Perception of Speech Sounds in School-Aged Children with Speech Sound Disorders

Comparing online versus laboratory measures of speech perception in older children and adolescents

Given the increasing prevalence of online data collection, it is important to know how behavioral data obtained online compare to samples collected in the laboratory. This study compares online and in-person measurement of speech perception in older children and adolescents. Speech perception is important for assessment and treatment planning in speech-language pathology; we focus on the American English /ɹ/ sound because of its frequency as a clinical target. Two speech perception tasks were adapted for web presentation using Gorilla: identification of items along a synthetic continuum from rake to wake, and category goodness judgment of English /ɹ/ sounds in words produced by various talkers with and without speech sound disorder. Fifty typical children aged 9-15 completed these tasks online using a standard headset. These data were compared to a previous sample of 98 typical children aged 9-15 who completed the same tasks in the lab setting. For the identification task, participants exhibited smaller boundary widths (suggestive of more acute perception) in the in-person setting relative to the online setting. For the category goodness judgment task, there was no statistically significant effect of modality. The correlation between scores on the two tasks was significant in the online setting but not in the in-person setting, but the difference in correlation strength was not statistically significant. Overall, our findings agree with previous research in suggesting that online and in-person data collection do not yield identical results, but the two contexts tend to support the same broad conclusions. In addition, these results suggest that online data collection can make it easier for researchers connect with a more representative sample of participants.

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.

Auditory and Somatosensory Development for Speech in Later Childhood

PURPOSE

This study collected measures of auditory-perceptual and oral somatosensory acuity in typically developing children and adolescents aged 9-15 years. We aimed to establish reference data that can be used as a point of comparison for individuals with residual speech sound disorder (RSSD), especially for RSSD affecting American English rhotics. We examined concurrent validity between tasks and hypothesized that performance on at least some tasks would show a significant association with age, reflecting ongoing refinement of sensory function in later childhood. We also tested for an inverse relationship between performance on auditory and somatosensory tasks, which would support the hypothesis of a trade-off between sensory domains.

METHOD

Ninety-eight children completed three auditory-perceptual tasks (identification and discrimination of stimuli from a "rake"-"wake" continuum and category goodness judgment for naturally produced words containing rhotics) and three oral somatosensory tasks (bite block with auditory masking, oral stereognosis, and articulatory awareness, which involved explicit judgments of relative tongue position for different speech sounds). Pairwise associations were examined between tasks within each domain and between task performance and age. Composite measures of auditory-perceptual and somatosensory functions were used to investigate the possibility of a sensory trade-off.

RESULTS

Statistically significant associations were observed between the identification and discrimination tasks and the bite block and articulatory awareness tasks. In addition, significant associations with age were found for the category goodness and bite block tasks. There was no statistically significant evidence of a trade-off between auditory-perceptual and somatosensory domains.

CONCLUSIONS

This study provided a multidimensional characterization of speech-related sensory function in older children/adolescents. Complete materials to administer all experimental tasks have been shared, along with measures of central tendency and dispersion for scores in two subgroups of age. Ultimately, we hope to apply this information to make customized treatment recommendations for children with RSSD based on sensory profiles.

Speech Perception Variability in Childhood Apraxia of Speech: Implications for Assessment and Intervention

PURPOSE

Beyond hallmark production deficits characterizing childhood apraxia of speech (CAS), largely attributed to disruption(s) in speech motor planning, children with CAS often present with co-occurring speech perception and language difficulties. Thus, careful consideration of the potential for speech perception difficulties to have cascading downstream effects on intervention responsiveness and real-life functioning for some children with CAS is highly important. The purpose of this tutorial was to consider the impact of speech perception abilities in children with CAS, which carries implications for caring for the needs of the whole child.

METHOD

This tutorial summarizes the current literature on speech perception and how it relates to speech production, language, and reading abilities for children with CAS. We include case illustrations that are adapted from real clinical scenarios illustrating how speech perception difficulties may impact some children with CAS and provide recommendations for incorporating speech perception into assessment and intervention practices.

RESULTS

Although speech perception difficulties do not seem to be a core deficit of CAS, they are strongly linked to language difficulties, which are highly prevalent among children with CAS. Speech perception and language difficulties are also associated with reading difficulties and risk for lower academic achievement.

CONCLUSIONS

Children with CAS who have co-occurring language difficulties likely also demonstrate speech perception deficits, which puts them at heightened risk for reading difficulties and struggles with academic achievement. Comprehensive assessment of children with CAS should address speech perception and production, language, and reading abilities, which carries important implications for multifaceted approaches to intervention.

Clinical Linguistics: Analysis of Mapping Knowledge Domains in Past, Present and Future

Across the world, many infants, children, adults, and elderly people are reported with many types of disorders and disabilities that damage, delay, or impede typical language development and/or use. Speech-language pathologists and other relevant clinicians are responsible for diagnosing, assessing, and rehabilitating these conditions. In nearly all types of disorders or disabilities that affect language, clinical linguistics plays a significant role in their study, diagnosis, and evaluation. This study provides a thorough analysis of the field of clinical linguistics. Data from Scopus, WOS, and Lens were used between 1981 and 2022. The documents included in the analysis were 1685, 1628, and 2677 articles published between 1981 and 2022 in clinical linguistics in Scopus, WOS, and Lens, respectively. For the purpose of assessing the development and impacts of the field of clinical linguistics, we used eight bibliometric and eight scientometric indicators. As part of the study, the results summarized the top contributors to clinical linguistics in terms of production size by year, country, university/research centre, journal, publisher, and author. The impact of the examined evidence on clinical linguistics was visualized and tabulated in the form of visual networks, citation counts, burst, cooccurrence, centrality, and sigma factors that are helpful in identifying the main influencers in clinical linguistics. A few examples of clinical linguistics patterns that are being explored extensively by researchers include cleft palate speech with model theories, visual feedback, motor speech disorders with instrumental analysis, acoustic analysis to understand conversational breakdown, nonlinear phonological theory, aphasic conversation in atypical interaction, and diagnostic markers in functional segments. There are also phonological disorders, William Syndrome, and the use of ultrasound, which may be considered potential clusters of clinical linguistics. A key contribution of this paper is highlighting the importance of clinical linguistics as well as its integration with linguistics, speech-language pathology, neurolinguistics, psycholinguistics, neuroscience, cognitive sciences, psychology, and psychometrics.

Acoustic and Articulatory Characteristics of English Semivowels /ɹ, l, w/ Produced by Adult Second-Language Speakers

PURPOSE

This study presents the results of acoustic and kinematic analyses of word-initial semivowels (/ɹ, l, w/) produced by second-language (L2) speakers of English whose native language is Korean. In addition, the relationship of acoustic and kinematic measures to the ratings of foreign accent was examined by correlation analyses.

METHOD

Eleven L2 speakers and 10 native speakers (first language [L1]) of English read The Caterpillar passage. Acoustic and kinematic data were simultaneously recorded using an electromagnetic articulography system. In addition to speaking rate, two acoustic measures (ratio of third-formant [F3] frequency to second-formant [F2] frequency and duration of steady states of F2) and two kinematic measures (lip aperture and duration of lingual maximum hold) were obtained from individual target sounds. To examine the degree of contrast among the three sounds, acoustic and kinematic Euclidean distances were computed on the F2-F3 and x-y planes, respectively.

RESULTS

Compared with L1 speakers, L2 speakers exhibited a significantly slower speaking rate. For the three semivowels, L2 speakers showed a reduced F3/F2 ratio during constriction, increased lip aperture, and reduced acoustic Euclidean distances among semivowels. Additionally, perceptual ratings of foreign accent were significantly correlated with three measures: duration of steady F2, acoustic Euclidean distance, and kinematic Euclidean distance.

CONCLUSIONS

The findings provide acoustic and kinematic evidence for challenges that L2 speakers experience in the production of English semivowels, especially /ɹ/ and /w/. The robust and consistent finding of reduced contrasts among semivowels and their correlations with perceptual accent ratings suggests using sound contrasts as a potentially effective approach to accent modification paradigms.

Identification of the factors associated with the severity of the speech production problems in children with comorbid speech sound disorder and developmental language disorder

It has been suggested that factors such as auditory perception, oral motor skills, phonological awareness, and working memory are all associated with speech production problems in children with speech sound disorder (SSD) and developmental language disorder (DLD). However, it remains unclear whether the severity of the speech production problems in these children can be explained by an interaction among the aforementioned factors. The aim of this study was to determine which of these four factors best explain the severity of the speech production problems in children with SSD and DLD and whether an interaction between factors occurs. Forty-one children with SSD and DLD between 5 and 5;11 years old were selected. The number of phonological process errors was used as a measure of the severity of the speech production problems. The association between the number of phonological process errors and performance in auditory perception, oral motor skills, phonological awareness, and working memory along with the severity of the DLD was explored using univariate and multivariate regression models (with and without an interaction term). The results showed that the number of phonological process errors was largely explained by working memory and phonological awareness. An interaction between these two factors was also found. This means that working memory and phonological awareness interact to have an effect on the number of phonological process errors that is more than the sum of their parts. In addition, the severity of the DLD was significantly associated with the number of phonological process errors. These findings suggest that phonological awareness and working memory should be considered when assessing and treating children with comorbid SSD and DLD.

Effect of the Finnish Tube on the Voice of a Deaf Musician: A Case Report

PURPOSE

To verify the auditory-perceptual and acoustic effects of the semioccluded vocal tract exercise with Finnish tube on the vocal quality of a deaf musician.

METHODS

A seven-day protocol with Finnish tube was performed with guidance for its home replication twice a day. A 46-years-old man with profound bilateral sensorineural hearing loss, musician and composer participated. Before and after the application of the protocol had undergone tonal audiometry, nasofibrolaryngoscopy, acoustic analysis with Praat and auditory-perceptual evaluation of the voice with Voice Profile Analysis Scheme for Brazilian Portuguese.

RESULTS

The postintervention auditory-perceptual analysis identified reduction of the deviation in lip spreading, extensive labial range, raised tongue body, pharyngeal expansion, nasal resonance, larynx height, larynx and vocal tract tension and irregularity, pitch, speech rate, and a better respiratory support. The maximum phonation time reduced, probably because of elimination of the abrupt vocal attack and tension, articulatory deviations, improvement in voicing and the absence of the use of expiratory reserve air. The fundamental frequency became lower, and the first, second, third, and fourth formants became higher. The jitter increased, and the shimmer reduced.

CONCLUSION

The use of the Finnish tube might have facilitated the voicing sensations in the deaf musician, by enhancing the tactile-kinesthetic perception of the vocal tract and brought a greater source-filter interaction.

Perception of Sibilants by Preschool Children With Overt and Covert Sound Contrasts

Purpose This study explores the role of overt and covert contrasts in speech perception by children with speech sound disorder (SSD). Method Three groups of preschool-aged children (typically developing speech and language [TD], SSD with /s/~/ʃ/ contrast [SSD-contrast], and SSD with /s/~/ʃ/ collapse [SSD-collapse]) completed an identification task targeting /s/~/ʃ/ minimal pairs. The stimuli were produced by 3 sets of talkers: children with TD, children with SSD, and the participant himself/herself. We conducted a univariate general linear model to investigate differences in perception of tokens produced by different speakers and differences in perception between the groups of listeners. Results The TD and SSD-contrast groups performed similarly when perceiving tokens produced by themselves or other children. The SSD-collapse group perceived all speakers more poorly than the other 2 groups of children, performing at chance for perception of their own speech. Children who produced a covert contrast did not perceive their own speech more accurately than children who produced no identifiable acoustic contrast. Conclusion Preschool-aged children have not yet developed adultlike phonological representations. Collapsing phoneme production, even with a covert contrast, may indicate poor perception of the collapsed phonemes.

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.

Modelling category goodness judgments in children with residual sound errors

This study investigates category goodness judgments of /r/ in adults and children with and without residual speech errors (RSEs) using natural speech stimuli. Thirty adults, 38 children with RSE (ages 7-16) and 35 age-matched typically developing (TD) children provided category goodness judgments on whole words, recorded from 27 child speakers, with /r/ in various phonetic environments. The salient acoustic property of /r/ - the lowered third formant (F3) - was normalized in two ways. A logistic mixed-effect model quantified the relationships between listeners' responses and the third formant frequency, vowel context and clinical group status. Goodness judgments from the adult group showed a statistically significant interaction with the F3 parameter when compared to both child groups (p < 0.001) using both normalization methods. The RSE group did not differ significantly from the TD group in judgments of /r/. All listeners were significantly more likely to judge /r/ as correct in a front-vowel context. Our results suggest that normalized /r/ F3 is a statistically significant predictor of category goodness judgments for both adults and children, but children do not appear to make adult-like judgments. Category goodness judgments do not have a clear relationship with /r/ production abilities in children with RSE. These findings may have implications for clinical activities that include category goodness judgments in natural speech, especially for recorded productions.

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

PURPOSE

To investigate whether Australian-English speaking children with and without speech sound disorder (SSD) differ in their overall speech perception accuracy. Additionally, to investigate differences in the perception of specific phonemes and the association between speech perception and speech production skills.

METHOD

Twenty-five Australian-English speaking children aged 48-60 months participated in this study. The SSD group included 12 children and the typically developing (TD) group included 13 children. Children completed routine speech and language assessments in addition to an experimental Australian-English lexical and phonetic judgement task based on Rvachew's Speech Assessment and Interactive Learning System (SAILS) program (Rvachew, 2009). This task included eight words across four word-initial phonemes-/k, ɹ, ʃ, s/.

RESULTS

Children with SSD showed significantly poorer perceptual accuracy on the lexical and phonetic judgement task compared with TD peers. The phonemes /ɹ/ and /s/ were most frequently perceived in error across both groups. Additionally, the phoneme /ɹ/ was most commonly produced in error. There was also a positive correlation between overall speech perception and speech production scores.

CONCLUSIONS

Children with SSD perceived speech less accurately than their typically developing peers. The findings suggest that an Australian-English variation of a lexical and phonetic judgement task similar to the SAILS program is promising and worthy of a larger scale study.

Intensive Treatment for Persisting Rhotic Distortions: A Case Series

PURPOSE

The study explored changes in accuracy of American English rhotics as a result of an intensive 1-week therapy program for adolescents and young adults with residual speech sound errors that had not resolved with previous therapy.

METHOD

Four case reports are presented of individuals aged 13, 17, 21, and 22 years with residual /ɹ/ distortions. Each participant attended a 1-week intensive program consisting of pretreatment assessments, 14 hr of therapy, and posttreatment assessment. Treatment sessions included structured motor-based practice, ultrasound visual feedback of the tongue, and auditory speech perception training. To assess generalization, untreated words and sentences with rhotics were recorded before and after therapy; these were rated by listeners who were blind to when the recordings were taken.

RESULTS

All participants showed measurable and statistically significant improvement in speech sound accuracy. Averaged across the 4 participants, rhotic accuracy at the word level improved from 35% to 83%. At the sentence level, rhotic accuracy increased from 11% pretreatment to 66% posttreatment in 1 week.

CONCLUSION

The promise of an intensive treatment program that includes motor-based practice, biofeedback, and auditory perception training is illustrated by the case presentations in which substantial improvements in speech sound accuracy were observed.

SUPPLEMENTAL MATERIALS

https://doi.org/10.23641/asha.5561254.

Percepção da inteligibilidade e gravidade do desvio fonológico por fonoaudiólogos e leigos

RESUMO Objetivo: comparar o julgamento perceptual por fonoaudiólogos(as) e leigos(as) quanto à inteligibilidade da fala de crianças com desvio fonológico, e verificar a concordância deste julgamento com a gravidade do desvio fonológico. Métodos: a pesquisa foi composta por duas amostras: julgada e julgadora. A amostra julgada foi constituída por 30 crianças do banco de dados da clínica fonoaudiológica da instituição, com diagnóstico de desvio fonológico, na faixa etária de 4 anos e 1 mês a 7 anos e 11 meses (20 do gênero masculino e 10 do feminino). A amostra julgadora, foi composta por seis leigos, que não possuíam qualquer contato com crianças, sendo três do gênero masculino e três do feminino; e seis fonoaudiólogos, sendo três do gênero masculino e três do feminino. Resultados: o julgamento da inteligibilidade por leigos(as) é mais prejudicado do que a inteligibilidade por fonoaudiólogos(as), pois estes possuem formação técnica para entender a fala do outro, julgando melhor a fala da criança. Leigos e leigas concordam de forma semelhante em relação à gravidade do desvio fonológico, diferentemente do grupo de fonoaudiólogos x fonoaudiólogas, onde as fonoaudiólogas julgam e concordam melhor quanto à inteligibilidade e a gravidade do desvio fonológico. Conclusão: profissionais fonoaudiólogos(as) julgam de forma mais adequada a inteligibilidade da fala de crianças com desvio fonológico; as fonoaudiólogas possuem melhor percepção para julgar a gravidade do desvio quando comparadas aos grupos de leigos e leigas, demonstrando haver necessidade de informações a este último sobre o tema.

Perception-production relations in later development of American English rhotics

It is known that some adult listeners have more sharply defined perceptual categories than others, and listeners with more precise auditory targets are also more precise in their production of contrasts. There is additionally evidence that children who have not yet mastered production of a contrast show diminished performance on perceptual measures of the same contrast. To date, however, few studies have investigated developmental perception-production relations using the fine-grained measures typical of adult studies. Existing evidence suggests that perception and production can be closely connected in development, but this relationship may break down as perception and articulation mature at different rates. This study evaluated perception and production of the English /r-w/ contrast in 40 typically-developing children aged 9-14. Perceptual sensitivity was measured with a logistic function fitted over responses in a forced-choice identification task using two synthetic 10-step continua from rake to wake. Participants also produced rhotic and non-rhotic words. Across participants, there was a significant correlation between perceptual acuity and rhoticity in production, although this effect was only observed for one of two continua tested. These results provide preliminary evidence compatible with the hypothesis that children with a more refined auditory target for a sound also produce that sound more accurately.

Motor-based treatment with and without ultrasound feedback for residual speech-sound errors

BACKGROUND

There is a need to develop effective interventions and to compare the efficacy of different interventions for children with residual speech-sound errors (RSSEs). Rhotics (the r-family of sounds) are frequently in error American English-speaking children with RSSEs and are commonly targeted in treatment. One treatment approach involves the use of ultrasound visual feedback of the tongue.

AIMS

Although prior studies have shown that children with RSSEs acquire rhotics and generalize to untrained words with ultrasound visual feedback treatment, predictions from schema-based motor learning theory suggest that visual feedback might impede generalization. Therefore, the primary aim was to compare the generalization of rhotics treated with and without ultrasound in children with RSSEs.

METHODS & PROCEDURES

Twelve children aged 10-16 years with RSSEs affecting rhotics participated in a multiple-baseline single-case design with two treatment phases. For each participant, rhotics in one syllable position were treated for 7 h-long sessions with ultrasound visual feedback and rhotics in a different syllable position were treated without ultrasound in a second treatment phase. The order of treatment conditions was counterbalanced across participants. A treatment framework incorporating the principles of motor learning through chaining procedures was implemented across both treatment phases; thus the primary distinction between conditions was the use of ultrasound visual feedback.

OUTCOMES & RESULTS

On average, both treatments resulted in an approximately 30% increase in accuracy of untreated words in seven sessions. However, variability in response suggested some children showed a preferential response to one treatment over another, some responded well to both interventions, and some responded minimally to both interventions.

CONCLUSIONS & IMPLICATIONS

Motor-based treatment with and without ultrasound visual feedback of the tongue may aid in speech-sound acquisition for children with RSSEs. Both approaches may be viable options for some children. Future research is necessary to determine which children are the best candidates for interventions with and without ultrasound visual feedback.