Children with CP have Smaller Vowel Spaces than their TD Peers • This finding replicates previous findings (Higgins & Hodge, 2001; Hustad et al., 2010) • May be due to the movement deficits observed in the CP group, causing decreased intelligibility OAI Predicts Acous<c Vowel Space • Larger mouth openings are associated with greater vowel contrast • Increased vowel contrast improves intelligibility (Lee et al., 2013) Rela<onship Between OAI and Vowel Space Differs Between Children with CP and their TD Peers • Changes in mouth shape have a more pronounced effect on vowel contrast in children with CP than their TD peers • Vowel contrast is dependent on arLculatory movements, parLcularly the tongue • Speakers with CP have reduced tongue control (Rong et al., 2012) and increased jaw movements (Nip, 2012; Rong et al., 2012; Ward et al., 2013), suggesLng that increased jaw movements may be a compensatory strategy • Children with CP who have high OAIs can compensate for reduced tongue control by making greater use of their lips and jaw • In contrast, children with CP who have low OAIs cannot compensate for the reduced tongue control, leading to reduced vowel contrast Future Direc<ons • Examine OAI and vowel space in connected speech (e.g., sentences, conversaLon) • Direct comparison of OAI to intelligibility • Larger number of parLcipants • Examine tongue movement data INTRODUCTION AcousLc Changes Due to Impaired Speech Movements in Children with Cerebral Palsy TaLana Zozulya, Lindsay Kempf, Alyssa Yee, & IgnaLus S. B. Nip School of Speech, Language, and Hearing Sciences San Diego State University Data Analysis • Vowel formant frequencies (F1, F2) were obtained using TF32 (Milenkovic, 2010) and ploaed (F2 by F1) to obtain acousLc vowel space (Hz 2 ) • The distance between the upper and lower lip markers (height) and the distance between the leb and right corners of the mouth (width) were measured at the midpoint of each vowel. Each vowel was ploaed (height by width) to obtain the oral area index (OAI; mm 2 ) • Repeatedmeasures mixed model was conducted to evaluate the effect of Group (CP, TD) and oral area index on acousLc vowel space while controlling for age. Par<cipants • 8 children with CP (2F, 7M) and 8 ageand sexmatched typically developing peers (TD; 2F, 7M), aged 4 to 15 years • All parLcipants passed a hearing screening (ASHA, 1997) at .5, 1, 2, and 4 kHz in at least one ear Speaking Tasks • ParLcipants produced 10 repeLLons of the vowels /i, a, u/ Data Collec<on • KinemaLc recordings from 8camera opLcal moLon capture system (MoLon Analysis, Ltd.) with simultaneous audio recording (16bit, 44.1 KHz) • Fibeen markers were placed on the face to track lip and jaw movement DISCUSSION American SpeechLanguageHearing AssociaLon. (1997). Guidelines for Audiologic Screening. In ASHA PracLce Policy. Retrieved February 17, 2012, from hap://www.asha.org/docs/html/GL199700199.html . Higgins, C.M., & Hodge, M.M. (2001). F2/F1 vowel quadrilateral area in young children with and without dysarthria. Journal of the Canadian Acous6cal Associa6on, 29 (3), 6667. Hodge, M. & Daniels, J. (2007). TOCS+ Intelligibility Measures. Edmonton, AB: University of Alberta Hustad, K.C., Gorton, K., Lee, J. (2010). ClassificaLon of speech and language profiles in 4yearold children with cerebral palsy: a prospecLve preliminary study. Journal of Speech, Language, and Hearing Research, 53, 14961513. Hustad, K.C., Schueler, B., Schultz, L., DuHadway, C. (2012) Intelligibility of 4YearOld Children With and Without Cerebral Palsy. Journal of Speech, Language, and Hearing Research, 55, 11771189. Lee, J., & Hustad, K.C. (2013). A preliminary invesLgaLon of longitudinal changes in speech producLon over 18 months in young children with cerebral palsy. US Na6onal Library of Medicine Na6onal Ins6tutes of Health, 65 (1). Lee, J., Hustad, K.C., & Weismer, G. (2014). PredicLng speech intelligibility with a mulLple speech subsystems approach in children with cerebral palsy. Journal of Speech, Language and Hearing Research, 57, 16661678. Milenkovic, P. ( 2002). TF32 [Computer soLware]. Retrieved fromhap ://userpages.chorus.net/cspeech/ Nip, I.S.B. (2012). KinemaLc characterisLcs of speaking rate in individuals with Cerebral Palsy: A preliminary study. Journal of Medical SpeechLanguage Pathology, 20, 8894. Nip, I.S.B. in press. InterarLculator coordinaLon in children with and without cerebral palsy. Developmental Neurorehabilita6on. Parkes, J., Hill, N., Plaa, J., & Donnelly, C. (2010). Oromotor dysfuncLon and communicaLon impairments in children with cerebral palsy: a register study. Developmental Medicine & Child Neurology, 52 (12), 11131119. Plaa, L.J., Andrews, G., Young, M., & Qurinn, P.T. (1980). Dysarthria of Adult Cerebral Palsy: Intelligibility and ArLculatory Impairment. Journal of Speech, Language, and Hearing Research, 23, 2840. Rong, P., Loucks, T., Kim, H., HasegawaJohnson, M. (2012). RelaLonship between kinemaLcs, F2 slope, and speech intelligibility in dysarthria due to cerebral palsy. Clinical Linguis6cs & Phone6cs, 26 (9) 806822. Semel, E., Wiig, E. H., & Secord, W. A. (2003). Clinical Evalua6on of Language Fundamentals (4 th ed.). San Antonio, TX: PsychCorp. Stevens, K. N. (1989). On the quantal nature of speech. Journal of Phone6cs, 17, 3–45. Ward, R., Strauss, G., & Leitao, S. (2013). KinemaLc changes in jaw and lip control of children with cerebral palsy following parLcipaLon in a motorspeech (PROMPT) intervenLon. Interna6onal Journal of SpeechLanguage Pathology, 15(2), 136155 Yorkston, K. M., Beukelman, D. R., Hakel, M., & Dorsey, M. (2007). Speech Intelligibility Test [Computer sobware]. Lincoln, NE: InsLtute for RehabilitaLon Science and Engineering at Madonna RehabilitaLon Hospital. METHOD Acknowledgments: This study was funded by NIHNIDCD (R03DC012135), the American SpeechLanguageHearing Founda6on, and the SDSU University Grants Program. Thank you to par6cipants and their families as well as Sara Benjamin, Amy Boyer, Katherine Bristow, Anne Coleman, Lauren Coyne, Julie Cunningham, Erica J. Greenberg, Brennan Hefner, Adeena Homampour, Lucia Kearney, David Kremp, Anne Merkel, Stefanie Opdycke, Frances Ramos, Casey Rockmore, Grace Si_on, Danielle Torrez, Carina Valdivieso, and Kris6n Wilfon for their assistance with data collec6on and data analysis. Thank you to Irina Potapova for her helpful comments on this poster. Children with Cerebral Palsy have Oral Movement Deficits • Cerebral Palsy (CP) is a group of disorders caused by perinatal damage to the central nervous system resulLng in movement, sensory, communicaLon, and cogniLve impairments (Rosenbaum et al., 2007) • Speech difficulLes in children with CP include: • Oral motor deficits are present in half of this populaLon (Parkes et al., 2010) • Intelligibility is reduced for all groups of children with CP relaLve to typicallydeveloping (TD) children (Hustad et al., 2012) Acous<c Measure Differences Affect Intelligibility • AcousLc measures (F1, F2, vowel duraLon) affect speech intelligibility (Lee et al., 2014) • PosiLve correlaLon between intelligibility and vowel space noted for children with CP (Lee et al., 2013) • Children with dysarthria have smaller vowel space than those of their agematched TD peers (Higgins & Hodge, 2001) • Individuals with CP produce corner vowels (/i, a, u/) less accurately due to impaired movements (Plaa et al., 1980) Impaired Movements Impact the Resultant Acous<cs and Intelligibility • Children with CP who have dysarthria have markedly reduced speech intelligibility (Hustad et al., 2012) • ReducLons of F2 slope and intelligibility in speakers with CP are related to reduced tongueLp displacements (Rong et al., 2012) • Speakers with CP have increased jaw range of movement (Nip, 2012; Rong et al., 2012) resulLng in a larger verLcal mouth opening (Ward et al., 2013) • CoordinaLon of arLculators is posiLvely associated with intelligibility in children with CP (Nip, in press) Theore<cal and Clinical Implica<ons • Models of speech producLon posit that oral movements shape the resultant acousLc signal (Stevens, 1989); therefore the impaired movements observed in this populaLon may negaLvely impact acousLc variables, such as vowel space • Understanding the relaLon between movement and acousLc variables may provide insight for assessments and intervenLons targeLng intelligibility in this populaLon Research Ques<ons • How do movement characterisLcs (oral area index) relate to acousLc outcomes (vowel space) in children with CP and their ageand sex matched typicallydeveloping (TD) peers? • Does this relaLonship differ between children with CP and their TD peers? Fig 1: Marker set up and 3D model of a parCcipant RESULTS Table 1: Participant demographic information Speaker Age Sex CP Type GMFCS Dysarthria Word Intelligibility Sentence Intelligibility CELF4 Std Score Age of TD Peer 1 4;8 F SpasLc Quadriplegia V SpasLc 23% 16% 106 4;7 2 6;6 M SpasLc Diplegia III SpasLc 72% 83% 106 6;2 3 7;5 F SpasLc Hemiplegia III Mild 68% 65% 102 7;4 4 8;2 M SpasLc Diplegia II Mild 80% 72% 98 8;4 5 9;9 M SpasLc Hemiplegia III Mild 81% 66% 67 9;4 6 10;7 M SpasLc Quadriplegia IV /r/ error 85% 96% 127 10;11 7 12;4 M SpasLc Diplegia II None 91% 95% 112 13;2 8 15;0 F SpasLc Diplegia II None 82% 93% 129 15;7 Age [F(1, 90) = 81.78, p < .001] Group [F(1, 90) = 23.27, p < .001], CP < TD Oral Area Index [F(1, 90) = 29.78, p < .0001] Group x Oral Area Index = [F(1, 92) = 8.71, p < .01] CP TD Oral Area Index (mm 2 ) 24.27 (15.71) 16.47 (7.33) Vowel Space (Hz 2 ) 706483.60 (137072.23) 137072.23 (91412.38) REFERENCES Fig 3: Oral Area Index of a parCcipant Fig 2: Vowel Space triangle of a parCcipant