Age-specific agreement between Hi-DongDong and UTAP-2 articulation assessments in Korean children aged 2–13 years
- 1Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- 2Department of Rehabilitation, Gyeonggi Provincial Medical Center Anseong, Anseong, Republic of Korea
- 3Department of Rehabilitation, Gyeonggi Provincial Medical Center Icheon, Icheon, Republic of Korea
Abstract
Introduction: 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.
Methods: 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.
Results: 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.
Discussion: 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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BibTeX
@article{lee2026agespecific,
title = {{Age-specific agreement between Hi-DongDong and UTAP-2 articulation assessments in Korean children aged 2–13 years}},
author = {Jinju Lee and Sejin Kwon and Jin Young Ko and Yulhyun Park and Jaewon Lee and Ju Seok Ryu and Jee Hyun Suh},
journal = {Frontiers in Pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.1944143},
url = {https://doi.org/10.3389/fped.2026.1944143},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Age-specific agreement between Hi-DongDong and UTAP-2 articulation assessments in Korean children aged 2–13 years
AU - Jinju Lee
AU - Sejin Kwon
AU - Jin Young Ko
AU - Yulhyun Park
AU - Jaewon Lee
AU - Ju Seok Ryu
AU - Jee Hyun Suh
PY - 2026
DA - 2026/10/12
JO - Frontiers in Pediatrics
DO - 10.3389/fped.2026.1944143
UR - https://doi.org/10.3389/fped.2026.1944143
AB - Introduction: 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. Methods: 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. Results: 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. Discussion: 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
SN - 2296-2360
ER -