Article  |   April 2013
A Motor Speech Assessment for Children With Severe Speech Disorders: Reliability and Validity Evidence
 
Author Affiliations & Notes
  • Edythe A. Strand
    Mayo Clinic, Rochester, Minnesota
  • Rebecca J. McCauley
    The Ohio State University, Columbus
  • Stephen D. Weigand
    Mayo Clinic, Rochester, Minnesota
  • Ruth E. Stoeckel
    Mayo Clinic, Rochester, Minnesota
  • Becky S. Baas
    Mayo Clinic, Rochester, Minnesota
  • Correspondence to Edythe A. Strand: strand.edythe@mayo.edu
  • Editor: Jody Kreiman
    Editor: Jody Kreiman×
  • Associate Editor: Julie Liss
    Associate Editor: Julie Liss×
Article Information
Speech, Voice & Prosodic Disorders / Research Issues, Methods & Evidence-Based Practice / Speech, Voice & Prosody / Article
Article   |   April 2013
A Motor Speech Assessment for Children With Severe Speech Disorders: Reliability and Validity Evidence
Journal of Speech, Language, and Hearing Research, April 2013, Vol. 56, 505-520. doi:10.1044/1092-4388(2012/12-0094)
History: Received March 24, 2012 , Revised July 9, 2012 , Accepted August 18, 2012
 
Journal of Speech, Language, and Hearing Research, April 2013, Vol. 56, 505-520. doi:10.1044/1092-4388(2012/12-0094)
History: Received March 24, 2012; Revised July 9, 2012; Accepted August 18, 2012
Web of Science® Times Cited: 1

Purpose: In this article, the authors report reliability and validity evidence for the Dynamic Evaluation of Motor Speech Skill (DEMSS), a new test that uses dynamic assessment to aid in the differential diagnosis of childhood apraxia of speech (CAS).

Method: Participants were 81 children between 36 and 79 months of age who were referred to the Mayo Clinic for diagnosis of speech sound disorders. Children were given the DEMSS and a standard speech and language test battery as part of routine evaluations. Subsequently, intrajudge, interjudge, and test–retest reliability were evaluated for a subset of participants. Construct validity was explored for all 81 participants through the use of agglomerative cluster analysis, sensitivity measures, and likelihood ratios.

Results: The mean percentage of agreement for 171 judgments was 89% for test–retest reliability, 89% for intrajudge reliability, and 91% for interjudge reliability. Agglomerative hierarchical cluster analysis showed that total DEMSS scores largely differentiated clusters of children with CAS vs. mild CAS vs. other speech disorders. Positive and negative likelihood ratios and measures of sensitivity and specificity suggested that the DEMSS does not overdiagnose CAS but sometimes fails to identify children with CAS.

Conclusions: The value of the DEMSS in differential diagnosis of severe speech impairments was supported on the basis of evidence of reliability and validity.

Acknowledgments
The first author acknowledges the support of Mayo Clinic CTSA through National Center for Research Resources Grant UL1RR024150. We also thank Heather Clark and David Ridge for reading and commenting on earlier versions of this article.
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