What influences literacy outcome in children with speech sound disorder?

Listening and Processing Skills in Young School Children with a History of Developmental Phonological Disorder

There is a lack of longitudinal studies on the broad-based outcomes in children with Developmental Phonological Disorder (DPD). The aim of this study was to investigate listening and processing skills in a clinical sample of 7-to-10-year-old children diagnosed with DPD in their preschool years and compare these to same-aged typically developing (TD) children. The Evaluation of Children's Listening and Processing Skills (ECLiPS) was completed by parents of 115 children with DPD and by parents of 46 TD children. The total ECLiPS mean score, and the five subscale mean scores, the proportion of children with clinically significant difficulties (≤10th percentile), and the proportion of children with co-occurrence of clinically significant difficulties on more than one subscale, were calculated. Results showed that the ECLiPS mean scores did not differ between the groups. There was no difference between groups regarding language and literacy, but a higher proportion of children with DPD than TD had difficulties in the total score, speech, and auditory processing, environmental and auditory sensitivity, and pragmatic and social skills. In addition, 33.9% of children with DPD had clinically significant difficulties in two or more subscales compared to 10.9% of TD children.

Preliteracy Skills Mediate the Relation Between Early Speech Sound Production and Subsequent Reading Outcomes

PURPOSE

Learning to read is a complex, multifaceted process that relies on several speech and language-related subskills. Individual differences in word reading outcomes are indicated among children with inaccurate speech sound productions, with some of these children developing later reading difficulties. There are inconsistent reports as to whether phonological deficits and/or weaknesses in oral language explain these subsequent reading difficulties. Thus, it remains unclear how variability in speech production accuracy in early childhood may impact reading development. Therefore, the present longitudinal study seeks to clarify the relation between speech sound production accuracy in kindergarten and subsequent reading outcomes with a focus on additional potential mediating factors.

METHOD

Speech accuracy, core preliteracy skills (phonological awareness, rapid naming, and letter-name knowledge), and additional potential mediators (phonological memory and oral language abilities) were characterized at the start of formal reading instruction. Word reading, decoding, reading fluency, and comprehension were assessed at the end of second grade. Mediation analyses were conducted to examine factors that mediate the relation between speech accuracy in kindergarten and subsequent reading outcomes.

RESULTS

Initial associations between early speech sound production accuracy and subsequent reading outcomes were indicated; however, mediation effects of preliteracy skills (phonological awareness and letter-name knowledge) were identified for word reading, decoding, and reading fluency outcomes. For reading comprehension, mediation effects of preliteracy and vocabulary skills were observed.

CONCLUSIONS

The relation between speech sound production accuracy and subsequent word reading, decoding, reading fluency, and comprehension was observed to be mediated by preliteracy skills, specifically phonological awareness and letter-name knowledge. For reading comprehension only, vocabulary knowledge were of additional importance.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23671491.

Spelling Proficiency of Children with a Resolved Phonological Speech Sound Disorder Treated with an Integrated Approach-A Long-Term Follow-Up Randomized Controlled Trial

Phonological developmental speech sound disorders (pDSSD) in childhood are often associated with later difficulties in literacy acquisition. The present study is a follow-up of the randomized controlled trial (RCT) on the effectiveness of PhonoSens, a treatment for pDSSD that focuses on improving auditory self-monitoring skills and categorial perception of phoneme contrasts, which could have a positive impact on later spelling development. Our study examines the spelling abilities of 26 German-speaking children (15 girls, 11 boys; mean age 10.1 years, range 9.3-11.2 years) 3-6 years after their successful completion of the PhonoSens treatment. Spelling assessment revealed that only 3 out of 26 participants developed a spelling disorder. In the overall population of fourth-graders, one in five children showed a spelling deficit; in another study of elementary school children, with resolved pDSSD, 18 of 32 children had a spelling deficit. Thus, the applied pDSSD treatment method appears to be associated with positive spelling development. Multiple regression analysis revealed that among the potentially predictive factors for German-speaking children with resolved pDSSD to develop later spelling difficulties, parental educational level and family risk for developmental language disorder (DLD) had an impact on children's spelling abilities; gender and the child's phonological memory had not.

Bioenvironmental Predictors of Childhood Reading and Speech Difficulties

PURPOSE

Reading and speech difficulties are common in childhood, yet it is not fully understood how much of their etiology is shared. This partly derives from methodological issues related to overlooking the potential co-occurrence between the two sets of difficulties. This study investigated the effects of five bioenvironmental predictors in a sample assessed for such co-occurrence.

METHOD

A combination of exploratory and confirmatory analyses was performed on longitudinal data from the National Child Development Study. Exploratory latent class analysis was performed on children's reading, speech, and language outcomes at ages 7 and 11 years. Membership in the obtained classes was modeled using a regression with sex and four early-life predictors: gestation period, socioeconomic status, maternal education, and the home reading environment.

RESULTS

The model yielded four latent classes that broadly reflected (1) average reading and speech, (2) excellent reading, (3) reading difficulties, and (4) speech difficulties. Early-life factors significantly predicted class membership. Male sex and preterm birth emerged as risk factors for both reading and speech difficulties. Protective effects against reading difficulties were identified for maternal education, and lower (but not higher) levels of socioeconomic status and the home reading environment.

CONCLUSIONS

Co-occurrence of reading and speech difficulties in the sample was low, and differential patterns of effect of the social environment were supported. Reading outcomes were under stronger malleable influence than speech outcomes.

Speech-Language Pathologists' Endorsement of Speech, Language, and Literacy Myths Reveals Persistent Research-Practice Gap

PURPOSE

We explore the extent to which speech-language pathologists (SLPs) are operating under assumptions about speech, language, and literacy that are not supported by evidence or are contradicted by evidence.

METHOD

SLPs (N = 106) marked the degree to which they endorsed or rejected four true and 11 myth (i.e., false) statements on a visual analog scale via an online survey. We analyzed the degree to which participants agreed or disagreed with these statements related to speech, language, and literacy development and impairment.

RESULTS

Based on results of one-sample t tests, participants as a group correctly rejected seven myth statements and correctly endorsed three true statements. Participants as a group provided equivocal responses to the remaining four myth statements and one true statement. Scores for each statement spanned all or nearly all of the possible range. Even when participants overall showed relatively strong disagreement with a particular myth statement, at least a few participants endorsed the myth statement.

CONCLUSIONS

The findings indicate areas of relative strength for SLPs' knowledge of current evidence for augmentative and alternative communication, bilingualism, and language input that supports language development. Identified areas of relative weakness include knowledge of the expected grammatical and speech production skills of children with typical development and the influence of ear infections in childhood on language impairment. Additional research is needed to evaluate efforts to enhance SLPs' knowledge and use of evidence-based practices.

Speech Error Variability and Phonological Awareness in Preschoolers

PURPOSE

The purpose of this article was to investigate the relationship between speech error variability and phonological awareness.

METHOD

This article begins with a narrative review of the theoretical interpretation of speech error variability. The post hoc exploratory analysis of the relationship between speech error variability and phonological awareness included 40 children: 20 with typical speech and language and 20 with speech sound disorder and typical language. Groups were matched on gender, age, maternal education, receptive and expressive vocabulary, nonverbal intelligence, and expressive morphosyntax. Multiple regression was used to identify the best fit model for the relationship between vocabulary, speech errors, and phonological awareness.

RESULTS

Segmental variability was associated with poor phonological awareness in preschool-aged children.

CONCLUSION

Children with high levels of segmental variability have poor phonological awareness, likely due to unstable phonological representations.

Phonological processing skills in children with speech sound disorder: A multiple case study approach

BACKGROUND

Children with speech sound disorder (SSD) are at increased risk of reading difficulties due to poor phonological processing skills. However, the extent to which children with SSD demonstrate weaknesses on specific or all phonological processing tasks is not well understood.

AIMS

To examine the phonological processing abilities of a clinically identified sample of children with SSD, with and without reading difficulties. To determine the extent to which the proportion of children with concomitant SSD and reading difficulties exhibited weaknesses in specific areas of phonological processing, or a more general phonological deficit.

METHODS & PROCEDURES

Data were obtained from 157 school-aged children (M_age = 77 months, SD = 7.01) in receipt of school-based speech therapy. Approximately 25% of the sample was identified as poor readers, based on a standardized measure of word decoding. We compared the proportion of children who scored at or below 1 SD below the mean, or the bottom 16th percentile, on measures of phonological awareness, rapid automatized naming and verbal short-term memory among those identified as poor readers and good readers.

OUTCOMES & RESULTS

Children with SSD demonstrated a range of phonological processing difficulties, particularly on the measure of verbal short-term memory. No specific skill differentiated groups of children with SSD with and without reading difficulties; however, those classified as poor readers on the word-decoding measure exhibited more widespread difficulties, even after controlling for language ability.

CONCLUSIONS & IMPLICATIONS

Results support a cumulative risk model such that children with SSD and reading difficulties are likely to demonstrate generally poor phonological processing abilities.

WHAT THIS PAPER ADDS

What is already known on the subject Children with SSD are at heightened risk of reading difficulties, particularly if their SSD persists into school age. However, not all children with SSD experience reading problems. Research aimed at determining which children are at the highest risk is mixed as to how best to identify which children with SSD are most likely to experience reading difficulties. What this paper adds to existing knowledge The study used a multiple case study approach to determine if performance on phonological processing skills might differentiate children with SSD who were poor readers from those who were good readers. As a group, children with SSD exhibited poor verbal short-term memory but relatively intact rapid automatized naming skills. No one phonological processing skill differentiated children who were poor readers from good readers. However, children with reading difficulties appeared to experience more general difficulties across phonological processing tasks, even after controlling for language abilities. What are the potential or actual clinical implications of this work? A single deficit (i.e., speech sound production) is not sufficient data to make a complete diagnosis or treatment decisions. Multiple sources of data, including several aspects of phonological processing, should be obtained to understand reading risk in children with SSD.

Novel Neurocognitive Profile in a Minority of Boys with 47,XXY (Klinefelter Syndrome)

INTRODUCTION

47,XXY, also known as Klinefelter syndrome, is the most commonly occurring sex chromosomal variation (1:660). The neurocognitive profile of boys with 47,XXY, in addition to verbal abilities, language skills, and general intelligence, has been explored in this study.

METHODS

Fifty-five participants with 47,XXY were segregated into groups according to their performance on the Wechsler Intelligence Scale for Children (WISC): (1) those with a higher performance intelligence quotient (PIQ) in comparison with their verbal IQ (VIQ) and (2) those with a higher VIQ compared with their PIQ. Two-tailed independent t tests were completed to analyze group differences.

RESULTS

Our study results demonstrate novel findings that one-third of subjects have higher verbal capabilities than perceptual skills. Those participants who showed the typical presentation of 47,XXY with increased PIQ in comparison with their VIQ excelled on perceptual and visual spatial subtests on the WISC and on nonverbal IQ on the Leiter International Performance Scale-III. In addition, it was found that expressive and receptive vocabulary skills were commensurate in both groups, which has not been reported previously.

DISCUSSION

To the best of our knowledge, this is the first study to identify an alternative profile of 47,XXY with increased verbal capabilities in comparison with perceptual skills. In addition, previous research has found that boys with 47,XXY often show increased receptive vocabulary skills in comparison with their expressive vocabulary skills early in life. Therefore, our findings of commensurate expressive and receptive vocabulary skills suggest that age may be an impactful factor in vocabulary development. Further research is necessary to determine individualized treatment options for these patients, focusing on the specific cognitive profile they present.

Reading Skills in Children With Suspected Childhood Apraxia of Speech and Children With Reading Disorders: Same or Different?

PURPOSE

The primary aim of this study was to compare decoding and literacy-related skills of children with suspected childhood apraxia of speech (sCAS) to children with reading disorders (RD) and no history of speech sound disorder (RD-no SSD) to determine if the groups differ in decoding and the endophenotypes that contribute to RD. We also explored the association between language impairment (LI) and decoding and literacy-related skills within the participant group with sCAS.

METHOD

Participants were school-age children and adolescents, 8-14 years of age, with a diagnosis of sCAS (n = 13) or RD-no SSD (n = 16). The sCAS and RD-no SSD groups were compared on measures of single-word decoding, oral language, motor-speech skills, phonological processing, and speech-in-noise perception, employing t tests and analysis of covariance. The sCAS + LI and sCAS-only groups were compared on similar measures using t tests.

RESULTS

Compared to the RD-no SSD group, the sCAS group performed significantly worse on measures of phonological processing, multisyllable word repetition, diadochokinetic rate, and speech-in-noise perception. The groups did not differ on measures of single-word decoding, with mean scores for both groups falling below average. All participants with sCAS + LI demonstrated deficits in literacy and literacy-related skills compared to a smaller percentage of the sCAS-only group.

CONCLUSIONS

Children with sCAS and children with RD-no SSD demonstrate similar impairments in literacy. However, the endophenotypes underlying these difficulties can differ between the groups. Deficits in skills needed for literacy may require specifically tailored interventions to address reading difficulties for children with sCAS, especially for those with comorbid LI.

Predictors of Speech Severity and Inconsistency Over Time in Children With Token-to-Token Inconsistency

PURPOSE

The aim of this study was to describe and explain changes in severity of speech sound disorder (SSD) and token-to-token inconsistency in children with high levels of inconsistency.

METHOD

Thirty-nine children (aged 4;6-7;11 [years;months]) with SSDs and high levels of token-to-token inconsistency were assessed every 6 months for 2 years (i.e., five assessment points). Growth modeling was used to assess relations among therapy support, receptive vocabulary, severity, and inconsistency over time.

RESULTS

Children with the most severe SSDs and highest levels of token-to-token inconsistency showed the smallest improvements in speech accuracy over time. Therapy support did not predict changes in speech accuracy or token-to-token inconsistency over time. Receptive vocabulary (measured at the outset of the study) was also a significant predictor of speech accuracy and inconsistency.

CONCLUSIONS

These findings suggest that an immediate start to intervention (rather than a wait-and-see approach) is recommended for children with inconsistent speech error patterns. The results also highlight the value of developing vocabulary knowledge in addition to improving speech accuracy for some children with inconsistent speech production.

The Functional Neuroanatomy of Reading Intervention

The present article reviews the literature on the brain mechanisms underlying reading improvements following behavioral intervention for reading disability. This includes evidence of neuroplasticity concerning functional brain activation, brain structure, and brain connectivity related to reading intervention. Consequently, the functional neuroanatomy of reading intervention is compared to the existing literature on neurocognitive models and brain abnormalities associated with reading disability. A particular focus is on the left hemisphere reading network including left occipito-temporal, temporo-parietal, and inferior frontal language regions. In addition, potential normalization/compensation mechanisms involving right hemisphere cortical regions, as well as bilateral sub-cortical and cerebellar regions are taken into account. The comparison of the brain systems associated with reading intervention and the brain systems associated with reading disability enhances our understanding of the neurobiological basis of typical and atypical reading development. All in all, however, there is a lack of sufficient evidence regarding rehabilitative brain mechanisms in reading disability, which we discuss in this review.

Sequencing Deficits and Phonological Speech Errors, But Not Articulation Errors, Predict Later Literacy Skills

PURPOSE

Speech sound disorder (SSD) in conjunction with a language disorder has been associated with poor literacy acquisition; however, no study has evaluated whether articulation, phonological, or sequencing skills are differentially related to reading skills. Therefore, this study examined the relationship between speech error types at ages 5-6 years and literacy at ages 7-9 years. Phonological errors were hypothesized to predict phonological awareness (PA) and literacy even while accounting for other speech error types and language skills.

METHOD

One hundred twenty-three children, 86 with a history of speech impairment, completed a battery of speech, language, and literacy tests at ages 5-6 years and again at ages 7-9 years. Speech production at ages 5-6 years was analyzed, and indices of articulation errors, phonological errors, and sequencing deficits were obtained. The relationships of these error types to concurrent language and preliteracy skills and to later literacy outcomes were assessed.

RESULTS

As expected, phonological, but not articulation, errors at ages 5-6 years predicted concurrent PA and letter knowledge, as well as literacy at ages 7-9 years, even while accounting for language skills. Surprisingly, of all the error types, sequencing deficits showed the strongest relationship with PA (ages 5-6 years) and literacy (ages 7-9 years).

CONCLUSIONS

These results suggest that some components of SSD uniquely predict preliteracy and literacy skills, even when controlling for language ability. Future investigations should examine further the association between sequencing deficits and literacy skills, test whether observed relationships hold at younger ages, and evaluate the efficacy of integrating literacy interventions into speech therapy to reduce later reading difficulties.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19624020.

Speech perception in noise in children with dyslexia: Does speech sound disorder matter?

The aim of this observational cohort study with a control group is to compare consonant perception skills in quiet and in noise in children with typical language and learning development and in children with dyslexia, with and without Speech Sound Disorder (SSD). Three groups were included: A control group of twenty children with normal reading abilities and typical language development, twelve children with dyslexia and typical language development and thirteen children with dyslexia and SSD. All subjects received a consonant recognition test in three different listening conditions (quiet, + 10 and 0 Signal-to-Noise Ratio). In all test conditions, children with dyslexia and SSD had significantly lower consonant recognition scores than the control group and the children with dyslexia and typical language development (p < .0001). The poorer performances observed in children with dyslexia and SSD may be explained by impaired phonological processing underlying both conditions.

Phonological variations in typically-developing Italian-speaking children aged 3;0-4;11

Normative data on phonological acquisition of a language are a prerequisite for evaluating children's speech sound competences. To date, these data are not sufficiently available for Italian. This study, therefore, aimed to describe the phonological development of 183 typically developing monolingual Italian-speaking children aged 3;0-4;11 (four 6-months age bands). Participants were assessed through a picture naming task, and performances analysed in terms of number of phonological variations (Tokens), Types and percentage of occurrence of patterns, and number of infrequent variants (InfrVar) as a measure of stability in speech production. Two cut-off criteria to distinguish InfrVar from phonological patterns were applied. Results showed a gradual reduction of all measures with increasing age. Twenty-two patterns generally in line with previous Italian and cross-linguistic studies were observed, with only five patterns and two phonetic distortions occurring across all age groups. Eight patterns only emerged when applying the lower cut-off criterion, while further seven patterns only occurred with very low frequency or in isolated age groups. These findings highlight the influence of the selected cut-off criterion on the identification of patterns and raise the question of whether some patterns should rather be considered InfVar. Data on younger children are still needed to clarify whether low-frequency patterns are patterns of younger typically developing children that have almost resolved in the age groups assessed. At least half of the phonological variation Tokens fell into the category of InfrVar, indicating a need to pay more attention to this so far ignored measure.

A comparison of two phonological screening tools for French-speaking children

Purpose: To examine two screening tools for phonological production, the Evaluation Sommaire de la Phonologie chez l'enfant d'âge préscolaire (ESPP) and the Test de Phonologie du Français Canadien-Dépistage (TPFC-D), developed according to differing theoretical perspectives. The TPFC-D, designed according to nonlinear phonology, includes more words and contains a greater variety of segments across word structure as compared to the ESPP, which was guided by a linear phonological framework. The greater response rate to test items, time of administration, and phonological complexity were expected on the TPFC-D.Method: Each screening tool was administered to 14 4-year-old French-speaking children living in Central Canada. Paired samples t-tests compared children's responses on the two tasks with regards to (a) response rate and time of administration, (b) an overall percentage of consonants correct (PCC) and percentage of vowel correct (PVC), and (c) complexity of productions (i.e. PCC and PVC in relation to word structure, Word Shape Match, Whole Word Match, Phonological Mean Length of Utterance (pMLU) and Proportion of Whole-Word Proximity).Result: Item response rates were higher for the TPFC-D whereas time of administration, PCC and PVC were similar for both the ESPP and TPFC-D. Complexity measures showed a higher proportion of deletions in clusters and higher pMLUs on the TPFC-D compared to the ESPP.Conclusion: Both screening measures are appropriate for speech-language pathologists who want to assess quickly pre-school-aged children. Since the TPFC-D is phonologically more complex, it is recommended for clinicians needing to screen children who likely present with multiple speech sound errors across their phonological system.

Clinical Utility of Repeated Urimal Test of Articulation and Phonation for Patients with Childhood Apraxia of Speech

Childhood apraxia of speech (CAS) causes inconstant oromotor production. We investigated the clinical efficacy of repeated urimal test of articulation and phonation (U-TAP) in CAS patients. Twenty-eight children were recruited: 19 with CAS and 9 with functional articulation disorder (FAD). Four age-matched typically developing children were also recruited. U-TAP was performed twice repeatedly, and the error rate of consonant accuracy (CA) was measured. Preschool Receptive-Expressive Language Scale (PRES) was also performed. The mean U-TAP CA showed a significant difference between the three groups, with 42.04% for CAS, 77.92% for FAD, and 99.68% for the normal group (p < 0.05). The mean difference between the two U-TAP CAs was 10.01% for CAS, 0.82% for FAD, and no difference for the normal group, revealing a significant intergroup difference between CAS and FAD (p < 0.05). For the expressive and receptive PRES scores, CAS group showed significantly decreased results compared to FAD and normal group. Only in the CAS group, expressive PRES showed significant decrease rather than receptive PRES score. The CAS group showed a significant difference in the two U-TAP CA compared to the FAD and normal groups. This result implies that repeated U-TAP can be useful for supportive diagnostic tool for CAS by detecting poor reliability of phonation.

Toward Preventing Speech and Language Disorders of Known Genetic Origin: First Post-Intervention Results of Babble Boot Camp in Children With Classic Galactosemia

Purpose Babble Boot Camp (BBC) is a package of proactive activities and routines designed to prevent speech and language disorders in infants at predictable risk. It is implemented via parent training and currently undergoing clinical trial in children with a newborn diagnosis of classic galactosemia (CG), a metabolic disease with high risk of speech and language disorders. The purpose of this study is to provide updates to a previous pilot study and to present the first set of post-intervention results. Method The intervention and data collection occurred during child ages < 6-24 months, with follow-up assessments of speech and language at ages 2.5 and 3.5 years. Treatment targets included earliest vocalization rates, babble complexity, speech production accuracy, and vocabulary and syntactic growth. The oldest 15 children with CG (including three untreated controls) completed the first set of follow-up assessments. Aggregate data up to 10 months were available for 17 treated children with CG, six untreated children with CG, and six typical controls. Results At ages 7-9 months, babbling complexity, as measured with mean babbling level, was higher in the treated children with CG than in the untreated children with CG and the typical controls. Prior to 24 months of age, the treated children with CG had greater expressive but not receptive vocabulary sizes than an untreated control. Follow-up testing showed typical language scores for all 12 treated children with CG and typical articulation scores for 11 of these, whereas one of three untreated children with CG had low articulation and expressive language scores. Conclusions The BBC appears to be a viable intervention to support the speech and expressive language development of children with GC. Future studies will evaluate the relative contributions of the earliest and later BBC components to outcomes.

Speech inconsistency and its association with speech production, phonological awareness and nonword repetition skills

The purpose of this study was to investigate relationships between speech inconsistency, speech production skills, phonological awareness and nonword repetition (NWR) in 24 preschool-aged Finnish-speaking children with speech sound disorder (SSD) and in 31 children with typical speech and language development (TD). Speech inconsistency was assessed by a picture-naming task repeated three times during one assessment session. The participants' speech production skills were assessed with the Finnish Test for Phonology and a diadochokinetic (DDK) task. Phonological awareness was investigated by the tasks of Rhyme and initial syllable awareness and Syllable segmentation, and NWR by ten 2-4-syllabic nonwords. The findings indicated that the children with SSD were less accurate in speech production and NWR than the children with TD. No difference was found in phonological awareness. Among the children with SSD, speech inconsistency was correlated with accuracy in overall speech production, DDK task, and NWR. Among the children with TD, speech inconsistency was correlated with accuracy in overall speech production, partly with phonological awareness, and with NWR. The results provide support for the idea that when assessing speech inconsistency in children with SSD, a process-oriented approach may be needed in order to obtain an adequately broad picture of their skill profiles.

Linguistic Predictors of Single-Word Spelling in First Grade Students with Speech and/or Language Impairments

The purpose of this study was (a) to compare the single-word spelling performance of first graders across four groups that varied by speech and language status; and (b) to determine the linguistic predictors of first-grade spelling for children with speech and/or language impairment compared to children with typical development. First grade children (N = 529) completed measures of spelling, early word reading, expressive vocabulary, phonological awareness, and morphosyntactic knowledge. Children with language impairment, with or without speech impairments, demonstrated lower spelling performance than children with typical development; children with speech impairment only did not differ from children with typical development. Additionally, early word reading and phonological awareness predicted spelling performance, regardless of group. Study findings indicate that language status, but not speech status, is a risk factor for low spelling performance in first grade, and that first grade spelling instruction should focus on developing early word reading and phonological awareness.

Educational outcomes associated with persistent speech disorder

BACKGROUND

Children with persistent speech disorder (PSD) are at higher risk of difficulties with literacy, with some evidence suggesting an association with poorer educational attainment. However, studies to date have either used small clinical samples, which exclude children who have not been referred to clinical services, or relied on parent-teacher report of children's speech development. There is a need for an inclusive study to investigate the impact of PSD on educational outcomes using a population-based sample and robust measures of speech development.

AIM

Using a large prospective UK population-based study-the Avon Longitudinal Study of Parents and Children (ALSPAC)-this study investigated: (1) how children identified with PSD at age 8 years perform on educational attainment tests at ages 10-11 and 13-14 years in comparison with children without PSD; and (2) whether children identified with PSD at age 8 years are more likely to receive a label of special educational needs (SEN) in secondary school.

METHODS & PROCEDURES

We examined the data for 263 children with PSD and 6399 controls who had speech assessed at age 8 years in a research clinic. Educational attainment was measured using data from English school standard attainment tests. Data on SEN categorization were obtained between 11 and 13 years of age. Children with PSD and controls were compared using regression analyses adjusted for biological sex, maternal age, verbal, performance and full-scale IQ.

OUTCOMES & RESULTS

Children with PSD at age 8 years were more likely to achieve lower attainment scores at ages 10-11 years in English and mathematics and across all three subjects of English, mathematics and science at ages 13-14 years after controlling for biological sex and maternal education; score below target levels for English at both time points after controlling for verbal IQ, and at ages 13-14 years after controlling for performance IQ; and receive a label of SEN (typically for the category of cognition and learning needs or communication and interaction needs) in secondary school.

CONCLUSIONS & IMPLICATIONS

PSD identified at age 8 years is associated with poor educational attainment at ages 10-11 and 13-14 years in the core subjects of English, mathematics and science. Children with PSD at age 8 years are more likely to be identified with SEN at ages 11-13 years, particularly cognition and learning needs, and communication and interaction needs. We need to be aware of the potential for the long-term impact of PSD on educational attainment in providing appropriate and effective support throughout school. What this paper adds What is already known on the subject Speech-sound disorder is associated with reading and spelling difficulties, with some evidence to suggest that PSD is associated with a higher risk of literacy difficulties. Limited evidence also suggests that speech-sound disorder may be associated with poorer educational attainment. However, studies to date have used small clinical samples or parent-teacher report of speech development and there is a need to determine whether the association is observed in larger and more inclusive population-based samples. What this paper adds to existing knowledge This prospective, longitudinal study of a large community-based sample of English children has shown that PSD is associated with poorer educational attainment at the end of primary school and at ages 13-14 years. Children with PSD are also more likely to be identified as having SEN in secondary school, especially communication and interaction needs but also including cognition and learning needs. What are the potential or actual clinical implications of this work? Understanding the long-term implications of PSD on educational attainment highlights the importance of ongoing monitoring and support to enable children to reach their potential throughout primary and secondary school. The identification of children with a history of PSD during transition to secondary school will enable effective support to be put in place. The intervention for children with PSD should involve close collaboration between speech and language therapists and education professionals.

Technical Reading and Writing Skills and Their Relationship with Linguistic Processes in Children with a Cleft (Lip and) Palate: A Comparison with Peers

<b><i>Introduction:</i></b> Poor word decoding skills and writing skills can impact job opportunities and psychosocial functioning. Despite the importance of identifying possible literacy problems for the child’s future performance, there seems to be no consensus on this topic in children with a cleft of the palate with or without a cleft of the lip (CP±L). The aim of this study was to investigate reading and writing skills and their relationship with linguistic processes in Dutch-speaking children with a CP±L compared to a group of children without a CP±L. <b><i>Methods:</i></b> Twelve children with a CP±L and 12 children without a CP±L (age range 7–12 years) were included in the study. The 2 groups were matched based on age, gender, and socioeconomic status. An assessment battery including language, reading, and writing tests was administered to both groups. <b><i>Results:</i></b> No statistically significant differences in reading and writing skills were found when comparing children with and without a CP±L. Interestingly, a moderate correlation was found between the children’s reading skills and phonological awareness. Moderate correlations were also revealed between writing skills and several working memory tasks. <b><i>Discussion/Conclusion:</i></b> Our findings did not provide evidence for any difference in word decoding skills and writing skills between children with a CP±L and their peers. Some linguistic processes, more specifically phonological awareness and working memory, are important factors that contribute to the child’s literacy development. Identification of these linguistic skills can provide important information on the child’s future reading and writing performance. Future studies should increase sample sizes to confirm these results.

Speech sound errors of Mandarin-speaking preschool children with co-occurring speech sound disorder and developmental language disorder

This study examined the occurrence and types of speech sound errors in Mandarin-speaking children and compared those with co-occurring developmental language disorder (DLD) and speech sound disorders (SSDs) to those with SSD only and those with no DLD or SSD. The participants were 64 four-year-old Mandarin-speaking children, including 20 age-matched children with co-occurring SSD and LI (SSD + DLD), 20 with SSD only, and 24 with no DLD or SSD (typical development [TD]). Speech samples from a list of 20 pictures of common objects and animals were elicited in a picture-naming task. One speech-language therapist transcribed and analysed consonant production accuracy and coded speech errors into the types of substitution, omission, distortion, and addition and phonological processes into typical and atypical sound changes. The interrater reliability of consonant production analysis was checked by another experienced speech-language pathologist. Children with co-occurring SSD and DLD demonstrated the least accuracy of speech production among the three groups of children. Children with co-occurring SSD and DLD showed more frequent use of substitutions, omissions, typical sound changes (i.e. stopping of affricates, stopping of fricatives, deaspiration), and atypical sound changes (i.e. initial consonant deletion, fronting, affrication of stops) than children with SSD only, while no significant difference between the SSD and TD groups was observed in omission error types and atypical sound changes. These results suggest that the disorders in speech sound production in children with SSD and DLD may be associated with underlying phonological-linguistic processing.

Reading Risk in Children With Speech Sound Disorder: Prevalence, Persistence, and Predictors

Purpose The purpose of this study was to determine the extent to which school-age children with speech sound disorder (SSD) exhibit concomitant reading difficulties and examine the extent to which phonological processing and speech production abilities are associated with increased likelihood of reading risks. Method Data were obtained from 120 kindergarten, first-grade, and second-grade children who were in receipt of school-based speech therapy services. Children were categorized as being "at risk" for reading difficulties if standardized scores on a word decoding measure were 1 SD or more from the mean. The selected predictors of reading risk included children's rapid automatized naming ability, phonological awareness (PA), and accuracy of speech sound production. Results Descriptive results indicated that just over 25% of children receiving school-based speech therapy for an SSD exhibited concomitant deficits in word decoding and that those exhibiting risk at the beginning of the school year were likely to continue to be at risk at the end of the school year. Results from a hierarchical logistic regression suggested that, after accounting for children's age, general language abilities, and socioeconomic status, both PA and speech sound production abilities were significantly associated with the likelihood of being classified as at risk. Conclusions School-age children with SSD are at increased risk for reading difficulties that are likely to persist throughout an academic year. The severity of phonological deficits, reflected by PA and speech output, may be important indicators of subsequent reading problems.

Preschool Speech Intelligibility and 8-Year Literacy: A Moderated Mediation Analysis

Purpose The aims of this study were (a) to examine the relationship between speech intelligibility at the age of 5 years and literacy skills at the age of 8 years, (b) to explore the possible mediating or moderating role of broader language skills at 5 years in the relationship of interest, and (c) to assess whether the potential risk factors (child gender; maternal education levels; and family history of speech, language, reading, and writing difficulties) influence the relationship between speech intelligibility and literacy in terms of moderated mediation effects. Method We used mother-reported questionnaire data on 16,184 children participating in the population-based, prospective Norwegian Mother, Father and Child Cohort Study as well as conducted linear regression analyses using the PROCESS macro in SPSS. In addition, logistic regression was conducted to make predictions about risk. Results The association between speech intelligibility at 5 years and literacy skills at 8 years was statistically significant (β = .168, p < .001). Children with speech problems at 5 years had a risk ratio of 2.38 (95% CI [2.10, 2.70]) and an odds ratio of 2.74 (95% CI [2.35, 3.19]), as compared to children without such problems. Broader language skills at 5 years partially mediated the relationship between speech intelligibility at 5 years and literacy at 8 years, and the effect of language skills appeared to be moderated by child gender, a family history of language difficulties, a family history of reading difficulties, and maternal education. Conclusions Severity of speech problems indexed by parent-reported speech intelligibility in preschool predicted school-age literacy problems. Broader language skills are a crucial mediating mechanism through which these problems are linked, and the mediated relationship is amplified by female gender, low maternal education, family history of language difficulties, and family history of reading difficulties. The findings call for increased use of a multiple-risk model when planning early interventions in children with unclear speech.

In Search of Cognitive Promotive and Protective Factors for Word Reading

This study examined whether strong cognitive skills (i.e. vocabulary, rapid naming, verbal working memory [VWM], and processing speed [PS]) contributed to resilience in single-word reading skills in children at risk for reading difficulties because of low phonological awareness scores (PA). Promotive factors were identified by main effects and protective factors through PA x cognition interactions. This study included 1,807 children ages 8-16. As predicted, all cognitive skills were significantly related to reading, consistent with promotive effects. A significant, but small effect PA x vocabulary interaction (R2 change=.002, p=.00038) was detected but its form was not consistent with a classic protective effect. Rather, the PA x vocabulary interaction was consistent with a "skill-enhancement" pattern, such that children with strong PA and vocabulary skills had better than expected reading. This study provides a framework for reading resilience research and directs attention to promotive mechanisms underlying reading success.

Morphological Awareness Skills of Second- and Third-Grade Students With and Without Speech Sound Disorders

Purpose Morphological awareness is the ability to consciously manipulate the smallest units of meaning in language. Morphological awareness contributes to success with literacy skills for children with typical language and those with language impairment. However, little research has focused on the morphological awareness skills of children with speech sound disorders (SSD), who may be at risk for literacy impairments. No researcher has examined the morphological awareness skills of children with SSD and compared their skills to children with typical speech using tasks representing a comprehensive definition of morphological awareness, which was the main purpose of this study. Method Thirty second- and third-grade students with SSD and 30 with typical speech skills, matched on age and receptive vocabulary, completed four morphological awareness tasks and measures of receptive vocabulary, real-word reading, pseudoword reading, and word-level spelling. Results Results indicated there was no difference between the morphological awareness skills of students with and without SSD. Although morphological awareness was moderately to strongly related to the students' literacy skills, performance on the morphological awareness tasks contributed little to no additional variance to the children's real-word reading and spelling skills beyond what was accounted for by pseudoword reading. Conclusions Findings suggest that early elementary-age students with SSD may not present with concomitant morphological awareness difficulties and that the morphological awareness skills of these students may not play a unique role in their word-level literacy skills. Limitations and suggestions for future research on the morphological awareness skills of children with SSD are discussed.

Breadth versus depth: Cumulative risk model and continuous measure prediction of poor language and reading outcomes at 12

This study examines whether, and how, multiple risks in early childhood are associated with an increased likelihood of a poor language or literacy outcome in early adolescence. Using data from 210 participants in the longitudinal Twins Early Developmental Study, we focus on the following risk factors at age 4: family risk, and poor language, speech, emergent literacy and nonverbal skills. The outcomes of interest at age 12 are language, reading fluency and reading comprehension. We contrast a 'cumulative risk' model, counting the presence or absence of each risk factor (breadth), with a model that also considers the severity of the early deficits (depth). A 'cumulative risk index' correlated modestly but significantly with outcome (r = 0.32-0.40). Odds ratios confirmed that having many risk factors (3-6) confers a higher probability of a poor outcome (OR 7.86-17.71) than having one or two (OR 3.65-7.28). Logistic regression models showed that predictive validity is not improved by including information about the severity of each deficit. Even with rich information on children's risk status at age 4, we can make only a moderately accurate prediction of the likelihood of a language or literacy disorder 8 years later (Area Under the Curve = 0.74-0.84; Positive Predictive Value = 0.33-0.55, Negative Predictive Value = 0.86-0.91). Taken together, and consistent with the idea of 'cumulative risk', these results suggest that the breadth of risk is a core predictor of outcome, and furthermore, that the severity of early deficits does not add significantly to this prediction.

Unisensory and multisensory temporal processing in autism and dyslexia: A systematic review and meta-analysis

This study presents a comprehensive systematic review and meta-analysis of temporal processing in autism spectrum disorder (ASD) and developmental dyslexia (DD), two neurodevelopmental disorders in which temporal processing deficits have been highly researched. The results provide strong evidence for impairments in temporal processing in both ASD (g = 0.48) and DD (g = 0.82), as measured by judgments of temporal order and simultaneity. In individual analyses, multisensory temporal processing was impaired for both ASD and DD, and unisensory auditory, visual and tactile processing were all impaired in DD. In ASD, speech stimuli showed moderate impairment effect sizes, whereas nonspeech stimuli showed small effects. Greater reading and spelling skills in DD were associated with greater temporal precision. Temporal deficits did not show changes with age in either disorder. In addition to more clearly defining temporal impairments in ASD and DD, the results highlight common and distinct patterns of temporal processing between these disorders. Deficits are discussed in relation to existing theoretical models, and recommendations are made for future research.

Early neurodevelopmental and medical profile in children with sex chromosome trisomies: Background for the prospective eXtraordinarY babies study to identify early risk factors and targets for intervention

Sex chromosome trisomies (SCT), including Klinefelter syndrome/XXY, Trisomy X, and XYY syndrome, occur in 1 of every 500 births. The past decades of research have resulted in a broadening of known associated medical comorbidities as well as advances in psychological research. This review summarizes what is known about early neurodevelopmental, behavioral, and medical manifestations in young children with SCT. We focus on recent research and unanswered questions related to the risk for neurodevelopmental disorders that commonly present in the first years of life and discuss the medical and endocrine manifestations of SCT at this young age. The increasing rate of prenatal SCT diagnoses provides the opportunity to address gaps in the existing literature in a new birth cohort, leading to development of the eXtraordinarY Babies Study. This study aims to better describe and compare the natural history of SCT conditions, identify predictors of positive and negative outcomes in SCT, evaluate developmental and autism screening measures commonly used in primary care practices for the SCT population, and build a rich data set linked to a bank of biological samples for future study. Results from this study and ongoing international research efforts will inform evidence-based care and improve health and neurodevelopmental outcomes.

Home and Clinical Literacy Practices for Children With Cleft Lip and Palate

Objective:

The purpose of this study was to examine experiences and practices related to supporting literacy development and preventing reading difficulties in children with cleft lip and/or palate (CL/P).

Methods:

Via online surveys, 67 respondents including 35 parents/guardians of children with CL/P and 32 speech-language pathologists (SLPs) answered questions about home literacy practices, clinical practices, and perceptions of SLPs’ role in literacy.

Results:

The variability in responses highlights both the positive contributions of parents/guardians and SLPs in supporting literacy development and preventing reading disabilities in children with cleft and the need for increased education and efforts to meet their literacy needs.

The Functional Neuroanatomy of Developmental Dyslexia Across Languages and Writing Systems

The present article reviews the literature on the functional neuroanatomy of developmental dyslexia across languages and writing systems. This includes comparisons of alphabetic languages differing in orthographic depth as well as comparisons across alphabetic, syllabic, and logographic writing systems. It provides a synthesis of the evidence for both universal and language-specific effects on dyslexic functional brain activation abnormalities during reading and reading-related tasks. Specifically, universal reading-related underactivation of dyslexic readers relative to typical readers is identified in core regions of the left hemisphere reading network including the occipito-temporal, temporo-parietal, and inferior frontal cortex. Orthography-specific dyslexic brain abnormalities are mainly related to the degree and spatial extent of under- and overactivation clusters. In addition, dyslexic structural gray matter abnormalities across languages and writing systems are analyzed. The neuroimaging findings are linked to the universal and orthography-dependent behavioral manifestations of developmental dyslexia. Finally, the present article provides insights into potential compensatory mechanisms that may support remediation across languages and writing systems.

A computerized tool to assess reading skills of students with motor impairment

Conventional tests for assessing the early reading skills of preschool children on school entry are not accessible to students with motor limitations of upper limbs. This paper presents a game-like computerized test featuring an appealing scenario that is accessible to these students. It was developed on a platform that creates 2D vector graphics and contains three phases of interactive content accessible through an adapted peripheral. A conventional card-based test was also used to validate the effectiveness of the computerized test. Both tests were performed by thirty-three preschool children without mobility impairment all aged between four years and six months and six years and two months (x¯ = 5,33; σ = 0,44). The Wilcoxon signed-rank test was used to compare the nonparametric data from the computerized test with the card-based test in the first and second phase, yielding results of p = 0.11 and p = 0.21, respectively. The Student's t-test was conducted to compare the parametric data of the third phase of the computerized test with the data from the third phase of the card-based test yielded results of p = 0.07.Three gaming experts considered the computerized test to be fun and engaging, and three teachers concluded that the computerized test meets educational goals. Additionally, seven volunteers with moderate mobility impairment (group T), aged between eight and seventeen years old (x¯=11.8; σ = 3.5), accompanied by two physical therapists, took the computerized test using the adapted peripheral device and performed the required tasks without difficulty and without showing signs of fatigue. Based on the results obtained it can be concluded that the computerized test may enable educators to include students with mobility difficulties in literacy assessments and to design teaching strategies that are appropriate given their levels of knowledge.

The Neurocognition of Developmental Disorders of Language

Developmental disorders of language include developmental language disorder, dyslexia, and motor-speech disorders such as articulation disorder and stuttering. These disorders have generally been explained by accounts that focus on their behavioral rather than neural characteristics; their processing rather than learning impairments; and each disorder separately rather than together, despite their commonalities and comorbidities. Here we update and review a unifying neurocognitive account—the Procedural circuit Deficit Hypothesis (PDH). The PDH posits that abnormalities of brain structures underlying procedural memory (learning and memory that rely on the basal ganglia and associated circuitry) can explain numerous brain and behavioral characteristics across learning and processing, in multiple disorders, including both commonalities and differences. We describe procedural memory, examine its role in various aspects of language, and then present the PDH and relevant evidence across language-related disorders. The PDH has substantial explanatory power, and both basic research and translational implications.

Sensitivity and specificity of a low-cost screening protocol for identifying children at risk for language disorders

OBJECTIVES

To compare the diagnostic accuracy of a low-cost screening test for identifying children at risk for language disorders with that of a specific language assessment.

METHODS

The study was conducted during a polio vaccination campaign in basic health units in western São Paulo, Brazil. The parents/guardians of 1000 children aged between 0 and 5 years were asked to answer questions of a specific screening test. The instrument consisted of a uniform set of questions about the main milestones in language development (from 0 to 5 years of age) with scaled scores to assess responses. There were no exclusion criteria. After the screening test, the children were referred to a specific language assessment by ABFW, following a determined flow of referrals. The results obtained in the screening were compared to those obtained in the specific language assessment; then, the sensitivity, specificity, accuracy, and positive and negative predictive values were determined for the screening test. Children who failed the screening test also underwent an audiological evaluation. The statistical significance was set at 5%.

RESULTS

The majority of the participants were aged between 4 and 5 years (21.82%) and were male (51.6%). The sensitivity and specificity values were 82.5% and 98.93%, respectively. The area under the curve was 0.907 (0.887-0.925), and the screening test showed 96% accuracy.

CONCLUSIONS

The screening test showed high diagnostic efficiency in determining the risk of language disorders in children aged between 0 and 5 years.

Reading Outcomes for Individuals With Histories of Suspected Childhood Apraxia of Speech

Purpose The primary aims of this study were to examine the speech-language correlates of decoding difficulties in children with histories of suspected childhood apraxia of speech (sCAS) and to identify predictors of low-proficiency reading levels. Method Participants were school-age children and adolescents, 7-18 years of age, diagnosed with sCAS (n = 40) or speech sound disorder but no sCAS (SSD-no sCAS; n = 119). The sCAS and SSD-no sCAS reading groups were compared on measures of performance IQ, oral language, phonological awareness, rapid automatic naming, diadochokinetic rates, single word articulation, and multisyllable and nonsense word repetition. Logistic regression analyses were employed to identify predictors of low-proficiency reading in the sCAS and SSD-no sCAS groups. Results Sixty-five percent of the participants with sCAS compared to 24% of those with SSD-no sCAS were classified as low-proficiency readers based on nonsense and single word decoding. Analysis failed to reveal significant differences in reading, oral language, or phonological awareness between low-proficiency readers with sCAS and low-proficiency readers with SSD-no sCAS. Oral language and phonological awareness skills were the best predictors of reading level for all participants, followed by performance on multisyllabic word repetition and diadochokinetic rate. Conclusions The language and phonological awareness deficits of children with sCAS are related to their risks for reading failure. To a lesser degree, motor speech deficits and speech sound production also increase risks for reading difficulties. The findings justify early intervention for this subset of children.

Speech Errors and Phonological Awareness in Children Ages 4 and 5 Years With and Without Speech Sound Disorder

Purpose The aim of this study was to examine the relationship between types of speech errors produced by children with speech sound disorders (SSD) and children with typical speech and language development (TD) and phonological awareness (PA) skills. Method Participants were 40 children, half with SSD and half with TD, ages 4 and 5 years. They completed standard speech, language, and PA tests as well as produced single words varying in length from 1 to 5 syllables. Production of each consonant was classified as either correct production, omission, substitution, and distortion; errors were also classified as typical or atypical. Results The children with SSD produced similar proportions of each type of speech errors in mono-, di-, and multisyllabic words. In contrast, the children with TD produced much lower, but not significantly different, proportions of omissions, substitutions, distortions, and typical speech errors at each word length. They produced no atypical errors in monosyllabic words and were significantly more likely to produce them in multisyllabic words. Proportions of omissions and atypical speech errors were significantly correlated with PA performance. Variance in PA skills was predicted partly by vocabulary, language skills, and age; omissions accounted for an additional 5% of variance in PA. Other types of speech errors did not account for additional significant variance in PA performance. Conclusions Poorer PA skills were found to be associated with omissions and atypical speech errors. Research is required to investigate the potential of omission and atypical error use in predicting which children are likely to receive diagnoses of SSD and later literacy difficulties.

Assessment of Speech Sound Production by Story-retelling in Persian Speaking Children: Introducing a New Instrument

Background

Speech and language pathologists should include connected speech assessment as part of their evaluation for children with speech sound disorders. The purpose of the present study was to design and validate an instrument for assessment of articulation by story-retelling for Persian children.

Methods

261 typically developing children, aged 4-5 years old in Iran, Tehran, in 2016-2017, were recruited in the current study. First, two stories were designed. Next, the expert panel reviewed those two stories and selected one story for assessment. The strengths of the test for discriminating between the two age groups (48-54 months and 55-60 months) and between boys and girls were investigated for construct validity. Test-retest was performed for 15 children. Also, inter-rater reliability was evaluated via calculating the correlation between the two examiners' scores. Statistical Package for Social Sciences (SPSS), version 24, was used for statistical analysis. The significance level was set at (P<0.05).

Results

There was 80% or more agreement in experts' response to questions regarding content validity. All of the reliability values were higher than 0.85. No significant difference was observed between boys and girls (P=0.77), but there was a significant difference between the two age groups (P<0.001). There was a significant correlation between this test and phonetic test of the Persian version of diagnostic articulation and phonology (r=0.62, P=0.002).

Conclusion

The Persian story for the assessment of speech sound production is a reliable and valid instrument that can be used to evaluate the articulation of Persian children.

Quantifying phonological knowledge in children with phonological disorder

Generative phonologists use contrastive minimal pairs to determine functional phonological units in a language. This technique has been extended for clinical purposes to derive phonemic inventories for children with phonological disorder, providing a qualitative analysis of a given child's phonological system that is useful for assessment, treatment, and progress monitoring. In this study, we examine the single-word productions of 275 children with phonological disorder from the Learnability Project (Gierut, 2015b) to confirm the relationship between phonemic inventory - a measure of phonological knowledge - and consonant accuracy - a quantitative, relational measure that directly compares a child's phonological productions to the target (i.e. adult-like) form. Further, we identify potential percentage accuracy cutoff scores that reliably classify sounds as in or out of a child's phonemic inventory in speech-sound probes of varying length. Our findings indicate that the phonemic function of up to 90% of English consonants can be identified from percentage accuracy for preschool-age children with phonological disorder when a sufficiently large and thorough speech sample is used.

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.

Exploring the Overlap Between Dyslexia and Speech Sound Production Deficits

Purpose

Children with dyslexia have speech production deficits in a variety of spoken language contexts. In this article, we discuss the nature of speech production errors in children with dyslexia, including those who have a history of speech sound disorder and those who do not, to familiarize speech-language pathologists with speech production-specific risk factors that may help predict or identify dyslexia in young children.

Method

In this tutorial, we discuss the role of a phonological deficit in children with dyslexia and how this may manifest as speech production errors, sometimes in conjunction with a speech sound disorder but sometimes not. We also briefly review other factors outside the realm of phonology that may alert the speech-language pathologist to possible dyslexia.

Results

Speech-language pathologists possess unique knowledge that directly contributes to the identification and remediation of children with dyslexia. We present several clinical recommendations related to speech production deficits in children with dyslexia. We also review what is known about how and when children with speech sound disorder are most at risk for dyslexia.

Conclusion

Speech-language pathologists have a unique opportunity to assist in the identification of young children who are at risk for dyslexia.

It Might Not Be “Just Artic”: The Case for the Single Sound Error

Purpose

The purpose of this article is to explore the ways in which children with mild speech sound disorders (SSDs)—that is, single sound errors—may be at risk for difficulties with phonological awareness, decoding, spelling, and social–emotional well-being.

Conclusions

SSDs comprise a group of children who have difficulty in consistently and correctly producing 1 or more phonemes in their ambient language. Presently, there is a concerning trend with respect to service provision for children who have only a few—or only 1—sounds in error. That is, these children may not receive services at all. This practice is problematic, because it assumes that children with a single sound in error are not at risk for or experiencing any related educational difficulties. However, research supports connections between SSDs, including single sound errors, and decoding, spelling, and social–emotional deficits. This article aims to make the case for the single sound error—sometimes it is not “just artic.” Clinical recommendations for assessment, treatment, and advocacy are included.

Tutorial: Assessment and Analysis of Polysyllables in Young Children

Purpose

Polysyllables, words of 3 or more syllables, represent almost 30% of words used in American English. The purpose of this tutorial is to support speech-language pathologists' (SLPs') assessment and analysis of polysyllables, extending the focus of published assessment tools that focus on sampling and analyzing children's segmental accuracy and/or the presence of phonological error patterns.

Method

This tutorial will guide SLPs through a review of 53 research papers that have explored the use of polysyllables in assessment, including the sampling and analysis procedures used in different research studies. The tutorial will also introduce two new tools to analyze and interpret polysyllable speech samples: the Word-Level Analysis of Polysyllables (WAP; Masso, 2016b) and the Framework of Polysyllable Maturity (Framework; Masso, 2016a).

Results

Connected speech and single-word sampling tasks were used across the 53 studies to elicit polysyllables, and a number of analysis methods were reported, including measures of segmental accuracy and measures of structural and suprasegmental accuracy. The WAP and the Framework extend SLPs' depth of analysis of polysyllables.

Conclusion

SLPs need a range of clinical tools to support the assessment and analysis of polysyllables. A case study comparing different speech analysis methods demonstrates the clinical value in utilizing the WAP and the Framework to interpret children's polysyllable productions in addition to traditional methods of speech sampling and analysis.

Associations Between Hypernasality, Intelligibility, and Language and Reading Skills in 10-Year-Old Children With a Palatal Cleft

Background:

This study investigated the associations between hypernasality and intelligibility, and language and reading skills in 10-year old children with a cleft palate ± lip.

Design:

Cross-sectional data collected during routine assessments of speech and language in a centralized treatment setting.

Participants:

Children aged 10, born with cleft palate ± lip from 4 birth cohorts (N = 123).

Outcome Measures:

Hypernasality and intelligibility: Swedish Articulation and Nasality Test-N; language: Language 6-16 (Sentence recall, Serial recall, Vocabulary); reading: word chain test and reading comprehension test.

Results:

A total of 71.3% of the children had no occurrence of hypernasality and 82.8% had intelligibility scores within the normal range. For all children with hypernasality and intelligibility within the normal range, reading and language scores were also within normal ranges. Children with presence of hypernasality had significantly lower language skills, with mean scores within the lower normal range. Children with reduced intelligibility had lower scores on reading comprehension.

Conclusions:

The findings highlight a possible association between hypernasality and language skills, and intelligibility and reading skills. Cleft teams should consider routine assessments of language and reading skills in children with speech impairment, in order to identify potential needs for intervention as early as possible.

Estimates of the prevalence of speech and motor speech disorders in persons with complex neurodevelopmental disorders

Estimates of the prevalence of speech and motor speech disorders in persons with complex neurodevelopmental disorders (CND) can inform research in the biobehavioural origins and treatment of CND. The goal of this research was to use measures and analytics in a diagnostic classification system to estimate the prevalence of speech and motor speech disorders in convenience samples of speakers with one of eight types of CND. Audio-recorded conversational speech samples from 346 participants with one of eight types of CND were obtained from a database of participants recruited for genetic and behavioural studies of speech sound disorders (i.e., excluding dysfluency) during the past three decades. Data reduction methods for the speech samples included narrow phonetic transcription, prosody-voice coding, and acoustic analyses. Standardized measures were used to cross-classify participants' speech and motor speech status. Compared to the 17.8% prevalence of four types of motor speech disorders reported in a study of 415 participants with idiopathic Speech Delay (SD), 47.7% of the present participants with CND met criteria for one of four motor speech disorders, including Speech Motor Delay (25.1%), Childhood Dysarthria (13.3%), Childhood Apraxia of Speech (4.3%), and concurrent Childhood Dysarthria and Childhood Apraxia of Speech (4.9%). Findings are interpreted to indicate a substantial prevalence of speech disorders, and notably, a substantial prevalence of motor speech disorders in persons with some types of CND. We suggest that diagnostic classification information from standardized motor speech assessment protocols can contribute to research in the pathobiologies of CND. Abbreviations: 16p: 16p11.2 deletion and duplication syndrome; 22q: 22q11.2 deletion syndrome; ASD: Autism Spectrum Disorder; CAS: Childhood Apraxia of Speech; CD: Childhood Dysarthria; CND: Complex Neurodevelopmental Disorder; DS: Down syndrome; FXS: Fragile X syndrome; GAL: Galactosemia; IID: Idiopathic Intellectual Disability; MSD: Motor Speech Disorder; No MSD: No Motor Speech Disorder; NSA: Normal(ized) Speech Acquisition; PEPPER: Programs to Examine Phonetic and Phonologic Evaluation Records; PSD: Persistent Speech Delay; PSE: Persistent Speech Errors; SD: Speech Delay; SDCS: Speech Disorders Classification System; SDCSS: Speech Disorders Classification System Summary; SE: Speech Errors; SMD: Speech Motor Delay; SSD: Speech Sound Disorders; TBI: Traumatic Brain Injury.

School-Aged Children's Phonological Accuracy in Multisyllabic Words on a Whole-Word Metric

PURPOSE

The purpose of this study is to examine differences in phonological accuracy in multisyllabic words (MSWs) on a whole-word metric, longitudinally and cross-sectionally, for elementary school-aged children with typical development (TD) and with history of protracted phonological development (PPD).

METHOD

Three mismatch subtotals, Lexical influence, Word Structure, and segmental Features (forming a Whole Word total), were evaluated in 3 multivariate analyses: (a) a longitudinal comparison (n = 22), at age 5 and 8 years; (b) a cross-sectional comparison of 8- to 10-year-olds (n = 12 per group) with TD and with history of PPD; and (c) a comparison of the group with history of PPD (n = 12) with a larger 5-year-old group (n = 62).

RESULTS

Significant effect sizes (ηp2) found for mismatch totals were as follows: (a) moderate (Lexical, Structure) and large (Features) between ages 5 and 8 to 10 years, mismatch frequency decreasing developmentally, and (b) large between 8- to 10-year-olds with TD and with history of PPD (Structure, Features; minimal lexical influences), in favor of participants with TD. Mismatch frequencies were equivalent for 8- to 10-year-olds with history of PPD and 5-year-olds with TD. Classification accuracy in original subgroupings was 100% and 91% for 8- to 10-year-olds with TD and with history of PPD, respectively, and 86% for 5-year-olds with TD.

CONCLUSION

Phonological accuracy in MSW production was differentiated for elementary school-aged children with TD and PPD, using a whole-word metric. To assist with the identification of children with ongoing PPD, the metric has the ability to detect weaknesses and track progress in global MSW phonological production.

The multiple deficit model of dyslexia: what does it mean for identification and intervention?

Research demonstrates that phonological skills provide the basis of reading acquisition and are a primary processing deficit in dyslexia. This consensus has led to the development of effective methods of reading intervention. However, a single phonological deficit is not sufficient to account for the heterogeneity of individuals with dyslexia, and recent research provides evidence that supports a multiple-deficit model of reading disorders. Two studies are presented that investigate (1) the prevalence of phonological and cognitive processing deficit profiles in children with significant reading disability and (2) the effects of those same phonological and cognitive processing skills on reading development in a sample of children that received treatment for dyslexia. The results are discussed in the context of implications for identification and an intervention approach that accommodates multiple deficits within a comprehensive skills-based reading program.

Heritability and longitudinal outcomes of spelling skills in individuals with histories of early speech and language disorders

This study examined the spelling skills in middle childhood and adolescence in individuals with histories of early childhood speech sound disorders (SSD) with and without language impairment (LI). Youth without such histories were also included (No SSD/LI group). The heritability of spelling skills at each age level was estimated. Children with SSD were classified as SSD-only, SSD with LI but without childhood apraxia of speech (SSD + LI/ No CAS), and CAS and LI (CAS + LI). The SSD-only group did not differ in spelling from the No SSD/LI group, suggesting that SSD-only did not increase risk for poor spelling. The SSD + LI/No CAS and CAS + LI groups had poorer spelling skills than the SSD-only and No SSD/LI groups. Spelling was associated with phonological awareness in the middle childhood and adolescent samples and with rapid automatized naming in the adolescent sample. Heritability of spelling skills was stronger in adolescence than in middle childhood. Differences in the correlates of spelling and in heritability at the two ages suggest developmental changes in the factors contributing to spelling.

The Potential Effect of Forbrain as an Altered Auditory Feedback Device

PURPOSE

The purpose of this study was to run a proof of concept on a new commercially available device, Forbrain® (Sound For Life Ltd/Soundev, Luxemburg, model UN38.3), to test whether it can modulate the speech of its users.

METHOD

Participants were instructed to read aloud a text of their choice during 3 experimental phases: baseline, test, and posttest, while wearing a Forbrain® headset. Critically, for half of the participants (Forbrain group), the device was turned on during the test phase, whereas for the other half (control group), the device was kept off. Voice recordings were analyzed to derive 6 quantitative measures of voice quality over each of the phases of the experiment.

RESULTS

A significant Group × Phase interaction was obtained for the smoothed cepstral peak prominence, a measure of voice harmony, and for the trendline of the long-term average spectrum, a measure of voice robustness, this latter surviving Bonferroni correction for multiple comparisons.

CONCLUSIONS

The results of this study indicate the effectiveness of Forbrain® in modifying the speech of its users. It is suggested that Forbrain® works as an altered auditory feedback device. It may hence be used as a clinical device in speech therapy clinics, yet further studies are warranted to test its usefulness in clinical groups.

The development of a vocabulary for PEEPS-SE-profiles of early expressive phonological skills for Swedish

This paper describes the development of a vocabulary for Profiles of Early Expressive Phonological Skills for Swedish (PEEPS-SE), a tool for assessment of expressive phonology in Swedish-learning children in the age range of 18-36 months. PEEPS-SE is the Swedish version of the original PEEPS, Profiles of Early Expressive Phonological Skills, which uses two age-adequate word lists-a basic word list (BWL) for the assessment of 18-24-month-old children, to which an expanded word list (EWL) is added for assessment of 24-36-month-old children, or children with more than 250 words in their expressive vocabulary. The selection of words in PEEPS-SE is based on two types of criteria: age of acquisition and phonological complexity. The words also need to be easy to elicit in a natural way in test situations. Vocabulary data previously collected with the Swedish Early Communicative Development Inventory are used for selection of age-adequate words, where the BWL contains words acquired earlier compared to the additional words in the EWL. The latter also contains words that are more phonologically complex compared to those in the BWL. Word complexity was determined by the Swedish version of word complexity measure. PEEPS-SE has made an attempt to match the original version of PEEPS in terms of both assessment method and word selection.