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Cueing Korean-speaking children with CP (Chang et al., 2024)

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posted on 2024-04-04, 16:55 authored by Younghwa M. Chang, Pil-Yeon Jeong, KyungHae Hwang, Bo-Yeon Ihn, Megan J. McAuliffe, Hyunsub Sim, Erika S. Levy

Purpose: Reduced speech intelligibility is often a hallmark of children with dysarthria secondary to cerebral palsy (CP), but effects of speech strategies for increasing intelligibility are understudied, especially in children who speak languages other than English. This study examined the effects of (the Korean translation of) two cues, “speak with your big mouth” and “speak with your strong voice,” on speech acoustics and intelligibility of Korean-speaking children with CP.

Method: Fifteen Korean-speaking children with CP repeated words and sentences in habitual, big mouth, and strong voice conditions. Acoustic analyses were performed and intelligibility was assessed by means of 90 blinded listeners’ ease-of-understanding (EoU) ratings and percentage of words correctly transcribed (PWC).

Results: In response to both cues, children’s vocal intensity and utterance duration increased significantly and differentially, whereas their vowel space area gains did not reach statistical significance. EoU increased significantly in the big mouth condition at word, but not sentence, level, whereas in the strong voice condition, EoU increased significantly at both levels. PWC increases were not statistically significant. Considerable variability in children’s responses to cues was noted overall.

Conclusions: Korean-speaking children with CP modify their speech styles differentially when provided with cues aimed to increase their articulatory working space and vocal intensity. The results provide preliminary support for the use of the strong voice cue, in particular, to increase EoU. While the findings do not offer conclusive evidence of the intelligibility benefits of these cues, investigation with a larger sample size should provide further insight into optimal cueing strategies for increasing intelligibility in this population. Implications for language-specific versus language-independent treatment approaches are discussed.

Supplemental Material S1. (A) Instructions provided to the children during recording; (B) word-level task: 21 Korean contrastive monosyllabic real words and corresponding International Phonetic Alphabet (IPA) transcription; (C) sentence-level task: three Korean sentences and corresponding IPA transcription; (D) reliability of acoustic measures: Pearson product–moment correlation between the first and second measurements and mean absolute difference; and (E) reliability of intelligibility-related measures: Intraclass correlation coefficient (ICC) and corresponding 95% confidence interval.

Supplemental Material S2. Individual participant data for (A) word-level acoustic and intelligibility measures and (B) sentence-level acoustic and intelligibility measures.

Chang, Y. M., Jeong, P.-Y., Hwang, K., Ihn, B.-Y., McAuliffe, M. J., Sim, H., & Levy, E. S. (2024). Effects of speech cues on acoustics and intelligibility of Korean-speaking children with cerebral palsy. Journal of Speech, Language, and Hearing Research. Advance online publication.

Publisher Note: This article is part of the Forum: Native Language, Dialect, and Foreign Accent in Dysarthria: Clinical and Research Considerations.