Vowel Patterns in Developmental Apraxia of Speech: Three Longitudinal Case Studies

Clinical Linguistics & Phonetics, June 2005; 19(4): 249–274
Vowel patterns in developmental apraxia of speech: three

longitudinal case studies
BARBARA L. DAVIS, ADAM JACKS, & THOMAS P. MARQUARDT
The University of Texas at Austin, TX, USA

Clin Linguist Phon Downloaded from informahealthcare.com by UB Wuerzburg on 11/01/14
(Received 6 May 2003; accepted 17 February 2004)
Abstract
Vowel inventories and error patterns for three children with suspected developmental apraxia of
speech (DAS) were analysed over a 3-year period using phonetic transcriptions of connected speech
samples. The children demonstrated complete English vowel inventories except for rhotics. However,
accuracy of vowel targets in connected speech did not normalize during this period. No consistent
For personal use only.
patterns of vowel errors were found. There was no decrease in vowel accuracy with increased
utterance length or syllable complexity. Findings indicate persistence of vowel inaccuracy in the
presence of a relatively complete vowel inventory. This longitudinal data can help to build consensus
on use of vowels as a potential clinical marker for differential diagnosis of DAS.
Keywords: Vowel disorder, apraxia of speech, articulation disorder, developmental speech disorder
Introduction
Developmental apraxia of speech (DAS) is a speech disorder characterized by deficits in
speech motor planning for sequenced speech output in the absence of overt neuromuscular
impairment (e.g. Hall, Jordan, & Robin, 1993). Researchers investigating DAS have failed
to reach consensus on a number of important issues, including etiology, clinical symptoms
for differential diagnosis, and effectiveness of assessment procedures and treatment
approaches (see Davis, 2003, for a review). In the absence of decisive evidence supporting a
precise etiological origin for DAS, careful description of potentially distinctive clinical
characteristics is a critical first step to developing assessment and intervention procedures
and for constructing a theoretical framework for the disorder.
Clinical diagnosis of DAS is controversial, with identification most frequently based on a
group of behavioural correlates including a reduced phonemic repertoire, inconsistent
errors, prosodic abnormalities, and vowel errors (Davis, Jakielski, & Marquardt, 1998;
see Guyette, & Diedrich, 1981 for a critique of differential diagnosis of DAS). Other
characteristics associated with DAS include persistence of clinical symptomatology
(Ekelman, & Aram, 1983; Byrd, & Cooper, 1989; Thoonen, Maassen, Gabreels, &
Schreuder, 1994) and difficulty in sequencing movements in speech (e.g. Velleman, &
Correspondence: Barbara L. Davis, Department of Communication Sciences and Disorders, The University of Texas at Austin,
Austin, TX 78712, USA. E-mail: babs@mail.utexas.edu
ISSN 0269-9206 print/ISSN 1464-5076 online # 2005 Taylor & Francis Ltd
DOI: 10.1080/02699200410001695367
250 B. L. Davis et al.
Strand, 1994). Due to the uncertainty surrounding the diagnostic category, we will refer to
children with clinical diagnosis of DAS as children with suspected DAS (Shriberg, Aram, &
Kwiatkowski, 1997)
Although vowel errors have been cited frequently as a characteristic feature of DAS
(Morley, 1959; Rosenbek, & Wertz, 1972), detailed clinical descriptions of vowel patterns
in children with DAS are few (Pollock, & Hall, 1991; Smith, Marquardt, Cannito, & Davis,
1994; Davis et al., 1998) and no studies have documented the persistence of vowel disorder
in children with DAS over time. Furthermore, to date no studies have explored the effects
of word and utterance level complexity on vowel errors that may result from deficient
sequential movement patterns.
Claims that unusual vowel production is distinctive for DAS are not founded on in-depth
clinical analyses of children diagnosed with the disorder. Examination of vowel production
patterns in children with DAS, the persistence of vowel disorder over time, and the effects
of complexity on vowel production will provide helpful information for evaluating the
relevance of vowels in clinical description of DAS. The goal of the current study is to
provide detailed longitudinal description of vowel inventory and accuracy patterns relative
to contextual complexity in three children who have been clinically diagnosed using
the DAS label to examine persistence of vowel errors over time in spite of ongoing
remediation.
Vowels have been less studied than consonants in speech acquisition of typically
developing children (although see Ball, & Gibbon, 2002; Selby, Robb, & Gilbert, 2000).
Typical developmental milestones form a crucial backdrop for consideration of the

relevance of vowels as a potential clinical marker for DAS. Key findings from studies of
vowel inventories and accuracy in typically developing children are summarized in table I.
Most studies include phonetic transcription of vowels in babbling and early words. Ages
range from 16 weeks to 36 months. Studies have included both longitudinal (Davis, &
MacNeilage, 1990; Otomo, & Stoel-Gammon, 1992; Tyler, & Langsdale, 1996; Selby
et al., 2000; Davis, MacNeilage, & Matyear, 2002) and cross sectional (Pollock, 2002) data
in spontaneous (Davis, & MacNeilage, 1990; Davis et al., 2002) and elicited (e.g. Pollock,
2002) contexts. Two studies (Davis, & MacNeilage, 1990; Selby et al., 2000) also analysed
both intelligible and unintelligible vocalizations, to evaluate the contribution of
unintelligible utterances to understanding the full dimensions of phonetic production
abilities in very young children.
An overview of developmental studies suggests that the vowel inventory is complete by 24
months in typically developing English-learning children, with at least nine non-rhotic
monophthongs present. Some studies suggest that the inventory may be complete by 14
months or earlier (Buhr, 1980; Kent, & Bauer, 1985; Davis, & MacNeilage, 1990).
However, Tyler and Langsdale (1996) reported less complete vowel inventories as late as
24 months (cf. table I), although their findings may be related to fewer tokens analysed.
Differentiation of vowels varying in features other than place (e.g. laxness, rounding) and
infrequently used vowels in English (low-back round vowels) may show a prolonged course
of development, but all areas of the vowel quadrant appear to be represented in the
inventory. Large-scale longitudinal studies would help to establish the earliest age of
acquisition of the vowel inventory more firmly, although available studies suggest early
acquisition of vowel types in English with the exception of rhotics.
While some studies analyse only inventories, vowel accuracy has been analysed in
children as young as 14 months of age. Generally, vowel accuracy improves between 1 and
2 years of age. In a case study of one English learning infant from 14–20 months, Davis and
Table I. Summary of vowel production studies in typically developing infants
Completeness of Vowel Frequency

Author Age n Study type Vowel Inventory of Occurrence Vowel Accuracy
Buhr (1980) 16–64 weeks 1 Acoustic analysis and 37 wks: all vowels produced [e]: 31%, [æ]: 17%, Not reported
phonetic transcription 41 wks: good acoustic [ı]: 12%, [‘]: 11%,
of 944 spontaneously separation btw vowels [u]: 11%, [i] [e] [a]: 5%
produced vowels
(babble)
Davis and MacNeilage 7–12 months 6 Phonetic transcription; 7–12 mo.: 9 vowels .10% Front: 43%; high: 29%; Not reported
(1995) 15,709 vowels (range freq.; [i] [c] [o] always central: 42%; mid: 40%;
1,411–3,514 across ,10% freq. back: 14%; low: 29%
participants) in babbling
Davis, MacNeilage and 9–25 months 10 Phonetic transcription; Not reported Front: 36%; Not reported
Matyear (2002) 9218 vowels (range central: 38%;
396–3,118 across back: 24%; min.
participants) in difference in freq of
spontaneous single words vowel height
Oller and Eilers (1982) 12 months 16 Phonetic transcription of 12 months: all vowels Frequencies for English, Not reported
spontaneous babbling present Spanish
utterances (.50 per child) [e]: 14%, 15%; [æ]: 22%,
for English- and Spanish- 15%;
learning infants [e]: 8%, 12%; [i]: 9%,
11%;
Vowels in DAS
[a]: 8%, 10%
Kent and Bauer (1985) 13 months 5 Phonetic transcription 13 months: all vowels [‘/e]: 46%; [e]: 22%; Not reported
1,170 isolated vowels in present [æ]: 8%; [u]: 6%;
spontaneous babble [e] [a] [o]: ,5%
251
252
B. L. Davis et al.
Table I. (Continued )

Davis and MacNeilage 14–20 months 1 Phonetic transcription; 20 months: all vowels (monosyll. words and (words only)
(1990) 16,908 vowels in present babble)
spontaneous babble and [a] [e] [o]: .10%; [u] [o] [i] [ı]: 75–89%
single words [i] [ı] [æ] [‘] [u] [u]: [u] [c] [æ] [a] [e]:
5–10%; 42–69%
[e] [e] [e]: ,5% [e] [e] [e]: 15–30%
Tyler and Langsdale 18–24 months 15 Mixed longitudinal/cross- 18 mo.: five vowels most common- 18 mo.: 59% acc.
(1996) sectional study (n55 at represented;

three times); Phonetic 24 mo.: nine vowels in 5/5 low-back, high-front, 21 mo.: 71% acc.
transcription of elicited children; 11 vowels in 4/5 low-front,
or repeated words; total children; [c] produced least common- 24 mo.: 73% acc.; most
917 vowels by 1/5 high-back, mid-front errors within same
area of vowel space
(lax/tense)
Otomo and 22–30 months 6 Longitudinal study; Not reported Not reported 22 mo.: .50% acc. for
Stoel-Gammon Phonetic transcription of [i] [a]
(1992) 900 elicited unrounded 26 mo.: >70% acc. for
vowels [i] [I] [e] [e] [æ] [i] [a] [æ] [e]
[a] 30 mo.: >70% acc. for
[i] [a] [æ] [e]
Lowering- most freq.
error at all times;
raising and
centralization at
22 mo.
Table I. (Continued )

Selby, Robb, and 15–36 months 4 Longitudinal study; 15 mo.: 4 vowels 15 mo.: lax vowels Not reported
Gilbert (2000) Phonetic transcription of represented in 3/4 children present
1,404 vowels in 18 mo.: 7 vowels 18 mo.: tense vowels and
spontaneous babble and corner vowels

words; reported vowels 21 mo.: 8 vowels 24 mo.: 8 cardinal vowels
present in 3 of 4 children all present
[ı e e æ a c o u]
24 mo.: 9 vowels present 36 mo.: all English
vowels present
36 mo.: 12 vowels
Pollock (2002) 18–82 months 162 Phonetic transcription PVC-NR
of vowels in single- 18–23 mo.: 82%
word elicitations, 24–35 mo.: 92–94%
story-retelling, and 36–83 mo.: 97–99%
controlled imitation PVC-R
18–29 mo.: 24–38%
30–35 mo.: 63%
Vowels in DAS
36–83 mo.: 77–90%
253
MacNeilage (1990) found that accuracy varied by vowel category, with best accuracy for
[i, I, u, o] at 75–89% and poorest for [i, e, e] at 15–30%. Tyler and Langsdale (1996)
reported improved average vowel accuracy from 59% at 18 months to 73% at 24 months in
elicited or repeated tokens produced by 15 children. At 3 years, Templin and Darley
(1969) found 91% accuracy for monophthongs in 60 children using elicited productions in
an articulation test format. Otomo and Stoel-Gammon found that /i/ and /e were mastered
early and /i/ and /a/ were the least accurate in their study of six children 22–30 months of
age using a picture naming task. A large cross-sectional study of 162 normally developing
children showed approximately 82% accuracy by 18–23 months (ten children) and 92% by
24–29 months (18 children) in elicited speech contexts (Pollock, 2002).
Based on the available data, errors in this developmental period tend to be substitutions
in the same region of the vowel quadrant (e.g. Davis, & MacNeilage, 1990; Tyler, &
Langsdale, 1996), as well as frequent neutralization of non-central vowels (e.g. Otomo, &
Stoel-Gammon, 1992) and mutual substitution of high back and high front vowels (Davis,
& MacNeilage, 1990). Overall, vowel production in young children seems to be largely
accurate by 3 years, despite category-specific errors in younger children. Variability in
accuracy has been noted both across children and across vowel types by a number of
investigators (e.g. Davis, & MacNeilage, 1990; Otomo, & Stoel-Gammon, 1992; Pollock,
2002) and should be included in understanding patterns of vowel accuracy during typical
development in this early period, especially as variability has been another frequently cited
clinical characteristic of DAS (Smith et al., 1994; Thoonen, Maassen, Gabreels, Schreuder,
& de Swart, 1997, Marquardt, Jacks, & Davis, 2004).

Vowels have also been less studied than consonants in children with developmental
speech disorders (although see Ball, & Gibbon, 2002). Several case studies of children with
vowel errors are available, including children with phonological disorder (PD) (Stoel-
Gammon, & Herrington, 1990; Gibbon, Shockey, & Reid, 1992; Robb, Bleile, & Yee,
1999), unspecified severe speech disorder (Hargrove, 1982), and DAS (Davis et al., 1998).
In addition, several studies document vowel patterns in larger groups of children with PD
(Reynolds, 1990, n520; Pollock, & Keiser, 1990; n515; Pollock, 2002; n5121) and DAS
(Pollock, & Hall, 1991; n55). Findings of vowel inventories and accuracy from these
studies are summarized in table II.
Results indicate that children with clinical speech disorders have relatively complete
vowel inventories, including children with DAS and PD. Some case studies of children
diagnosed with PD show complete vowel repertoires for non-rhotic monophthongs
(Hargrove, 1982; Gibbon et al., 1992), while others report incomplete vowel inventories
(Stoel-Gammon, & Herrington, 1990; Robb et al., 1999). Pollock and Keiser (1990) report
ten of 15 children with complete monophthong inventories, with five of 15 children
omitting one or more vowels, including /e, c, u/ as well as rhotic vowels. In the two studies
of larger cohorts of children (Reynolds, 1990; Pollock, 2002), variability in the
characteristics of vowel errors within and across children was noted. The Pollock (2002)
study was a cross sectional analysis of elicited tokens and the Reynolds study (1990) was a
longitudinal analysis of spontaneous tokens. Because of these different methodologies,
generalizations, even across these larger cohorts, is difficult. As in the vowel inventories of
typically developing children, when inventories were incomplete for children with PD, all
areas of the vowel space were well represented, with omissions occurring for infrequently
used vowel categories (e.g. /c/) or those representing the tense/lax distinctions (e.g. /e, u/).
Two studies of vowels in DAS (Pollock, & Hall, 1991; Davis et al., 1998) found complete
inventories except for diphthongs and rhotics.
Table II. Summary of vowel production studies in developmental speech disorders
Author Diag-nosis C.A. N Inventory Accuracy Error types

Pollock and Keiser PD 3;8–6;4 15 10/15: no monoph. overall PVC 54–98% backing1 37%,
(1990) omissions;
5/15 with monoph. 7/15 PVC-NR .90% lowering 30%;
omissions:
[ı, æ, u, e, e];
2/15 diphthongs absent 3/15 PVC-NR ,75% diphthong errors 28%;
most correct: [i a c] de-rhoticization
most in error: [au æ u]
Stoel-Gammon and PD 3;8, 4;2 2 omission of [e, c, u, e]; 38%, 47% accuracy for Substitutions common for
Herrington (1990) some diphthongs monophthongs vowels not in inventory by

present stable vowel categories;
de-rhoticization
Reynolds (1990) PD Not Reported 20 Most frequent: Mid-front Not reported Common error patterns include:
vowels [e eı], diphthongs,
triphthongs, central vowel
Least frequent: high vowels, Lowering of midfront vowels
low back vowels, and high vowels
unstressed vowels Fronting of low back vowels to
mid back vowels
Diphthong reduction,
Decentralization of central vowels
Gibbon, Shockey and PD 4;0 1 No non-rhotic monoph. post-treatment: improved diphthong reduction, lowering
Reid (1992) omissions; 4/7 diphthongs accuracy for high vowels
Vowels in DAS
omitted [eı aı eu cı]
Robb, Bleile and Yee PD 4;0 1 Pre-treatment: 5-vowel Pre-treatment PVC: vowel substitutions usually
(1999) inventory 48% [ı æ] 100% acc. [ı, æ, ‘, a] (100% accurate
Post-treatment: 7-vowel Post-treatment PVC: vowels)
inventory (omitted 80% [a u] 100% acc.
[e, c, u, ‘])
255
256
B. L. Davis et al.
Table II. (Continued )
Author Diag-nosis C.A. N Inventory Accuracy Error types

Pollock (2002) PD 30–81 months 121 Reported for one child: PVC-NR:
full inventory of back and 30–35 mo. 78%
central vowels; limited 36–83 mo. 89–98%
front inventory PVC-R
30–35 mo. 0%
36–83 mo. 29–68%
Hargrove (1982) Artic. disorder 4;7 1 No non-rhotic PVC: ,60% De-rhoticization, raising, fronting,
with lingual monophthong omissions PVC-Front: 81%; tensing, lowering, vowel harmony
apraxia Back: 69%;
Central: 19%;
High: 85%;
Low: 60%; Mid: 51%
Pollock and Hall DAS 8;2–10;9 5 5/5: No non-rhotic monoph. PVC-NR: 56–96% laxing1 20%, backing 14%, tensing
(1991) Omissions 12%; diphthong reduction 28%
4/5: Diphthongs present PVC-R: 0–12%
1/5: Rhotics present
Davis, Jakielski and DAS 5;7 1 No non-rhotic monoph. [u u o c]: .90% acc. Diphthong reduction; no clear
Marquardt omissions; [au aı] present [i ı e e æ ‘]: 70–85% acc. pattern of vowel error types
(1998) [cı] absent [a, e]: 50% acc.
Note: PD5Phonological Disorder; DAS5Developmental Apraxia of Speech; PVC5Percentage of Vowels Correct; PVC-NR5PVC-Non-Rhotic; PVC-R5(PVC-Rhotic);
1
Frequency of occurrence represents percentage of monophthong errors.
Vowels in DAS 257
Vowel accuracy varied extensively across studies, with lowest reported accuracy for a
child with PD (age 3;8 years, 38% accuracy, Stoel-Gammon, & Herrington, 1990). In
contrast, seven of 15 children with PD in the Pollock and Keiser (1990) study showed
accuracy of 90% or greater for non-rhotic vowels. Similar variation in accuracy was
reported for the five children with DAS in the Pollock and Hall (1991) study (56–96%),
while Davis et al. (1998) found that accuracy varied by vowel category in their DAS case
study. Pollock (2002) reported mean accuracy of 77% at 36–41 months and 96%
accuracy by 78–83 months for her cohort of PD children. Reynolds (1990) did not report
group data for vowel accuracy in his study of 20 children, concentrating instead on
case study example data for various within and across child patterns (e.g. fronting or
lowering)
Vowel error types reported in children with PD and unspecified speech disorder appear
to be quite varied across studies in addition to varied methodologies and low number of
participants in many studies. These differences preclude clear generalizations on available
data. However, a few preliminary generalizations can be made about error patterns. Rhotic
vowels are poorly produced, although they were present in the inventories of some of the
participants. Other commonly observed patterns of vowel substitutions included backing
and lowering. Diphthong reduction and diphthongization errors were present in some but
not all children. In addition, Stoel-Gammon and Herrington (1990) and Robb et al. (1999)
found that vowel types produced more accurately tended to be the substituting segment
when other vowels were in error.
In children with DAS, Pollock and Hall (1991) and Davis et al. (1998) reported absence
of any clear pattern of vowel feature errors. Pollock and Hall reported most frequent error
types of laxing, tensing, backing, and lowering of vowels. However, the most frequent error
class (laxing; 20% of all feature errors) was not much more frequent than backing or
tensing (with frequencies of 14% and 12%, respectively). In contrast, children with PD in
the Pollock and Keiser (1990) study made mostly backing and lowering errors, with
frequency of occurrence of 37% and 30%, respectively. Extensive diphthong reduction in
children with DAS was reported by Davis et al. and Pollock and Hall, more frequent than
any feature error in the Pollock and Hall study (viz. 30 occurrences) and occurring in 29%
of opportunities for /aI/ in the Davis et al. case study.
Previous reports have suggested that DAS is marked by breakdowns in accuracy with
increased length (Rosenbek, & Wertz, 1972; Yoss, & Darley, 1974) or complexity (Morley,
1959). Hargrove (1982) found a length effect on vowel production in a child with severe
speech disorder and lingual apraxia, with 77% vowel accuracy in words with one vowel and
29% accuracy in words with two or more vowels. Analysis of vowel production in children
with suspected DAS should account for contextual effects on vowel production (e.g. length
of phrase, syllable complexity).
Studies of vowel disorder in children with suspected DAS and those diagnosed with
other developmental speech disorders (e.g. PD) are suggestive of potential differences in
the nature of vowel error patterns in the distinct disorders. In particular, inconsistency of
vowel error patterns in DAS may reflect generalized speech variability, which has been
frequently suggested as another clinical marker for differential diagnosis of DAS (for a
detailed study of token-to-token variability in the three children studied here, see
Marquardt et al., 2004). However, the assertion that DAS and PD differ in vowel
production patterns is based on few studies. Careful comparative study of vowel production
using consistent methodologies in various disorders is needed to evaluate the potential
power of persistent vowel errors as a differential diagnostic marker for DAS.
While vowel errors continue to be frequently listed as a differential diagnostic marker for
DAS, few clinical descriptions of vowel inventories or patterns of vowel errors in children
diagnosed with DAS have been reported. Detailed longitudinal clinical analysis of vowel
inventories and error patterns in children with suspected DAS will help to determine
whether persistent vowel errors are present in these children. This type of information is an
important first step in pursuing needed comparisons with PD children for establishment of
differential diagnostic markers for DAS.
The goal of the current study is to provide detailed description of vowel inventories and
accuracy patterns for three children with suspected DAS. The following questions will be
addressed by longitudinal yearly analysis across a 3-year period for each child:
1. Does the vowel inventory change?
2. Does vowel accuracy change?

3. How is vowel accuracy related to vowel inventory?
4. How is vowel accuracy affected by complexity at the word and utterance levels?
Method
Participants
Three English-speaking1 male children (P1, P2 and P3) referred for differential diagnosis of
developmental apraxia of speech (DAS) participated in the study. Each of the children was
referred by certified speech-language pathologists (SLPs) for a second opinion on the

diagnosis of DAS. A team of three SLPs in a university clinical setting confirmed the
diagnosis. The diagnosis of suspected DAS was based on identification of a cluster of
speech and language characteristics typical of the disorder, including prosodic abnorm-
alities, vowel errors, high frequency of consonant and syllable omissions, and segmental
variability (Davis et al., 1998). When available, previous assessments of hearing, cognition,
and expressive and receptive language were used to establish participant status. All
participants demonstrated auditory acuity within normal limits bilaterally based on pure
tone audiometric screening at octave frequencies from 250 Hz to 4000 Hz. Review of
clinical records revealed no positive history for fluctuations in auditory acuity due to middle
ear disorders. An oral mechanism examination, diadochokinetic tasks, and informal oral
and limb praxis tasks revealed no obvious signs of structural or neuromuscular impairment.
Vowel production data was taken from a larger study tracking longitudinal change of
speech production. Following diagnosis, participants were assessed at 1-year intervals
(Time 1, Time 2 and Time 3) between the ages of 4;6 and 7;7. The assessment included
articulation testing and spontaneous speech sampling.
1
The phonological characteristics of Southern American English (SAE) as spoken by Texans have been studied in some depth (see
Bailey, & Bernstein, 1989; Bailey, & Tillery, 1996; Thomas, 1997). Common vowel differences between Texan English and Standard
English include (1) merger of [i] and [ı] before [l] (e.g. ‘field’ R [fıld]), (2) [e] and [e] before [l] (e.g. ‘bale’ R [bel]), (3) merger of [ı] and
[e] before [n] (e.g. ‘pen’ R [pın]), (4) merger of [a] and [c] (e.g. ‘caught’ R [kat]) and (5) monophthongal [aı] before voiceless
obstruents (e.g. ‘right’ R [rat]). Occurrence of dialect features has been shown to vary by area of residence (metropolitan vs. rural)
(Bailey, & Bernstein, 1989; Thomas, 1997). In particular, an acoustic study of Texas Anglo high school students showed lower F2
offset values of /aı/ for rural speakers than metropolitan speakers, suggesting monophthongization in the former group but not in the
latter (Thomas, 1997). Our participants lived in urban regions of Texas and their parents were judged to have minimal Texan accent.
We believe that the participants’ spoken accents are representative of Standard American English and therefore do not affect the
results of the vowel analyses.
Vowels in DAS 259
Participant descriptions. Speech profiles for participants are shown in table III, including age
at each assessment, scores on single-word articulation tests, and accuracy of consonant and
vowel production from connected speech samples. Relational analyses of consonants and
vowels were based on speech samples collected at each time. Participants’ speech and
language histories are described below.
Participant P1
P1 had a normal developmental history with the exception of speech and language,
producing his first word at 22 months. He was diagnosed with DAS at the age of 3;8.
Neurological evaluation revealed mild dysarthria and oral apraxia. Between the ages of 3;5
and 5;0, speech and language evaluations indicated auditory comprehension generally
within normal limits, although below average for elaborated sentences. In this period,
speech production was characterized by a limited number of consistent word forms,
restricted phonetic repertoire, rudimentary syllable shapes, and reduced ability to imitate
nonverbal movements of the speech mechanism. P1 began receiving speech and language
therapy at 2;2 and continued in treatment at the time of this study. Initially treatment
focused on increasing the accuracy of verbal communication with supplementary use of
sign and communication boards to facilitate language and cognitive development.
Subsequently, goals were to expand the phonemic repertoire, stabilize consistent sound
production, and increase the use of more complex syllable shapes in words and phrases. P1
was seen for follow-up evaluations at the ages of 4;6, 5;5 and 6;5 years, making continuous
gains in single-word articulation (see table III).
Participant P2
P2 had a normal developmental history with the exception of speech and language. Speech
and language evaluations at the age of 2;6 revealed severe deficits in receptive and
expressive communication, respectively. P2 was diagnosed with DAS at the age of 5;0.
At that time, his receptive language was within normal limits although his speech was
Table III. Participant data: age, articulation test results, and percent accuracy of consonant and vowel production
at three times
Time 1 Time 2 Time 3

P1 Age 4;6 5;5 6;5
Articulation Test Profound1 3rd %ile2 31 %ile3
Consonant Accuracy 71 61 76
Vowel Accuracy 61 72 85
P2 Age 5;10 6;10 7;7
Articulation Test Severe1 4 %ile2 16 %ile2
P3 Age 5;6 6;10 7;5
Articulation Test ,1 %ile2 ,1 %ile2 ,1 %ile2
Note: Consonant and vowel accuracy represent relational measures derived from analysis of entire connected
speech sample from each time. 1Assessment of Phonological Processes- Revised (APP-R, Hodson, 1986); 2Goldman-
Fristoe Test of Articulation (GFTA, Goldman and Fristoe, 1986); 3Khan-Lewis Phonological Assessment (KLPA, Khan
and Lewis, 1986).
characterized by frequent vowel errors, final consonant deletion, errors on initial

consonants, glottal stops and reduction of consonant clusters. P2 began therapy at 2;6
and had been enrolled in speech and language therapy for approximately five years at the
last time point in the study. Treatment goals focused on expanding the phonemic
repertoire, increasing the accuracy of frequently incorrect consonants and vowels, and
increasing the use of consonant clusters. He was seen for follow-up evaluations
approximately once a year at 5;10, 6;10 and 7;7 years of age, with consistent gains in
single-word articulation (see table III).
Participant P3
P3 had a normal developmental history with the exception of speech and language. He
began saying words between 1 and 2 years, although his mother reported that his
speech was ‘unclear’. He was diagnosed with DAS at the age of 5;6. Speech and
language evaluations conducted between of 4;2 and 5;11 revealed profoundly impaired
speech production characterized by an incomplete phonetic inventory, variable
consonant and vowel errors, unusual and persistent phonological processes, incon-
sistency of stress and intonation and nasality. His comprehension of single words was
within normal limits, although tasks of short-term auditory memory and metalinguistic
skills indicated difficulty in repeating more than two lexical items, identifying words
with greater than two syllables, and identifying the different segment in CVC minimal
word pairs. He began receiving speech and language therapy at 4;2 focusing on
increasing the accuracy of vowel and consonant segments and increased syllabic
complexity. He was seen for evaluation in the longitudinal study at the ages of 5;6, 6;10
and 7;5 years. He showed negligible gains in single-word articulation testing across the
period (see table III).
Data collection
In the clinical evaluations for each participant, a graduate clinician and two certified
speech-language pathologists experienced in diagnosis of DAS collected connected speech
and language samples. A total of nine 1-hour samples (one sample at each of the three times
for the three participants) were analysed. Developmentally appropriate materials including
games, stories and spontaneous narratives were employed for sample collection. Connected
samples were assessed as representative of the child’s connected speech patterns and
language level based on parent interviews at the time of each evaluation.
Data analysis
All verbal communication attempted during each session was analysed. A certified speech-
language pathologist then transcribed spontaneous samples using broad phonetic
transcription. Transcription reliability was completed on 10% of the nine samples with
an average of 86.22% and a range of 75 to 96.26% inter-rater agreement across samples.
Reliability for vowel transcription averaged 88.68% agreement with a range of 73.91 to
96.00% across samples. Vowel transcription was based on 12 US English non-rhotic
monophthongs /i, I, e, æ, e, ‘, o, c, a, u, u/, rhotic vowels, and the phonemic diphthongs /aı,
au, cI/. Rhotic vowels included the central r-coloured [e] as well as the vowels [a, c, o, i, e]
when followed by [r].
Vowels in DAS 261
Phonetic inventory of vowels. Vowel inventories were based on computation of frequency of

occurrence of vowel types in each category listed above compared to the frequency of other
categories produced in the same time period. The vowel inventory was based on presence of
the vowel category, not on accuracy related to the target intended. This analysis was
intended to give a picture of what vowel qualities each child was capable of producing
without regard to whether they were produced accurately. Frequencies of vowel types at
each measurement point were compared to normative vowel frequency in English-speaking
children from Southern California in the first, second, and third grades (adapted from
Carterette and Jones, 1974), approximately the chronological age of these children.
Specific vowel types were not targeted, due to the spontaneous nature of data collection. A
vowel category was considered present when the vowel occurred 2 or more times in a
session (Robb et al., 1999).
Accuracy analysis for vowels. The methods used for computing vowel accuracy were adapted
from previous studies examining vowels, including (1) vowel accuracy (Pollock, 1994), (2)
analysis of error types on the basis of feature changes or complexity (Pollock, 1994), and
(3) descriptions of predominant error patterns based on most accurate or stable vowel
categories (Stoel-Gammon and Herrington, 1990).
Transcribed vowels were analysed to assess the relationship between the participants’
intended lexical targets and the actual vowel produced for each target. Phonetic targets for
the children’s vowel productions were determined in consideration of Texas dialect
features. For example, two variant productions of ‘dog’ were considered acceptable (viz.
[dag] or [dcg]), as they are both considered correct in the Texas dialect. Percentage of
vowel correctness (PVC) was computed for non-rhotic vowels (PVC-NR), diphthongs
(PVC-D), rhotic vowels (PVC-R) and total vowels (PVC) on the basis of number of vowels
matching lexical targets out of total opportunities for vowel occurrences. Errors were
classified in the following four categories: (1) substitution errors (including spatial errors of
fronting, backing, raising, lowering, centralization, as well as tensing, laxing, rounding and
unrounding), (2) complexity errors (diphthong reduction or diphthongization of a
monophthong vowel), (3) deletion errors and (4) de-rhoticization. These procedures are
similar to those suggested by Pollock (1994), with the addition of deletion errors, in which
intended vowels were omitted altogether. Frequency of occurrence was computed for the
four categories of errors, as well as the frequencies of the nine substitution error types. For
substitution errors, some vowel errors are characterized by more than one type of feature
error (e.g. lowering and laxing); therefore, total number of substitution error types exceeds
the number of actual substitutions (Pollock, & Keiser, 1990)
Stoel-Gammon and Herrington (1990) examined errors with reference to each
participant’s most accurate vowel categories. They found that vowel types used in
substitutions were usually the same vowel types that were always or almost always correctly
produced (i.e. if /a/ was 100% correct, it was most often used to substitute for other vowel
targets; if /a/ was 25% correct, it was rarely used as a substitution). Spearman rank
correlations were used to capture the quantitative relationship between the accuracy of
vowel types and their participation in vowel substitutions. For each participant at each
time, vowel types were ranked according to relative accuracy compared to the other vowel
types, and according to relative frequency of vowel types used in vowel substitutions. The
Spearman rank correlation was computed according to the formula: 12((6*Sd2)/(N32N))
where d2 is the sum of the squared difference in ranks for each vowel type’s accuracy and
frequency in substitutions and N is the number of vowel categories. This correlation is
interpreted relatively equivalently to the Pearson r, where 1.0 represents maximum positive
correlation between variables, 21.0 maximum inverse correlation, and 0.0 no correlation
between variables.
Contextual analysis of vowel accuracy. In addition to the accuracy analyses of vowel

production overall, the data were examined to assess effects of context on vowel accuracy,
including both response length and syllable complexity. To assess the effect of response
length on vowel accuracy, percentage of vowels correct (PVC) was computed for vowel
categories analysed based on number of words in the response. Computation of length of
response in words (not morphemes) was computed for two reasons. First, frequent
omission of final morphological markers precluded knowledge of whether the speaker
was attempting a grammatically correct word production and failing due to a production
deficit or attempting a grammatically incorrect target and producing it correctly (e.g.

‘says’ R ‘say’). Due to this uncertainty, it was not clear how many morphemes were
attempted for each word target. Second, length in morphemes is primarily a linguistic
analysis, and the focus of this analysis was the effects of motoric demand due to increased
length on vowel accuracy, not on the effects of increased linguistic demand on vowel
accuracy. PVC was computed separately for each response length from one to five words;
accuracy for responses greater than five words was combined.
The effect of syllable complexity on vowel accuracy was assessed by calculating per cent
of vowels correct separately for simple (CV, VC, CVC) and complex (e.g. containing
consonant clusters) monosyllable types, for all disyllables (CVCV, VCVC), and for all
words with three or more syllables (i.e. CVCVCV +). Along with the accuracy analyses by
length and syllable complexity, analyses were performed to assess the frequency of
occurrence for responses of different lengths and of syllables of different shapes.
Results
Vowel productions were analysed as follows: (1) inventory, (2) accuracy, (3) error types,
(4) accuracy by phrase length and (5) accuracy by syllable complexity. Each analysis is
described for each participant at each time point. Analyses were completed for 2,884 total
vowel productions. Number of vowel productions at each time point is shown in table IV.
Vowel inventory
Vowel inventories for non-rhotic vowels are displayed in figures 1–3 for each participant,
with comparison vowel frequencies from typical children in first through third grades
(adapted from Carterette, & Jones, 1974).
P1’s vowel inventory resembled the child norms, particularly at Time 3 (figure 1). At
Time 1, several vowel categories were over-represented, including [i], [a] and [o], while
others were under-represented [I], [e], [e], [æ] and [c]. Central vowels were generally less
Table IV. Number of vowels produced by Participants 1, 2 and 3 at Times 1, 2 and 3
Time 1 Time 2 Time 3 Total

P1 301 233 395 929
P2 257 507 336 1100
P3 248 305 302 855
Vowels in DAS 263
Figure 1. Vowel inventory, Participant 1: per cent occurrence of non-rhotic vowel categories at Times 1, 2 and 3.
Child frequencies of vowel categories are adapted from Carterette and Jones, 1974.
frequent at all time points compared to the normative data, while [u] and [u] were over-
represented, particularly at Time 3. At Time 1, the vowels [e] and [c] did not occur. At
Times 2 and 3, all non-rhotic vowels occurred at least twice.
P2’s vowel category distribution differed considerably over time (figure 2), although
vowel frequencies are similar to child norms as well. In particular, several vowel categories
appear to have unusual distributions at Time 3 relative to earlier time points, with high
frequencies of [i] and [c], low frequencies of [ı] and [æ] and absence of [e]. Central vowels
were underrepresented at all time points relative to the typical development norms, while
phonemic diphthongs were more frequent, particularly at Times 1 and 3. P2 produced
most non-rhotic vowels at least twice at every time point, with the exception of [e], with no
occurrences at Time 3, and [a], with only one occurrence at Time 1.
P3’s vowel inventory largely also resembled the child normative data, with a few
exceptions (see figure 3). At Time 1, [i] was less frequent than the comparison data,
although it was produced more frequently over the whole period. Several back rounded
vowels were over-represented at Time 1 ([c] [o] [u]) although these differences were not
extensive. Frequency of [u] increased over time, and was considerably more frequent than
normative values at Time 3. As with the other two children central vowels were generally
not as frequently produced as they were by the normative comparison group, with the
exception of Time 2. P3 produced all non-rhotic vowels at least twice at all times.
Rhotic vowels were infrequent, with only 29 occurrences produced by the three
participants over the 3-year period. In six of the nine speech samples, rhotic vowels
represented less than 1% of the non-rhotic vowels. Exceptions included P1 at Time 2, (9
rhotic vowels, 3% of non-rhotic vowels) and P2 and Times 1 and 2 (4 and 11 rhotic vowels,
respectively, 2% of non-rhotic vowels).
Vowels in DAS 265
These results demonstrate that most vowel types, with the exception of rhotics, were
produced by all participants in approximately the same proportion as reported for typically
developing grade-school children. There was no clear pattern of longitudinal change with
respect to vowel inventories for the three participants.
Vowel accuracy
Vowel accuracy for the three participants is shown in figures 4–6, including percentage of
vowels correct for all vowels (PVC), diphthongs (PVC-D), non-rhotic vowels (PVC-NR)
and rhotic vowels (PVC-R).
P1 achieved improved vowel accuracy over the period, with increased accuracy for all
vowels and diphthongs, non-rhotic and rhotic vowels calculated separately (figure 4). By
Time 3, P1 produced vowels accurately in 85–95% of targets attempted. Total vowel

accuracy and accuracy for diphthongs and non-rhotics was comparable, although total
accuracy was slightly less. Rhotic accuracy was poor at all times, with 0% accuracy at Time
1 and a high of 38% at Time 2.
P2 showed an unusual pattern of change in accuracy over time. He was most accurate at
Time 2 for total vowels and non-rhotic vowels, with poorest vowel accuracy at Time 3.
Diphthong production was 100% accurate at Time 1 and declined at the following two
time points. As seen in the phonetic inventory analyses, diphthongs occurred with
considerable frequency. Thus, this result is not an artifact of few opportunities for
diphthongs in the sample. In general, P2 produced diphthongs most accurately, followed

by non-rhotic vowels, and then total vowel accuracy, although the overall levels of accuracy
are similar. Rhotic accuracy was low at all times, never greater than 15%.
Figure 4. Vowel accuracy, Participant 1: per cent of vowels correct (PVC) for all vowels, diphthongs, non-rhotic
monophthongs and rhotic vowels at Time 1, Time 2 and Time 3.
monophthongs, and rhotic vowels at Time 1, Time 2 and Time 3.
monophthongs, and rhotic vowels at Time 1, Time 2 and Time 3.
Vowels in DAS 267
P3 increased in vowel accuracy over the three times for total vowels, diphthongs, and
non-rhotic vowels. His vowel accuracy was notably lower than the other participants, never
reaching 90%. Like the other two children, accuracy for total vowels, diphthongs, and non-
rhotic vowels was similar, being slightly higher for non-rhotics and diphthongs than for
rhotics. Rhotic accuracy was less than 15% at all times, and decreased over the course of
the study, with less than 5 % accuracy at Time 3.
While accuracy for vowels overall, diphthongs, and non-rhotics were superior to rhotic
vowels, accuracy remained lower than expected for typically developing children more than
four years of age (Templin and Darley, 1969). In spite of the essentially normal distribution
of vowel inventory categories in these connected speech samples, accuracy of all vowel
types was impaired for these children as late as 8–9 years of age. These vowel impairments
persisted even with intensive therapeutic intervention.
Vowel error analysis

Results of vowel error analyses are displayed in tables V and VI. Table V lists the frequency
of error types including vowel substitutions, complexity changes (diphthong reduction or
diphthongization), vowel deletion, and de-rhoticization. Table VI shows the frequency of
different types of vowel substitutions (i.e. vowel feature errors).
P1 made a total of 240 vowel errors in the three times. The majority of his errors were
characterized as substitutions and de-rhoticization (i.e. incorrect place of articulation,
rounding, or tensing errors), followed by complexity errors, and deletion (see table V). The
frequency distribution of his error types at Times 1 and 2 were similar. At Time 3, fewer
vowel errors were substitutions, accompanied by an increase in rhotic vowel errors.
Among vowel substitutions, there was no apparent pattern of error type at any time
(table VI). Vowel centralization, laxing of tense vowels, and unrounding of rounded vowels
were most frequent at Times 1 and 2, while tensing of lax vowels was most frequent at
Time 3.
P2 made 239 vowel errors overall (table V). Most of his errors were substitutions and
rhotic vowel errors. Tensing of lax vowels was the most frequent substitution error at all
times (table VI). No other pattern of substitution errors was apparent.
P3 made 250 vowel errors overall (table V). As with other participants, most errors were
substitutions and rhotic vowel errors. At Time 1, P3 differed from other participants in the
frequency of vowels omitted. In 22% of his errors, the vowels and correspondingly, entire
syllables, were omitted. No particular pattern of errors was present for vowel substitutions,
although centralization of vowels was most frequent at Time 2, and lowering and laxing of
vowels at Time 3.
Table V. Error type frequency: per cent occurrence of vowel error types, including substitutions, complexity errors
(diphthong reduction or diphthongization), deletion, and rhotic errors). Total number of vowel errors for each
participant and time is listed in bold
P1 P2 P3
Time 1 Time 2 Time 3 Time 1 Time 2 Time 3 Time 1 Time 2 Time 3
Substitutions 56 56 36 42 42 41 40 60 41
Complexity errors 17 17 12 11 5 16 16 18 10
Deletion 2 2 0 8 4 6. 22 2 6
Rhotic errors 25 25 52 40 49 36 23 20 44
Total vowel errors 118 64 58 65 77 97 88 91 71
Table VI. Substitution error frequency: percent occurrence of vowel substitution types, including backing,
fronting, lowering, raising, centralization, laxing, tensing, rounding, and unrounding. Total number of all
substitutions for each participant and time is listed in bold. Some vowel errors may have included more than one
substitution (i.e. both laxing and lowering may occur for one vowel error)
P1 P2 P3
Backing 9 11 13 14 15 10 17 6 7
Fronting 7 1 5 2 7 11 7 4 4
Lowering 10 18 11 13 8 11 15 14 20
Raising 9 6 11 14 7 11 10 17 9
Centralization 17 20 5 9 3 7 11 29 13
Laxing 19 16 21 0 12 11 11 16 20
Tensing 8 10 24 36 29 25 14 6 6
Rounding 4 5 5 11 14 6 10 5 7
Unrounding 17 13 5 2 5 7 4 5 13
Total feature errors 150 80 38 56 59 81 71 109 54
To assess whether the children were preferentially using their most accurate vowel
categories as vowel substitutions, a Spearman rank correlation analysis was used to rank
vowel accuracy by category from most to least accurate, and to rank frequency of category
use as a substitution from greatest to least frequency. Spearman coefficients were generally
low (see table VII), suggesting the lack of a relationship between vowel category accuracy
and frequency of use in vowel substitutions. Three exceptions were P1 at Time 1 (0.68), P2
at Time 1 (0.41) and P3 at Time 3 (0.39). The high Spearman coefficient for P1 at Time 1
was related to similar rankings for several vowel types on accuracy and use in substitutions,
namely /c/ and /u/, which was produced with very low accuracy and used very infrequently
in substitution errors, and /æ/ and /e/, which had relatively high accuracy and frequent use
in substitution errors. P2’s high Spearman coefficient of 0.41 at Time 1 was related to low
accuracy and infrequent substitutions using /u/ and /æ/ and high accuracy and frequent
substitutions with /i/ and /o/. P3’s high Spearman coefficient of 0.39 at Time 3 was related
to relatively low accuracy and infrequent substitutions using /u/, /e/, and /u/, with higher
accuracy and frequent substitutions using /e/. The remainder of coefficients ranged from
20.29 to 0.26, suggesting that vowel types used for substitutions were for the most part
unrelated to accuracy for the various types.
Vowel accuracy by phrase length

Accuracy of vowel production was examined relative to the phrase length, as measured by
number of words per phrase. Table VIII displays the frequency of occurrence for phrases of
various lengths, and accuracy of vowel production for those phrase lengths.
Table VII. Correlation of vowel frequency and error types: Spearman rank correlation coefficients are listed for
each participant and time. The coefficients represent the relationship between frequency of occurrence for vowel
types and use of those vowels in error productions
Time 1 Time 2 Time 3

P1 0.68 0.26 20.29
P2 0.41 20.04 0.12
P3 0.12 0.13 0.39
Table VIII. Length of response and vowel accuracy: percent occurrence of vowels in responses of varying lengths (1–4, 5 + word responses) and percentage of vowels
correct (PVC) in responses of these lengths are listed for each time and participant. Total number of vowels produced are listed in bold
P1 P2 P3
Length of Response Freq. Acc. Freq. Acc. Freq. Acc. Freq. Acc. Freq. Acc. Freq. Acc. Freq. Acc. Freq. Acc. Freq. Acc.
1 49 55 20 70 3 67 28 64 7 74 23 67 26 58 26 100 4 58
2 41 66 19 70 15 86 28 67 5 87 8 71 19 69 19 25 5 93
3 4 58 8 68 15 76 26 88 6 81 8 65 23 59 23 78 3 75
4 4 85 16 79 14 87 4 80 6 84 15 78 11 68 11 65 14 88
5+ 2 60 37 70 53 88 13 82 75 86 46 72 21 73 21 72 74 74
Total vowels produced 301 233 395 257 507 336 248 305 302
Table IX. Word complexity and vowel accuracy: percent occurrence of vowels in words of differing complexity (simple and complex monosyllables, disyllables, and
polysyllables) and percentage of vowels correct (PVC) at those levels of complexity are listed for each time and participant. Total number of vowels produced are listed in
bold
P1 P2 P3
Vowels in DAS
Word complexity Freq Acc. Freq Acc. Freq Acc. Freq Acc. Freq Acc. Freq Acc. Freq Acc. Freq Acc. Freq Acc.
Simple 56 59 48 73 67 89 43 81 59 90 36 75 45 78 61 72 60 83
Complex 2 14 13 77 17 82 11 100 14 91 16 83 13 82 11 58 11 72
Disyll. 39 70 31 68 15 73 30 66 21 78 32 58 19 56 23 77 23 66
Polysyll 3 22 8 63 1 67 16 54 6 47 16 74 22 35 5 60 7 57
Total vowels produced 301 233 395 257 507 336 248 305 302
269
At Time 1, one- and two-word responses were the most frequent response lengths,
although this was most pronounced for P1; both P2 and P3 produced many multi-word
phrases. Over time, the frequency of multi-word phrases increased, with phrases 5 words or
longer representing the majority of phrase lengths for P2 at Time 2 and for P1 and P3 at
Time 3.
As table VIII shows, there was no apparent trend of decreasing vowel accuracy with
increased phrase length. For these three children, vowel accuracy for one-word phrases was
poorer than accuracy in longer phrases (with the exception of P3 at Time 2). This
apparently contradictory finding may potentially be due to use of one-word phrases to
produce more difficult words.
These findings suggest lack of a response length effect on vowel accuracy. As in the
overall vowel accuracy analyses, vowel accuracy was low, but was not apparently related to
increased response length in these three children.
Vowel accuracy by word complexity

Vowel accuracy was calculated separately for different levels of word complexity. Table IX
shows frequency of occurrence for vowels in simple and complex monosyllables,
disyllables, and polysyllables, and accuracy for vowels produced at these different levels
of complexity.
Simple monosyllabic words were produced most frequently, followed by disyllabic
words. Complex monosyllables and polysyllables were infrequent. Frequency of more

complex word types did not increase over time. Monosyllables remained the most frequent
word type for all three children at all times.
On the whole, syllable complexity had no consistent effect on vowel accuracy. Vowels in
monosyllables appeared to have the highest accuracy, followed by disyllables and
polysyllables, although vowels in complex monosyllables were very inaccurate for P1 at
Time 1. Over time, the discrepancy in accuracy for vowels produced at different levels of
complexity appeared to normalize, with less difference at time 3 than at time 1
Discussion
Vowel inventory and accuracy patterns of three children with suspected DAS were analysed
across a 3-year period. The children were between the ages of 4;6 and 7;7 years and
received therapeutic intervention services throughout the study. Overall, findings indicate
impaired vowel accuracy in all children over this period, despite generally intact vowel
inventories for English phonemes.
At each time, all three children were able to produce vowel types in all areas of the vowel
space, with relative frequencies of vowel types similar to those previously reported for
English-speaking children (Carterette, & Jones, 1974). The most notable deficiency in
vowel inventories involved r-coloured (rhotic) vowels. Accuracy analyses also indicated
very low accuracy for rhotic vowels. The finding of essentially complete vowel inventories
suggests that these three children had the capability to produce almost all vowel phonemes,
and that impaired vowel accuracy was not primarily attributable to inability to produce one
or more vowel categories.
Accuracy of vowel production was quite low for all three children related to expectations
for their chronological age, as vowels are generally described as being accurate in typically
developing children by 36 months. Individual accuracy for all vowels ranged from 61 to
Vowels in DAS 271
85% in the children. These accuracy levels are comparable to average vowel accuracy
previously reported for 2-year-old children (e.g. Tyler, & Langsdale, 1996), but are
considerably lower than reports of 92% non-rhotic accuracy in 2-year-old children
(Pollock, 2002) and 93% overall vowel accuracy for 3-year-old children (Templin, &
Darley, 1969). Analysis of vowel accuracy over time showed a moderate increase over
time, with ranges of 61–75% accuracy at Time 1 and 71–85% accuracy at Time 3.
Separate analysis of rhotic vowel accuracy revealed still lower accuracy, ranging from 0 to
38% across all participants and times. While non-rhotic accuracy was slightly higher than
overall vowel accuracy, non-rhotic and overall vowel accuracy were not so disparate as to
suggest that rhotic vowels accounted for these children’s difficulty in vowel production.
In contrast to previous studies of vowels in DAS (Pollock, & Hall, 1991; Davis et al.,
1998), the children in this study did not demonstrate substantial diphthong reduction. In
fact, accuracy of diphthongs was comparable and frequently higher than non-rhotic
accuracy.
Most vowel errors were classified as vowel substitutions or de-rhoticization. Among
vowel substitutions, there were no consistent patterns of vowel errors for the three children.
Neither height errors nor tongue advancement errors were predominant, although a slight
tendency was noted for greater frequency of tongue advancement errors than tongue height
errors. Errors involving small changes in vowel quality in the same area of the vowel space
(e.g. tensing/laxing) were slightly higher than other error types.
These results are largely comparable to those of Pollock and Hall (1991) who found no
prevalent pattern of vowel feature errors in five children with DAS. In contrast, Pollock and
Keiser (1990) reported that backing and lowering errors were much more common than
other vowel substitutions in phonologically disordered (PD) children with vowel errors.
Interestingly, while backing and lowering errors were not particularly prominent in this
study, backing was more common than fronting and lowering tended to be more common
than raising. Comparative studies with larger cohorts of children, including direct
comparison of children with suspected DAS and children with PD are needed to achieve
more definitive answers regarding the nature and potential differences in errors in both
populations.
Analysis of the relationship between vowel accuracy and frequency of vowel types used in
substitution errors suggested that vowel categories used in substitution errors were not
highly correlated with the accuracy of production for that category in most instances for
these three children. This finding contrasts with the Stoel-Gammon and Herrington (1990)
study of vowel errors in two children with phonological disorder (PD), in which the vowel
category of substitutions was found to be related to the most accurately produced vowel
categories. This may provide another fruitful area for further inquiry regarding potential
differential diagnostic indicators for DAS.
Contextual analysis of vowel accuracy related to utterance length and syllable/word level
complexity suggested no effect of response length on vowel accuracy and only a slight trend
towards decreased vowel accuracy with increased syllable/word complexity in these
spontaneous speech samples. There was a preference for production of one-word responses
and for simple monosyllabic word productions (e.g. V, CV, CVC, VC) by all three
children, in accord with normative data suggesting predominance of simple syllable shapes
in English (Faircloth and Faircloth, 1973, as cited by Shriberg and Kent, 2003). While the
dominance of short utterance lengths and simple syllables in these children may reflect an
avoidance of long phrases and complex syllables, absence of a length or complexity effect
on vowel accuracy suggests that such a compensatory strategy was ineffective, as there
was no increase in vowel accuracy with decreased contextual complexity in spontaneous

speech.
These results suggest persistent impairment of vowel accuracy that is generally not
contingent upon an incomplete vowel inventory for English, higher accuracy for any
particular vowel type, length of response, or syllable/word complexity. These three children
showed no obvious pattern of vowel error across the entire period of this study. The lack of a
length or complexity effect on vowel accuracy implies that motor planning processes related
to length or complexity of sequences do not appear to be responsible for vowel errors in these
children. However, it is possible that intra-syllabic processes may be involved in a manner
not examined here, with vowel errors conditioned on the place of articulation for consonants
immediately preceding or following the vowel. Recent literature suggests immediate context
effects in the preference for co-occurring place of articulation for adjacent vowels and
consonants in infant babbling and speech as well as in languages (Davis, & MacNeilage,
1995; MacNeilage, & Davis, 2000). It is possible that this type of local context effect may be
involved in the vowel errors of children with DAS. This type of contextual analysis should be
explored further in future studies to understand context effects more precisely.
Vowel errors may represent one manifestation of speech variability, which has also been
frequently mentioned as another potential differential diagnostic characteristic of DAS
(Smith et al., 1994; Thoonen et al., 1997). However, reports of speech variability in DAS
have been mostly anecdotal and usually do not define or measure variability with any
uniformity. A companion article analysing variability data for the children in this study
reviews the variability research in DAS in detail and provides analysis of token-to-token
variability for these three children (Marquardt et al., 2004).
Acoustic measures of vowel production have been found to be more variable in children
with DAS than typically developing children or those with functional articulation disorders
(Smith et al., 1994). Therefore, it is possible that variable spatial targeting of vowels could
account for the propensity for vowel substitution errors in children with DAS. The effects
of variable spatial targeting on correct vowel production may not be evident in acoustic
studies where word stimuli are closely controlled. However, transcribed connected speech
sample data in this study suggest that variability is responsible for category-level errors in
vowel production, which may play an important role in the impaired speech intelligibility of
these children.
Continued research into vowel differences in children with suspected DAS relative to
other developmental speech disorders is needed. Future studies should include comparison
groups of children with functional or phonological disorder to determine if vowel accuracy
is a robust clinical marker for building a differential profile for DAS. Use of multiple
assessment methods, including acoustic analysis and perceptual judgments of vowels, can
also help to explore the sources of explanation for vowel errors. Investigation of therapeutic
interventions focused specifically on vowel accuracy is also needed to further understand
the role of vowels in speech intelligibility and the potential for functional improvement in
this area for children with persistent vowel accuracy deficits.
This detailed longitudinal study of vowel production patterns in three children with
suspected DAS supports the need for expansion of vowel assessment at a clinical level.
Although the small number of participants limits generalization and comparison studies of
PD children using consistent methodologies are needed, clinical description of these three
children with suspected DAS indicates that vowel errors persisted over time despite clinical
intervention and may be a fruitful area of continued inquiry in understanding the clinical
manifestations of this disorder as well as in theory building.
Vowels in DAS 273
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Vowel Patterns in Developmental Apraxia of Speech: Three Longitudinal Case Studies

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Clinical Linguistics & Phonetics, June 2005; 19(4): 249–274

Vowel patterns in developmental apraxia of speech: three

BARBARA L. DAVIS, ADAM JACKS, & THOMAS P. MARQUARDT

The University of Texas at Austin, TX, USA

(Received 6 May 2003; accepted 17 February 2004)

Typical developmental milestones form a crucial backdrop for consideration of the

Table I. Summary of vowel production studies in typically developing infants

Completeness of Vowel Frequency

Completeness of Vowel Frequency

(1996) sectional study (n55 at represented;

Completeness of Vowel Frequency

spontaneous babble and corner vowels

& de Swart, 1997, Marquardt, Jacks, & Davis, 2004).

Author Diag-nosis C.A. N Inventory Accuracy Error types

Herrington (1990) some diphthongs monophthongs vowels not in inventory by

Table II. (Continued )

Author Diag-nosis C.A. N Inventory Accuracy Error types

2. Does vowel accuracy change?

referred by certified speech-language pathologists (SLPs) for a second opinion on the

gains in single-word articulation (see table III).

Time 1 Time 2 Time 3

characterized by frequent vowel errors, final consonant deletion, errors on initial

Phonetic inventory of vowels. Vowel inventories were based on computation of frequency of

Contextual analysis of vowel accuracy. In addition to the accuracy analyses of vowel

deficit or attempting a grammatically incorrect target and producing it correctly (e.g.

Table IV. Number of vowels produced by Participants 1, 2 and 3 at Times 1, 2 and 3

Time 1 Time 2 Time 3 Total

Time 3, P1 produced vowels accurately in 85–95% of targets attempted. Total vowel

diphthongs in the sample. In general, P2 produced diphthongs most accurately, followed

monophthongs, and rhotic vowels at Time 1, Time 2 and Time 3.

Vowel error analysis

Vowel accuracy by phrase length

Time 1 Time 2 Time 3

increased response length in these three children.

Vowel accuracy by word complexity

words. Complex monosyllables and polysyllables were infrequent. Frequency of more

was no increase in vowel accuracy with decreased contextual complexity in spontaneous

differential diagnosis. Clinical Linguistics and Phonetics, 12, 25–45.

disordered children. Clinical Linguistics and Phonetics, 4, 145–160.

Language, 16, 159–191.

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