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Speech severity was rated using the Viking Speech Scale (VSS), a four\u2010level classification rating scale, at 4, 6, 8, and 10\u00a0years (age 4\u00a0years: mean\u00a0=\u00a052 months [3 SD]; age 6\u00a0years: mean\u00a0=\u00a075\u00a0months [2 SD]; age 8\u00a0years: mean\u00a0=\u00a0100\u00a0months [4 SD]; age 10\u00a0years: mean\u00a0=\u00a0125 months [5 SD]). We used Bayesian mixed\u2010effects ordinal logistic regression to model (1) the extent to which speech severity changed over time and (2) patterns of change across age groups and classification rating group levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>VSS ratings decreased (speech severity became less severe) between 4 and 10\u00a0years of age. Children who were first classified in VSS levels I, II, or III at age 4\u00a0years had a high probability of staying at, or improving to, VSS level I by 10\u00a0years. Children who were first classified in VSS level IV at 4\u00a0years had a high probability of remaining in VSS level IV at 10\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Early speech performance is highly predictive of later childhood speech abilities. Children with any level of speech impairment at age 4\u00a0years should be receiving speech therapy. Those with more severe speech impairments should be introduced to augmentative and alternative communication as soon as possible.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Children with early Viking Speech Scale (VSS) ratings below level IV have a good prognosis for speech improvement.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Children with early VSS level IV ratings are likely to remain at VSS level IV over time.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Children did not show worsening of VSS level between the ages of 4 and 10 years.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.15198","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T11:43:12Z","timestamp":1646826192000},"page":"1096-1105","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Longitudinal change in speech classification between 4 and 10\u00a0years in children with cerebral palsy"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6406-1222","authenticated-orcid":false,"given":"Helen L.","family":"Long","sequence":"first","affiliation":[{"name":"Waisman Center University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8890-5116","authenticated-orcid":false,"given":"Tristan J.","family":"Mahr","sequence":"additional","affiliation":[{"name":"Waisman Center University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3397-0455","authenticated-orcid":false,"given":"Phoebe","family":"Natzke","sequence":"additional","affiliation":[{"name":"Waisman Center University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8380-4300","authenticated-orcid":false,"given":"Paul J.","family":"Rathouz","sequence":"additional","affiliation":[{"name":"Dell Medical School Department of Population Health University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8544-7754","authenticated-orcid":false,"given":"Katherine\u00a0C.","family":"Hustad","sequence":"additional","affiliation":[{"name":"Waisman Center University of Wisconsin\u2013Madison  Madison Wisconsin USA"},{"name":"Department of Communication Sciences and Disorders University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Centers for Disease Control and PreventionCerebral palsy (Internet);2020.https:\/\/www.cdc.gov\/ncbddd\/cp\/index.html. 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