Predicting speech intelligibility with a multiple speech subsystems approach in children with cerebral palsy.

PURPOSE Speech acoustic characteristics of children with cerebral palsy (CP) were examined with a multiple speech subsystems approach; speech intelligibility was evaluated using a prediction model in which acoustic measures were selected to represent three speech subsystems. METHOD Nine acoustic variables reflecting different subsystems, and speech intelligibility, were measured in 22 children with CP. These children included 13 with a clinical diagnosis of dysarthria (speech motor impairment [SMI] group) and 9 judged to be free of dysarthria (no SMI [NSMI] group). Data from children with CP were compared to data from age-matched typically developing children. RESULTS Multiple acoustic variables reflecting the articulatory subsystem were different in the SMI group, compared to the NSMI and typically developing groups. A significant speech intelligibility prediction model was obtained with all variables entered into the model (adjusted R2 = .801). The articulatory subsystem showed the most substantial independent contribution (58%) to speech intelligibility. Incremental R2 analyses revealed that any single variable explained less than 9% of speech intelligibility variability. CONCLUSIONS Children in the SMI group had articulatory subsystem problems as indexed by acoustic measures. As in the adult literature, the articulatory subsystem makes the primary contribution to speech intelligibility variance in dysarthria, with minimal or no contribution from other systems.