A procedure for phonetic transcription by consensus

Language Sampling for Preschoolers With Severe Speech Impairments

Purpose

The purposes of this investigation were to determine if measures such as mean length of utterance (MLU) and percentage of comprehensible words can be derived reliably from language samples of children with severe speech impairments and if such measures correlate with tools that measure constructs assumed to be related.

Method

Language samples of 15 preschoolers with severe speech impairments (but receptive language within normal limits) were transcribed independently by 2 transcribers. Nonparametric statistics were used to determine which measures, if any, could be transcribed reliably and to determine if correlations existed between language sample measures and standardized measures of speech, language, and cognition.

Results

Reliable measures were extracted from the majority of the language samples, including MLU in words, mean number of syllables per utterance, and percentage of comprehensible words. Language sample comprehensibility measures were correlated with a single word comprehensibility task. Also, language sample MLUs and mean length of the participants' 3 longest sentences from the MacArthur-Bates Communicative Development Inventory (Fenson et al., 2006) were correlated.

Conclusion

Language sampling, given certain modifications, may be used for some 3-to 5-year-old children with normal receptive language who have severe speech impairments to provide reliable expressive language and comprehensibility information.

Gesture Use in 14-Month-Old Toddlers With Hearing Loss and Their Mothers' Responses

PURPOSE

This study examined the gesture use of 14-month-old toddlers with hearing loss (HL) and mothers' responses to children's early gesture use. Comparisons were made to symbolic language and to dyads in which the toddler had normal hearing (NH).

METHOD

Participants were 25 mother-toddler dyads in which the child had HL and a socioeconomic-status matched group of 23 mother-toddler dyads in which the child had NH. Thirty-minute mother-child interactions were video-recorded, transcribed for spoken language, sign, and gesture use, and coded for maternal responses to children's gestures. Mothers also reported on children's gestural and spoken language abilities.

RESULTS

Toddlers with HL used gesture similarly to their peers with NH, but demonstrated delays in spoken language. Spoken language and gesture were not significantly related for either group. Hearing levels were related to spoken language, but not gesture for the HL group. Maternal and child gesture were only related for signing mothers. Mothers of children with HL were more likely than their counterparts to provide no response to children's gestures.

CONCLUSION

Although toddlers' gesture abilities remain intact in the presence of HL, mothers were not maximally responsive to those gestures and thus should be coached to increase their provision of contingent feedback.

Modelo de correlações entre consoantes: implicações para a prática clínica

RESUMO Objetivo: construir um modelo de complexidade entre consoantes conforme a estrutura silábica de cada uma, evidenciando possíveis correlações estatísticas entre elas, baseando-se na estrutura do Modelo Implicacional de Complexidade de Traços (MICT) e utilizando dados de aquisição fonológica típica. Métodos: analisaram-se os sistemas fonológicos de 186 crianças estudantes de escolas municipais de educação infantil com idades entre um ano e seis meses e cinco anos, 11 meses e 29 dias, e desenvolvimento típico de linguagem. Com base nos fonemas adquiridos em cada faixa etária determinaram-se os níveis de complexidade. Após, buscaram-se as correlações entre os fonemas, utilizando como critérios a significância estatística e a força das correlações para criar o modelo. Resultados: o modelo de correlações entre consoantes foi construído com nove níveis de complexidade. O modelo mostra que o fonema menos complexo é o /t/ e o mais complexo é o /l/ na posição de onset complexo. Há várias correlações moderadas e fortes entre os fonemas, exceto para /(/. O fonema com maior número de correlações foi o /l/ na posição de onset simples. Conclusão: o modelo criado evidenciou muitas semelhanças com o MICT. Ele descreve detalhes da aquisição fonológica típica e pode ser um guia para a escolha dos sons alvo na terapia fonológica.

Correlações entre aquisição do vocabulário e da fonologia: número de palavras produzidas versus consoantes adquiridas

RESUMO Objetivo Verificar as possíveis correlações entre o número de tipos lexicais e o número de consoantes no sistema fonológico geral em crianças com desenvolvimento típico de linguagem. Métodos 186 crianças entre um ano e seis meses e cinco anos, 11 meses e 29 dias, falantes monolíngues do Português Brasileiro, com desenvolvimento típico de linguagem, participaram do estudo. A coleta de dados envolveu avaliações fonoaudiológicas e gravação da fala espontânea. Analisou-se a fonologia quanto ao número de consoantes adquiridas no sistema fonológico geral, em cada estrutura silábica e nos níveis do Modelo Implicacional de Complexidade de Traços (MICT). O vocabulário foi analisado quanto ao número de tipos de itens lexicais produzidos. Estes dados foram comparados entre as faixas etárias. A seguir, foram analisadas as correlações entre os tipos lexicais produzidos e as variáveis estabelecidas para o sistema fonológico. O nível de significância adotado foi de 5%. Resultados Todos os aspectos da fonologia avaliados apresentaram crescimento gradual. Os tipos lexicais apresentaram comportamento semelhante, porém com uma pequena regressão na idade de cinco anos. Houve diferentes correlações positivas entre os tipos lexicais produzidos e as variáveis analisadas no sistema fonológico. Houve apenas uma correlação negativa, referente à produção dos tipos lexicais com o onset complexo na última faixa etária analisada. Conclusão A fonologia e o vocabulário apresentam comportamentos semelhantes. Há diversas correlações positivas entre os tipos lexicais produzidos e diferentes aspectos da fonologia, exceto em relação ao onset complexo.

O uso das conjunções por crianças com desenvolvimento típico de linguagem

RESUMO Objetivo Verificar o uso das conjunções na fala espontânea de crianças de três anos de idade com desenvolvimento típico de linguagem, residentes do município de Santa Maria - RS. Métodos Participaram da pesquisa 45 crianças, com idades entre 3:0;0 e 3:11;29 (anos:meses;dias), do banco de dados do Centro de Estudos de Linguagem e Fala (CELF). Foi transcrita a fala espontânea de cada sujeito. Em seguida, foram feitas as análises das amostras identificando os tipos de conjunções de cada faixa etária. As amostras foram analisadas estatisticamente, analisando-se o número e o tipo de conjunções empregadas em cada faixa etária e comparando-as entre si. Resultados Os dados indicaram que quanto maior a faixa etária da criança, maior o número dos tipos de conjunções utilizadas por elas. Quanto à comparação entre as faixas etárias, houve diferença estatística na comparação entre os números médios de conjunções por faixa etária, assim como para conjunções aditivas e para conjunções subordinativas. Conclusão Aos três anos de idade, a criança já apresenta o uso gramatical das conjunções. No começo, aparecem as conjunções coordenativas aditivas, adversativas e explicativas, e aos 3:6, as conjunções mais complexas, como as subordinativas.

An exploration of the role of executive functions in preschoolers' phonological development

There is limited yet compelling evidence that domain-general processes may contribute to speech sound change. This study explored whether executive functions contribute to the achievement of adult-like speech production. Children who are 4 to 5 years old, 42 with high-average speech production skills, 11 with low-average and nine with speech sound disorder (SSD), participated in a battery of executive function and speech production tasks. Performance accuracy was compared across groups and also correlated with speech sound accuracy from a single-word naming task. Children with SSD demonstrated poorer performance than other groups on forward digit span, whereas children with low-average speech skills underperformed their peers on the Flexible Item Selection Task (FIST). These preliminary results suggest that children with speech errors may have less mature working memory than peers who have mastered phonological targets earlier in development.

Differentiating School-Aged Children With and Without Language Impairment Using Tense and Grammaticality Measures From a Narrative Task

PURPOSE

To determine the diagnostic accuracy of the finite verb morphology composite (FVMC), number of errors per C-unit (Errors/CU), and percent grammatical C-units (PGCUs) in differentiating school-aged children with language impairment (LI) and those with typical language development (TL).

METHOD

Participants were 61 six-year-olds (50 TL, 11 LI) and 67 eight-year-olds (50 TL, 17 LI). Narrative samples were collected using a story-generation format. FVMC, Errors/CU, and PGCUs were computed from the samples.

RESULTS

All of the three measures showed acceptable to good diagnostic accuracy at age 6, but only PGCUs showed acceptable diagnostic accuracy at age 8 when sensitivity, specificity, and likelihood ratios were considered.

CONCLUSION

FVMC, Errors/CU, and PGCUs can all be used in combination with other tools to identify school-aged children with LI. However, FVMC and Errors/CU may be an appropriate diagnostic tool up to age 6. PGCUs, in contrast, may be a sensitive tool for identifying children with LI at least up to age 8 years.

Toddlers' Verb Lexicon Diversity and Grammatical Outcomes

Purpose

The goals of this study were to quantify longitudinal expectations for verb lexicon growth and to determine whether verb lexicon measures were better predictors of later grammatical outcomes than noun lexicon measures.

Method

Longitudinal parent-report measures from the MacArthur-Bates Communicative Development Inventory (Fenson et al., 2007) from ages 21 to 30 months from an archival database were used to model growth in common noun and verb lexicon size for 45 typically developing toddlers. Communicative Development Inventory growth coefficients and 24-month measures of lexical diversity from spontaneous language samples were used to predict 30-month grammatical outcomes on the Index of Productive Syntax (Scarborough, 1990).

Results

Average verb growth was characterized by 50.57 verbs at 24 months, with linear growth of 8.29 verbs per month and deceleration overall. Children with small verb lexicons or slow linear growth at 24 months accelerated during this developmental period. Verb lexicon measures were better predictors of grammatical outcomes than noun lexicon measures, accounting for 47.8% of the variance in Index of Productive Syntax scores. Lexical verb diversity in spontaneous speech emerged as the single best predictor.

Conclusion

Measures of verb lexicon size and diversity should be included as part of early language assessment to guide clinical decision making with young children at risk for language impairment.

Relation of motor, linguistic and temperament factors in epidemiologic subtypes of persistent and recovered stuttering: Initial findings

PURPOSE

The purpose of this study was to determine the presence of any patterns reflecting underlying subtypes of persistence and recovery across epidemiologic, motor, language, and temperament domains in the same group of children beginning to stutter and followed for several years.

METHODS

Participants were 58 2-4-year-old CWS and 40 age and gender matched NFC from four different sites in the Midwest. At the end of the multi-year study, stuttering children were classified as Persistent or Recovered. The same protocol obtaining data to measure stuttering, motor, language and temperament characteristics was used at each site. They have not been included in previous reports.

RESULTS

The Persistent group performed consistently differently from the Recovered and Control groups. They performed lower on standardized language tests and in phonological accuracy, had greater kinematic variability, and were judged by their parents to be more negative in temperament.

CONCLUSIONS

The present study provides data supporting the hypothesis that subtypes of stuttering can be identified along persistency/recovery lines, but results were not definitive.

EDUCATIONAL OBJECTIVES

Readers will be able to (a) describe the current state of subtypes of stuttering research; (b) summarize possible contributions of epidemiologic, motoric, linguistic and temperament to such subtyping with regard to persistency and recovery.

Non-word repetition in 2-year-olds: Replication of an adapted paradigm and a useful methodological extension

Accurate non-word repetition (NWR) has been largely attributed to phonological memory, although the task involves other processes including speech production, which may confound results in toddlers with developing speech production abilities. This study is based on Hoff, Core and Bridges' adapted NWR task, which includes a real-word repetition (RWR) condition. We tested 86 typically developing 2-year-olds and found relationships between NWR and both receptive and expressive vocabulary using a novel measure that controls for speech production by comparing contextually matched targets in RWR. Post hoc analyses demonstrated the influence of lexical and sublexical factors in repetition tasks. Overall, results illustrate the importance of controlling for speech production differences in young children and support a useful methodological approach for testing NWR.

Early lexical and phonological acquisition and its relationships

PURPOSE

Verifying likely relationships between lexical and phonological development of children aged between 1 year to 1 year, 11 months and 29 days, who were enrolled in public kindergarten schools of Santa Maria (RS).

METHODS

The sample consisted of 18 children of both genders, with typical language development and aged between 1 year to 1 year, 11 months and 29 days, separated in three age subgroups. Visual recordings of spontaneous speech of each child were collected and then lexical analysis regarding the types of the said lexical items and phonological assessment were performed. The number of sounds acquired and partially acquired were counted together, and the 19 sounds and two all phones of Brazilian Portuguese were considered. To the statistical analysis, the tests of Kruskal-Wallis and Wilcoxon were used, with significance level of prelace_LT0.05.

RESULTS

When compared the means relating to the acquired sounds and mean of the acquired and partially acquired sounds percentages, there was difference between the first and the second age subgroup, and between the first and the third subgroup. In the comparison of the said lexical items means among the age subgroups, there was difference between the first and the second subgroup, and between the first and the third subgroup again. In the comparison between the said lexical items and acquired and partially acquired sounds in each age subgroup, there was difference only in the age subgroup of 1 year and 8 months to 1 year, 11 months and 29 days, in which the sounds highlighted.

CONCLUSION

The phonological and lexical domains develop as a growing process and influence each other. The Phonology has a little advantage.

Sample size for measuring grammaticality in preschool children from picture-elicited language samples

PURPOSE

The purpose of this study was to investigate whether a shorter language sample elicited with fewer pictures (i.e., 7) would yield a percent grammatical utterances (PGU) score similar to that computed from a longer language sample elicited with 15 pictures for 3-year-old children.

METHOD

Language samples were elicited by asking forty 3-year-old children with varying language skills to talk about pictures in response to prompts. PGU scores were computed for each of two 7-picture sets and for the full set of 15 pictures.

RESULTS

PGU scores for the two 7-picture sets did not differ significantly from, and were highly correlated with, PGU scores for the full set and with each other. Agreement for making pass-fail decisions between each 7-picture set and the full set and between the two 7-picture sets ranged from 80% to 100%.

CONCLUSION

The current study suggests that the PGU measure is robust enough that it can be computed on the basis of 7, at least in 3-year-old children whose language samples were elicited using similar procedures.

Sample length affects the reliability of language sample measures in 3-year-olds: evidence from parent-elicited conversational samples

PURPOSE

The goal of this study was to investigate the extent to which sample length affected the reliability of total number of words (TNW), number of different words (NDW), and mean length of C-units in morphemes (MLCUm) in parent-elicited conversational samples for 3-year-olds.

METHOD

Participants were sixty 3-year-olds. A 22-min language sample was collected from each child during free play with the parent in the laboratory. Samples of 1, 3, 7, and 10 min were extracted from the 22-min samples. TNW, NDW, and MLCUm were computed from each shorter sample and the 22-min sample. TNW and NDW were adjusted by number of minutes for comparisons. The differences and correlations between each shorter sample cut and the 22-min sample on MLCUm and adjusted TNW and NDW were computed.

RESULTS

The shorter samples and the 22-min samples significantly differed in adjusted TNW and NDW, but not in MLCUm. TNW reached an acceptable reliability level (i.e., r = .90) in 7-min samples. NDW and MLCUm approached the acceptable reliability level (rs = .88) in 7-min samples and reached it in 10-min samples.

CONCLUSION

For conversational language samples with similar collection procedures, samples of 7 to 10 min are desirable for calculating TNW, NDW, and MLCUm in 3-year-olds.

Intraword variability in typical speech development

PURPOSE

Intraword variability (sometimes called token-to-token variability) has been associated with certain types of speech disorder. It has also been documented in typical speech development. The purpose of this study was to investigate intraword variability in typically developing 2- and 3-year-olds to determine expected rates and patterns of variability in typical speech development.

METHOD

Participants were 33 children aged 2;6 (years;months) to 3;11 with typical speech development. Three productions of 25 target words were elicited, and an overall variability score was calculated. Response type and the effect of word length were investigated.

RESULTS

Variability rates decreased with age; however, the oldest children (ages 3;6-3;11) continued to display considerable variability. The most common response type was variable with no hits (i.e., variable production with none matching the target form) for all age groups, and variability was greatest for longer words.

CONCLUSIONS

Variability is prevalent in the speech of typically developing 2- and 3-year-olds and was observed even in the oldest children. Future work is needed to determine at what age this type of phonemic variability is no longer prevalent in typical speech development. Clinicians should use caution in interpreting the presence of intraword variability as indicative of specific subtypes of speech disorder.

Predictors of token-to-token inconsistency in preschool children with typical speech-language development

The purpose of this study was to examine potential concurrent predictors and replicate rates of token-to-token inconsistency (inconsistency in repeated productions of the same word) in 43 children with typical speech-language development, ages 2;6 to 4;2. A standard linear regression was used to determine which variables, if any, among age, expressive and receptive vocabulary, and speech sound production abilities predicted token-to-token inconsistency. Inconsistency rates in children from one research site, reported elsewhere, were compared to rates in children from a second research site. The results revealed that expressive vocabulary was the only significant predictor of token-to-token inconsistency in these children. Furthermore, inconsistency rates were similarly high across the two research sites. The findings are discussed in terms of their implications for our theoretical understanding of token-to-token inconsistency and its role in the differential diagnosis of speech sound disorders in children.

Proximate factors associated with speech intelligibility in children with cochlear implants: A preliminary study

The purpose of this descriptive pilot study was to examine possible relationships among speech intelligibility and structural characteristics of speech in children who use cochlear implants. The Beginners Intelligibility Test (BIT) was administered to 10 children with cochlear implants, and the intelligibility of the words in the sentences was judged by panels of naïve adult listeners. Additionally, several qualitative and quantitative measures of word omission, segment correctness, duration, and intonation variability were applied to the sentences used to assess intelligibility. Correlational analyses were conducted to determine if BIT scores and the other speech parameters were related. There was a significant correlation between BIT score and percent words omitted, but no other variables correlated significantly with BIT score. The correlation between intelligibility and word omission may be task-specific as well as reflective of memory limitations.

A Cross-Sectional Cohort Study of Speech in Five-Year-Olds with Cleft Palate ± Lip to Support Development of National Audit Standards

Objective

To develop national standards for speech outcomes and processes of care for children with cleft palate ± lip and to test the standards using national data.

Design, Setting, and Participants

In this large, multicenter, prospective cohort study, speech recordings of 1110 five-year-olds with cleft palate involvement (born 2001 to 2003) were collected by 12 cleft centers in Great Britain and Ireland. Recordings were analyzed by consensus by specialist speech and language therapists using the Cleft Audit Protocol for Speech-Augmented. Results were benchmarked against evidence-based process and speech outcome standards and statistical analysis undertaken.

Results

From the 1110 children audited, 48% (530) had speech within the normal range. This was not significantly different from the agreed standard of 50% ( P = .20, CI = 45–50%). Sixty-six percent (734) had speech with no evidence of structurally related speech problems or history of speech-related secondary surgery. This was significantly below the standard of 70% ( P =.007, CI = 62–69%). Sixty percent (666) had no serious cleft-related articulation errors. This was significantly better than the agreed standard of 50% ( P < .001, CI = 67–73%). More than 80% of 2-year-olds received a specialist speech and language assessment against a benchmark of 100%.

Conclusions

Developing standards has facilitated more meaningful reporting of speech outcomes and treatment processes. Evidence-based standards were defined and extensively tested, enabling centers to compare their performance with national trends. One 5-year outcome standard was achievable; the other two standards will require modification through the mandatory annual national audit program.

Growth of finiteness in the third year of life: replication and predictive validity

PURPOSE

The authors of this study investigated the validity of tense and agreement productivity (TAP) scoring in diverse sentence frames obtained during conversational language sampling as an alternative measure of finiteness for use with young children.

METHOD

Longitudinal language samples were used to model TAP growth from 21 to 30 months of age for 37 typically developing toddlers. Empirical Bayes (EB) linear and quadratic growth coefficients and child sex were then used to predict elicited grammar composite scores on the Test of Early Grammatical Impairment (TEGI; Rice & Wexler, 2001) at 36 months.

RESULTS

A random-effects quadratic model with no intercept best characterized TAP growth, replicating the findings of Rispoli, Hadley, and Holt (2009). The combined regression model was significant, with the 3 variables accounting for 55.5% of the variance in the TEGI composite scores.

CONCLUSION

These findings establish TAP growth as a valid metric of finiteness in the 3rd year of life. Developmental and theoretical implications are discussed.

The diagnostic accuracy of two tense measures for identifying 3-year-olds with language impairment

PURPOSE

The authors of this study investigated the diagnostic accuracy of the Finite Verb Morphology Composite (FVMC; Bedore & Leonard, 1998) and the Tense and Agreement Productivity Score (TAPS; Hadley & Short, 2005) in identifying 3-year-olds with language impairment (LI).

METHOD

Eighteen pairs of 3-year-olds with and without LI participated in the current study. The FVMC and the TAPS were computed from 100- and 50-utterance language samples.

RESULTS

The FVMC and TAPS demonstrated higher diagnostic accuracy in the 100-utterance samples than in the 50-utterance samples. For 100-utterance samples, when children's age or severity was not considered, the FVMC showed a slight advantage over the TAPS in diagnostic accuracy. However, when children's age or severity was considered, the opposite pattern was observed.

CONCLUSION

Both the FVMC and TAPS can be used to differentiate 3-year-olds with and without LI. To reliably identify 3-year-olds with LI by using tense measures, language samples with at least 100 utterances are recommended.

Emergence of speech sounds between 7 and 24 months of cochlear implant use

OBJECTIVES

To investigate the process of speech development in five 42-month-old children with profound deafness who received cochlear implants (CIs) between 19 and 36 months of age and five normal hearing (NH) age mates.

METHODS

Conversational samples were collected and transcribed. Sounds produced correctly within meaningful words (target sounds) and recognizable sounds produced in spontaneous productions (target-less sounds) were analyzed for all 10 children.

RESULTS

Revealed that there was overlap in the total number of vowels and consonants produced by the two groups. The differences between the two groups were more evident in the target condition, whereas the two groups were more similar in the target-less condition.

DISCUSSION

The similarities documented in the target-less repertoire of CI and NH children underscore the importance of examining the emerging sound system to predict the end-point sound system in children with CIs. Using target and target-less speech sound comparisons offers a supplementary view of the emergent process of speech sound development and is a valid method of analysis. Results suggest that early implantation may help some children with profound deafness develop speech sounds in a manner similar to NH age mates.

Factors that enhance English-speaking speech-language pathologists' transcription of Cantonese-speaking children's consonants

PURPOSE

To investigate speech-language pathology students' ability to identify errors and transcribe typical and atypical speech in Cantonese, a nonnative language.

METHOD

Thirty-three English-speaking speech-language pathology students completed 3 tasks in an experimental within-subjects design.

RESULTS

Task 1 (baseline) involved transcribing English words. In Task 2, students transcribed 25 words spoken by a Cantonese adult. An average of 59.1% consonants was transcribed correctly (72.9% when Cantonese-English transfer patterns were allowed). There was higher accuracy on shared English and Cantonese syllable-initial consonants /m,n,f,s,h,j,w,l/ and syllable-final consonants. In Task 3, students identified consonant errors and transcribed 100 words spoken by Cantonese-speaking children under 4 additive conditions: (1) baseline, (2) +adult model, (3) +information about Cantonese phonology, and (4) all variables (2 and 3 were counterbalanced). There was a significant improvement in the students' identification and transcription scores for conditions 2, 3, and 4, with a moderate effect size. Increased skill was not based on listeners' proficiency in speaking another language, perceived transcription skill, musicality, or confidence with multilingual clients.

CONCLUSION

Speech-language pathology students, with no exposure to or specific training in Cantonese, have some skills to identify errors and transcribe Cantonese. Provision of a Cantonese-adult model and information about Cantonese phonology increased students' accuracy in transcribing Cantonese speech.

A multidimensional investigation of children's /r/ productions: perceptual, ultrasound, and acoustic measures

PURPOSE

This study explored relationships among perceptual, ultrasound, and acoustic measurements of children's correct and misarticulated /r/ sounds. Longitudinal data documenting changes across these parameters were collected from 2 children who acquired /r/ over a period of intervention and were compared with data from children with typical speech.

METHOD

Participants were 3 children with typical speech, recorded once, and 2 children with /r/ misarticulation, recorded over 7-8 months. The following data from /r/ produced in nonwords were collected: perceptually rated accuracy, ultrasound measures of tongue shape, and F3 - F2 distance.

RESULTS

Regression models revealed significant associations among perceptual, ultrasound, and acoustic measures of /r/ accuracy. The inclusion of quantitative tongue-shape measurements improved the match between the ultrasound and perceptual/acoustic data. Perceptually incorrect /r/ productions were found to feature posteriorly located peaked tongue shapes. Of the children who were seen longitudinally, 1 developed a bunched /r/ and 1 demonstrated retroflexion. The children with typical speech also differed in their tongue shapes.

CONCLUSION

Results support the validity of using qualitative and quantitative ultrasound measures to characterize the accuracy of children's /r/ sounds. Clinically, findings suggest that it is important to encourage pharyngeal constriction while allowing children to find the /r/ tongue shape that best fits their individual vocal tract.

Tracking change in children with severe and persisting speech difficulties

Standardised tests of whole-word accuracy are popular in the speech pathology and developmental psychology literature as measures of children's speech performance. However, they may not be sensitive enough to measure changes in speech output in children with severe and persisting speech difficulties (SPSD). To identify the best ways of doing this, we compared a range of commonly used procedures for perceptual phonological and phonetic analysis of developmental speech difficulties. Data are drawn from four children with SPSD, recorded at 4 years and again at 6 years old performing naming and repetition tasks. Measures of speech output included percentage of whole words correct (PWC), percentage of consonants correct (PCC), proportion of whole-word proximity (PWP), phonological pattern (process) analysis and phonetic inventory analysis. Results indicate that PWC captures change only when identical stimuli are used across time points. PCC is a more robust indicator of change, being less affected by the choice of stimuli. PWP also captures change across time and tasks, while appearing to be more sensitive than PCC to psycholinguistic variables. PCC and PWP are thus both potentially useful tools for evaluating speech outcomes.

Consonant accuracy after severe pediatric traumatic brain injury: a prospective cohort study

PURPOSE

The authors sought to describe longitudinal changes in Percentage of Consonants Correct-Revised (PCC-R) after severe pediatric traumatic brain injury (TBI), to compare the odds of normal-range PCC-R in children injured at older and younger ages, and to correlate predictor variables and PCC-R outcomes.

METHOD

In 56 children injured between age 1 month and 11 years, PCC-R was calculated over 12 monthly sessions beginning when the child produced ≥ 10 words. At each session, the authors compared odds of normal-range PCC-R in children injured at younger (≤ 60 months) and older (> 60 months) ages. Correlations were calculated between final PCC-R and age at injury, injury mechanism, gender, maternal education, residence, treatment, Glasgow Coma Score, and intact brain volume.

RESULTS

PCC-Rs varied within and between children. Odds of normal-range PCC-R were significantly higher for the older than for the younger group at all sessions but the first; odds of normal-range PCC-R were 9 to 33 times higher in the older group in sessions 3 to 12. Age at injury was significantly correlated with final PCC-R.

CONCLUSION

Over a 12-month period, severe TBI had more adverse effects for children whose ages placed them in the most intensive phase of PCC-R development than for children injured later.

Disfluency patterns and phonological skills near stuttering onset

There is a substantial amount of literature reporting the incidence of phonological difficulties to be higher for children who stutter when compared to normally fluent children, suggesting a link between stuttering and phonology. In view of this, the purpose of the investigation was to determine whether, among children who stutter, there are relationships between phonological skills and the initial characteristics of stuttering. That is, close to the onset of stuttering, there are differences in specific stuttering patterns between children who exhibit minimal and moderate phonological deviations in terms of frequency of stuttering and length of stuttering events? Twenty-nine preschool children near the onset of stuttering, ranging in age from 29 to 49 months, with a mean of 39.17 months, were divided into two groups based on the level of phonological ability: minimal phonological deviations and moderate phonological deviations. The children's level of stuttering-like disfluencies was examined. Results revealed no statistically significant differences in the stuttering characteristics of the two groups near onset, calling into the question the nature of the stuttering-phonology link.

Idiosyncratic gesture use in atypical language development, and its interaction with speech rhythm, word juncture, syntax, pragmatics and discourse: a case study

Very little is known about the use of gesture by children with developmental language disorders (DLDs). This case study of 'Lucy', a child aged 4;10 with a DLD, expands on what is known and in particular focuses on a type of idiosyncratic "rhythmic gesture" (RG) not previously reported. A fine-grained qualitative analysis was carried out of video recordings of Lucy in conversation with the first author. This revealed that Lucy's RG was closely integrated in complex ways with her use of other gesture types, speech rhythm, word juncture, syntax, pragmatics, discourse, visual processing and processing demands generally. Indeed, the only satisfactory way to explain it was as a partial byproduct of such interactions. These findings support the theoretical accounts of gesture which see it as just one component of a multimodal, integrated signalling system (e.g. Goldin-Meadow, S. (2000). Beyond words: The importance of gesture to researchers and learners. Child Development, 71(1), 231-239), and emergentist accounts of communication impairment which regard compensatory adaptation as integral (e.g. Perkins, M. R. (2007). Pragmatic Impairment. Cambridge: Cambridge University Press.).

Differentiating children with and without language impairment based on grammaticality

PURPOSE

This study compared the diagnostic accuracy of a general grammaticality measure (i.e., percentage grammatical utterance; PGU) to 2 less comprehensive measures of grammaticality--a measure that excluded utterances without a subject and/or main verb (i.e., percentage sentence point; PSP) and a measure that looked only at verb tense errors (i.e., percentage verb tense usage; PVT)--in differentiating children with and without language impairment.

METHOD

Two groups of 3-year-olds, 17 with language impairment and 17 with typical language, participated in a picture description task. PGU, PSP, and PVT were computed. Receiver operating characteristic curve analyses were conducted to determine the best cutoff value for each measure.

RESULTS

All 3 measures demonstrated a sensitivity of 100%. PGU showed a specificity of 88%, and both PSP and PVT showed a specificity of 82%. In addition, PGU showed a larger positive likelihood ratio than the other 2 measures.

CONCLUSION

PGU, PSP, and PVT were all sensitive to language impairment. However, PGU was less likely than PSP and PVT to misclassify children with typical language. The resultant diagnostic accuracy makes PGU an appropriate measure to use to screen for language impairment.

The relationship between inexperienced listeners' perceptions and acoustic correlates of children's /r/ productions

This study examined inexperienced listeners' perceptions of children's naturally produced /r/ sounds with reference to levels of accuracy determined by consensus between two expert clinicians. Participants rated /r/ sounds as fully correct, distorted or incorrect/non-rhotic. Second and third formant heights were measured to explore the relationship between acoustic cues and perceptual judgments. Inexperienced listeners' agreement was greater for correct productions than for distorted or incorrect/non-rhotic productions. In addition, inexperienced listeners' differentiation of intermediate versus fully incorrect /r/ had lower sensitivity and specificity relative to an acoustically defined threshold than experienced listeners' classification. These findings are consistent with results of previous studies highlighting the difficulty in identifying gradations of correctness in misarticulated /r/, and they suggest that this ability may be influenced by clinical experience. Additionally, all listeners were noted to be more consistent in rating vocalic /r/ than consonantal /r/. Implications for clinician training and treatment planning are discussed.

Distinct developmental profiles in typical speech acquisition

Three- to five-year-old children produce speech that is characterized by a high level of variability within and across individuals. This variability, which is manifest in speech movements, acoustics, and overt behaviors, can be input to subgroup discovery methods to identify cohesive subgroups of speakers or to reveal distinct developmental pathways or profiles. This investigation characterized three distinct groups of typically developing children and provided normative benchmarks for speech development. These speech development profiles, identified among 63 typically developing preschool-aged speakers (ages 36-59 mo), were derived from the children's performance on multiple measures. These profiles were obtained by submitting to a k-means cluster analysis of 72 measures that composed three levels of speech analysis: behavioral (e.g., task accuracy, percentage of consonants correct), acoustic (e.g., syllable duration, syllable stress), and kinematic (e.g., variability of movements of the upper lip, lower lip, and jaw). Two of the discovered group profiles were distinguished by measures of variability but not by phonemic accuracy; the third group of children was characterized by their relatively low phonemic accuracy but not by an increase in measures of variability. Analyses revealed that of the original 72 measures, 8 key measures were sufficient to best distinguish the 3 profile groups.

Effect of dialect on identification and severity of speech impairment in Indigenous Australian children

This study investigated the effect of dialectal difference on identification and rating of severity of speech impairment in children from Indigenous Australian backgrounds. The speech of 15 Indigenous Australian children identified by their parents/caregivers and teachers as having 'difficulty talking and making speech sounds' was assessed using the Diagnostic Evaluation of Articulation and Phonology. Fourteen children were identified with speech impairment on the Diagnostic Evaluation of Articulation and Phonology using Standard Australian English (AusE) as the target pronunciation; whereas 13 were identified using Australian Aboriginal English (AAE) as the target. There was a statistically significant decrease in seven children's severity classification and a statistically significant increase in all children's percentage of consonants, vowels and phonemes correct when comparing AAE with AusE. Features of AAE used by the children included /h/ insertion and deletion, primary stress on the first syllable and diphthongs alternating with short clear vowels. It is important that speech-language pathologists consider children's dialect as one component of culturally and linguistically appropriate services.

Aquisição fonológica do Português Brasileiro em crianças do Rio de Janeiro

OBJETIVO: Descrever a aquisição fonológica típica do Português Brasileiro, para fins clínicos. MÉTODOS: Por meio de um teste de nomeação de figuras, foram coletadas amostras de fala de 480 crianças (240 do gênero feminino e 240 do gênero masculino), provenientes de escolas públicas e privadas do município do Rio de Janeiro, que foram divididas em cinco grupos etários entre 3 e 8 anos. Três tipos de análises foram realizadas e os resultados foram comparados em relação ao gênero, à idade e ao nível socioeconômico: (1) análise do inventário fonológico detalhando quantas e quais consoantes foram adquiridas, (2) avaliação do percentual de consoantes corretas e (3) análise dos processos fonológicos observados. RESULTADOS: Os resultados mostraram com clareza um desenvolvimento mais acelerado de crianças de nível socioeconômico alto em comparação com as crianças de nível socioeconômico baixo. Os dados apontaram ainda que a idade é o fator mais determinante na aquisição fonológica. A completude do inventário de consoantes, o percentual de consoantes corretas e o uso de processos fonológicos melhoraram com o aumento da idade, e a variabilidade entre as crianças diminuiu. Não foram, no entanto, observadas diferenças relativas ao gênero. CONCLUSÃO: As informações coletadas podem ajudar os fonoaudiólogos na avaliação e no tratamento dos transtornos dos sons da fala.

How Grammatical Are 3-Year-Olds?

Purpose

This study investigated the level of grammatical accuracy in typically developing 3-year-olds and the types of errors they produce.

Method

Twenty-two 3-year-olds participated in a picture description task. The percentage of grammatical utterances was computed and error types were analyzed.

Results

The mean level of grammatical accuracy in typical 3-year-olds was ∼71%, with a wide range of variability. The current study revealed a variety of error types produced by 3-year-olds, most of which were produced by fewer than 5 children. The pattern observed for most of the children was to produce a scattering of errors with no more than a few of any 1 error type.

Conclusion

The level of grammatical accuracy in 3-year-olds was skewed toward the high end. Although tense marking errors were the most frequent error type, they accounted for only 1/3 of the errors produced by 3-year-olds. A more general measure of grammaticality that considers additional aspects of language might, therefore, be useful in assessing language at this age.

Spoken word recognition in adolescent cochlear implant users during quiet and multispeaker babble conditions

OBJECTIVE

To assess overall speech intelligibility in adolescent cochlear implant speakers during quiet and multispeaker babble conditions.

STUDY DESIGN

A cross-sectional assessment of intelligibility incorporating group (auditory-oral versus total communication speakers), sentence context (high versus low contexts), and background conditions (quiet versus multispeaker babble).

SETTING

A camp designed to assess adolescents over a concentrated period.

PARTICIPANTS

Fifty-seven adolescents who participated in an earlier study when they were 8 to 9 years old examining functional outcomes of speech perception, speech production, and language were asked to participate in follow-up study.

METHODS

Speech intelligibility was assessed by asking the adolescents to repeat sentences. Sentences were digitally edited and played to normal hearing listeners who either provided broad transcriptions of sound accuracy or wrote down the words they understood when the sentences were presented in quiet and in multispeaker babble.

MAIN OUTCOME VARIABLE

The dependent variables were percent correct consonants, vowels, and total words identified.

RESULTS

Very few substitutions or omissions occurred, resulting in high levels of accuracy for consonants and vowels. Speech intelligibility in quiet was significantly greater than in the multispeaker babble condition. Multispeaker babble decreased performance uniformly across sentence context for the 2 groups.

CONCLUSION

Accurate consonant production based on measures of substitutions and omissions fails to account for distortions and allophonic variations. Reductions in speech intelligibility relative to the phoneme correct productions suggest that the allophonic variations related to distortions may influence naive listener's ability to understand the speech of profoundly deaf individuals.

Early Consonant Production in Swedish Infants with and without Unilateral Cleft Lip and Palate and Two-Stage Palatal Repair

Objective

To investigate consonant production at 12 and 18 months of age following early soft palate repair in infants with unilateral cleft lip and palate (UCLP), and to compare it with typically developing children without clefts.

Design

Randomized study with comparison group.

Participants

Twenty Swedish infants born with UCLP and 21 without clefts (COMP) were included in a randomized trial of palatal surgery (Scandcleft project). Soft palate closure was completed at age 5 months; hard palate closure was performed in 11 of the infants with UCLP at 1 year of age (HPC) and was left open in nine (HPO).

Method

Audio recordings at 12 months (UCLP = 9, COMP = 21) and at 18 months (UCLP = 18, COMP = 21) were phonetically transcribed. Consonant inventory, frequency of manner and place of articulation, true canonical babbling (TCB), and impact of hearing status were analyzed.

Results

At 12 months of age, all children had reached the stage of TCB. Mild hearing impairment was significantly correlated with fewer consonant types. A lower frequency of dentals and oral stops was found in the UCLP group than in the COMP group. However, the number of oral stops was high compared with what has been previously reported.

Conclusions

Early soft palate closure seems to give a relatively high number of oral stops even with the hard palate unrepaired, although with significantly fewer dentals/alveolars than are seen in peers without clefts. Differences in consonant inventory were correlated with hearing function.

Phonetic variability in residual speech sound disorders: Exploration of subtypes

PURPOSE: To explore whether subgroups of children with residual speech sound disorders (R-SSDs) can be identified through multiple measures of token-to-token phonetic variability. METHOD: Children with R-SSDs were recorded during a rapid multisyllabic picture naming task and an oral diadochokinetic task. Transcription-based and acoustic measures of token-to-token variability were derived. Articulation accuracy and general indices of language skills were also measured. RESULTS: Low correlations were observed between transcription-based and acoustic measures of phonetic variability, and among the acoustic measures themselves. Children who were the most variable on one measure were not necessarily highly variable on other measures. Transcription-based measures of variability were associated with language skills. CONCLUSIONS: Measures of phonetic variability did not identify children in the sample as consistently high or low. Data do not support the notion that clear subgroups based on phonetic variability can be reliably identified in children with R-SSDs. The link between highly variable phonetic output (quantified by transcription-based measures) and lower language skills requires further exploration.

Developing a weighted measure of speech sound accuracy

PURPOSE

To develop a system for numerically quantifying a speaker's phonetic accuracy through transcription-based measures. With a focus on normal and disordered speech in children, the authors describe a system for differentially weighting speech sound errors on the basis of various levels of phonetic accuracy using a Weighted Speech Sound Accuracy (WSSA) score. The authors then evaluate the reliability and validity of this measure.

METHOD

Phonetic transcriptions were analyzed from several samples of child speech, including preschoolers and young adolescents with and without speech sound disorders and typically developing toddlers. The new measure of phonetic accuracy was validated against existing measures, was used to discriminate typical and disordered speech production, and was evaluated to examine sensitivity to changes in phonetic accuracy over time. Reliability between transcribers and consistency of scores among different word sets and testing points are compared.

RESULTS

Initial psychometric data indicate that WSSA scores correlate with other measures of phonetic accuracy as well as listeners' judgments of the severity of a child's speech disorder. The measure separates children with and without speech sound disorders and captures growth in phonetic accuracy in toddlers' speech over time. The measure correlates highly across transcribers, word lists, and testing points.

CONCLUSION

Results provide preliminary support for the WSSA as a valid and reliable measure of phonetic accuracy in children's speech.

Effect of speech-intrinsic variations on human and automatic recognition of spoken phonemes

The aim of this study is to quantify the gap between the recognition performance of human listeners and an automatic speech recognition (ASR) system with special focus on intrinsic variations of speech, such as speaking rate and effort, altered pitch, and the presence of dialect and accent. Second, it is investigated if the most common ASR features contain all information required to recognize speech in noisy environments by using resynthesized ASR features in listening experiments. For the phoneme recognition task, the ASR system achieved the human performance level only when the signal-to-noise ratio (SNR) was increased by 15 dB, which is an estimate for the human-machine gap in terms of the SNR. The major part of this gap is attributed to the feature extraction stage, since human listeners achieve comparable recognition scores when the SNR difference between unaltered and resynthesized utterances is 10 dB. Intrinsic variabilities result in strong increases of error rates, both in human speech recognition (HSR) and ASR (with a relative increase of up to 120%). An analysis of phoneme duration and recognition rates indicates that human listeners are better able to identify temporal cues than the machine at low SNRs, which suggests incorporating information about the temporal dynamics of speech into ASR systems.

Human phoneme recognition depending on speech-intrinsic variability

The influence of different sources of speech-intrinsic variation (speaking rate, effort, style and dialect or accent) on human speech perception was investigated. In listening experiments with 16 listeners, confusions of consonant-vowel-consonant (CVC) and vowel-consonant-vowel (VCV) sounds in speech-weighted noise were analyzed. Experiments were based on the OLLO logatome speech database, which was designed for a man-machine comparison. It contains utterances spoken by 50 speakers from five dialect/accent regions and covers several intrinsic variations. By comparing results depending on intrinsic and extrinsic variations (i.e., different levels of masking noise), the degradation induced by variabilities can be expressed in terms of the SNR. The spectral level distance between the respective speech segment and the long-term spectrum of the masking noise was found to be a good predictor for recognition rates, while phoneme confusions were influenced by the distance to spectrally close phonemes. An analysis based on transmitted information of articulatory features showed that voicing and manner of articulation are comparatively robust cues in the presence of intrinsic variations, whereas the coding of place is more degraded. The database and detailed results have been made available for comparisons between human speech recognition (HSR) and automatic speech recognizers (ASR).

Longitudinal development of phonology and morphology in children with late-identified mild-moderate sensorineural hearing loss

OBJECTIVE

Studies of language development in children with mild-moderate hearing loss are relatively rare. Longitudinal studies of children with late-identified hearing loss are relevant for determining how a period of unaided mild-moderate hearing loss impacts development. In recent years, newborn hearing screening programs have effectively reduced the ages of identification for most children with permanent hearing loss. However, some children continue to be identified late, and research is needed to guide management decisions. Furthermore, studies of this group may help to discern whether language normalizes after intervention and/or whether certain aspects of language might be vulnerable to persistent delays. The current study examines the impact of late identification and reduced audibility on speech and language outcomes via a longitudinal study of four children with mild-moderate sensorineural hearing loss.

DESIGN

Longitudinal outcomes of four children with late-identified mild-moderate sensorineural hearing loss were studied using standardized measures and language sampling procedures from at or near the point of identification (28 to 41 mos) through 84 mos of age. The children with hearing loss were compared with 10 age-matched children with normal hearing on a majority of the measures through 60 mos of age. Spontaneous language samples were collected from mother-child interaction sessions recorded at consistent intervals in a laboratory-based play setting. Transcripts were analyzed using computer-based procedures (Systematic Analysis of Language Transcripts) and the Index of Productive Syntax. Possible influences of audibility were explored by examining the onset and productive use of a set of verb tense markers and by monitoring the children's accuracy in the use of morphological endings. Phonological samples at baseline were transcribed and analyzed using Computerized Profiling.

RESULTS

At entry to the study, the four children with hearing loss demonstrated language delays with pronounced delays in phonological development. Three of the four children demonstrated rapid progress with development and interventions and performed within the average range on standardized speech and language measures compared with age-matched children by 60 mos of age. However, persistent differences from children with normal hearing were observed in the areas of morphosyntax, speech intelligibility in conversation, and production of fricatives. Children with mild-moderate hearing loss demonstrated later than typical emergence of certain verb tense markers, which may be related to reduced or inconsistent audibility.

CONCLUSIONS

The results of this study suggest that early communication delays will resolve for children with late-identified, mild-moderate hearing loss, given appropriate amplification and intervention services. A positive result is that three of four children demonstrated normalization of broad language behaviors by 60 mos of age, despite significant delays at baseline. However, these children are at risk for persistent delays in phonology at the conversational level and for accuracy in use of morphological markers. The ways in which reduced auditory experiences and audibility may contribute to these delays are explored along with implications for evaluation of outcomes.

Transcribing the speech of children with cochlear implants: clinical application of narrow phonetic transcriptions

PURPOSE

The phonological systems of children with cochlear implants may include segment inventories that contain both target and nontarget speech sounds. These children may not consistently follow phonological rules of the target language. These issues present a challenge for the clinical speech-language pathologist who uses phonetic transcriptions to evaluate speech production skills and to develop a plan of care. The purposes of this tutorial are to (a) identify issues associated with phonetic transcriptions of the speech of children with cochlear implants and (b) discuss implications for assessment.

METHOD

Narrow transcription data from an ongoing, longitudinal research study were catalogued and reviewed. Study participants had at least 5 years of cochlear implant experience and used spoken American English as a primary means of communication. In this tutorial, selected phonetic symbols and phonetic phenomena are reviewed.

CONCLUSIONS

A set of principles for phonetic transcriptions is proposed. Narrow phonetic transcriptions that include all segment possibilities in the International Phonetic Alphabet and extensions for disordered speech are needed to capture the subtleties of the speech of children with cochlear implants. Narrow transcriptions also may play a key role in planning treatment.

Phonological accuracy and intelligibility in connected speech of boys with fragile X syndrome or Down syndrome

PURPOSE

To compare the phonological accuracy and speech intelligibility of boys with fragile X syndrome with autism spectrum disorder (FXS-ASD), fragile X syndrome only (FXS-O), Down syndrome (DS), and typically developing (TD) boys.

METHOD

Participants were 32 boys with FXS-O (3-14 years), 31 with FXS-ASD (5-15 years), 34 with DS (4-16 years), and 45 TD boys of similar nonverbal mental age. We used connected speech samples to compute measures of phonological accuracy, phonological process occurrence, and intelligibility.

RESULTS

The boys with FXS, regardless of autism status, did not differ from TD boys on phonological accuracy and phonological process occurrence but produced fewer intelligible words than did TD boys. The boys with DS scored lower on measures of phonological accuracy and occurrence of phonological processes than all other groups and used fewer intelligible words than did TD boys. The boys with FXS and the boys with DS did not differ on measures of intelligibility.

CONCLUSIONS

Boys with FXS, regardless of autism status, exhibited phonological characteristics similar to those of younger TD children but were less intelligible in connected speech. Boys with DS showed greater delays in all phonological measures than the boys with FXS and the TD boys.

The effect of the communication output method on augmented interaction

The experiment compared the ability of a Comprehension Model versus an Interaction Model to account for the communication performance of augmented communicators. Five dyads consisting of adults without disabilities, with one participant in each dyad randomly assigned to use an augmentative communication device, engaged in ten direction-giving tasks in which the augmented communicator used either a Word Method (i.e., spoken words only) or a Mixed Method (i.e., mix of spoken words and letters) speech output. Results indicated an overall completion time and communication rate advantage for the Mixed Method output in most communication tasks, supporting the Interaction Model of augmented communication. The role of communication co-construction in augmented interaction and the implications of the Interaction Model for future communication device design are discussed.

Speed and accuracy of rapid speech output by adolescents with residual speech sound errors including rhotics

Children with residual speech sound errors are often underserved clinically, yet there has been a lack of recent research elucidating the specific deficits in this population. Adolescents aged 10-14 with residual speech sound errors (RE) that included rhotics were compared to normally speaking peers on tasks assessing speed and accuracy of speech production. The two groups were evaluated on an oral diadochokinetic task, which required rapid production of the trisyllable /p Lambda t Lambda k Lambda/, and two rapid naming tasks: monosyllabic letter names and multisyllabic picture names. No significant group differences were observed in the speed of trisyllables on the DDK task, whether examining all attempts or only correct productions. However, the RE group was less accurate and more variable in their production of the trisyllables. In addition, the RE group was slower and phonologically less accurate in rapidly naming multisyllabic pictures, but not in naming letters. A combination of speed and accuracy measures from these tasks revealed relatively little overlap between groups. Results suggest that both speed and accuracy may be impaired in adolescents with RE, although the underlying causal mechanisms require further exploration.

Between-Word Simplification Patterns in the Continuous Speech of Children With Speech Sound Disorders

Purpose

This study was designed to identify and describe between-word simplification patterns in the continuous speech of children with speech sound disorders. It was hypothesized that word combinations would reveal phonological changes that were unobserved with single words, possibly accounting for discrepancies between the intelligibility of single-word samples and that of continuous speech.

Method

Four boys with developmental speech sound disorders provided samples of single words and continuous speech. Substitutions and deletions with single words formed the basis for determining 2 categories of between-word segment mismatches: observed and novel . Mismatches were attributed to one of 4 types of between-word simplifications reported for typical phonological development: between-word consonant deletion, between-word cluster reduction, between-word consonant sequence reduction, and between-word assimilation.

Results

Continuous speech revealed observed and novel patterns. Segment mismatches occurred differentially among potential between-word simplification environments. The most frequently occurring novel pattern involved the deletion of a coda consonant within a between-word consonant sequence.

Conclusions

Children with speech sound disorders demonstrated substitutions and deletions between words in continuous speech that may not be predicted on the basis of single-word productions. The identification of potential contexts for such mismatches may serve as a framework for the assessment of continuous speech samples of children with speech sound disorders in health care and school settings.