{"title":"Acoustic Measures of Word-Level Prosody in Childhood Apraxia of Speech: An Initial Validation Study.","authors":"Meghan Littlejohn, Edwin Maas","doi":"10.1044/2025_AJSLP-24-00260","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The \"gold standard\" of childhood apraxia of speech (CAS) diagnosis is expert clinical judgment based on perception of core features: inconsistent errors, impaired transitions, and impaired prosody. However, this standard has several limitations, which may be addressed with acoustic measures.</p><p><strong>Purpose: </strong>This retrospective study aims to provide initial validity evidence for nine acoustic measures of prosody and examine lexical stress production in CAS.</p><p><strong>Method: </strong>The study involves 33 children with CAS (4-8 years) imitating six bisyllabic words (three strong-weak, three weak-strong). For each word, nine acoustic measures of prosody were obtained: three pairwise variability index measures, two lexical stress ratio measures and their three component ratios, and word syllable duration. To address construct validity, we examined effects of stress pattern, age, and severity. To address convergent validity, we correlated acoustic measures with each other and with clinical-perceptual judgments of prosody. Finally, we examined the degree to which children with CAS differentiated stressed and unstressed syllables.</p><p><strong>Results: </strong>Findings revealed that acoustic measures differed between stress patterns. Six of the measures had moderate and significant correlations with CAS severity for strong-weak words but not weak-strong words, and none of the measures correlated with age. All acoustic measures showed moderate or strong correlations with each other for strong-weak words but only some did for weak-strong words. None of the measures correlated significantly with clinical-perceptual measures of prosody. Children demonstrated equal stress on most measures for strong-weak words but clear evidence of stress differentiation for weak-strong words.</p><p><strong>Conclusions: </strong>This study provides qualified initial support for the validity of all acoustic measures. Findings replicate and extend prior research to show that children with CAS may have difficulty with production of lexical stress. Prospective research is needed to control for stimulus features with a larger sample that includes a range of diagnoses.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.29289032.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"2485-2508"},"PeriodicalIF":2.5000,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337114/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Speech-Language Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1044/2025_AJSLP-24-00260","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/15 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
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Abstract
Background: The "gold standard" of childhood apraxia of speech (CAS) diagnosis is expert clinical judgment based on perception of core features: inconsistent errors, impaired transitions, and impaired prosody. However, this standard has several limitations, which may be addressed with acoustic measures.
Purpose: This retrospective study aims to provide initial validity evidence for nine acoustic measures of prosody and examine lexical stress production in CAS.
Method: The study involves 33 children with CAS (4-8 years) imitating six bisyllabic words (three strong-weak, three weak-strong). For each word, nine acoustic measures of prosody were obtained: three pairwise variability index measures, two lexical stress ratio measures and their three component ratios, and word syllable duration. To address construct validity, we examined effects of stress pattern, age, and severity. To address convergent validity, we correlated acoustic measures with each other and with clinical-perceptual judgments of prosody. Finally, we examined the degree to which children with CAS differentiated stressed and unstressed syllables.
Results: Findings revealed that acoustic measures differed between stress patterns. Six of the measures had moderate and significant correlations with CAS severity for strong-weak words but not weak-strong words, and none of the measures correlated with age. All acoustic measures showed moderate or strong correlations with each other for strong-weak words but only some did for weak-strong words. None of the measures correlated significantly with clinical-perceptual measures of prosody. Children demonstrated equal stress on most measures for strong-weak words but clear evidence of stress differentiation for weak-strong words.
Conclusions: This study provides qualified initial support for the validity of all acoustic measures. Findings replicate and extend prior research to show that children with CAS may have difficulty with production of lexical stress. Prospective research is needed to control for stimulus features with a larger sample that includes a range of diagnoses.
期刊介绍：
Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work.
Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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