Intelligibility In Context Scale Research Articles

Exploring the relationship between cleft type and speech outcome in 4-to-6-year-olds with non-syndromic cleft palate using different measures: A preliminary report

ABSTRACT Cleft type affects speech outcomes, but exact relationships remain unclear as outcome measures vary. The primary aim was to investigate the relationship between cleft type and speech outcome using different measures in 4-to-6-year-olds with non-syndromic clefts. Secondary aims were to explore the relationships between (i) speech measures used; and (ii) parent perception of speech intelligibility and listener familiarity. Twenty-two pre-schoolers with clefts, plus one parent for each child, were recruited through a hospital outpatient clinic. Children with cleft lip and palate (CLP; n = 11) and those with cleft palate only (CP; n = 11), matched on age and time of palate repair, were compared on Percentage Consonants Correct (PCC), clinician-reported speech intelligibility, and parent rating on the Intelligibility-in-Context Scale (ICS). Children with CLP had significantly lower PCC scores than children with CP (p = .020), but had no significant differences in their clinician- or parent-reported speech intelligibility. Clinician-reported speech intelligibility correlated significantly with both PCC (τ = .594, p < 0.01) and ICS (τ = .424, p = 0.009). No significant correlation was found between PCC and ICS (τ =.197, p = 0.113). Overall, parents rated their child’s intelligibility higher for familiar compared to unfamiliar communication partners (τ = 2.325, p = 0.001, r = .76). Cleft type is crucial for intervention planning when objective measures are employed. Speech outcomes should be evaluated at impairment, activity, and participation levels, and by different communication partners, to comprehensively evaluate communicative effectiveness.

Extraction of primary maxillary incisors and children’s speech production: A case series

ABSTRACT Dental caries (tooth decay) is a disease with a significant global burden. Management may necessitate the extraction of teeth to restore oral health. The association between dental extractions and children’s speech is unclear, with clinical implications for speech-language pathologists and dentists. This case series describes a prospective study reporting the impact of primary maxillary incisor teeth extraction on speech sound accuracy for three children (C1 aged 5;6 (years; months), C2 aged 4;6, C3 aged 3;10). Their speech was assessed using the Diagnostic Evaluation of Articulation and Phonology (DEAP) and the Intelligibility in Context Scale (ICS) before (T1) and 1 month after dental treatment (T2). Speech analysis included the percentage of consonants correct (PCC) and error-type analyses. Caregiver and child perception of the child’s oral health-related quality of life (OHRQoL) were assessed pre- and post-operatively using a modified Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). At T1, all three children scored >1 standard deviation below the mean on normative data in the DEAP. There was no clinically significant change in PCC for any child (C1 T1: 89.6%, T2: 90.6%, C2 T1: 78.0%, T2: 75.9%, C3 T1: 56.1%, T2: 63.1%). OHRQoL measures were improved for C1 by the carergiver report and remained stable for C2 and C3 and all child reports. Speech sound difficulties were present before dental treatment in all participants and extraction of primary maxillary incisors did not significantly impact speech production. Dental extractions appear to be independent from speech production in this case series of preschool children.

Parent’s Perspective about Intelligibility of Speech in Children with Cerebral Palsy

Background: The term cerebral palsy (CP) refers to a collection of long-term abnormalities of posture and movement development that limit an individual's activities. These abnormalities are thought to be caused by non-progressive disruptions in the growing fetal or infant brain. Aim: To identify the speech Intelligibility of children with cerebral palsy with different communicative partners Methods: This study employed convenient sampling over two months, conducted within the Pakistan Society for the Rehabilitation of the Disabled (PSRD) and Rising Sun Institute for Special Children. Data collection involved the ICS questionnaire, capturing parents' ratings on their child's speech intelligibility in various social contexts. Results: Out of 119 participants, predominantly aged 4 to 12 years, the study revealed varying levels of speech intelligibility. Scores on the Intelligibility in Context Scale (ICS). Parents exhibited a high level of understanding, with a mean score of 4.32±0.96 SD, signifying a substantial level of intelligibility. Immediate family members, extended family members, and the child's teachers also demonstrated relatively high mean scores, ranging from 3.91 to 3.87. In contrast, strangers had a markedly lower mean score of 2.94±1.49 SD, indicating heightened challenges in comprehending the speech of children with cerebral palsy. Conclusion: The speech of children with cerebral palsy is most easily understood by parents, while strangers encounter more significant challenges. This reinforces the crucial role of familiarity in shaping speech intelligibility for these children. The observed difficulties in communication with unfamiliar individuals emphasize the need for targeted interventions and support to address the unique challenges faced by children with cerebral palsy in diverse social contexts. Keywords: Cerebral Palsy, Speech Intelligibility, Parental Perspective, Intelligibility in Context Scale (ICS)

Using "Real-World Data" to Study Cleft Lip/Palate Care: An Exploration of Speech Outcomes from a Multi-Center US Learning Health Network.

To assess the ability of a cleft-specific multi-site learning health network registry to describe variations in cleft outcomes by cleft phenotypes, ages, and treatment centers. Observed variations were assessed for coherence with prior study findings. Cross-sectional analysis of prospectively collected data from 2019-2022. Six cleft treatment centers collected data systematically during routine clinic appointments according to a standardized protocol. 714 English-speaking children and adolescents with non-syndromic cleft lip/palate. Routine multidisciplinary care and systematic outcomes measurement by cleft teams. Speech outcomes included articulatory accuracy measured by Percent Consonants Correct (PCC), velopharyngeal function measured by Velopharyngeal Competence (VPC) Rating Scale (VPC-R), intelligibility measured by caregiver-reported Intelligibility in Context Scale (ICS), and two CLEFT-Q™ surveys, in which patients rate their own speech function and level of speech distress. 12year-olds exhibited high median PCC scores (91-100%), high frequency of velopharyngeal competency (62.50-100%), and high median Speech Function (80-91) relative to younger peers parsed by phenotype. Patients with bilateral cleft lip, alveolus, and palate reported low PCC scores (51-91%) relative to peers at some ages and low frequency of velopharyngeal competency (26.67%) at 5 years. ICS scores ranged from 3.93-5.0 for all ages and phenotypes. Speech Function and Speech Distress were similar across phenotypes. This exploration of speech outcomes demonstrates the current ability of the cleft-specific registry to support cleft research efforts as a source of "real-world" data. Further work is focused on developing robust methodology for hypothesis-driven research and causal inference.

Intelligibility in Context Scale: Psychometric evidence and implications for Saudi Arabic-English-speaking preschoolers

Purpose: To evaluate the reliability, validity, and diagnostic accuracy (sensitivity, specificity) of the Intelligibility in Context Scale in Saudi Arabic (ICS-SA) and English (ICS-E) as potential measures of functional speech intelligibility in bilingual preschool-aged Saudi Arabian children. Method: The study included 36 parent-child (aged 3;0 to 6;5 years; months) dyads who were bilingual speakers of Saudi Arabic and English, which included two groups—typically developing (TD, n = 29) and suspected speech sound disordered (sSSD, n = 7). The children’s intelligibility was evaluated in both languages using the ICS-SA and ICS-E. Children’s single-word productions were collected in both languages and calculated for percentage of consonants, vowels, and phonemes correct (i.e. PCC/PVC/PPC) to establish their speech-sound competence. Result: The mean scores for the entire sample (n = 36) were 4.43 (SD = 0.79) for the ICS-SA and 4.48 (SD = 0.79) for the ICS-E, showing that parents rated their children’s intelligibility in both languages similarly. Both the ICS-SA and ICS-E demonstrated excellent internal consistency (α = 0.96 and α = 0.95, respectively). There was high inter-rater and test-retest reliability for the ICS-SA, while there was fair to high inter-rater and test-retest reliability in ICS-E. Significant correlations were found for the ICS-SA, but weak correlations were noted for the ICS-E, which indicated fair to moderate evidence of criterion validity. Construct validity efforts indicated a weak correlation with age on both the ICS-SA and ICS-E. The findings also indicated high discriminant accuracy for both the ICS-SA (0.86, 0.86) and ICS-E (0.71, 0.69). Conclusion: This study provides initial validation and reliability evidence for using the ICS-SA and ICS-E with Saudi Arabic- and English-speaking preschoolers, however, ICS-E scores suggest further testing is warranted. By extension, these findings expand the bilingual knowledge base and offer new tools for identifying children in Saudi Arabia who may be at risk for having a speech sound disorder.

The Effectiveness of Rapid Syllable Transition Treatment in Improving Communication in Children with Cerebral Palsy: A Randomized Controlled Trial

ABSTRACT Cerebral palsy (CP) is a movement disorder and majority of children with CP have communication impairments which impact participation with this population. Rapid Syllable Transition Treatment (ReST) is a motor speech intervention primarily for children with Childhood Apraxia of Speech (CAS). A recent pilot study in which ReST was trialed with children with CP showed improved speech performance. Therefore, a single blind randomized controlled trial to compare ReST to usual care with 14 children with moderate-to-severe CP and dysarthria was conducted. ReST was provided on telehealth. ANCOVA with 95% confidence intervals indicated significant group differences in favor of ReST in speech accuracy (F = 5.1, p = .001), intelligibility (F = 2.8, p = .02) and communicative participation on both the FOCUS (F = 2, p = .02) and Intelligibility in Context Scale (F = 2.4, p = .04). ReST was found to be more effective than usual care.

Intelligibility in Context Scale: Growth Curves for Typically Developing English-Speaking Children Between Ages 2;6 and 9;11.

The aim of this study was to quantify the clinical utility of the Intelligibility in Context Scale (ICS) English version by characterizing the growth patterns of the ICS composite scores and seven ICS individual item scores of typically developing American English-speaking children. Parents of 545 typically developing children aged 2;6-9;11 (years;months) completed the ICS. Using a proportional odds model, we regressed ICS composite scores on age and computed for model-estimated mean and lower quantile ICS composite scores. Logistic regression and proportional odds modeling were utilized to quantify the relationship of individual ICS items and age. ICS composite scores of typically developing children changed with age, but change was small and incremental, with scores compressed between 3 and 5 across the range of ages. An average child (i.e., on the 50th percentile) is expected to have an ICS composite score of 4 beginning at 3;0 and an ICS composite score of 5 by 6;6. On average, parents gave different intelligibility ratings based on communicative partners, and the rating differences between communicative partners decreased with age. Given that ICS scores increase with age, the expected score for average children also increases. A child's age is a main factor for interpreting ICS scores.

Characterizing Communicative Participation in Multilingual Jamaican Preschoolers.

This study characterized communicative participation and related aspects of functional communication for Jamaican Creole (JC)-English-speaking preschoolers with and without functionally defined speech sound disorders (fSSDs). This study included parent reports and direct assessment measures from an existing corpus of baseline data collected prior to the COVID-19 pandemic. The communicative participation of typically developing (TD; n = 226) bilingual JC-English-speaking preschoolers and those with fSSDs (n = 39) was documented using the Focus on the Outcomes of Communication Under Six (FOCUS). Functional speech intelligibility was recorded using the Intelligibility in Context Scale (ICS) in English and JC (ICS-JC). Objective measures of speech production were collected through direct child assessment in both languages and then transcribed and calculated for percent of consonants (PCC), vowels (PVC), and phonemes correct (PPC). Within-group relationships were explored using association testing, and differences between groups were explored through multivariate analyses. FOCUS scores and ICS and ICS-JC scores were found to be minimally to moderately related for Jamaican preschoolers in the TD group (r = .28-.34, p < .002) and strongly related in the fSSD group (r = .56-.60, p < .002). No relations were observed between the FOCUS scores and PCC/PVC/PPC in either language. There was a statistically significant difference between all FOCUS scores for Jamaican preschoolers in the TD and fSSD groups (p ≤ .002). These findings provide additional evidence for using the FOCUS beyond documenting change in communicative participation to support clinical decision-making in planning and developing speech-language interventions. This study also documents an important characterization of JC-English-speaking children with and without fSSDs, offering data on children's abilities that can be used in future comparisons of communicative participation and speech functioning observed during the COVID-19 pandemic and beyond.

Psychometric properties of the Viking Speech Scale-Turkish version for children with cerebral palsy aged 4-18 years based on live and video-based observation.

Speech is the most common method of communication. Video-based clinical communication evaluation is a requirement for children with speech-language impairments living in rural areas, and those who have limited mobility. To determine the validity and reliability of the Turkish version of the Viking Speech Scale (VSS-T) via live and video-based observation for children with cerebral palsy (CP) aged 4-18 years. A total of 142 children (mean age 8.18 ± 3.98 years; 68 female) with CP were included in this study. Their motor, communication, visual and eating-drinking function levels and comorbidities (dental, swallowing, cognitive impairments and epilepsy) were recorded. The Intelligibility in Context Scale (ICS), the Pediatric Evaluation of Disability Inventory-Social Function (PEDI-SF), and the Functional Independence Measure for Children-Communication (WeeFIM-C) were assessed to examine the concurrent validity of the VSS-T. The interrater reliability of the VSS-T was analysed between parents, physical therapists, and speech and language therapists from live and video-based observation. Intra-rater reliability was calculated from ratings made from live and video-based observations taken 3 weeks apart. The VSS-T was strongly related to the ICS (r = -0.830), PEDI-SF (r = -0.819), WeeFIM-C (r = -0.643), other functional classifications (r > 0.432), and the comorbidities (Cramer's V > 0.284, p < 0.001). Good to excellent interrater reliability (κw ≥ 0.838) and intra-rater reliability (intraclass correlation coefficient (ICC) = 0.848-0.995) were found between parents and therapists. Speech and language therapists, physical therapists, and parents can use the VSS-T as a valid and reliable classification system to describe speech intelligibility of 4-18-year-old children with CP. Both live and video-based observations can be used to administer the VSS-T. What is already known on the subject The English version of the VSS has been shown to be a valid and reliable tool used to classify the speech of children with CP aged 4-13 years. The scale can be administered by means of live observation of the child or based on clinicians' notes on the case by parents, SLTs, physiotherapists and paediatricians. What this paper adds to existing knowledge The VSS-T is valid and reliable for children with CP aged 4-18 years. Video-based observation is a suitable method for evaluating the VSS-T levels. The VSS-T has a moderate association with the CFCS. What are the potential or actual clinical implications of this work? The VSS-T is a valid and reliable method of categorizing the severity of motor speech impairment for Turkish children with CP in clinical research studies, registry systems or epidemiological studies. Both experienced and inexperienced therapists can use either live or video-based observation methods to administer the VSS-T. This study extended the validity and reliability of the scale in children with CP aged up to 18 years. The VSS-T is also associated with the Visual Functional Classification System (VFCS), which has been recently developed for describing the visual abilities of children with CP in daily life. In addition, the VSS-T is associated with the presence of dental, swallowing, cognitive problems and epilepsy.

Translation and validation of the Intelligibility in Context Scale into Sinhala for adolescents in Sri Lanka with cleft lip and palate

ABSTRACT The Intelligibility in Context Scale (ICS) is a parent-report screening tool used to measure parents’ perceptions of children’s functional intelligibility. This tool has been translated into over 60 languages and found to have a good reliability and validity. The purpose of the current study was to translate the ICS into Sinhala (the ICS-SIN), the main language spoken by the Sinhalese people in Sri Lanka, and to validate it with both typically developing (TD) children and children with repaired cleft lip and/or palate (CLP). The translation process followed the forward-backward-forward method. A total of 88 parents of TD children and children with CLP aged 12–15 years old (TD n = 50, CLP n = 38) completed the ICS-SIN questionnaire. Parents of TD and CLP children reported their children’s speech as most intelligible to parents and least intelligible to strangers. The ICS-SIN had high internal consistency for both groups (TD α = 0.87, p < 0.05, CLP α = 0.97, p < 0.05). The ICS-SIN total scores and item scores showed significant correlations, indicating a good construct validity. TD participant group’s ICS-SIN average mean scores (M = 4.88, SD = 0.29) were significantly higher compared to the CLP ICS-SIN average mean scores (M = 4.64, SD = 0.67) and varied according to gender in both groups, suggesting good discriminant validity. The ICS-SIN has overall good psychometric properties. Therefore, this tool has the potential to be used as a valid parent-rating screening tool for clinical and research purposes in Sri Lanka.

Validation of the Intelligibility in Context Scale in Tamil (ICS-Tamil) and insights into children’s speech sound accuracy

ABSTRACT The study aimed to develop and validate the Intelligibility in Context Scale in Tamil (ICS-Tamil) among preschoolers. A total of 170 children between three-to-six years of age [125 children with typical speech and 45 children with suspected speech sound disorder (SSD)] participated in the study. Parents completed the ICS-Tamil. Children's speech production was assessed using a single-word list of 50 Tamil words. Children's responses were transcribed using the PHON software to calculate percentage of consonants correct (PCC), percentage of vowels correct (PVC) and percentage of phonemes correct (PPC). ICS-Tamil demonstrated excellent test-retest reliability (ICC = 0.99, 95% CI = 0.98-0.99) and internal consistency reliability (α = 0.92). Bivariate correlation analyses showed a moderate correlation with PCC (r s = 0.67), PPC (r s = 0.65) and PVC (r s = 0.53), suggesting adequate construct validity. Children with typical speech scored significantly higher on the ICS-Tamil (M = 4.51, SD = 0.44) in comparison to children with suspected SSD (M = 3.46, SD = 0.54), establishing the known group validity of ICS-Tamil. A score lower than a cut-off of 4.07 on the ICS-Tamil average score demonstrated 93% sensitivity and 80% specificity in distinguishing children with suspected SSD from children with typicalspeech. Speech errors seen in children from both groups predominantly included errors in retroflex sounds. The psychometric properties of ICS-Tamil support its use to measure children's functional intelligibility across multiple environmental contexts and communication partners among Tamil-speaking children. In addition, the data on speech sound acquisition and intelligibility contribute to the much-needed data corpus to support speech-language pathologists' assessment, diagnosis and intervention planning for children with speech sound disorders in Tamil.

Predicting Which Children Will Normalize Without Intervention for Speech Sound Disorders.

The speech of some children does not follow a typical normalization trajectory, and they develop speech sound disorders (SSD). This study investigated predictive correlates of speech sound normalization in children who were at risk of SSD. A prospective population cohort study of 845 Cantonese-speaking preschoolers was conducted over 2.5 years to examine (a) children who resolved nonadult realizations of consonants (normalized) and (b) those who had persisting speech sound difficulties (did not normalize). From these 845, a sample of 82 participants characterized as having SSD (1.25 SDs below the mean in a standardized speech assessment, with a delay in initial consonant acquisition or with one or more atypical errors) was followed for 2 years at 6-month intervals or until the completion of their initial consonant inventory. Data from 43 children who did not receive speech-language pathology services were analyzed with survival analysis to model time to normalization while controlling for covariates. The target event (outcome) was the completion of their initial consonant inventory. Under the no-intervention condition, the estimated median time to normalization was 6.59 years of age. Children who were more likely to normalize or normalized in a shorter time were stimulable to all errors and more intelligible as rated by caregivers using the Intelligibility in Context Scale. Those who showed atypical error patterns did not necessarily take longer to normalize. Similarly, expressive language ability was not significantly associated with speech normalization. Stimulability and intelligibility were more useful prognostic factors of speech normalization when compared to (a)typicality of error patterns and expressive language ability. Children with low intelligibility and poor stimulability should be prioritized for speech-language pathology services given that their speech errors are less likely to resolve naturally.

Construct validity of the focus on the outcomes of communication under six (FOCUS) total and profile scores for multilingual preschoolers: Considering functional speech skills

Purpose To conduct an exploratory study to establish construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS) in the Jamaican context for FOCUS Total and Profile scores. Method Parents of a representative sample of 3-to-6-year-old Jamaican Creole (JC)-English-speaking simultaneous bilingual children completed the FOCUS in English, and the Intelligibility in Context Scale (ICS) in JC and in English. Children completed the Diagnostic Evaluation of Articulation and Phonology (DEAP) in both languages. Percent phonemes, consonants, and vowels correct were calculated using single word responses to DEAP items. Pearson correlations were completed to describe relationships between measurement scores. Result Convergent validity was found for FOCUS Total and ICS/JC scores. Convergent and divergent validity were found for specific FOCUS Profile scores and ICS/JC scores. Minimal evidence of convergent validity was found with FOCUS Total scores and transcription-based measures of speech production in JC and in English. Convergent and divergent validity were found between specific FOCUS Profile scores and some transcription-based measures of speech production in JC and in English. Conclusion This study provides evidence of construct validity for FOCUS Total and Profile scores. It also provides validity evidence for FOCUS scores in a multilingual context using a representative sample of children that serves to broaden the range of applicability of the FOCUS.

Utility of the Intelligibility in Context Scale for Predicting Speech Intelligibility of Children with Cerebral Palsy.

The Intelligibility in Context Scale (ICS) is a widely used, efficient tool for describing a child’s speech intelligibility. Few studies have explored the relationship between ICS scores and transcription intelligibility scores, which are the gold standard for clinical measurement. This study examined how well ICS composite scores predicted transcription intelligibility scores among children with cerebral palsy (CP), how well individual questions from the ICS differentially predicted transcription intelligibility scores, and how well the ICS composite scores differentiated between children with and without speech motor impairment. Parents of 48 children with CP, who were approximately 13 years of age, completed the ICS. Ninety-six adult naïve listeners provided orthographic transcriptions of children’s speech. Transcription intelligibility scores were regressed on ICS composite scores and individual item scores. Dysarthria status was regressed on ICS composite scores. Results indicated that ICS composite scores were moderately strong predictors of transcription intelligibility scores. One individual ICS item differentially predicted transcription intelligibility scores, and dysarthria severity influenced how well ICS composite scores differentiated between children with and without speech motor impairment. Findings suggest that the ICS has potential clinical utility for children with CP, especially when used with other objective measures of speech intelligibility.

TỔNG QUAN MÔ TẢ VỀ THANG ĐO TÍNH DỄ HIỂU THEO NGỮ CẢNH

Speech intelligibility describes the degree of understanding messages between speakers and listeners. Speech intelligibility plays an important role in examining children’ speech, in diagnosing speech sound disorders, in setting goals, planning intervention, and evaluating effectiveness of speech interventions. The Intelligibility in Context Scale (ICS) is one of the most popular speech intelligibility measurement tools and has been translated into more than 60 languages across the world. This paper presents a scoping review of 39 publications including five describing, 19 norming and validation studies and 15 studies reporting on the use of ICS. Based on content analysis, this paper describes the development and translation, norming, validation and use of the ICS with children speaking English (five descriptions and nine papers), children speaking 14 other languages across the world (21 papers), and children speaking Vietnamese in Vietnam (four papers). Participants in the ICS studies were: monolingual, bilingual and multilingual; with and without speech sound disorders; and from 1-2 years old to adults but mainly in the preschool age range. The ICS’s mean scores, internal reliability, internal consistency, sensitivity, specificity as well as other psychometric properties were reported in ICS studies. These indicators reveal evidence that ICS is a reliable scale to use in research and clinical practice to measure speech intelligibility of children speaking different languages across the world including children speaking northern and southern Vietnamese dialects.

TỔNG QUAN CÁC TIÊU CHUẨN CHẨN ĐOÁN RỐI LOẠN ÂM LỜI NÓI Ở TRẺ EM

Speech sound disorders (SSD) is a common communication disorder with long-term consequences in children. Diagnosis and assessment play an important role in the identification of SSD and its severity, to assist goal setting and intervention planning and to measure progression. In order to define and describe diagnostic criteria regarding SSD in children, this review paper uses content analysis of 14 studies reporting on children with SSD. Results reveal that diagnostic criteria for SSD in children include: 1) Mean scores of percentage phonemes correct (e.g., percentage of consonants correct, PCC, and percentage of vowels correct, PVC); 2) phonological processes; 3) “concern” from parents, teachers, and children themselves about children’s speech and pronunciation; and 4) children's speech intelligibility. While mean scores of the percentage of consonants correct were varied between studies, diagnostic criteria for identifying SSD were achieving a PCC score between one and two standard deviations below the mean for the child’s age. Some children with SSD were reported to use phonological processes that are occasional (&gt;10%) and rare (&gt;5%), or are still being used at an older age compared to typically developing children. Many children with SSD had parents and teachers who were concerned about their speech and pronunciation. Mean scores of young children’s speech intelligibility measured by the Intelligibility in Context Scale were typically below 4.0. This review provides useful information and a foundation for research and clinical practice in a language in which diagnosis criteria for SSD have not been established.

Parent rating of intelligibility: A discussion of the construct validity of the Intelligibility in Context Scale (ICS) and normative data of the Swedish version of the ICS.

Intelligibility can be defined as the speakers' ability to convey a message to the listener and it is considered the key functional measure of speech. The Intelligibility in Context Scale (ICS) is a parent rating scale used to assess intelligibility in children. To describe normative and validation data on the ICS in Swedish and to investigate how these are related to age, gender and multilingualism. Two studies were included. Study 1 included ICS forms from 319 Swedish-speaking children (3:2-9:2 years:months). Study 2 included video recordings and ICS forms from 14 children with speech sound disorder (SSD) and two with typical speech. The video recordings were transcribed in the validation process, resulting in intelligibility reference scores to which ICS scores were correlated. Study 1: The mean value of the ICS for the 319 children was 4.73. There were no differences in ICS score related to age or gender. The children in the multilingual group were significantly older than the monolingual group and had significantly lower ICS scores than the group of monolinguals. Study 2: There was a moderate correlation between the ICS score and the transcription-based intelligibility score, with the two children with typical speech excluded; however, this correlation was not significant. We contribute mean scores and percentiles on the ICS for Swedish-speaking children. The finding that the ICS does not provide valid measures of intelligibility for the included children with SSD suggests that the instrument measures a different construct. What is already known on the subject The ICS has been translated to numerous languages and validated against articulation measures in several previous studies. The validity of the Swedish version has been investigated against intelligibility based on transcription of single words. What this paper adds to existing knowledge The study provides normative values of the Swedish version of the ICS for children aged 3-9 years. This is the first study to use a gold standard measure of intelligibility in continuous speech to validate the ICS. The results show a somewhat dubious validity regarding ICS for the group of children with SSD included in the study. What are the potential or actual clinical implications of this work? The ICS's suitability as a measure of intelligibility is questionable; however, it might be of use for speech and language pathologists to give an overview of the parents' view of their child's ability to communicate, in order to make a decision on possible further assessment and intervention. The normative values of the Swedish version of the ICS could be of use in this decision process.

Assessment of Intelligibility in Children with Velopharyngeal Insufficiency: The Relationship between Intelligibility in Context Scale and Experimental Measures

Purpose: The purpose of this study was to investigate the clinical application of the Intelligibility in Context Scale (ICS) instrument in children with velopharyngeal insufficiency (VPI). This study investigated the relationship between clinical speech outcomes and parental reports of speech intelligibility across various communicative partners. Methods: The ICS was completed by the parents of 20 English-speaking children aged 4–12 years diagnosed with VPI. The parents were asked to rate their children’s speech intelligibility across communication partners using a 5-point scale. Clinical metrics obtained using standard clinical transcription on the Picture-Cued SNAP-R Test were: (1) percentage of consonants correct (PCC), (2) percentage of vowels correct (PVC), and (3) percentage of phonemes correct (PPC). Nasalance from nasometer data was included as an indirect measure of nasality. Intelligibility scores obtained from naive listener’s transcriptions and speech-language pathologists’ (SLP) ratings were compared with the ICS results. Result: Greater PCC, PPC, PVC, and transcription-based intelligibility values were significantly associated with higher ICS values, respectively (r[20] = 0.84, 0.82, 0.51, and 0.70, respectively; p < 0.05 in all cases). There was a negative and significant correlation between ICS mean scores and SLP ratings of intelligibility (r = –0.74; p < 0.001). There was no significant correlation between ICS values and nasalance scores (r[20] = –0.28; p = 0.22). Conclusion: The high correlations obtained between the ICS with PCC and PPC measures indicate that articulation accuracy has had a great impact on parents’ decision-making regarding intelligibility in this population. Significant agreement among ICS scores with naive listener transcriptions and clinical ratings supports use of the ICS in practice.

Consonant accuracy and intelligibility of Southern Vietnamese children

ABSTRACT Understanding typically developing children’s speech acquisition is useful to assist speech-language pathologists’ diagnosis and intervention planning for children with speech sound disorders. The aim of this research was to investigate Southern Vietnamese-speaking children’s speech accuracy and intelligibility. Participants were 132 children aged 3;0–5;11 living in Southern Viet Nam (Ho Chi Minh City) whose consonants, semivowels, vowels, and tones were assessed using the Vietnamese Speech Assessment (VSA) and parent-reported intelligibility was assessed using the Vietnamese version of the Intelligibility in Context Scale (ICS-VN). Participants’ percentage of consonants correct (PCC) was significantly lower for the younger children compared with the other age groups. Mean PCC was 89.19 (SD = 7.83) at 3;0–3;5 years and 99.31 (SD = 1.33) at 5;6–5;11 years. Percentage of semivowels correct was higher than the percentage of initial and final consonants correct. Participants produced tones and vowels accurately even from the youngest age group. On average, the participants were reported to be usually to always intelligible and were more intelligible with their parents than other communication partners. There was a positive, weak correlation between speech accuracy (PCC) and intelligibility (ICS-VN). There was no sex effect for PCC and no significant effect for age or sex on intelligibility. These data provide information about typical speech acquisition to support the emerging speech-language pathology profession in Viet Nam.

Intelligibility in 3-Year-Olds With Cleft Lip and/or Palate Using the Intelligibility in Context Scale: Findings from the Cleft Collective Cohort Study.

To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type. Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children's cleft type and syndromic status. A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old. Mothers' rating of their children's intelligibility using the ICS. The average ICS score for the total sample was 3.75 (sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 (always intelligible). Children's speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence (P < .001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81). These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement.