A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: IV. The Pause Marker Index Purpose Three previous articles provided rationale, methods, and several forms of validity support for a diagnostic marker of childhood apraxia of speech (CAS), termed the pause marker (PM). Goals of the present article were to assess the validity and stability of the PM Index (PMI) to scale CAS severity. ... Supplement Article
Supplement Article  |   April 14, 2017
A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: IV. The Pause Marker Index
 
Author Affiliations & Notes
  • Lawrence D. Shriberg
    Waisman Center, University of Wisconsin–Madison
  • Edythe A. Strand
    Department of Neurology, Mayo Clinic–Rochester, NY
  • Marios Fourakis
    Waisman Center, University of Wisconsin–Madison
  • Kathy J. Jakielski
    Department of Communication Sciences and Disorders, Augustana College, Rock Island, IL
  • Sheryl D. Hall
    Waisman Center, University of Wisconsin–Madison
  • Heather B. Karlsson
    Waisman Center, University of Wisconsin–Madison
  • Heather L. Mabie
    Waisman Center, University of Wisconsin–Madison
  • Jane L. McSweeny
    Waisman Center, University of Wisconsin–Madison
  • Christie M. Tilkens
    Waisman Center, University of Wisconsin–Madison
  • David L. Wilson
    Waisman Center, University of Wisconsin–Madison
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Lawrence D. Shriberg: shriberg@waisman.wisc.edu
  • Editor and Associate Editor: Julie Liss
    Editor and Associate Editor: Julie Liss×
Article Information
Speech, Voice & Prosodic Disorders / Apraxia of Speech & Childhood Apraxia of Speech / Voice Disorders / Speech, Voice & Prosody / Supplement: A Diagnostic Marker to Discriminate Childhood Apraxia of Speech from Speech Delay
Supplement Article   |   April 14, 2017
A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: IV. The Pause Marker Index
Journal of Speech, Language, and Hearing Research, April 2017, Vol. 60, S1153-S1169. doi:10.1044/2016_JSLHR-S-16-0149
History: Received April 12, 2016 , Revised August 2, 2016 , Accepted August 21, 2016
 
Journal of Speech, Language, and Hearing Research, April 2017, Vol. 60, S1153-S1169. doi:10.1044/2016_JSLHR-S-16-0149
History: Received April 12, 2016; Revised August 2, 2016; Accepted August 21, 2016

Purpose Three previous articles provided rationale, methods, and several forms of validity support for a diagnostic marker of childhood apraxia of speech (CAS), termed the pause marker (PM). Goals of the present article were to assess the validity and stability of the PM Index (PMI) to scale CAS severity.

Method PM scores and speech, prosody, and voice precision-stability data were obtained for participants with CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech consequent to stroke and primary progressive apraxia; and idiopathic speech delay. Three studies were completed including criterion and concurrent validity studies of the PMI and a temporal stability study of the PMI using retrospective case studies.

Results PM scores were significantly correlated with other signs of CAS precision and stability. The best fit of the distribution of PM scores to index CAS severity was obtained by dividing scores into 4 ordinal severity classifications: mild, mild-moderate, moderate-severe, and severe. Severity findings for the 4 classifications and retrospective longitudinal findings from 8 participants with CAS supported the validity and stability of the PMI.

Conclusion Findings support research and clinical use of the PMI to scale the severity of CAS.

Acknowledgments
This research was supported by National Institute on Deafness and Other Communication Disorders Grant DC000496 and by a core grant to the Waisman Center from the National Institute of Child Health and Development (Grant HD03352). Authors Christie Tilkens and Heather Karlsson made the original observations and substantial continuing contributions leading to the development of the PM. We are grateful to the following colleagues and collaborators for their significant contributions to this research: Len Abbeduto, Nancy Alarcon, Becky Baas, Adriane Baylis, Richard Boada, Roger Brown, Stephen Camarata, Thomas Campbell, Richard Folsom, Lisa Freebairn, Jordan Green, Barbara Lewis, Christopher Moore, Katherine Odell, Bruce Pennington, Nancy Potter, Jonathan Preston, Erin Redle, Heather Leavy Rusiewicz, Alison Scheer-Cohen, Kristie Spencer, Ruth Stoeckel, Bruce Tomblin, Jennifer Vannest, and Emily White. We also thank the many participants, parents of participants, and research colleagues who have contributed significant insights into the needs and issues of diagnostic research in CAS.
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