(CASP) and Speech Sample Analyses

Report
Concurrent Validity of the Conditioned Assessment of Speech
Production (CASP)
and
Speech Sample Analyses
Early Hearing Detection and Intervention Conference
Glendale, AZ
April 15, 2013
David J. Ertmer, Ph.D., CCC-SLP
Speech, Language, and Hearing Sciences
Purdue University
West Lafayette, IN USA
This project was supported by a grant from the National Institute on Deafness and other Communicative
Disorders (1R03DC04226)
Acknowledgements
• This project was supported by a grant from the National
Institute on Deafness and other Communicative Disorders
(1R03DC04226)
• Jongmin Jung, Diana True Kloiber, Denise Bradford
• Faculty at
•
•
•
•
•
Child’sVoice, Wood Dale, IL
St. Joseph Institute, St. Louis ,MO
St. Joseph Institute, Indianapolis, IN
Moog Center, St. Louis ,MO
Ohio Valley Voices, Cincinnati, OH
Background
• Newborn Hearing Screening enables children with hearing
losses to receive hearing aids (HAs) and cochlear implants (CIs)
very early in life.
• Noticeable changes in speech production are among the first
signs of CI and HA benefit
• Evidence of auditory-guided speech development can be
heard as prelinguistic utterances become progressively more
speech-like.
Prelinguistic Vocal Development
• …is a process by which infant and toddlers’
utterances become more
• phonetically diverse,
• structurally complex,
• speech-like
• Basic Canonical Syllables
• (e.g., CV, CVCV, babbling)
• Advanced Forms
• (e.g., CVC, diphthongs, jargon)
…prior to saying words on a regular basis.
Precanonical Vocalizations (PC)
(Range of emergence 0 –6 months in NH children)
• Lack true vowels and true consonants in
combination with a rapid transition between them
(Oller, 2000)
• Types
• Quasi- and fully-resonant nuclei (Oller & Lynch,
1992)
• Squeals
• Vowels / vocants in isolation or in series (Kent &
Bauer, 1985)
• Consonants / Closants in isolation or in series
(Stark, 1980)
Precanonical Video Examples
• http://www.youtube.com/watch?v=4oNhmWbn67c
• http://www.youtube.com/watch?v=lKLQOYMgf1A
Basic Canonical Syllables
(Range of emergence 6 –10 months in TD children)
• characterized by…
•
•
•
•
Normal phonation
Full vocalic resonance
At least one consonant
Rapid CV transitions
(Oller & Lynch, 1992)
• Types
• CV syllables and disyllables (CVCV)
• Reduplicated and nonreduplicated babbling
• Whispered vocalizations
Basic Canonical Syllables
•
•
•
•
http://www.youtube.com/watch?v=37JxkDNJ0Aw
http://www.youtube.com/watch?v=WRKEElUjetg
http://www.youtube.com/watch?v=bt077TOugdA&feature=related
http://www.youtube.com/watch?v=_JmA2ClUvUY&feature=relate
d
OLLER, D. K. & EILERS, R. E. (1988). THE ROLE OF AUDITION IN INFANT BABBLING. CHILD
DEVELOPMENT 59, 441 -449.
Advanced Forms
(Range of emergence in NH children: 10 - 18 months)
• … have canonical attributes but are phonetically or prosodically
more complex than BCS (Nathani, Ertmer, & Stark, 2002)
• Types
• Complex syllables (e.g. CCV or CVC)
• Jargon
• combinations of different consonants and vowels with changes in stress or
intonation
• Diphthongs
Advanced Forms
• http://www.youtube.com/watch?v=drMaxN5ohA0
• http://www.youtube.com/watch?v=WdoZ8WkfoAE
Cross-sectional Data: 30 Infants with Normal Hearing
Nathani, Ertmer, & Stark (2006)
Typically Developing Infants
100
80
Precanonicals
60
AF
40
20
0
0 - 2 Mos.
BCS
3-5 Mos.
6 - 8 Mos.
9 - 12 Mos. 13 - 15 Mos. 16 - 20 Mos.
http://www.vocaldevelopment
.com
• Definitions
• More audio examples
• Language input and response
strategies
• Video examples of strategies
• Intervention program (SPPI)
Speech Sampling
• In research, vocal development is commonly
monitored through speech sample analysis.
• Speech sample analysis…
• …requires special training in identifying many
kinds of vocalizations (Nathani, Ertmer, &
Stark, 2007)
• … time-intensive
• …may not be practical for routine clinical use
Emergence of Speech-Like
Utterances (BCS + AF)
100
* p<.05, and **p<.005
90
(n = 3)
(6)
(11)
(11)
(12)
(12)
(12)
(12)
*
80
70
**
(12)
*
(12)
**
60
CI PC
50
CI SL
**
40
TD SL
**
30
20
10
0
Pre
early
3months
6months
9 months
12 months
15 months
18 months
21 months
24 months
Basic
Canonical
Syllables *
Advanced
Forms *
Precanonical
* Speech-like
The Conditioned Assessment of Speech
Production (CASP): An alternative to speech
sampling (Ertmer & Jung, 2012; Ertmer & Stoel-Gammon, 2008)
• Easy-to-administer imitation “game”
• Vocal stimuli from 3 developmental levels of the Stark
Assessment of Early Vocal Development-Revised (SAEVD-R;
Nathani et al, 2007)
• Precanonical (PC)
• Basic Canonical Syllables (BCS)
• Advanced Forms (AF)
• For ages 18 – 48 months in children who have hearing loss
• Has been used with English, Spanish, and Korean-speaking
children
CASP Administration
• Parents and clinician provide models of
• Isolated vowels (PC) (/ʌ/, /i i/, /æ æ æ/ )
• CV syllables (BCS) ( [ba], [ma], [wa], [sa], [ka] )
• CVC, C + diphthong syllables (AF) ( [tʌk], [naI]
)
• Child’s imitative attempts are reinforced with
Classical Stacker toy
• Graduated scoring scale
• 0 = no attempt, not a close match
• 1 = partially acceptable match
• 2 = fully acceptable match
Research Question: Do CASP scores have
concurrent validity with speech sample
measures ?
• 19 children with CIs (2 with additional disabilities)
• Mean implant age = 21.5 months
• CASP and 20-minute speech samples collected after
6, 12, 18, 24 months of CI use
• 50 child-utterances from each sample classified as PC, BCS,
or AF
• Correlation variables
• Percent of CASP points earned
• Percent of speech-like utterances in speech samples
Relationship between speech-like
utterances in samples and CASP
scores (Ertmer & Jung, in press)
Mean Percent of Speech-like Utterances and
CASP scores at each interval (Ertmer & Jung, 2012)
Conclusions
• The CASP …
• has high concurrent validity with speech sample measures in English-speaking
children
• is time-efficient tool for assessing progress in vocal development after CI of HA
fitting
• Also…
• CASP may identify children with secondary disabilities as well as those with
speech delays
• Scores of two children with second disabilities were found to be >1.5 standard deviations
below the mean CASP scores at 18 months and 24 months.
• CASP scores at 2:0 in children with mild – moderate HL predict speech production on
GFTA at 3:0 (personal communication, M.P. Moeller, February 28, 2013)
• Adaptations of the AF level are needed for languages that differ from English in the
use of closed syllables and diphthongs (e.g., Japanese, French, Finish, and Italian)
• Further study needed to develop norms based on amount of hearing
experience
References , related readings,
and internet resources
• Ertmer, D. J. & Jung, J. (2012). Monitoring Progress in Vocal Development in Young
Cochlear Implant Recipients: Relationships between Speech Samples and Scores from the
Conditioned Assessment of Speech Production (CASP). American Journal of Speech-language
Pathology, 21, 313-328 (Instructions and forms in appendices)
• Ertmer, D. J. & Jung, J. (2011). Vocal development in young cochlear implant recipients
during year one of cochlear implant use: Comparisons with typically developing children.
Journal of Deaf Studies and Deaf Education. doi:10.1093/deafed/enr021
• Ertmer, D. J. & Stoel-Gammon, C. (2008) The Conditioned Assessment of Speech Production
(CASP): A tool for evaluating auditory-guided speech development in young children with
hearing loss. The Volta Review, 108, 59-80.
• Ertmer, D. J. , Young, N. M., & Nathani, S. (2007). Profiles in vocal development in young
cochlear implant recipients. Journal of Speech, Language, and Hearing Research, 50, 393407. doi:10.1044/1092-4388(2007/028)
• Nathani, S., Ertmer, D.J., & Stark, R. E. (2006). Assessing vocal development in infants and
toddlers. Clinical Linguistics and Phonetics, 20, 351-369. doi:10.1080/02699200500211451
• Video of CASP administration http://nc.agbell.org/NetCommunity/Page.aspx?pid=533.
ctions and forms www.vocaldevelopment.com

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