Submitted:
18 October 2024
Posted:
21 October 2024
You are already at the latest version
Abstract

Keywords:
1. Introduction
1.1. Hypotheses
1.2. Significance
2. Materials and Methods
2.1. Participants
2.2. Stimuli
2.3. Procedures
2.3.1. Extraction of Facial Measurements
2.3.2. Validation
3. Results
3.1. Differences Between Participant Cohorts
3.1.1. Classifying Similarity of Movement
4. Discussion
4.1. Measurements of Anterior/Posterior Facial Movement Will Show Significant Classification Performance
4.2. The Measurements with the Best Classification Performance Will Be the Same Across Participant Cohorts
4.3. The Measurements Designed to Capture the Distinctive Orofacial Movements Characteristic of the Words Will Perform Best in Classification
4.4. Measurements of Lateral Deviation or Asymmetry Will Not Demonstrate Significant Classification Performance
4.5. The “Face Size” Measurement Will Not by Itself Demonstrate Significant Classification Performance
5. Conclusions
6. Limitations
7. Future Work
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| S-LP | Speech-Language Pathologist |
| SSD | Speech Sound Disorder |
Appendix A
| Word | Onset Criteria | Offset Criteria |
|---|---|---|
| Ba | Lips together before compression | Return to neutral |
| Eye | Maximum open before voice onset as start to move to close | Return to neutral (mouth closed or open) |
| Map | Lips together before compression | Lips together |
| Um | Maximum open before voice onset as start to move to close | Lips together |
| Ham | Maximum open before voice onset as start to move to close | Lips together |
| Papa | Lips together before compression | Return to neutral |
| Bob | Lips together before compression | Release |
| Pam | Lips together before compression | Lips together |
| Pup | Lips together before compression | Release |
| Pie | Lips together before compression | Return to neutral |
| Boy | Lips together before compression | Release of labial-facial action |
| Bee | Lips together before compression | Release of retraction |
| Peep | Lips together before compression | Release of lips for word’s final /p/ |
| Bush | Lips together before compression | Release of rounding posture towards neutral |
| Moon | Lips together before compression | Return to neutral |
| Phone | Initiation of upward movement of lower lip towards top lip | Return to neutral |
| Feet | Open mouth before lower lip commences movement to upper lip | Return to neutral |
| Fish | Open mouth before lower lip commences movement to upper lip | Release of rounding posture towards neutral |
| Wash | Initiation of inward movement for rounding | Release of rounding |
| Show | Jaw at maximum before initiation of labial-facial contraction | Release of rounding |
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| Younger Children | Older Children | |
|---|---|---|
| Age 3.0 – 3.5 years | Age 3.5 – 4.0 years | |
| Age in months (Mean; SD) | 38.14 (1.84) | 44.73 (1.67) |
| CELF-P2 Core Language SS (PR) | 109.39 (69.91) | 110.77 (74.26) |
| GFTA-3 SS (PR) | 106.94 (66.06) | 107.21 (66.62) |
| GFTA-3 Percent Phonemes Correct | 89.62 | 92.84 |
| Blazeface Mesh IDs | Clinical Landmarks | Measurement |
|---|---|---|
| 199 | Pogonion | Pogonion |
| 17, 199 | Labrale Inferius, Pogonion | Lower Lip from Pogonion |
| 178, 402, 81, 311 | Mid-Labial Fissure | Lip Action |
| 178, 402, 81, 311 | Mid-Labial Fissure | Medial 1/3 Symmetry |
| 178, 402, 81, 311, 61, 291 | Mid-Labial Fissure, Cheilion | Medial 1/3 Action |
| 178, 402, 61, 291 | Mid-Labial Fissure, Cheilion | Medial 1/3 Lower Action |
| 81, 311, 61, 291 | Mid-Labial Fissure, Cheilion | Medial 1/3 Upper Action |
| 178, 402, 81, 311, 61, 291 | Mid-Labial Fissure, Cheilion | Mouth Opening |
| 0, 17, 61, 291 | Labrale, Cheilion | Mouth Area Symmetry |
| 61, 291 | Cheilion | Labial Fissure Width |
| 13, 14 | Stomion | Mouth Height |
| 172, 397, 2 | Gonion, Subnasale | Gonion |
| 199, 172, 397 | Pogonion, Gonion | Mandibular Angle |
| 93, 323, 227, 447, 168, 9, 133, 362, (68, 71), (301, 298) | Tragion, Zygion, Sellion, Glabella, Inner-Canthus, Frontotemporale | Face Size |
| Measurement | Definition | Physiology |
|---|---|---|
| Pogonion | Displacement of the chin tip (pogonion). | Mandibular range/control. |
| Lower Lip from Pogonion | Displacement of the inferior lip midline (stomion inferius) relative to pogonion. | Appropriate labial fissure close/open phase. |
| Lip Action | Displacement of the mean inferior medial 1/3 (of the labial fissure) with respect to the superior. | Appropriate labial fissure close/open phase. |
| Medial 1/3 Symmetry | Difference in the participant’s left half of the medial 1/3 labial fissure with the right half. | Labial symmetry. |
| Medial 1/3 Action | Displacement of the medial 1/3 labial fissure with respect to the mouth corners (cheilion). | Independent bilabial control and appropriate labial fissure rounding/retraction. |
| Medial 1/3 Lower Action | Displacement of the inferior medial 1/3 labial fissure with respect to the mouth corners (cheilion). | Inferior labial control. |
| Medial 1/3 Upper Action | Displacement of the superior medial 1/3 labial fissure with respect to cheilion. | Superior labial control. |
| Mouth | Ratio of vertical inferior and superior lip distance at the midline with the labial fissure width. | Appropriate mandibular range/control. |
| Mouth Area | Difference in area of the left half of the labial fissure with the right. Half labial fissure area is that of a triangle with corners stomion superior/inferior and that half’s cheilion. | Labial fissure symmetry. |
| Labial Fissure | Absolute lateral distance between cheilion. | Appropriate labial fissure rounding/retraction. |
| Mouth | Vertical distance from the facial origin to the midpoint position of stomion superius and stomion inferius. | Appropriate labial fissure close/open phase. |
| Gonion | Displacement of the mean of the most posterior and inferior points of the mandible (gonion). | Mandibular range/control. |
| Mandibular | The angle a line from pogonion and the bilateral gonial landmark mean makes with the anterior/posterior facial orientation about the transverse axis. | Mandibular range/control. |
| Face Size | A multidimensional measurement derived from several distances around the forehead and eyes designed to be invariant during participant speech motor movements. Used to normalise other measurements to facilitate inter-participant comparisons. | N/A |
| Class | Words | MSH-PW Level | Lip Shape | Distinguishing Characteristics |
|---|---|---|---|---|
| 1 | Ba, Map, Ham, Pam | Mandibular | Vertical | Low Vowel Height. |
| 2 | Eye, Pie | Mandibular | Vertical | Diphthongs. |
| 3 | Umm, Bob, Pup | Mandibular | Vertical | Mid Vowel Height. |
| 4 | Bee, Peep, Feet | Labial Facial | Horizontal | Lip action involves spreading (retraction). |
| 5 | Boy, Bush, Moon | Labial Facial | Horizontal | Lip action involves rounding, syllable contains bilabials. |
| 5 | Phone, Fish, Wash, Show | Labial Facial | Horizontal | Lip action involves rounding, syllable contains fricatives. |
| Adult | Older Children | Younger Children | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Measurement | Dis. | Vel. | Acc. | Dis. | Vel. | Acc. | Dis. | Vel. | Acc. |
| Thresholds @ | 11.0 | 11.0 | 11.0 | 10.9 | 10.9 | 10.9 | 11.5 | 11.5 | 11.5 |
| Labial Fissure Width | 11.3 | 15.8 | 15.3 | 12.1 | 13.6 | 12.9 | 9.3 | 13.8 | 13.9 |
| Mouth Height | 6.7 | 9.9 | 11.5 | 9.8 | 12.9 | 13.3 | 8.5 | 7.4 | 11.3 |
| Medial 1/3 Symmetry (X) | 4.4 | 4.6 | 5.2 | 4.8 | 4.4 | 4.3 | 3.9 | 4.4 | 4.5 |
| Medial 1/3 Symmetry (Y) | 4.9 | 5.1 | 4.2 | 6.5 | 7.1 | 7.8 | 5.8 | 5.3 | 7.0 |
| Medial 1/3 Symmetry (Z) | 4.5 | 5.8 | 5.7 | 4.8 | 6.0 | 6.5 | 4.6 | 4.6 | 5.2 |
| Mouth Area Symmetry | 4.9 | 4.4 | 5.0 | 4.6 | 4.6 | 4.8 | 3.7 | 4.6 | 4.9 |
| Mouth Opening | 49.8 | 44.5 | 26.6 | 39.6 | 31.7 | 20.9 | 37.2 | 34.8 | 23.8 |
| Lip Action (X) | 7.0 | 6.7 | 6.6 | 6.3 | 4.5 | 6.1 | 4.8 | 5.3 | 6.4 |
| Lip Action (Y) | 42.4 | 38.9 | 34.0 | 35.9 | 34.1 | 28.1 | 30.9 | 30.8 | 22.7 |
| Lip Action (Z) | 41.9 | 39.8 | 33.2 | 28.2 | 29.4 | 23.9 | 25.1 | 28.8 | 21.8 |
| Medial 1/3 Action (X) | 4.1 | 4.2 | 4.4 | 4.3 | 5.1 | 5.7 | 4.6 | 4.3 | 5.3 |
| Medial 1/3 Action (Y) | 7.3 | 9.6 | 10.6 | 10.1 | 12.0 | 12.8 | 8.6 | 9.7 | 9.6 |
| Medial 1/3 Action (Z) | 7.2 | 7.9 | 8.7 | 7.5 | 8.6 | 8.5 | 5.5 | 7.9 | 6.9 |
| Medial 1/3 Upper Action (X) | 4.1 | 4.9 | 5.0 | 4.3 | 5.5 | 5.2 | 5.3 | 5.6 | 6.3 |
| Medial 1/3 Upper Action (Y) | 27.1 | 33.7 | 27.9 | 31.4 | 32.1 | 24.2 | 21.5 | 28.2 | 23.4 |
| Medial 1/3 Upper Action (Z) | 11.6 | 14.4 | 15.9 | 15.4 | 17.0 | 17.4 | 12.7 | 15.6 | 15.0 |
| Medial 1/3 Lower Action (X) | 4.4 | 4.2 | 3.9 | 4.5 | 4.7 | 5.0 | 4.6 | 4.3 | 4.8 |
| Medial 1/3 Lower Action (Y) | 37.4 | 37.6 | 29.3 | 29.5 | 29.2 | 21.8 | 26.6 | 29.3 | 20.8 |
| Medial 1/3 Lower Action (Z) | 9.7 | 11.5 | 11.5 | 13.7 | 12.2 | 15.3 | 10.2 | 12.1 | 12.1 |
| Pogonion (X) | 4.6 | 4.7 | 5.1 | 5.7 | 7.0 | 6.7 | 4.7 | 4.7 | 5.3 |
| Pogonion (Y) | 7.2 | 10.5 | 12.4 | 11.0 | 17.2 | 17.0 | 8.6 | 10.3 | 14.1 |
| Pogonion (Z) | 12.2 | 19.1 | 19.3 | 6.9 | 22.5 | 21.1 | 3.8 | 19.3 | 17.1 |
| Gonion (X) | 5.2 | 4.6 | 4.8 | 4.7 | 5.5 | 5.2 | 6.1 | 4.0 | 4.5 |
| Gonion (Y) | 5.0 | 5.6 | 6.3 | 5.8 | 6.6 | 7.5 | 4.5 | 7.3 | 6.6 |
| Gonion (Z) | 6.2 | 7.5 | 8.7 | 5.3 | 6.4 | 8.2 | 4.3 | 7.8 | 7.2 |
| Lower Lip from Pogonion (X) | 4.7 | 5.1 | 4.8 | 5.1 | 5.9 | 5.8 | 5.3 | 4.8 | 5.4 |
| Lower Lip from Pogonion (Y) | 14.2 | 23.4 | 20.6 | 17.1 | 24.8 | 22.2 | 13.0 | 16.6 | 16.4 |
| Lower Lip from Pogonion (Z) | 5.4 | 6.4 | 5.7 | 4.9 | 6.7 | 5.8 | 4.0 | 4.8 | 5.0 |
| Mandibular Angle | 6.7 | 9.0 | 10.0 | 11.1 | 12.4 | 12.0 | 8.9 | 15.1 | 12.1 |
| Face Size | 4.0 | 6.4 | 7.3 | 5.4 | 8.7 | 8.1 | 5.2 | 7.9 | 6.9 |
| Adults vs | Adults vs | Older Children vs | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Older Children | Younger Children | Younger Children | |||||||
| Measurement | Dis. | Vel. | Acc. | Dis. | Vel. | Acc. | Dis. | Vel. | Acc. |
| Thresholds @ | 11.0 | 11.0 | 11.0 | 11.2 | 11.2 | 11.2 | 11.2 | 11.2 | 11.2 |
| Labial Fissure Width | 4.5 | 5.0 | 8.1 | 4.5 | 5.2 | 7.9 | 5.6 | 3.6 | 6.0 |
| Mouth Height | 6.2 | 6.0 | 6.3 | 4.1 | 5.5 | 6.5 | 5.8 | 8.3 | 5.7 |
| Medial 1/3 Symmetry (X) | 2.9 | 3.7 | 3.4 | 3.2 | 2.9 | 3.9 | 2.6 | 3.6 | 3.9 |
| Medial 1/3 Symmetry (Y) | 4.2 | 4.3 | 5.4 | 3.8 | 4.5 | 4.9 | 3.8 | 5.8 | 6.1 |
| Medial 1/3 Symmetry (Z) | 3.2 | 4.6 | 3.2 | 2.8 | 3.7 | 3.4 | 3.3 | 5.5 | 4.7 |
| Mouth Area Symmetry | 2.3 | 3.3 | 3.0 | 3.1 | 3.8 | 3.3 | 2.7 | 3.1 | 4.3 |
| Mouth Opening | 17.0 | 16.8 | 9.5 | 14.5 | 11.4 | 8.9 | 13.3 | 14.5 | 12.3 |
| Lip Action (X) | 4.3 | 4.1 | 5.2 | 4.4 | 4.7 | 4.7 | 3.4 | 4.3 | 4.7 |
| Lip Action (Y) | 15.2 | 11.1 | 14.3 | 13.4 | 10.6 | 11.9 | 10.2 | 8.8 | 9.8 |
| Lip Action (Z) | 17.8 | 13.8 | 12.2 | 16.8 | 11.5 | 13.1 | 10.2 | 10.0 | 7.9 |
| Medial 1/3 Action (X) | 3.0 | 3.9 | 2.8 | 3.0 | 2.6 | 2.9 | 2.6 | 3.9 | 1.8 |
| Medial 1/3 Action (Y) | 4.3 | 5.2 | 5.6 | 4.2 | 4.7 | 5.9 | 4.9 | 5.4 | 6.7 |
| Medial 1/3 Action (Z) | 3.3 | 5.6 | 5.7 | 3.8 | 3.3 | 4.6 | 2.9 | 5.5 | 5.0 |
| Medial 1/3 Upper Action (X) | 3.2 | 4.5 | 2.5 | 4.6 | 3.7 | 3.5 | 3.9 | 4.5 | 3.5 |
| Medial 1/3 Upper Action (Y) | 9.3 | 10.0 | 9.3 | 8.1 | 9.6 | 8.2 | 10.9 | 11.2 | 9.0 |
| Medial 1/3 Upper Action (Z) | 6.6 | 7.5 | 7.9 | 5.4 | 7.0 | 7.3 | 6.3 | 4.8 | 4.9 |
| Medial 1/3 Lower Action (X) | 2.9 | 3.5 | 3.1 | 2.3 | 2.9 | 3.7 | 2.9 | 2.7 | 2.9 |
| Medial 1/3 Lower Action (Y) | 14.1 | 13.2 | 11.1 | 11.6 | 11.9 | 11.2 | 11.4 | 12.2 | 7.7 |
| Medial 1/3 Lower Action (Z) | 6.3 | 7.4 | 8.1 | 3.8 | 4.3 | 6.4 | 5.1 | 6.2 | 7.5 |
| Pogonion (X) | 3.1 | 4.1 | 4.1 | 2.6 | 2.3 | 3.7 | 3.4 | 4.2 | 5.3 |
| Pogonion (Y) | 5.0 | 9.2 | 8.6 | 3.5 | 5.4 | 5.7 | 5.3 | 9.4 | 7.1 |
| Pogonion (Z) | 5.6 | 7.6 | 7.6 | 8.4 | 7.3 | 7.6 | 5.3 | 7.5 | 6.7 |
| Gonion (X) | 2.3 | 2.9 | 3.1 | 2.9 | 3.4 | 3.0 | 3.4 | 4.5 | 5.3 |
| Gonion (Y) | 2.8 | 4.0 | 4.4 | 2.6 | 3.5 | 3.0 | 2.5 | 5.1 | 4.8 |
| Gonion (Z) | 3.2 | 3.4 | 4.5 | 3.1 | 5.2 | 5.2 | 3.1 | 4.4 | 4.0 |
| Lower Lip from Pogonion (X) | 2.5 | 3.6 | 4.2 | 3.1 | 3.5 | 3.2 | 2.5 | 4.0 | 4.2 |
| Lower Lip from Pogonion (Y) | 7.0 | 7.7 | 8.5 | 4.5 | 9.0 | 6.0 | 8.2 | 9.5 | 9.3 |
| Lower Lip from Pogonion (Z) | 2.8 | 5.1 | 4.2 | 3.0 | 4.8 | 4.3 | 3.1 | 4.2 | 4.9 |
| Mandibular Angle | 6.0 | 6.2 | 7.5 | 3.7 | 7.5 | 5.4 | 5.8 | 6.8 | 6.7 |
| Face Size | 2.9 | 4.6 | 4.6 | 3.8 | 3.3 | 3.8 | 3.0 | 4.3 | 5.1 |
| Class | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|
| No. Words | 4 | 2 | 3 | 3 | 7 |
| Labial Fissure Width | 40.1 | 28.7 | 52.2 | ||
| Mouth Height | 35.3 | 19.9 | 24.1 | ||
| Medial 1/3 Symmetry (X) | |||||
| Medial 1/3 Symmetry (Y) | |||||
| Medial 1/3 Symmetry (Z) | 25.1 | ||||
| Mouth Area Symmetry | |||||
| Mouth Opening | 54.4 | 41.9 | 56.8 | 31.4 | 64.3 |
| Lip Action (X) | |||||
| Lip Action (Y) | 58.8 | 42.0 | 51.3 | 27.6 | 70.0 |
| Lip Action (Z) | 48.9 | 35.0 | 53.4 | 28.5 | 59.2 |
| Medial 1/3 Action (X) | |||||
| Medial 1/3 Action (Y) | 41.4 | 49.4 | |||
| Medial 1/3 Action (Z) | |||||
| Medial 1/3 Upper Action (X) | |||||
| Medial 1/3 Upper Action (Y) | 43.4 | 32.1 | 51.7 | 27.9 | 59.0 |
| Medial 1/3 Upper Action (Z) | 40.8 | 30.2 | 22.8 | 50.1 | |
| Medial 1/3 Lower Action (X) | |||||
| Medial 1/3 Lower Action (Y) | 54.4 | 35.1 | 49.2 | 29.1 | 63.7 |
| Medial 1/3 Lower Action (Z) | 33.4 | 29.3 | 27.2 | ||
| Pogonion (X) | |||||
| Pogonion (Y) | 35.5 | 21.6 | 23.5 | 26.2 | |
| Pogonion (Z) | 39.6 | 20.5 | 33.2 | 52.7 | |
| Gonion (X) | |||||
| Gonion (Y) | 27.1 | ||||
| Gonion (Z) | |||||
| Lower Lip from Pogonion (X) | |||||
| Lower Lip from Pogonion (Y) | 45.9 | 22.7 | 29.1 | 54.8 | |
| Lower Lip from Pogonion (Z) | |||||
| Mandibular Angle | 33.5 | 27.7 | 24.1 | ||
| Face Size |
| Class | 1 | 2 | 3 | 4 | 5 | ALL |
|---|---|---|---|---|---|---|
| TP | 6 | 3 | 2 | 4 | 2 | 17 |
| FP | 10 | 9 | 7 | 6 | 8 | 40 |
| FN | 0 | 1 | 1 | 1 | 1 | 4 |
| Recall | 1.00 | 0.75 | 0.67 | 0.80 | 0.67 | 0.81 |
| Precision | 0.38 | 0.25 | 0.22 | 0.40 | 0.20 | 0.30 |
| F1-Score | 0.55 | 0.38 | 0.33 | 0.53 | 0.31 | 0.44 |
| F1-Score Significance Threshold | 0.23 | 0.16 | 0.21 | 0.20 | 0.29 | 0.21 |
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