JMIR Publications

ABSTRACT

Background:

Oral diadochokinesis (oral-DDK) is widely used in pediatric speech assessment, but it is still often interpreted as a decontextualized speed measure. Published oral-DDK values vary with age, stimulus type, language background, elicitation conditions, and scoring method, yet few pediatric protocols explicitly specify how behavioral report, examiner-based screening, and same-day health context should be integrated into interpretation.

Objective:

This paper aims to document a structured multi-informant oral-DDK protocol for monolingual Mandarin-speaking children and adolescents after completion of the observational study.

Methods:

This paper retrospectively documents the protocol used in a completed cross-sectional observational study of 1,076 typically developing, native Mandarin-speaking children and adolescents from mainstream schools in Suzhou, Anhui Province, China, assessed between October 2024 and June 2025. The protocol integrated parent report, teacher report, and examiner-based assessment. Examiner procedures included oromotor/oral-mechanism screening, task-readiness checks, instruction-following assessment, a brief comprehension check using 8 structured 5W1H-format prompts, and same-day health and respiratory status confirmation. Oral-DDK was the core speech-motor task. Where applicable, performances were audio-recorded and scored using a count-with-time approach. Prespecified analyses addressed task-related variation, associations with examiner-based and health-related findings, cross-source relationships, and the incremental interpretive value of multi-informant integration.

Results:

Data collection was completed between October 2024 and June 2025. Of 1,076 recruited participants, 1,026 completed screening, with parent, teacher, and examiner records available for those screening-complete cases. At the time of manuscript preparation, final item-level data entry, verification, and protocol-defined validity adjudication were ongoing. Therefore, this paper does not report final analytic results. A retrospective protocol record has been deposited in the Open Science Framework.

Conclusions:

This protocol positions oral-DDK as a core speech-motor task embedded within a multi-informant interpretive framework. The protocol may support transparent reporting, reproducibility, and future adaptation for pediatric speech assessment in Mandarin-speaking and cross-linguistic contexts. Clinical Trial: Not applicable.