Validity of Parent Ratings of Speech Intelligibility for Children with Cerebral Palsy.
Ashley Sakash, Tristan Mahr, Katherine C Hustad
PMID 33100123WHAT IT FOUND
Parent ratings of speech intelligibility are valid for children at the extremes of severity but unreliable for those in the middle.
A parent rating of 3 or 4 could correspond to intelligibility scores ranging from 4% to 98%. Use objective measures alongside parent report.
Key findings
01Parent ratings of 1 and 7 were associated with narrow ranges of objective intelligibility scores (80-99% and 2-37% respectively), suggesting validity at the extremes.
02Parent ratings in the middle of the scale (2-5) showed marked variability in objective intelligibility scores, with ranges up to 94% within a single rating level.
03There was no significant difference in average parent ratings between the mild-moderate and severe intelligibility reduction groups, despite clear differences in objective scores.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Small sample size (50 children total, with group sizes of 14-21). Severity groups were defined based on previous work, not a widely accepted standard, which may affect generalizability. The study used a single holistic question ('How understandable is your child to others?') rather than breaking down ratings by context or partner. The 7-point scale may be too fine-grained for parents to use reliably. The study did not examine how current speech and language therapy services might influence parent perceptions.
Declared interests
The authors have no financial relationships or conflicts of interest to disclose.
The easy way to misread this
Do not assume that a parent's rating of intelligibility accurately reflects their child's objective speech clarity for children in the middle of the severity spectrum. A rating of 3 or 4 can encompass a huge range of actual intelligibility (e.g., 4% to 98%), meaning parent report alone is insufficient for clinical decision-making in these cases.