The speech perception skills of children with and without speech sound disorder

Four Cases of Children With Phonological Impairment and Precocious Vocabulary: Making Sense of a Clinical Conundrum

PURPOSE

The purpose of this study was to describe the speech production, speech perception, vocabulary, and word learning abilities of lexically precocious 4-year-old children with phonological impairment, in an effort to better understand the underlying nature of phonological impairment in children.

METHOD

Using a case series approach, we identified four children with phonological impairment and precocious vocabulary abilities. Each child completed routine speech production and vocabulary assessments, as well as experimental speech perception and word learning tasks. The results from these tasks were then used to create profiles of each child's individual strengths and needs across the abilities assessed.

RESULTS

Although all four children presented with phonological impairment and lexically precocious receptive and expressive vocabulary, they differed in their specific speech errors. One child presented with phonological speech errors only, while the other three children presented with an interdental lisp alongside their phonological errors. Three children presented with average speech perception abilities, and one child presented with poorer speech perception. The same three children also showed some learning of novel nonwords 1 week post-initial exposure, while the other child showed no evidence of word learning 1 week post-initial exposure.

CONCLUSIONS

The clinical profiles of lexically precocious children with phonological impairment offered different insights into the nature of the problem. Although one child appeared to present with underspecified underlying representations of words, the other three children appeared to present with well-specified underlying representations. Of the three children with well-specified underlying representations, two appeared to have difficulty abstracting particular rules of the ambient phonological system. Further research is needed to improve our understanding of the underlying nature of phonological impairment.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.26307640.

I remembered the chorm! Word learning abilities of children with and without phonological impairment

BACKGROUND

Children with phonological impairment present with pattern-based errors in their speech production. While some children have difficulties with speech perception and/or the establishment of robust underlying phonological representations, the nature of phonological impairment in children is still not well understood. Given that phonological and lexical development are closely linked, one way to better understand the nature of the problem in phonological impairment is to examine word learning abilities in children.

AIMS

To examine word learning and its relationship with speech perception, speech production and vocabulary knowledge in children aged 4-5 years. There were two variables of interest: speech production abilities ranging from phonological impairment to typical speech; and vocabulary abilities ranging from typical to above average ('lexically precocious').

METHODS & PROCEDURES

Participants were 49 Australian-English-speaking children aged 48-69 months. Children were each taught four novel non-words (out of a selection of eight) through stories, and word learning was assessed at 1 week post-initial exposure. Word learning was assessed using two measures: confrontation naming and story retell naming. Data were analysed by group using independent-samples t-tests and Mann-Whitney U-tests, and continuously using multiple linear regression.

OUTCOMES & RESULTS

There was no significant difference in word learning ability of children with and without phonological impairment, but regardless of speech group, children with above average vocabulary had significantly better word learning abilities than children with average vocabulary. In multiple linear regression, vocabulary was the only significant predictor of variance in word learning ability.

CONCLUSIONS & IMPLICATIONS

Children with phonological impairment can be lexically precocious and learn new words like their peers without phonological impairment. Contrary to expectations, vocabulary knowledge rather than expressive phonological ability explained variance in measures of word learning. These findings question an assumption that children with phonological impairment have underspecified phonological representations. They also highlight the heterogeneity among children with phonological impairment and the need to better understand the nature of their difficulty learning the phonological system of the ambient language.

WHAT THIS PAPER ADDS

What is already known on the subject There is limited research examining the word learning abilities of children with phonological impairment. Most previous research focuses on word properties such as phonotactic probability and neighbourhood density. Within the existing literature there are different reports and conclusions regarding the word learning abilities of children with phonological impairment and whether their word learning differs from that of children with typically developing speech. What this study adds to existing knowledge This study found that vocabulary was the strongest predictor of word learning across children with and without phonological impairment. There was no significant difference in word learning ability between children with and without phonological impairment. However, children with lexically precocious vocabulary abilities were significantly better at word learning than children with average vocabulary abilities. What are the potential or actual clinical implications of this work? Findings from this study support the importance of assessing and considering measures of word learning-including vocabulary-when working with children with phonological impairment. This study indicates that it is possible to use stories coupled with measures of confrontation naming and story retell to gain deeper insight into children's word learning abilities.

Speech perception: Auditory and visual cue integration in children with and without phonological disorder in voiceless fricatives

The literature reports contradictory results regarding the influence of visual cues on speech perception tasks in children with phonological disorder (PD). This study aimed to compare the performance of children with (n = 15) and without PD (n = 15) in audiovisual perception task in voiceless fricatives. Assuming that PD could be associated with an inability to integrate phonological information from two sensory sources, we presumed that children with PD would present difficulties in integrating auditory and visual cues compared to typical children. A syllable identification task was conducted. The stimuli were presented according to four conditions: auditory-only (AO); visual-only (VO); audiovisual congruent (AV+); and audiovisual incongruent (AV-). The percentages of correct answers and the respective reaction times in the AO, VO, and AV+ conditions were considered for the analysis. The correct percentage of auditory stimuli was considered for the AV- condition, as well as the percentage of perceptual preference: auditory, visual, and/or illusion (McGurk effect), with the respective reaction time. In comparing the four conditions, children with PD presented a lower number of correct answers and longer reaction time than children with typical development, mainly for the VO. Both groups showed a preference for auditory stimuli for the AV- condition. However, children with PD showed higher percentages for visual perceptual preference and the McGurk effect than typical children. The superiority of typical children over PD children in auditory-visual speech perception depends on type of stimuli and condition of presentation.

Subtract Before You Add: Toward the Development of a De-Implementation Approach in School-Based Speech Sound Therapy

PURPOSE

It is often difficult for school-based speech-language pathologists (SLPs) to prioritize implementing new practices for children with speech sound disorders (SSDs), given burgeoning caseloads and the myriad of other workload tasks. We propose that de-implementation science is equally as important as implementation science. De-implementation science is the recognition and identification of areas that are of "low-value and wasteful." Critically, the idea of de-implementation suggests that we first remove something from a clinician's workload before requesting that they learn and implement something new.

METHOD

Situated within the Sustainability in Healthcare by Allocating Resources Effectively (SHARE) framework, we review de-implementation science and current speech sound therapy literature to understand the mechanisms behind continuous use of practices that are no longer supported by science or legislation. We use vignettes to highlight real-life examples that clinicians may be facing in school-based settings and to provide hypothetical solutions, resources, and/or next steps to these common challenges.

RESULTS

By focusing on Phase 1 of the SHARE framework, we identified four primary practices that can be de-implemented to make space for new evidence-based techniques and approaches. These four practices were determined based on an in-depth review of SLP-based survey research: (a) overreliance on speech sound norms for eligibility determinations, (b) the omission of phonological processing skills within evaluations, (c) homogeneity of service delivery factors, and (d) the use of only one treatment approach for all children with SSDs.

CONCLUSIONS

De-implementation will take work and may lead to some difficult discussions. Implementing a framework, such as SHARE, can guide SLPs toward a reduction in workloads and improved outcomes for children with SSDs.

The Relationship Between Speech Perception, Speech Production, and Vocabulary Abilities in Children: Insights From By-Group and Continuous Analyses

PURPOSE

The purpose of this study was to explore the relationship between speech perception, speech production, and vocabulary abilities in children with and without speech sound disorders (SSDs), analyzing the data both by group and continuously.

METHOD

Sixty-one Australian English-speaking children aged 48-69 months participated in this study. Children's speech production abilities ranged along the continuum from SSDs through to typical speech. Their vocabulary abilities ranged along the continuum from typical to above average ("lexically precocious"). Children completed routine speech and language assessments in addition to an experimental Australian English lexical and phonetic judgment task.

RESULTS

When analyzing data by group, there was no significant difference between the speech perception ability of children with SSDs and that of children without SSDs. Children with above-average vocabularies had significantly better speech perception ability than children with average vocabularies. When analyzing data continuously, speech production and vocabulary were both significant positive predictors of variance in speech perception ability, both individually in simple linear regression and when combined in multiple linear regression. There was also a significant positive correlation between perception and production of two of the four target phonemes tested (i.e., /k/ and /ʃ/) among children in the SSD group.

CONCLUSIONS

Results from this study provide further insight into the complex relationship between speech perception, speech production, and vocabulary abilities in children. While there is a clinical and important need for categorical distinctions between SSDs and typically developing speech, findings further highlight the value of investigating speech production and vocabulary abilities continuously and categorically. By capturing the heterogeneity among children's speech production and vocabulary abilities, we can advance our understanding of SSDs in children.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22229674.

Interpretation of Misarticulated Words by Children With and Without Speech Sound Disorders

PURPOSE

Children with speech sound disorders (SSDs) often struggle with forming early representations for phonemes and words, which could impact their speech production as well as their lexical access. This difficulty may limit their ability to accurately identify nonexemplar productions of words, such as developmental misarticulations produced by peers. The purpose of this study was to examine word interpretation of misarticulated words by children with SSD.

METHOD

Seventeen monolingual English-speaking preschoolers were assessed for language, phonological processing, and articulation skills. Participants heard three types of words: accurate productions (e.g., "leaf"), common misarticulated productions (e.g., "weaf"), uncommon misarticulated productions (e.g., "yeaf"), and unrelated nonwords (e.g., "gim"). Children were presented with these words aurally and asked to select the picture that matched what they heard-either a real object or a blank square.

RESULTS

The proportion of real object picture selections was calculated for each word type and compared within subjects. The findings indicate that children with SSD reliably associated common misarticulated words with pictured objects more frequently than they did in the uncommon misarticulation condition. These results were compared between subjects to typically developing (TD) peers' responses using a one-way analysis of variance. The results indicate that children with SSD identified common substitutions as real object pictures more often than TD peers.

CONCLUSION

The results of this study suggest that children with SSD are sensitive to the commonness of misarticulations; however, they accept common substitutions as real object pictures significantly more often than TD peers.

The Effect of Somatosensory Input on Word Recognition in Typical Children and Those With Speech Sound Disorder

PURPOSE

Recent work suggests that speech perception is influenced by the somatosensory system and that oral sensorimotor disruption has specific effects on the perception of speech both in infants who have not yet begun to talk and in older children and adults with ample speech production experience; however, we do not know how such disruptions affect children with speech sound disorder (SSD). Response to disruption of would-be articulators during speech perception could reveal how sensorimotor linkages work for both typical and atypical speech and language development. Such linkages are crucial to advancing our knowledge on how both typically developing and atypically developing children produce and perceive speech.

METHOD

Using a looking-while-listening task, we explored the impact of a sensorimotor restrictor on the recognition of words whose onsets involve late-developing sounds (s, ʃ) for both children with typical development (TD) and their peers with SSD.

RESULTS

Children with SSD showed a decrement in performance when they held a restrictor in their mouths during the task, but this was not the case for children with TD. This effect on performance was only observed for the specific speech sounds blocked by the would-be articulators.

CONCLUSION

We argue that these findings provide evidence for altered perceptual motor pathways in children with SSD.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21809442.

Perception of the /t/-/k/ contrast by Mandarin-speaking children with Speech Sound Disorders

Mandarin-speaking children with speech sound disorders (SSD) often show difficulties in producing alveolar and velar plosives contrasts (e.g., /t/ vs. /k/). But it remains unclear whether such phonological disorder correlates with the perception of the contrast between alveolar and velar plosives. The present study assessed whether Mandarin-speaking children with SSD who substituted [t] for /k/ in production could perceptually distinguish between /t/ and /k/, and compared their results with those from typically developing children (TDC) and typically adults (TA). We adopted a categorical perception paradigm with a /ta/-/ka/ continuum. The continuum included nine stimuli, which were synthesized from a naturally-produced /ta/. The SSD, TDC, and TA groups completed both identification and discrimination tasks that required perceptual judgment of individual stimulus and pairs of stimuli from the continuum. The results showed that the TDC and TA groups showed typical patterns of categorical perception in the continuum. But the SSD group only reached or was slightly above the chance level in the identification task and did not show significant difference among pairs of stimuli in the discrimination task. Their performance was significantly different from that of the TDC and TA groups and lacked typical patterns of categorical perception. The results suggested that their perception of /t/ vs. /k/ may be impaired. Considering the SSD group's speech errors, this perception defect may be a cause for their tendency of substituting [t] for /k/ in production.

Working memory span and receptive vocabulary assessment in Urdu speaking children with speech sound disorder

Emerging evidence suggests that impaired speech may be related to reduced working memory (WM). The current study aimed to validate and compare the influence of articulation, short-term memory (STM), WM, and receptive vocabulary abilities of Pakistani children with speech sound disorder (SSD; N = 50) versus typically developing (TD; N = 30) children aged 7-13 years. Assessments included the Test for Assessment of Articulation and Phonology in Urdu (TAAPU), Peabody Picture Vocabulary Test-4, translated to Urdu (U-PPVT-4), and Digit Memory Test (DMT) used to determine speech articulation, receptive vocabulary, and memory abilities respectively. The percentage correct consonants (PCC) score was used to divide the SSD group further into SSD severity groups. The TD and SSD groups significantly differed in performance on all tasks (p < 0.05). Moreover, the SSD severity groups showed significant differences (p < 0.0001) in performance on different components of TAAPU (total errors and substitution errors) and DMT tasks. However, the SSD severity groups did not show significant differences in performance on the U-PPVT-4. Correlational analyses indicate statistically significant correlations of PCC with STM, WM, and receptive vocabulary. Regression analyses suggested that both WM and STM contribute to speech intelligibility in children with SSD. Our findings in Urdu-speaking children support previous results in English-speaking children suggesting the articulation skills, receptive vocabulary, STM, and WM were less developed in children with SSD than in TD children.

Speech production and speech perception in children with speech sound disorder

The goal of the present study was to investigate the relationship between speech production (SP) and speech perception in children with Speech Sound Disorder (SSD) from both typical speech production (TSP) and child's own atypical speech production (ASP). Ten children with SSD were evaluated by a speech production task (naming test) and two speech perception tasks (phonological contrast identification) using the PERCEFAL instrument. In the identification task, the acoustic stimulus, from typical and child's own atypical speech productions, was presented to each child, and they needed to choose the corresponding stimulus between two pictures displayed on the computer screen. The percentages of errors on speech production (SP) task, on the identification task from TSP and ASP were calculated for each child. ANOVA showed a significant difference between speech production and speech perception. Post hoc analysis demonstrated a greater mean of errors in the ASP compared to the mean of errors in the TSP and SP performances. Only SP and ASP performances presented a significant correlation (r = 0.65). Errors involving manner and manner+place were most recurring in SP. TSP seems to precede SP; that is, children with SSD perceive more speech from typical production than they are able to produce. The significant correlation between ASP and SP suggests that the evaluation of these skills accesses the children's equivalent underlying phonological representation. A more accurate production, such as typical production, may have cues that help children with SSD to identify phonological contrasts, even if their underlying representations are overly broad or not established.

Auditory-perceptual performance in children with and without phonological disorder in the stops class

PURPOSE

To compare the auditory-perceptual performance of children with and without phonological disorder (PD) in the identification task of contrasts between stops phonemes.

METHODS

Information was selected from a database regarding the auditory-perceptual performance of 46 children (23 with a diagnosis of PD with involvement in the stops (G1) and 23 with typical speech development (G2)), aged 4 and eight years old, in an identification task of the class of stops consonants in Brazilian Portuguese, using the speech perception assessment instrument (PERCEFAL). The reaction time, the number of errors and correctness, as well as the pattern of perceptual error were considered in the analysis.

RESULTS

Regarding the auditory-perceptual accuracy, T-Test showed a statistically significant difference, in which typical children had a higher average of correctness than children with PD and shorter reaction time for correct answers. Regarding the error pattern, repeated measures ANOVA showed a significant effect for the group and error pattern, but not for the interaction between group and error pattern. Tukey's Post Hoc test showed for both groups that errors involving place of articulation were superior to voicing and voicing + place of articulation errors.

CONCLUSION

children with phonological disorders have worse accuracy in relation to children without disorders and, also, longer response time for correctness. Errors involving the place of articulation between the stops were the most frequent for both groups.

Auditory-perceptual acuity in rhotic misarticulation: baseline characteristics and treatment response

The rhotic sound /r/ is one of the latest-emerging sounds in English, and many children receive treatment for residual errors affecting /r/ that persist past the age of 9. Auditory-perceptual abilities of children with residual speech errors are thought to be different from their typically developing peers. This study examined auditory-perceptual acuity in children with residual speech errors affecting /r/ and the relation of these skills to production accuracy, both before and after a period of treatment incorporating visual biofeedback. Identification of items along an /r/-/w/ continuum was assessed prior to treatment. Production accuracy for /r/ was acoustically measured from standard/r/stimulability probes elicited before and after treatment. Fifty-nine children aged 9-15 with residual speech errors (RSE) affecting /r/ completed treatment, and forty-eight age-matched controls who completed the same auditory-perceptual task served as a comparison group. It was hypothesized that children with RSE would show lower auditory-perceptual acuity than typically developing speakers and that higher auditory-perceptual acuity would be associated with more accurate production before treatment. It was also hypothesized that auditory-perceptual acuity would serve as a mediator of treatment response. Results indicated that typically developing children have more acute perception of the /r/-/w/ contrast than children with RSE. Contrary to hypothesis, baseline auditory-perceptual acuity for /r/ did not predict baseline production severity. For baseline auditory-perceptual acuity in relation to biofeedback efficacy, there was an interaction between auditory-perceptual acuity and gender, such that higher auditory-perceptual acuity was associated with greater treatment response in female, but not male, participants.

Perception of Correctly and Incorrectly Produced Words in Children With and Without Phonological Speech Sound Disorders

Purpose The purpose of this study was to examine the perception of correctly and incorrectly produced words in children with and without phonological speech sound disorder (SSD) with similar vocabulary and language skills. Method Thirty-six monolingual English-speaking children aged 4 and 5 years, half with SSD and half with typical speech and language skills, participated in this study. Participants completed standardized speech and language tests as well as a mispronunciation detection task targeting omissions and substitutions of the phonemes /k, s, ɹ/ in five word positions/shapes. Results The children with SSD obtained significantly lower perceptual accuracy than the children with typical development. There was no statistically significant effect for phoneme. Omissions were more likely to be detected by both groups of participants compared with substitutions, and children with SSD had greater difficulty identifying substitutions as incorrectly produced words. Conclusions Speech perception difficulties may be a distinguishing feature of children with phonological SSD and without concomitant language difficulties. Further research is needed to investigate specific speech contexts in which perception predicts accurate production in children with SSD.

Mismatch Negativity in children with Phonological Disorders

OBJECTIVE

to characterize the latency, amplitude and area variables of the Mismatch Negativity (MMN) elicited with verbal stimuli in children with PD, in addition to assessing whether this potential can be a useful tool in capturing auditory perception and discrimination deficits related to this disorder.

METHODS

MMN was recorded using a combination of speech contrast consisting of acoustic syllables [da vs ta], as the standard and deviant stimuli, in 34 children aged between 5 and 8 years. 14 children of the sample were already diagnosed with Phonological Disorder (PD) while 19 were characterized with typical development.

RESULTS

No statistically significant differences were observed for the MMN responses recorded between children with PD and their typically developed peers.

CONCLUSION

The results suggest that the MMN may not be the most suitable procedure to assess auditory perception and discrimination deficits that could potentially be related to PD.

Perception of Medial Consonants by Preschoolers With and Without Speech Sound Disorders

Purpose This study compared perception of consonants in medial position by preschoolers, with and without speech sound disorder (SSD), with similar vocabulary and language skills. In addition, we investigated the association between speech perception and production skills. Method Participants were 36 monolingual English-speaking children with similar vocabulary and language skills, half with SSD and half with typical speech and language development (TD). Participants completed a speech perception task targeting phonemes /p, k, s, ɹ/ in /aCa/ disyllables and a comprehensive battery of speech and language measures. Results Children with SSD were significantly less accurate in perceiving speech sound distinctions relative to peers with TD. The phoneme /p/ was perceived significantly more accurately than the three other target phonemes. The correlation between overall perceptual accuracy and overall production accuracy was significant. Furthermore, perceptual accuracy of targets /k, s, ɹ/ was significantly correlated with production accuracy of these phonemes. Conclusions Many children with SSD have greater difficulty perceiving the specific speech sounds they misarticulate. Nonetheless, most children with SSD present with broader perceptual difficulties than peers with TD with similar vocabulary and language skills.

Audience Response System-Based Evaluation of Intelligibility of Children's Connected Speech - Validity, Reliability and Listener Differences

PURPOSE

We assessed audience response systems (ARS)-based evaluation of intelligibility, with a view to find a valid and reliable intelligibility measure that is accessible to non-trained participants. In addition, we investigated potential listener differences between pediatric speech and language pathologists (SLPs) and untrained adults.

METHOD

Sixteen one-minute samples of connected speech were compiled, collected from 14 children with a speech sound disorder (SSD) and two children with typical speech. 16 SLPs and 13 untrained adults participated in a series of ARS listening sessions, where they were fitted with headphones and hand controls, and instructed to click a button whenever they did not understand the child speaking. Listeners' button clicks were registered and, for each speech sample, totaled into an (un)intelligibility index. The proportion of syllables perceived correctly - based on orthographic listener transcripts - was used as a reference score of intelligibility.

RESULTS

The ARS-based intelligibility scores correlated strongly with the intelligibility reference score. Reliability was high across listener groups and weaker for single listeners. No significant difference was found between the evaluations of SLPs and untrained adults.

CONCLUSIONS

ARS-based evaluation offers a valid and reliable measure of intelligibility of particular value in research as a practical tool for collecting input from listeners without experience or knowledge of SSDs. We stress that the ARS design presupposes a listener panel, and that evaluations obtained from individual listeners are predictably inadequate in terms of reliability.

Intra-word accuracy and consistency in Finnish-speaking children with speech sound disorder compared to their typically developing peers

This study examined intra-word accuracy and consistency in 32 preschool-aged Finnish-speaking children with speech sound disorder (SSD) compared to their typically developing (TD) age- and gender-matched peers. Accuracy and consistency of speech production were assessed by a picture-naming task repeated three times in one assessment session. Responses were classified into four categories: 1) consistently correct, 2) consistently incorrect, 3) variable with hits (when a child's variable responses included at least one matched with the adult target), and 4) variable with no hits (when responses included at least two different response types without the matched adult target). In addition, relationships between intra-word accuracy and consistency and children's receptive vocabulary knowledge and articulatory ability based on spontaneous speech samples were investigated. The findings showed that the children with SSD produced significantly more often 'consistently incorrect' and 'variable with no hits' responses than the TD children. There was a significant negative correlation between 'variable with no hits' responses and receptive vocabulary knowledge and articulatory abilities among the children with SSD. As intra-word accuracy and consistency has not previously been studied in Finnish children with SSD, the findings highlighted the need for drafting guidelines for assessment and intervention by paying close attention to high intra-word variability without correct word forms already from age three onwards.

Phonemic discrimination and reproduction in 4-5-year-old children: Relations to hearing

OBJECTIVE

The long-term objective of this research is to highlight the importance of speech perception assessment in children with developmental language disorder (DLD), and to investigate how hearing contributes to speech and language skills. As a first step in fulfilling this aim, the present study explored relations between phonemic discrimination and reproduction, and sensitive measures of hearing in young healthy children.

METHODS

The American Listen-Say test was developed and served as speech perception tool. This test reports speech discrimination of phonemic contrasts quantitatively for both quiet and in noise conditions, along with reproduction scores, all measured within one session. Speech tokens were perceptually homogenized in noise. Forty-one 4-5-year-old American children participated. Phonemic discrimination (quiet and speech shaped noise) and phonemic reproduction, audiometric thresholds in the conventional (1-8 kHz) and extended high frequency (EHF; 10-16 kHz) range, and distortion product otoacoustic emissions (DPOAEs) were examined.

RESULTS

All children had normal hearing thresholds within the conventional range (mean PTA bilaterally 8.6 dB HL). Ten (24.3%) of the children had elevated EHF thresholds (> 20 dB HL) for one or more frequencies or ears, and six (14.6%) had DPOAE signal to noise ratios (SNR) < 6 dB. EHF thresholds and DPOAE SNRs were significantly associated. Children's phonemic discrimination was impaired in noise, relative to quiet. There was a moderate, significant correlation between overall phonemic discrimination in noise and EHF audiometric thresholds.

CONCLUSIONS

Overall, the present study showed that sensitive hearing measures enabled the detection of subtle hearing difficulties in young healthy children. In particular, phonemic discrimination in noise showed associations with hearing. Implications of including sensitive hearing measures in children with DLD are discussed.

Identification of Foreign-Accented Words in Preschoolers With and Without Speech Sound Disorders

Purpose The aim of this study was to investigate the ability of preschoolers with speech sound disorder (SSD) and with typical speech and language development (TD) to understand foreign-accented words, providing a window into the quality of their underlying phonological representations. We also investigated the relationship between vocabulary skills and the ability to identify words that are frequent and have few neighbors (lexically easy words) and words that are less frequent and have many neighbors (lexically hard words). Method Thirty-two monolingual English-speaking children (16 with SSD, 16 with TD), ages 4 and 5 years, completed standardized speech and language tests and a two-alternative forced-choice word identification task of English words produced by a native English speaker and a native Korean speaker. Results Children with SSD had more difficulty identifying words produced by both talkers than children with TD and showed a larger difficulty identifying Korean-accented words. Both groups of children identified lexically easy words more accurately than lexically hard words, although this difference was not significant when including receptive vocabulary skills in the analysis. Identification of lexically hard words, both those produced by the native English speaker and the nonnative English speaker, increased with vocabulary size. Conclusion Considering the performance of the children with SSD under ideal listening conditions in this study, we can assume that, as a group, children with SSD may experience greater difficulty identifying foreign-accented words in environments with background noise.

Perception of Medial Consonants by Children With and Without Speech and Language Disorders: A Preliminary Study

Purpose The aim of this preliminary study was to investigate perception of the early-acquired consonant /p/ and later-acquired consonant /ʃ/ in medial word position by preschoolers with and without speech and language disorders. Method Twenty-four children, six with isolated speech sound disorder (SSD-only), six with SSD and concomitant developmental language disorder (SSD + DLD), and 12 with typical speech and language skills (TD) completed a battery of standardized speech and language tests as well as an identification task of /aCa/ disyllables. Targets and foils varied by only one place, manner, or voice feature. Mixed analysis of variance (participant groups × two target consonants) was conducted to compare performance of children in the three groups (between-subjects) and to compare performance on consonants that are early acquired or later acquired (within-subject). Results All groups of participants were more accurate in perceiving the early-acquired consonant than the later-acquired consonant. Overall performance by children with SSD-only did not differ significantly from children with TD. As a group, children with SSD + DLD were less accurate than children with TD and children with SSD-only for both target consonants. Conclusions Children with SSD + DLD performed less well than peers with SSD-only and with TD with both predictably easy and difficult sound contrasts. Children with SSD-only performed nominally less well than children with TD for the speech sound with which they have difficulty, but this difference did not reach statistical significance for these relatively small group sizes.

Auditory Perception and Ultrasound Biofeedback Treatment Outcomes for Children With Residual /ɹ/ Distortions: A Randomized Controlled Trial

Purpose This study evaluated whether outcomes from treatment, which includes ultrasound visual feedback (UVF), would be more or less effective when combined with auditory perception training for children with residual /ɹ/ errors. Method Children ages 8-16 years with /ɹ/ distortions participated in speech therapy that included real-time UVF of the tongue. Thirty-eight participants were randomized to speech therapy conditions that included a primary focus on articulation using UVF or a condition that included auditory perceptual training plus UVF (incorporating category goodness judgments and self-monitoring). Generalization of /ɹ/ production accuracy to untrained words was assessed before and after 14 hr of therapy. Additionally, the role of auditory perceptual acuity was explored using a synthetic /ɹ/-/w/ continuum. Results There was no difference between the treatment groups in rate of improvement of /ɹ/ accuracy (increase of 34% for each group; p = .95, ηp2 = .00). However, pretreatment auditory acuity was associated with treatment progress in both groups, with finer perceptual acuity corresponding to greater progress (p = .015, ηp2 = .182). Conclusion Similar gains in speech sound accuracy can be made with treatment that includes UVF with or without auditory perceptual training. Fine-grained perceptual acuity may be a prognostic indicator with treatment. Supplemental Material https://doi.org/10.23641/asha.11886219.

Speech development in preschool children: evaluating the contribution of phonological short-term and phonological working memory

Emerging evidence suggests domain-general processes, including working memory, may contribute to reduced speech production skills in young children. This study compared the phonological short-term (pSTM) and phonological working memory (pWM) abilities of 50 monolingual English-speaking children between 3;6 and 5;11 with typical speech production skills and percentage consonant correct (PCC) standard scores of 12 and above (n = 22) and typical speech production skills and PCC standard scores of between 8 and 11 (n = 28). A multiple hierarchical regression was also conducted to determine whether pSTM and/or pWM could predict PCC. Children with typical speech production skills and PCC standard scores of 12 and above had better pWM abilities than children with typical speech production skills and PCC standard scores of between 8 and 11. pSTM ability was similar in both groups. pWM accounted for 5.3% variance in overall phonological accuracy. Implications of phonological working memory in speech development are discussed.

Analysis of the components of Frequency-Following Response in phonological disorders

INTRODUCTION

When identifying the auditory performance of children with phonological disorders, researchers assume that this population has normal peripheral hearing. However, responses at more central levels might be atypical.

OBJECTIVE

To investigate the effect of phonological disorders on Frequency-Following Responses (FFRs) in the time domain.

METHODS

Participants were 60 subjects, aged 5 to 8:11 years, divided into two groups: a control group, composed of 30 subjects with normal language skills; and a study group composed of 30 subjects diagnosed with Phonological Disorder (PD). All subjects were tested for Frequency-Following Responses.

RESULTS

In the group of children with PD there was an increase in the latency of all FFR components, with a significant statistical difference for components V (p = 0.015); A (<0.001); C (0.022); F (<0.001); and O (0.001). There was also a reduction in the Slope measure in the group with PD (p = 0.004).

CONCLUSION

The FFR responses are altered in children with PD. This suggests that children with PD present a disorganization in the neural coding of complex sounds. This could compromise specially the development of linguistic/phonological abilities, which can reflect in daily communication.

The Persian version of auditory word discrimination test (P-AWDT) for children: Development, validity, and reliability

OBJECTIVE

Auditory discrimination of speech sounds is an important perceptual ability and a precursor to the acquisition of language. Auditory information is at least partially necessary for the acquisition and organization of phonological rules. There are few standardized behavioral tests to evaluate phonemic distinctive features in children with or without speech and language disorders. The main objective of the present study was the development, validity, and reliability of the Persian version of auditory word discrimination test (P-AWDT) for 4-8-year-old children.

METHODS

A total of 120 typical children and 40 children with speech sound disorder (SSD) participated in the present study. The test comprised of 160 monosyllabic paired-words distributed in the Forms A-1 and the Form A-2 for the initial consonants (80 words) and the Forms B-1 and the Form B-2 for the final consonants (80 words). Moreover, the discrimination of vowels was randomly included in all forms. Content validity was calculated and 50 children repeated the test twice with two weeks of interval (test-retest reliability). Further analysis was also implemented including validity, intraclass correlation coefficient (ICC), Cronbach's alpha (internal consistency), age groups, and gender.

RESULTS

The content validity index (CVI) and the test-retest reliability of the P-AWDT were achieved 63%-86% and 81%-96%, respectively. Moreover, the total Cronbach's alpha for the internal consistency was estimated relatively high (0.93). Comparison of the mean scores of the P-AWDT in the typical children and the children with SSD revealed a significant difference. The results revealed that the group with SSD had greater severity of deficit than the typical group in auditory word discrimination. In addition, the difference between the age groups was statistically significant, especially in 4-4.11-year-old children. The performance of the two gender groups was relatively same.

CONCLUSION

The comparison of the P-AWDT scores between the typical children and the children with SSD demonstrated differences in the capabilities of auditory phonological discrimination in both initial and final positions. It supposed that the P-AWDT meets the appropriate validity and reliability criteria. The P-AWDT test can be utilized to measure the distinctive features of phonemes, the auditory discrimination of initial and final consonants and middle vowels of words in 4-8-year-old typical children and children with SSD.