Title: Longitudinal growth in intelligibility of connected speech from 2 to 8 years in children with cerebral palsy: A novel Bayesian approach
Legend: Observed intelligibility scores and estimated growth trajectories. First row: Observed intelligibility with one connected line per child. Second row: Estimated trajectories for each child base on Bayesian model fit. Third row: Estimated population average of growth trajectories. Prediction bands here quantify uncertainty about the average trajectory (similar to confidence intervals). Groups with fewer children or more variability have wider prediction bands. Fourth row: Estimated population variability of individual growth trajectories. Prediction bands here quantify the population variability in trajectories about the average (similar to a standard deviation). These bands show the predicted trajectories for a new, as-yet unobserved child in each group.
Citation: Mahr TJ, Rathouz PJ, Hustad KC. Longitudinal Growth in Intelligibility of Connected Speech From 2 to 8 Years in Children With Cerebral Palsy: A Novel Bayesian Approach. Journal of Speech, Language, and Hearing Research. 2020;63(9):2880-2893.
Abstract: Aim — The aim of the study was to examine longitudinal growth in intelligibility in connected speech from 2 to 8 years of age in children with cerebral palsy. Method — Sixty-five children with cerebral palsy participated in the longitudinal study. Children were classified into speech-language profile groups using age-4 data: no speech motor impairment (SMI), SMI with typical language comprehension, and SMI with impaired language comprehension. We fit a Bayesian nonlinear mixed-effects model of intelligibility growth at the child and group levels. We compared groups by age of steepest growth, maximum growth rate, and predicted intelligibility at 8 years of age. Results — The no SMI group showed earlier and steeper intelligibility growth and higher average outcomes compared to the SMI groups. The SMI groups had more variable growth trajectories, but the SMI with typical language comprehension group had higher age-8 outcomes and steeper rates of maximum growth than the SMI with impaired language comprehension group. Language comprehension impairment at age of 4 years predicted lower intelligibility outcomes at age of 8 years, compared to typical language at age of 4 years. Interpretation — Children with SMI at age of 4 years show highly variable intelligibility growth trajectories, and comorbid language comprehension impairment predicts lower intelligibility outcomes. Supplemental Material https://doi.org/10.23641/asha.12777659.
About the Lab: Katherine Hustad is professor of Communication Sciences and Disorders. Her research examines speech and language development in children with cerebral palsy, with a focus on improving treatment decision-making, clinical outcomes, and quality of life. Visit the Wisconsin Intelligibility, Speech, and Communication (WISC) Lab for more information.