PVI of initial consonants) than younger children, but younger children performed as accurately as them. When compared with data from English speakers, the diadochokinetic rates of Cantonese children were generally lower. Conclusions Developmental progression was evident in terms of rate and regularity. The distinctive accuracy and regularity patterns between word and nonsense word repetition suggest a clinical value for both stimulus types. Language typology plays a role in diadochokinetic rate, supporting the use of language-specific reference data in practice. The typical diadochokinetic profile obtained in this study could serve as a clinical reference for speech motor assessments.
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Oromotor functioning plays a foundational role in spoken communication and feeding, two areas of significant difficulty for many autistic individuals. However, despite years of research and established differences in gross and fine motor skills in this population, there is currently no clear consensus regarding the presence or nature of oral motor control deficits in autistic individuals. In this scoping review, we summarize research published between 1994 and 2022 to answer the following research questions: (1) What methods have been used to investigate oromotor functioning in autistic individuals? (2) Which oromotor behaviors have been investigated in this population? and (3) What conclusions can be drawn regarding oromotor skills in this population? Seven online databases were searched resulting in 107 studies meeting our inclusion criteria. Included studies varied widely in sample characteristics, behaviors analyzed, and research methodology. The large majority (81%) of included studies report a significant oromotor abnormality related to speech production, nonspeech oromotor skills, or feeding within a sample of autistic individuals based on age norms or in comparison to a control group. We examine these findings to identify trends, address methodological aspects hindering cross-study synthesis and generalization, and provide suggestions for future research.
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