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

Speech-Language Pathologists' Perceptions of the Severity of Speech Sound Disorder

PURPOSE

Severity is a qualitative judgment typically made by speech-language pathologists (SLPs) to represent the impact of speech sound disorder (SSD) on a child's functional communication. Despite the influence of severity on clinical practice, there is no gold standard as to how SLPs should determine such a rating. The purpose of this study was to explore SLPs' perceptions regarding the concept of severity of SSD.

METHOD

An embedded mixed-methods research design was selected for this study to support the collection and analysis of both quantitative and qualitative data. An online survey of 30 closed-ended and 10 open-ended questions was created using Research Electronic Data Capture and disseminated to currently practicing SLPs across the United States. A total of 296 surveys were completed, and data were analyzed using descriptive statistics for the quantitative data and inductive content analysis for the qualitative data.

RESULTS

The majority of SLPs reported that they determine severity when assessing children with SSD. However, the mixed-methods analysis showed that SLPs disagreed in their decision making on whether to use severity ratings. The top five factors SLPs consider when judging severity are types of errors, intelligibility, perceptual judgment, normative data for speech sound development, and standardized percentile rankings with the addition of stimulability through qualitative responses.

CONCLUSIONS

SLPs need a standard biopsychosocial model for determining severity that truly evaluates the "impact" of SSD on a child's communicative participation and attitudes. Recommendations for clinical use of holistic assessments and future research on currently established severity rating scales are discussed.

A Scoping Review of Intervention Outcomes for School Students With Communication Difficulties

PURPOSE

For speech-language pathologists (SLPs) working in schools, outcome measurement is an important element of practice, enabling us to evaluate the efficacy of our service provision and guiding future decision making, funding, and resource allocation. When selecting outcomes to measure, it is helpful to consider both the level at which change may be occurring and the extent or impact of that change. The primary aim of this review was to identify the outcomes measured in intervention studies for school-aged children with speech, language, and communication difficulties (SLCD) using the International Classification of Functioning, Disability and Health to classify the outcomes. A second aim was to identify tools used in research studies to measure the outcomes.

METHOD

A systematic search of five databases was undertaken to identify papers reporting outcomes for school students who had received intervention targeting SLCD. Articles written in English and published between January 2000 and August 2021 were included. The Taxonomy for Categorizing Outcome Measures for SLCD was created to enable a review of outcomes and measurement tools.

RESULTS

There were 125 papers included in the final review. Most papers (n = 109, 87.2%) reported on studies that included outcome measures that captured changes at Body Function level, while approximately half captured Activity-level change. Only 24 (19.2%) explored changes at Participation level.

CONCLUSIONS

Change at the Body Function or Activity levels does not always reflect change at the Participation level. Measuring outcomes at the Participation level enables SLPs to determine the real-world impact of the adjustments they have recommended or the intervention they have provided. However, in order to measure outcomes at the Participation level, we need the tools for capturing those changes for school-aged students with SLCD.

Speech-Language Pathologist Self-Efficacy and Job Satisfaction: Resources in Special Education Eligibility Decisions

PURPOSE

Situated within the conservation of resources theory, this study sought to understand how resources such as self-efficacy, job satisfaction, caseload size, and geographic location influence the number of data sources used by school-based speech-language pathologists (SLPs) to determine eligibility.

METHOD

Using a cross-sectional descriptive design, 665 school-based SLPs from the United States reported professional demographics, workload, and assessment/eligibility characteristics, as well as levels of job satisfaction and self-efficacy. Multiple regression was used to examine the effects of self-efficacy, job satisfaction, caseload size, and geographic location on the number of data sources used in eligibility decision making and to examine the effects of caseload size and job satisfaction resources on SLP self-efficacy.

RESULTS

SLPs, on average, reported using 7.98 data sources to support eligibility determinations. Standardized tests, conversation samples, and review of records were most used, and literacy assessments were used least. Results of multiple regression models indicate that SLPs with higher self-efficacy scores reported using significantly more data sources and that SLPs with higher job satisfaction indicated significantly higher self-efficacy.

CONCLUSIONS

This study affirms self-efficacy as a strong resource for school-based SLPs and that it is, in fact, related to the number of data sources used in eligibility decisions. Limited literacy assessment was reported, despite the SLP's critical role in an educational setting. Job satisfaction as a predictor of self-efficacy and self-efficacy, in turn, as a predictor of data sources underscore the need for SLPs to advocate for work conditions that support their work.

Speech perception in the Specific Learning Disorder with and without Persistent Speech Sound Disorder

PURPOSE

Investigate if speech perception skills can differentiate school children with Specific Reading Disorders (SRD) with and without Persistent Speech Sound Disorders (PSSD).

METHODS

80 children, regularly enrolled in the 2nd (N=1), 3rd (N=28), 4th (N=29), 5th (N=15) and 6th (N=7) grades participated in the study. Control Group (CG) (N=48): no complaints, no speech alteration; and Resarch Group (RG) (N=32) - with SRD, RGI (N=15) without PSSD and RGII (N=17) with PSSD. Two tests evaluated auditory input reception: Simplified evaluation of auditory processing; and Perception task of nonwords, with Portuguese language structure (DNPLS). Data was analyzed by: Likelihood Ratio Test, Kruskal-Wallis test, Dunn test with Bonferroni correction, Mann-Whitney test, Spearman correlation, and construction of a ROC curve to obtain a threshold value for the correct answers in the perception of non-words test.

RESULTS

Control and RGI showed higher correct answer scores than RGII. There was no difference between the correct answer distributions of the Control and RGI, and RGI and RGII in the test of DNPLS and the number of correct answers in the CG was higher than in the RGII.

CONCLUSION

The ability to discriminate non-words enabled the differentiated between school-aged children with SRD associated with PSSD and typical children, thus characterizing this group for presenting a number of correct answers lower than 30.5, considering the task proposed to discriminate non-words. These results suggest that the presence of PSSD worsens the performance in speech perception of the schoolchildren with SRD.

Morphological Assessment Features and their Relations to Reading: A Meta-Analytic Structural Equation Modeling Study

Morphemes are the smallest meaningful unit of language (e.g., affixes, base words) that express grammatical and semantic information. Additionally, morphological knowledge is significantly related to children's word reading and reading comprehension skills. Researchers have broadly assessed morphological knowledge by using a wide range of tasks and stimuli, which has influenced the interpretation of the relations between morphological knowledge and reading outcomes. This review of 103 studies used meta-analytic structural equation modeling (MASEM) to investigate the relations between commonly occurring morphological knowledge assessment features (e.g., written versus oral, spelling versus no spelling) in the literature to reading outcomes, including word reading and reading comprehension. Meta-regression techniques were used to examine moderators of age and reading ability. Morphological assessments that used a written modality (e.g., reading, writing) were more predictive of word reading outcomes than those administered orally. Assessments of morphological spelling were more predictive of both word reading and reading comprehension outcomes than those that did not examine spelling accuracy. Age was a significant moderator of the relation between morphology and word reading, such that the relation was stronger for the younger than the older children. Younger children also demonstrated higher relations between multiple task dimensions and reading comprehension, including oral tasks, tasks without decoding, and tasks that provided context clues. These findings have important implications for future morphological intervention studies aimed to improve children's reading outcomes, in particular the use of orthography and spelling within the context of teaching morphology.

The High Rates of Comorbidity among Neurodevelopmental Disorders: Reconsidering the Clinical Utility of Distinct Diagnostic Categories

The boundaries between neurodevelopmental disorders are often indistinct, even among specialists. But do these boundaries exist, or do experts struggle to distinguish and categorize symptoms in order to arrive at a dominant diagnosis while comorbidity continually leaves questions about where each disorder ends and begins? What should be reconsidered? The introduction of the term 'spectrum of neurodevelopmental disorders' could pave the way for a re-appraisal of the clinical continuum of neurodevelopmental disorders. This study aims to highlight the problems that emerge in the field of the differential diagnosis of neurodevelopmental disorders and propose a renegotiation of the distinctiveness criteria.

Dynamic insights into research trends and trajectories in early reading: an analytical exploration via dynamic topic modeling

Introduction

Early reading has gained significant attention in the academic community. With the increasing volume of literature on this subject, it has become crucial to assess the current research landscape and identify emerging trends.

Methods

This study utilized the dynamic topic model to analyze a corpus of 1,638 articles obtained from the Web of Science Core Collection to furnish a lucid understanding of the prevailing research and forecast possible future directions.

Results

Our in-depth assessment discerned 11 cardinal topics, among which notable ones were interventions' impacts on early reading competencies; foundational elements of early reading: phonological awareness, letters, and, spelling; and early literacy proficiencies in children with autism spectrum disorder. Although most topics have received consistent research attention, there has been a marked increase in some topics' popularity, such as foundational elements of early reading and early literary proficiencies in children with autism spectrum disorder. Conversely, other topics exhibited a downturn.

Discussion

This analytical endeavor has yielded indispensable insights for scholars, decision-makers, and field practitioners, steering them toward pivotal research interrogatives, focal interest zones, and prospective research avenues. As per our extensive survey, this paper is a pioneering holistic purview of the seminal areas of early reading that highlights expected scholarly directions.

Examining Graduate Training in Written Language and the Impact on Speech-Language Pathologists' Practice: Perspectives From Faculty and Clinicians

PURPOSE

This study had two aims. Aim 1 was to query both communication science and disorders (CSD) faculty and school-based speech-language pathologists (SLPs) regarding how written language is/was covered in their graduate programs. Aim 2 was to query school-based SLPs about their written language service provision.

METHOD

CSD faculty (n = 143) and school-based SLPs (n = 610) completed an online survey examining (a) if and how written language was addressed in their graduate program, (b) what content related to written language was covered in graduate school, and (c) provision of written language services in schools (SLPs only).

RESULTS

There was a discrepancy in reports of training provision. Faculty reported providing more training than SLPs reported receiving. However, SLPs with fewer years of experience reported slightly higher levels of training compared to those with more years of experience. Additionally, there was variability among SLPs in how often they targeted written language in therapy. Finally, receipt of training in written language was a significant predictor of provision of written language services, as reported by SLPs.

CONCLUSIONS

SLPs play a key role on literacy teams in schools, but many SLPs did not receive adequate training in written language. In order to ensure SLPs are trained to work with children with reading difficulties, graduate programs should ensure that written language is part of the clinical and academic curricula.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24543469.

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.

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSION

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

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.

Auditory Experience, Speech Sound Production Growth, and Early Literacy in Children Who Are Hard of Hearing

PURPOSE

Children who are hard of hearing (CHH) are at risk for literacy difficulties. Speech sound production is related to literacy skills in typically hearing children. Speech sound production abilities can also be markedly weak in CHH due to inconsistent access to the speech signal. We longitudinally examined relations between auditory experience, speech sound production abilities, and literacy (i.e., nonword reading and spelling in second grade) in CHH.

METHOD

Participants included 166 CHH. All participants used hearing aids (HAs). Auditory experience is a weighted measure of the number of hours of daily HA use and the amount of audibility with and without their HAs. Children's speech sound production was tested 2-3 times between the ages of 3 and 9 years. At age 5 years and again in second grade, children were tested on a battery of language and literacy measures.

RESULTS

Auditory experience was significantly correlated with speech sound production abilities, but age at HA fitting was not. Speech sound production abilities at age 5 years did not predict nonword reading in second grade but did predict spelling skills in second grade.

CONCLUSIONS

Our results support the importance of auditory experience and speech sound production for later literacy abilities. Specifically, we found that speech sound production abilities and print knowledge at age 5 years are related to second grade spelling outcomes. Interestingly, we found that morphological knowledge at age 5 years was more predictive of decoding in second grade than was speech sound production. Although there are multiple factors that contribute to literacy success, our results underscore the unique contributions of speech sound production abilities in CHH.

Baseline Stimulability Predicts Patterns of Response to Traditional and Ultrasound Biofeedback Treatment for Residual Speech Sound Disorder

PURPOSE

This study aimed to identify predictors of response to treatment for residual speech sound disorder (RSSD) affecting English rhotics. Progress was tracked during an initial phase of traditional motor-based treatment and a longer phase of treatment incorporating ultrasound biofeedback. Based on previous literature, we focused on baseline stimulability and sensory acuity as predictors of interest.

METHOD

Thirty-three individuals aged 9-15 years with residual distortions of /ɹ/ received a course of individual intervention comprising 1 week of intensive traditional treatment and 9 weeks of ultrasound biofeedback treatment. Stimulability for /ɹ/ was probed prior to treatment, after the traditional treatment phase, and after the end of all treatment. Accuracy of /ɹ/ production in each probe was assessed with an acoustic measure: normalized third formant (F3)-second formant (F2) distance. Model-based clustering analysis was applied to these acoustic measures to identify different average trajectories of progress over the course of treatment. The resulting clusters were compared with respect to acuity in auditory and somatosensory domains.

RESULTS

All but four individuals were judged to exhibit a clinically significant response to the combined course of treatment. Two major clusters were identified. The "low stimulability" cluster was characterized by very low accuracy at baseline, minimal response to traditional treatment, and strong response to ultrasound biofeedback. The "high stimulability" group was more accurate at baseline and made significant gains in both traditional and ultrasound biofeedback phases of treatment. The clusters did not differ with respect to sensory acuity.

CONCLUSIONS

This research accords with clinical intuition in finding that individuals who are more stimulable at baseline are more likely to respond to traditional intervention, whereas less stimulable individuals may derive greater relative benefit from biofeedback.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20422236.

Understanding the nature and severity of reading difficulties among students with language and reading comprehension difficulties

This study investigated the presence of word reading difficulties in a sample of students in Grades 1-4 (n = 357) identified with language and reading comprehension difficulties. This study also examined whether distinct word reading and listening comprehension profiles emerged within this sample and the extent to which these groups varied in performance on cognitive and demographic variables. Findings showed that the majority of students (51%) with language and reading comprehension difficulties demonstrated significant risk in word reading (more than 1 SD below the mean), even though the participant screening procedures did not examine word reading directly. Three latent profiles emerged when students were classified into subgroups based on their performance in listening comprehension (LC) and word reading (WR): (1) severe difficulties in LC and moderate difficulties in WR (11%), (2) mild difficulties in both LC and WR (50%), and (3) moderate difficulties in LC and mild difficulties in WR (39%). Of note, even though students were identified for participation on the basis of poor oral language and reading comprehension abilities, all profiles demonstrated some degree of word reading difficulties. Findings revealed there were differences in age and performance on measures of working memory, nonverbal reasoning, and reading comprehension performance between profiles. Implications for educators providing instruction to students with or at risk for dyslexia and developmental language disorders were discussed.

Introduction: Innovations in Treatment for Children With Speech Sound Disorders

PURPOSE

There is a clear need for effective and efficient interventions for children with speech sound disorder (SSD) that can be implemented in both clinical and school-based settings.

METHOD

This forum was created for any clinician who treats SSDs. We asked the invited authors to include immediately actionable information, such as therapy activities, tips for goal writing or progress monitoring, assessment processes, and frameworks for conversations with parents.

RESULTS

We have curated nine scientifically based articles that highlight the heterogeneity of SSDs and how various subpopulations require uniquely tailored interventions. Some children with SSDs require treatment approaches that are more heavily embedded in phonological theories (e.g., maximal or multiple oppositions) or that extend beyond speech production and include speech perception and phonological awareness skills. Clinicians also need to be mindful of not only which sounds are affected, but which kinds of errors a child is making. For instance, lateral lisps and residual speech sound errors should be evaluated and treated differently from other kinds of speech sound errors. There are certainly subpopulations of children with SSDs for whom there is extremely limited data upon which speech-language pathologists can base clinical decisions, such as children under the age of 3 years or children who are multilingual. Finally, there is a crucial need to better understand the social-emotional impacts of SSDs. Tools to aid in including social-emotional data within assessment and intervention outcomes are also included in this forum.

CONCLUSION

The traditional articulation approach is the most commonly used approach in school-based settings; however, there are many children for whom this approach is not appropriate. We hope to provide a robust resource for busy school-based speech-language pathologists who treat children with SSD-specifically, we hope clinicians embrace the opportunity to "think outside the box" of traditional articulation therapy.

The importance of deep speech phenotyping for neurodevelopmental and genetic disorders: a conceptual review

BACKGROUND

Speech is the most common modality through which language is communicated, and delayed, disordered, or absent speech production is a hallmark of many neurodevelopmental and genetic disorders. Yet, speech is not often carefully phenotyped in neurodevelopmental disorders. In this paper, we argue that such deep phenotyping, defined as phenotyping that is specific to speech production and not conflated with language or cognitive ability, is vital if we are to understand how genetic variations affect the brain regions that are associated with spoken language. Speech is distinct from language, though the two are related behaviorally and share neural substrates. We present a brief taxonomy of developmental speech production disorders, with particular emphasis on the motor speech disorders childhood apraxia of speech (a disorder of motor planning) and childhood dysarthria (a set of disorders of motor execution). We review the history of discoveries concerning the KE family, in whom a hereditary form of communication impairment was identified as childhood apraxia of speech and linked to dysfunction in the FOXP2 gene. The story demonstrates how instrumental deep phenotyping of speech production was in this seminal discovery in the genetics of speech and language. There is considerable overlap between the neural substrates associated with speech production and with FOXP2 expression, suggesting that further genes associated with speech dysfunction will also be expressed in similar brain regions. We then show how a biologically accurate computational model of speech production, in combination with detailed information about speech production in children with developmental disorders, can generate testable hypotheses about the nature, genetics, and neurology of speech disorders.

CONCLUSIONS

Though speech and language are distinct, specific types of developmental speech disorder are associated with far-reaching effects on verbal communication in children with neurodevelopmental disorders. Therefore, detailed speech phenotyping, in collaboration with experts on pediatric speech development and disorders, can lead us to a new generation of discoveries about how speech development is affected in genetic disorders.

Using the Experience Sampling Method to Examine the Details of Dosage in School-Based Speech Sound Therapy

PURPOSE

The purpose of this project was to collect practice-based evidence regarding dosage in speech sound therapy sessions in school-based settings. Dosage is the number of trials within a therapy session for any one particular child. School-based speech-language pathologists (SLPs) face a variety of obstacles to service delivery, often making the implementation of evidence-based practices difficult. To that end, we were interested in exploring how therapy parameters, such as group size and session frequency were associated with dosage.

METHOD

Using the experience sampling method, we queried school-based SLPs (n = 90) across the United States. SLPs participated via a phone application, which randomly alerted them to participate 3 times per day for 5 days. SLPs also completed a demographic questionnaire that included information regarding caseload size and job satisfaction.

RESULTS

We report results from 670 therapy sessions. Results revealed that the therapy parameter of group size was negatively related to dosage. The SLP parameter of caseload size was positively related to dosage, but this was a small association. The child parameter of comorbidity was negatively related to dosage.

CONCLUSIONS

Our results support that as group size increases, children receive smaller doses of speech sound practice. Similarly, children who have a reported comorbidity received smaller doses compared to children who have an isolated speech sound disorder. We discuss implications for school-based practitioners and researchers.

Factors that influence non-word repetition performance in children with and without persistent speech sound disorders

BACKGROUND

Nonword repetition (NWR) is a common phonological processing task that is reported to tap into many cognitive, perceptual, and motor processes. For this reason, NWR is often used in assessment batteries to aid in verifying the presence of a reading or language disorder.

AIMS

To examine the extent to which child- and item-level factors predict the probability of a correct response on a non-word repetition (NWR) task in a sample of children with persistent speech sound disorders (P-SSDs) compared with their typically developing peers.

METHODS & PROCEDURES

A total of 40 American-English-speaking children were tested on an NWR task for which the stimuli were manipulated for phonological neighbourhood density and list length. Additional measures of vocabulary and word reading were also administered.

OUTCOMES & RESULTS

Children who were typically developing were 1.82 times more likely than children with P-SSD to respond correctly. The item-level factor of phonological neighbourhood density influenced performance, but only for the P-SSD group, and only at certain list lengths. Vocabulary and word-reading ability also influenced NWR task performance.

CONCLUSIONS & IMPLICATIONS

Children with P-SSD present as a complex and heterogeneous group. Multiple factors contribute to their ability to perform phonological tasks such as NWR. As such, attention to the item-level factors in screenings and assessments is necessary to ensure that appropriate decisions are made regarding diagnosis and subsequent treatment.

WHAT THIS PAPER ADDS

What is already known on the subject? Good expressive vocabulary is important for children with speech sound disorders; it can aid in their performance on phonological processing tasks like NWR. Nonword repetition may be a helpful test/ subtest to add to assessment batteries when evaluating children with speech sound disorders. What this paper adds to existing knowledge? Vocabulary and word reading abilities must also be measured for children with SSDs, to observe the bigger picture of their linguistic abilities. What are the potential or actual clinical implications of this work? The relation between word reading and speech sound production influences performance on phonological processing tasks.

Putting Policy Into Practice: Impact of the Every Student Succeeds Act on Speech-Language Pathologists and Students With Disabilities

Purpose Public policies can influence how speech-language pathologists (SLPs) provide services to students with disabilities. Specifically, this article is intended to provide background information and critical analysis regarding the Every Student Succeeds Act (ESSA) as it relates to speech-language pathology practice and provision of services to students with disabilities within the schools. Method The authors reviewed legislation text, publications from national education and speech and language organizations, and critical educational policy and research articles to examine the role that SLPs can play in the implementation of ESSA for students with disabilities. Results SLPs and other education professionals utilize ESSA to improve access to a well-rounded, college- and career-focused education for all students. ESSA state plans may not fully maximize equal opportunities for students with disabilities. There are additional ways that SLPs can capitalize on ESSA to expand and improve their service provision to students with disabilities, including SLPs broadening their understanding of the role ESSA plays in facilitating positive practices for students with and without disabilities. Conclusions SLPs, teachers, and other stakeholders can improve the impact of ESSA on students with disabilities by helping to improve accountability systems for the educational outcomes of students with disabilities, supporting funding allocation for students with disabilities and struggling learners in the general education setting, and assisting local education agencies to better align ESSA with the Individuals with Disabilities Education Act.

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.