The Speech Disorders Classification System (SDCS .
JSLHR, Volume 40, 723–740, August 1997The Speech Disorders ClassificationSystem (SDCS): Extensions andLifespan Reference DataLawrence D. ShribergDiane AustinUniversity of Wisconsin-MadisonBarbara A. LewisCase Western Reserve UniversityCleveland, OHJane L. McSweenyDavid L. WilsonUniversity of Wisconsin–MadisonA companion paper includes rationale for the use of 10 metrics of articulationcompetence in conversational speech (Shriberg, Austin, Lewis, McSweeny, &Wilson, 1997). The present paper reports lifespan reference data for thesemeasures using records from a total of 836 3- to 40 -year-old speakers withnormal and disordered speech. The reference data are subdivided by diagnosticclassification based on extensions to an instrument titled the Speech DisordersClassification System (SDCS; Shriberg, 1993). Appendices provide proceduralinformation on the SDCS and statistical rationale for the reference data.KEY WORDS: phonology, articulation, speech disorders, assessment,classificationAprevious paper provided rationale and validity data for a clinical classification instrument titled the Speech Disorders Classification System (SDCS; Shriberg, 1993). The present report provides rationale for extensions to the SDCS and lifespan reference datafor the 10 measures of articulation competence described in a companion paper (Shriberg, Austin, et al., 1997). For the interested reader, Appendix A provides procedural detail for the SDCS program, and AppendixB provides rationale and procedural detail for statistical analysis of thelifespan reference data.Extensions to the Speech Disorders ClassificationSystem (SDCS)Figure 1 is a revised version of the SDCS described in Shriberg (1993,1994), with extensions reflecting empirical findings in several subsequent reports (Lewis & Shriberg, 1994; Shriberg, Aram, & Kwiatkowski,1997a, 1997b; Shriberg, Gruber, & Kwiatkowski, 1994; Shriberg &Kwiatkowski, 1994; Shriberg, Kwiatkowski, & Gruber, 1994). Discussions of the need for an etiologically based classification system, evaluative literature reviews, and precursors of the SDCS are presented elsewhere (cf. Shriberg, 1980, 1983, 1994, 1997; Shriberg & Austin, in press).The purpose of the SDCS is to classify a person’s speech production statusthroughout the lifespan. Because the system was used to determine thespeech status of persons in the reference data to be reported, it is useful toreview theoretical and methodological assumptions underlying its original development and current extension. The following section provides 1997, American Speech-Language-Hearing Association1092-4388/97/4004-0723Journal of Speech, Language, and Hearing Research723
724JSLHR, Volume 40, 723–740, August 1997Figure 1. Revised version of the Speech Disorders Classification System (SDCS). The solid lines depict descriptive subtypes; the dashed linesdepict putative etiologic classifications.an overview of those perspectives, and Appendix A provides a technical review of program steps. As shown inFigure 1, the SDCS system is organized by both descriptive subtypes and etiologic subtypes.between differences and disorders, although procedures used to help persons modify speech differencesare generally similar to procedures used to normalizespeech disorders.Descriptive SubtypesThe middle box in the upper row of Figure 1, developmental phonological disorders (DPD), is divided into3 descriptive types: speech delay (SD), questionable residual errors (QRE), and residual errors (RE).The boxes in Figure 1 represent descriptive (solidlines) and etiologic (dashed lines) subtypes of speechdisorders based on a speaker’s current and priorspeech production status as sampled in conversation(cf. Shriberg 1993, 1994). The upper leftmost box includes two types of speakers: those who have had normal acquisition of speech and those whose speech disorders have normalized (normal or normalized speechacquisition: NSA). The two upper rightmost boxes include adult and child speakers whose speech patternsare classified as nondevelopmental speech disordersand speech differences. Nondevelopmental speech disorders occur after the developmental period for speechacquisition, nominally after age 9. Speech differencesinclude all speech and prosody-voice patterns thatspeakers may seek help in changing, such as patternsassociated with multicultural diversity and the acquisition of English as a second language. Competentspeech clinicians make clear classification distinctionsJournal of Speech, Language, and Hearing ResearchSpeech Delay (SD)SD is the classification for children younger than 9years who have persisting deletion and substitution errors on low intelligibility ( 75%) not observed in typicallyspeaking children of the same chronological age. The fourputative etiologic subtypes of SD shown in dashed linesare described elsewhere (Shriberg, 1994, 1997; Shriberg& Austin, in press).Questionable Residual Errors (QRE)QRE is the classification for children age 6 years to8 years 11 months whose error patterns include onlycommon clinical distortions (or substitutions that aredifficult to discriminate from common clinical distortions, e.g., w/r is similar to derhotacized /r/; see list ofQRE substitutions in Appendix A). Some children with
725Shriberg et al.: The Speech Disorders Classification System (SDCS)QRE could be children who normalized from SD or NSA/SD status, or, as indicated in Figure 1, they could haveno such history. Such errors may normalize by age 9, orthey could persist.Residual Errors (RE)RE is the classification for speakers 9 years old andolder who continue to have speech errors. RE includestwo subtypes, RE-A and RE-B (Shriberg, 1993, 1994).Children and adults classified as RE-A have histories ofSD, whereas speakers classified as RE-B do not havesuch histories. The three numbered subtypes classifythe error type patterns: RE-A1 or RE-B1 is for residualcommon distortion errors only (as listed in Shriberg,1993, Appendix), RE-A2 or RE-B2 is for residual common distortions and imprecise speech (omissions andsubstitutions; cf. Shriberg, 1993), and RE-A3 or RE-B3is for imprecise speech. The RE-2 and RE-3 forms ofresidual errors may have very low prevalence in adultpopulations. The utility of these RE subtypes for descriptive-explanatory research is illustrated in Shriberg,Aram, et al. (1997a, 1997b), in which SDCS classifications are used to classify the speech status of childrenranging in age from approximately 3 to 15 years.New Classification Category for Speechas a Continuous TraitIn addition to the SDCS descriptive subtypes of NSA,SD, QRE, and RE (with its six subtypes), an additionalclassification was found to be needed in studies usingthe SDCS approach since 1993 (Shriberg). Althoughclinical concerns dictate that children be classified asnormal (NSA) or speech delayed (SD) during the developmental period, this dichotomy is imposed on an underlying continuous verbal trait. For both research andclinical purposes, it is appropriate to provide a classification category for error patterns intermediate betweenNSA and SD. As shown in Figure 1, a descriptive subtype termed NSA/SD has been added to those describedin Shriberg, 1993. The slash between the two stems indicates that NSA/SD truly falls between NSA and SD.As discussed later, alternative perspectives on childrenclassified as NSA/SD depend on the particular purposefor which SDCS classification is being used.Special PopulationsThe remaining SDCS classification in Figure 1 (indicated by solid lines) represents a placeholder for allother forms of speech delay found in special populations(a term used in Bernthal & Bankson, 1994). Etiologicsubtypes in this category of special populations includespeech delay associated with frank deficits in mechanism (e.g., tracheostomy), cognitive-linguistic (e.g., cognitive disability), and psychosocial (e.g., elective mut-ism) processes. Children in these special populationsrequire special types of services and have specific typesof speech involvements that differ from other forms ofspeech delay. However, because their deficits occurwithin the developmental period for speech acquisition,their profiles of speech delay may also be similar in manyways to the speech involvements of children in each ofthe other proposed etiologic subgroups. Thus, for boththeoretical and applied educational purposes, it is useful to include this aggregate classification categorywithin the SDCS system.SDCS ClassificationsSix Conventions Subserving Validity andReliability NeedsClassification of a transcript into one of the descriptive subtypes above is performed by SDCS software using rules tables developed from review of normative dataon speech-sound acquisition (cf. Shriberg, 1993, Appendix). Appendix A includes a graphic illustrating the decision rules used by the SDCS to classify a conversational speech sample as modified by the conventionsdescribed below. Although the etiologic subtypes are central in associated research, the SDCS software currentlymakes only descriptive subtype classifications. That is,to date the SDCS does not have the diagnostic markersto discriminate among the four etiologic subtypes ofspeech delay shown in dashed lines in Figure 1 (cf.Shriberg & Austin, in press). To understand the reference data to follow, it is important to describe six validity and reliability considerations used in the classification process. For ease of understanding these technicaldetails, key concepts are italicized.First, although the SDCS tabulates all speech errors, only age-inappropriate errors that occur in at leasttwo different words are used for classification decisions.Moreover, because there are few developmental data onword-medial consonant development, errors in medialposition are excluded from the classification decisionprocess, as are sound changes termed casual forms (e.g.,“I donno”).Second, to ensure the validity of NSA, NSA/SD, andQRE classifications, the Intelligibility Index (II) and thenumber of usable words in the sample are examined.Because the SDCS uses conservative criteria in makingclassification assignments (i.e., the default is NSA), asample that is too brief or too unintelligible may notcontain enough information for the program to assignan appropriate disorder classification. If the II is 75%or lower and the sample receives a preliminary classification of NSA, NSA/SD, or QRE, the sample is reclassified as SD! (with the ! indicating that the classificationwas made using intelligibility criteria). Similarly, if theJournal of Speech, Language, and Hearing Research
726II is between 76% and 80% (inclusive) and the originalclassification is NSA or QRE, the sample is reclassifiedas NSA/SD!. If there are fewer than 100 usable wordsin a sample, an asterisk (*) is appended to the classification to indicate that detailed examination of thesample or a longer conversational speech sample maybe needed to make an accurate classification.Third, if a speaker has age-inappropriate errors foronly one sound, or has an incomplete inventory of wordshapes, consonants, or vowels/diphthongs, the NSA classification is enclosed in curly braces (i.e., {NSA}). Moreover, if a speaker has made age-appropriate errors onone or more sounds, a “-” is added to the NSA stem (i.e.,NSA- or {NSA-}).Fourth, when young children (aged 2 years to 5 years11 months) meet criteria for SD, but would not be classified as SD if they were one year younger, the SD classification is prefixed by Questionable (i.e., QSD).Fifth, when an older (9 years) speaker’s error pattern is between NSA and one of the RE types, the classification is enclosed in square brackets to indicate that itis a marginal classification (e.g., [RE-A1]). For youngerchildren, marginal classifications are subsumed by either {NSA} or NSA/SD.Sixth, when a speaker’s error pattern includes uncommon clinical distortions in over 20% of words (seelist of uncommon distortions in Shriberg, 1993), the suffix “ ” is added to the classification stem (e.g., SD , REA1 ). A square bracket around the “ ” (e.g., SD[ ]) indicates that only 10% to 20% of the words in the samplecontain these distortions.Thus, in combination, these six conventions lead toseveral variants of each main classification type (e.g.,{NSA-}*, QSD[ ], NSA–/SD! [RE-A2][ ]). For particular clinical and research applications, such classification detail is ignored or retained, depending on validity, reliability, and efficiency needs. For example, thesample reference data to follow does not differentiateamong the prevalence percentages for bracketed versus unbracketed classifications.Lifespan Reference DataArticulation Competence MeasuresA companion paper (Shriberg, Austin, et al., 1997)describes 10 measures of articulation competence thatcan be calculated from a conversational speech sample.Rationale is provided for the following alternatives tothe Percentage of Consonants Correct (PCC): Percentage of Consonants Correct–Adjusted (PCC-A), Percentage of Consonants Correct–Revised (PCC-R), Percentage of Consonants in the Inventory (PCI), ArticulationJournal of Speech, Language, and Hearing ResearchJSLHR, Volume 40, 723–740, August 1997Competence Index (ACI), Percentage of Vowels/Diphthongs Correct (PVC), Percentage of Vowels/DiphthongsCorrect–Revised (PVC-R), Percentage of Phonemes Correct (PPC), Percentage of Phonemes Correct–Revised(PPC-R), and the Intelligibility Index (II). For each ofthe consonant measures (PCC, PCC-A, PCC-R, ACI,PCI), subscale data are also provided by developmentalsound class (Early-8, Middle-8, Late-8). Transcriptionreliability data and standard error of measurement dataare provided for all measures and submeasures (including reliability of SDCS classification) with the exception of the Intelligibility Index.A brief review of the characteristics of some of thesemeasures is important to the discussion of the reference data. For three “original” measures of consonants(PCC), vowels (PVC), or phonemes (PPC) “revised”measures have been derived (i.e., PCC-R, PVC-R, PPCR). For consonants, there is also an “adjusted” measure (PCC-A). The original, revised, and adjusted measures differ in the way they score speech-sounddistortions. The original measures score all omissions,substitutions, and distortions as errors, whereas therevised measures score only omissions and substitutions as errors. The PCC-A makes a further distinction, dividing distortion errors into common clinical distortions and uncommon clinical distortions, and scoringonly omissions, substitutions, and uncommon clinicaldistortions as errors.DatabaseSince approximately 1980, essentially similar conversational speech protocols and data reduction procedures have been used to obtain, transcribe, and formatspeech samples from children and adults for computerized analyses (cf. Shriberg, 1986, 1993; Shriberg & Kent,1982, 1995; Shriberg & Kwiatkowski, 1980, 1982, 1983,1985; Shriberg, Kwiatkowski, & Hoffmann, 1984). Inaddition to cross-sectional and follow-up studies conducted in Madison and several other cities in Wisconsin, conversational speech samples from children andadults have been collected in collaborative research inseveral states. With few exceptions, the demographiccharacteristics of speakers from these sites are middleclass, monolingual English-speaking children and adultsspeaking General American dialect. From an initial database of 1,386 conversational speech samples, referencesamples for each of the 10 speech measures to be reported were assembled in three steps.First, the database was searched to eliminate conversational samples from children and adults withknown developmental disability, cognitive disability,craniofacial anomaly, and/or sensory-motor problems.Additionally, if more than one conversational speech
727Shriberg et al.: The Speech Disorders Classification System (SDCS)sample was available from a speaker (e.g., from a treatment or longitudinal study), the sample selected for inclusion was either the earliest, the most linguisticallyrepresentative, or the sample that best met cell sizeneeds for each subgroup in the reference data.reported. The SDCS program classified a conversationalspeech sample from each of 836 speakers into one of thecells in Table 1. For 3- to 8-year-old children, cell sizesare reported for single-year age groups and for combinedgroups of 3- to 5-year-olds and 6- to 8-year-olds. For the657 children aged 3 years to 8 years 11 months, cell sizesfor the NSA group range from 7 (8-year-old boys andgirls) to 59 (5-year-old boys). For the 179 older childrenand adults, cell sizes for the NSA group range from 5 (9to 11-year-old girls) to 42 (18- to 39-year-old women).Second, for each age from 3 years to 8 years, conversational samples from four subgroups of childrenwere assembled based on their SDCS classification: NSA,NSA/SD, SD, and QRE. (Only 6- to 8-year-old childrenare eligible for classification as QRE.) All bracketedSDCS classifications and “ ” and “–” suffixes were disregarded, and QSD and SD classifications were combined. Four classification groups of older children andadults were also assembled: NSA, RE-1, RE-2, and RE3. SDCS classifications were combined across bracketsand suffixes, as were RE-A (history of speech delay) andRE-B (no history of speech delay) classifications.Again, it is important to underscore that the reference data for these speakers are purposefully definedby SDCS classification categories, rather than by history of speech involvement, history of speech normalization, or suspected etiologic subtype. This procedureassures a standard definition for NSA and the disordercategories, rather than relying on clinical experience andhistorical data to define which speaker is normal andwhich is disordered. Thus, data for speakers coded NSA(normal or normalized speech acquisition) reflect performance from both control subjects in several studies(including adult family members of children with speechdisorders) and speech-disordered subjects whose speechhad normalized at the tested age. Speakers meetingSDCS criteria for SD were referred by speech-languagepathologists, recruited as subjects, or identified as SDby the SDCS in the course of a study (e.g., a sibling ofan SD child). As noted above, the many demographicThird, to maximize the validity of the NSA, NSA/SD, and QRE subgroup data, conversational samplesfor children with these SDCS classifications were excluded if there were fewer than 100 usable words in thesample. Because the SDCS program uses conservativecriteria in making classification assignments (the default is NSA), a sample that was too brief might nothave contained a sufficient number of tokens to be classified reliably as one of the SDCS disorder categories.Table 1 summarizes cell sizes by age, gender, andSDCS group for the final set of reference data to beTable 1. Cell sizes for the reference data by age, SDCS classification, and 1657Ages 3:0 119242427322179Ages 9:0 –40 9–11:1112–17:1118–39:1140 339340185110785111510001Journal of Speech, Language, and Hearing Research
728constraints relative to standard test development andepidemiological considerations require that the information assembled from these database samples be viewedas reference data, rather than as normative data. Thus,they provide only guidelines for use of the 10 measures.We caution readers against unquestioned use of thesereference data for clinical decision making or for controldata in research studies.Statistical AnalysesA series of statistical a
1997, American Speech-Language-Hearing Association 1092-4388/97/4004-0723 Journal of Speech, Language, and Hearing Research 723 A previous paper provided rationale and validity data for a clini-cal classification instrument titled the Speech Disorders Classi fication System (SDCS; Shriberg, 1993). The present report pro-
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