DISCUSSION

1. 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 • 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 • 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. • 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. • 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. Table 1. Group Results for each variable Table 2. Significant correlations between speech production and developmental variables 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.