Decoding skills in children with language impairment: contributions of phonological processing and classroom experiences

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.

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.

The Access to Literacy Assessment System for Phonological Awareness: An Adaptive Measure of Phonological Awareness Appropriate for Children With Speech and/or Language Impairment

Purpose The Access to Literacy Assessment System-Phonological Awareness (ATLAS-PA) was developed for use with children with speech and/or language impairment. The subtests (Rhyming, Blending, and Segmenting) are appropriate for children who are 3-7 years of age. ATLAS-PA is composed entirely of receptive items, incorporates individualized levels of instruction, and is adaptive in nature. Method To establish the construct validity of ATLAS-PA, we collected data from children with typical development (n = 938) and those who have speech and/or language impairment (n = 227). Results Rasch analyses indicated that items fit well together and formed a unidimensional construct of phonological awareness. Differential item functioning was minimal between the two groups of children, and scores on ATLAS-PA were moderately to strongly related to other measures of phonological awareness. Information about item functioning was used to create an adaptive version of ATLAS-PA. Conclusions Findings suggest that ATLAS-PA is a valid measure of phonological awareness that can be used with children with typical development and with speech and/or language impairment. Its adaptive format minimizes testing time and provides opportunities for monitoring progress in preschool and early elementary classrooms. Supplemental Material https://doi.org/10.23641/asha.12931691.

Contributions to Gain in Speech Sound Production Accuracy for Children With Speech Sound Disorders: Exploring Child and Therapy Factors

Purpose The purpose of this study was to explore the extent to which child- and therapy-level factors contribute to gains in speech sound production accuracy for children with speech sound disorders in receipt of school-based services. Method Data were obtained from 126 kindergarten and first- and second-grade children currently in receipt of speech therapy services in their public school setting. Pretest and posttest measures of spontaneous speech production and language ability were collected at the beginning and end of one academic year. Using a spontaneous speech sample, percentage of consonants correct (PCC) was calculated for each child; a gain score was computed by subtracting the pretest PCC score from the posttest PCC score. The children's speech-language pathologist completed weekly therapy logs during business-as-usual therapy, indicating the frequency, duration, and group composition of services throughout the school year. Results Results supported that gain in PCC from pretest to posttest was predicted by several child- and therapy-level variables. Children's initial speech sound severity was negatively related to gains in PCC. Our results also supported that the total number of therapy sessions received in a year was positively predictive of PCC gain. Interestingly, the number of individual therapy sessions was negatively associated with PCC gain. Conclusion Several malleable therapy factors contribute to gains in speech sound accuracy for children with speech sound disorders. Speech-language pathologists should consider how these factors may be manipulated to best tailor treatment to the individual needs of the children on their caseloads.

Academic Outcomes in Bilingual Children With Developmental Language Disorder: A Longitudinal Study

Previous studies have shown that most English-speaking children with language difficulties show academic difficulties during their schooling. The present study aimed to describe the academic achievement of children speaking Spanish and Catalan with developmental language disorder (DLD) during their primary education and to predict their academic outcomes using several processing skills assessed at the beginning of their schooling. To this end, we followed 28 children during their schooling (6–12 years of age). Participants were divided into two groups, one with DLD (n = 14) and a control group (n = 14) paired by age, gender, socio-economic status (SES), family language (L1), and classroom. All participants were assessed through different processing skills with the Spanish version of the NEPSY at the beginning of their schooling (age 6): attention (visual attention, auditory attention, and response set), phonological awareness, verbal short-term memory (sentence repetition, and narrative memory), access to language (semantic verbal fluency and rapid naming), and language comprehension (comprehension of verbal commands). At the end of primary education, schools reported the official academic marks at the 1st cycle (6–8 years), 2nd cycle (8–10 years) and 3rd cycle (10–12 years). Direct scores of the processing skills and academic results were used for statistical analyses. Results showed that children with DLD had more frequent grade retention, and their academic marks were significantly lower than those of their peers in all the cycles and for all academic subjects with a high language dependency (all except physical education and mathematics). Those subjects with lower language dependence did not show significant differences (physical education and mathematics). Rapid naming accounted for most of the variance of academic outcomes, followed by phonological awareness, and language comprehension when both groups were taken together. Only rapid naming accounted for academic results in the DLD group and phonological awareness did so for the control group. In sum, children with DLD experienced more academic difficulties during their primary education. Those children (with and without DLD) who experienced difficulties not only with rapid naming but also with phonological awareness and oral language comprehension at the beginning of their schooling showed a higher probability of academic failure.

Understanding Word Reading Difficulties in Children With SLI

Children with specific language impairment (SLI) often show considerable reading difficulties. Research has revealed two primary reading profiles among children with SLI: (a) one of poor word reading and decoding skills and associated reading comprehension difficulties, and (b) one involving relatively strong word reading skills but poor comprehension. This article reviews studies characterizing these two subtypes of SLI, discusses their current clinical implications, and suggests important directions for future study.

Impact of Diglossia on Word and Non-word Repetition among Language Impaired and Typically Developing Arabic Native Speaking Children

The study tested the impact of the phonological and lexical distance between a dialect of Palestinian Arabic spoken in the north of Israel (SpA) and Modern Standard Arabic (StA or MSA) on word and non-word repetition in children with specific language impairment (SLI) and in typically developing (TD) age-matched controls. Fifty kindergarten children (25 SLI, 25 TD; mean age 5;5) and fifty first grade children (25 SLI, 25 TD; mean age 6:11) were tested with a repetition task for 1-4 syllable long real words and pseudo words; Items varied systematically in whether each encoded a novel StA phoneme or not, namely a phoneme that is only used in StA but not in the spoken dialect targeted. Real words also varied in whether they were lexically novel, meaning whether the word is used only in StA, but not in SpA. SLI children were found to significantly underperform TD children on all repetition tasks indicating a general phonological memory deficit. More interesting for the current investigation is the observed strong and consistent effect of phonological novelty on word and non-word repetition in SLI and TD children, with a stronger effect observed in SLI. In contrast with phonological novelty, the effect of lexical novelty on word repetition was limited and it did not interact with group. The results are argued to reflect the role of linguistic distance in phonological memory for novel linguistic units in Arabic SLI and, hence, to support a specific Linguistic Distance Hypothesis of SLI in a diglossic setting. The implications of the findings for assessment, diagnosis and intervention with Arabic speaking children with SLI are discussed.