Differential Diagnosis of Functional Speech Deficits in Children with Cerebral Palsy

项目摘要 大约50%的脑瘫(CP)儿童患有语言障碍构音障碍。构音障碍是 在幼儿中很难识别，因为它的特征(言语子系统特征)与 早期典型发育特征。区分典型言语与非典型言语的量化标准 儿童的子系统发育目前还不存在。这项研究旨在提高早期识别能力 以及通过创建临床可访问的、基于数据的发育来治疗慢性阻塞性肺病儿童的构音障碍 允许我们区分典型和非典型听觉-知觉语音子系统的标准 儿童的特点。为此，我们将验证《井》儿科版的英文改编版- 建立了Bgenhausen构音障碍量表(Bodys-Kid)，包括31个基于子系统的知觉语音 功能和10个域。这项研究将利用573个典型发展中国家(TD)的语音样本 第一个资助周期收集的儿童；74名脑瘫儿童(699个纵向演讲 样本)。我们将从1300名语言病理学家(SLP)那里收集新的数据，他们将使听觉- 使用Bodys-Kid对儿童语言的感知评级，组成有史以来第一个大规模 基于听觉-知觉特征的英语言语子系统发展的综合研究 会说话的孩子。具体目标是：1.)量化听觉-知觉言语子系统的成熟度 典型发育儿童的特征和领域。2.)量化听觉知觉的成熟度 脑性瘫痪儿童言语系统的特点和领域。3.)为了识别和量化听觉上的- 感知语音子系统的特征和领域，区分临床组和 与CP和TD儿童的语言清晰度相关。这项研究的产品将是。)一个 语音子系统听觉-知觉评估的理论依据和验证的临床工具 英语儿童的特点/领域，用于临床SLP的练习，以支持差异 语言障碍的诊断；b.)一套规范的标准，用于量化收购过程和 为听觉-知觉语音子系统特征/领域确定按年龄划分的预期可变性范围；c.) 儿童亚系统特征/领域习得纵向模式的定量表征 Cp(伴和不伴构音障碍)，d.)最佳的特定功能/领域的基础知识 区分典型的和关节紊乱的言语发育，并对 子系统特征/领域及其聚类对儿童语音清晰度的相对贡献。 研究结果将推动循证临床言语评估方法的发展和验证 这将为儿童构音障碍提供临床可接受的解释基础 可用于指导治疗的语音子系统。

Project Summary Approximately 50% of children with cerebral palsy (CP) have the speech disorder dysarthria. Dysarthria is difficult to identify in young children because its characteristics (speech subsystem features) overlap with features of early typical development. Quantitative standards for differentiating typical from atypical speech subsystem development in children do not currently exist. This research seeks to improve early identification and treatment of dysarthria in children with CP by creating clinically accessible, data-based developmental standards that allow us to differentiate between typical and atypical auditory-perceptual speech subsystem features in children. To do this, we will validate an English adaptation of the pediatric version of the well- established Bogenhausen Dysarthria Scales (BoDyS-Kid), including 31 subsystem-based perceptual speech features and 10 domains. The research will capitalize on speech samples from 573 typically developing (TD) children, collected in the first funding cycle; and 74 children with cerebral palsy (699 longitudinal speech samples). We will collect new data from 1300 speech language pathologists (SLPs) who will make auditory- perceptual ratings of children’s speech using the BoDyS-Kid, comprising the first ever large-scale comprehensive study of the development of speech subsystem based auditory-perceptual features in English- speaking children. Specific aims are: 1.) To quantify the maturation of auditory-perceptual speech subsystem features and domains in typically developing children. 2.) To quantify the maturation of auditory-perceptual speech subsystem features and domains in children with cerebral palsy. 3.) To identify and quantify auditory- perceptual speech subsystem features and domains that discriminate among clinical groups and are associated with speech intelligibility for children with CP and TD. Products of this research will be a.) a theoretically grounded and validated clinical tool for auditory-perceptual assessment of speech subsystem features/domains in English speaking children for use by practicing clinical SLPs to support differential diagnosis of speech disorders; b.) a set of normative standards that quantify the course of acquisition and define an expected range of variability by age for auditory-perceptual speech subsystem features/domains; c.) quantitative characterization of longitudinal patterns of subsystem feature/domain acquisition in children with CP (with and without dysarthria), and d.) foundational knowledge of specific features/domains that best differentiate between typical and dysarthric speech development, and a quantitative understanding of the relative contributions of subsystem features/domains and clusters thereof to children’s speech intelligibility. Results will advance the development and validation of evidence-based clinical speech assessment methods for pediatric dysarthria that will provide a clinically accessible explanatory basis for intelligibility deficits across speech subsystems that can be used to direct treatment.