How do children learn to speak so their intended meaning is understood readily by listeners? For many children, this remarkable process happens without apparent effort before they enter school. However for 3-4% of children, this process presents a considerable challenge.

There are many reasons why some children do not develop intelligible speech. Some reasons are known, for example, when a child has a considerable hearing loss or the speech muscles (e.g., lips, tongue, soft palate) are paralyzed. In other cases there is no obvious reason why a child fails to develop intelligible speech by the end of the preschool years. Regardless of the cause, reduced speech intelligibility has major implications for children’s social development, academic progress and future career choices.

Megan Hodge, Network researcher at the University of Alberta, is working with her project team to create a computer-based, functional assessment tool that will measure how well children with serious speech impairments make their words understood. This new software package, named the TOCS+, will allow speech pathologists to measure a child’s speech intelligibility in a direct, standardized, time-efficient way. It is being designed so that the results identify effective ways to increase a particular child’s speech intelligibility. These results will be linked with treatment modules to increase speech intelligibility that can be used by clinicians and families. The initial version will be in English. However, future plans include collaborating with Network partners to develop a French version as well.

"My experience with an earlier analog form of the TOCS has convinced me of its potential value," says Hodge. "In one case, the parents of a young girl noticed a lack of facial expression at 11 months. At 18 months, hearing loss was diagnosed. Later, the child was found to have a progressive muscle wasting disease that caused permanent facial paralysis. Because she could not move her lips, she could not smile or use her lips to make speech sounds. I used an earlier version of the TOCS to identify new possibilities to increase her speech intelligibility and to measure her success in using these at regular intervals over a five-year period. These strategies included using whole sentences as opposed to single words, using her tongue in unique ways to make sounds that sounded like lip sounds, making her vowel and consonant sounds as distinctive as possible for listeners who were not familiar with her speech, and using letters of the alphabet to give listeners more information when communication breakdowns occurred. She is a remarkable child. Our TOCS measures showed that she increased her sentence intelligibility to 95% and was able to maintain this. More sophisticated acoustic analyses of her recorded TOCS productions showed just how well she was able to compensate for her lip paralysis by using her tongue in new ways."

Hodge’s research program and the new computer application will enable professionals to measure young children’s speech intelligibility directly in a reliable, valid, time-efficient manner, and to help children maximize their success in making their spoken messages understood. This new, shared knowledge and timesaving tool should increase the chance that every Canadian child will become a successful communicator.