Frontiers in pediatrics
Par Lee J, Kwon S, Ko JY et 4 autres.
Contenu en anglais
Digital approaches to articulation assessment are increasingly proposed to expand access to speech-language evaluation, yet the comparability of speech performance elicited by digital and conventional word lists across age groups remains insufficiently understood.
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This study assessed age-specific agreement between Hi-DongDong word list, a novel digital articulation assessment instrument, and the Urimal Test of Articulation and Phonology 2 (UTAP-2), the standard reference in South Korea, in 505 typically developing Korean children aged 2-13 years. Each child's audio recordings were scored by three independent speech-language pathologists on both instruments. Agreement for consonant accuracy measures-Percentage of Consonants Correct (PCC), its revised form, and their totals-and for whole-word correctness was evaluated using intraclass correlation coefficients (ICC), Bland-Altman bias and limits of agreement (LoA), and linear mixed-effects models.
Inter-rater reliability was excellent for all metrics (ICC ≥ 0.995). At the population level, no significant instrument-by-age or instrument-by-age² interactions were observed, indicating that the age-related developmental trajectories did not differ significantly between Hi-DongDong and UTAP-2, although PWC showed a significant main effect of instrument, with lower scores for Hi-DongDong than UTAP-2 at the mean-centered age. Individual-level agreement, however, was strongly age-dependent. Low ICC values at ages 9 and 12 co-occurred with narrow LoA and ceiling-compressed scores, identifying them as artifacts of variance restriction rather than true disagreement. In contrast, ages 4 and 7 showed low ICC with wide LoA, reflecting genuine measurement divergence during periods of rapid or transitional phonological development. Among school-age children (7 years and older), bias was negligible (within ±1 percentage point) and LoA were narrow (approximately 8-24 percentage points), whereas preschool-age children showed substantially wider individual-level LoA. Hi-DongDong additionally sustained discriminative sensitivity for both consonants and vowels-including diphthongs-across a wider developmental range than the monophthong-only UTAP-2.
These findings support the use of Hi-DongDong as a complementary articulation word-list assessment across development, while underscoring that the present study evaluated clinician-scored agreement between word lists rather than automated diagnostic performance. Clinical trial registration: https://clinicaltrials.gov/study/NCT07273370?term=NCT07273370&rank=1, NCT07273370.
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