Tracking change in children with severe and persisting speech difficulties

The development of speech output processing skills in Greek-speaking children

There is a growing body of literature on phonological development in Greek-speaking children, either typically developing (TD) or with speech sound disorders (SSD). In this paper, a cross-sectional longitudinal approach was used to investigate the development of speech output processing skills in TD Greek-speaking preschool-aged children. Moreover, a group of Greek-speaking children with SSD were assessed to identify potential loci of impairment in atypical development. The developmental study involved two groups: group 1 (n = 16) aged 3;0-3;5 years and group 2 (n = 22) aged 4;6-5;0 years, assessed at three assessment points six months apart. Children with SSD (n = 15) aged 5;6-6;0 years were assessed to be compared with performance of group 2 TD children (at the third assessment point). Assessment tasks included (a) a picture naming task, (b) a task of real word repetition and (c) a task of nonword repetition. A strong time effect was found in both groups of TD children in the development of speech output processing abilities. Performance accuracy was higher on tasks including real words than nonwords; children performed more accurately on repetition rather than spontaneous naming of real words; repetition accuracy on 2-3 syllables items was significantly better than on 4-5 syllables items. Children with SSD were outperformed by TD children of the same age in all assessment tasks; lexicality and word length effect were found in the clinical group. Findings from the present study may be used as a starting point to diagnose children with speech production difficulties in Greece.

Speech assessment tool methods for speech impaired children: a systematic literature review on the state-of-the-art in Speech impairment analysis

Speech is a powerful, natural mode of communication that facilitates effective interactions in human societies. However, when fluency or flow of speech is affected or interrupted, it leads to speech impairment. There are several types of speech impairment depending on the speech pattern and range from mild to severe. Childhood apraxia of speech (CAS) is the most common speech disorder in children, with 1 out of 12 children diagnosed globally. Significant advancements in speech assessment tools have been reported to assist speech-language pathologists diagnosis speech impairment. In recent years, speech assessment tools have also gained popularity among pediatricians and teachers who work with preschoolers. Automatic speech tools can be more accurate for detecting speech sound disorders (SSD) than human-based speech assessment methods. This systematic literature review covers 88 studies, including more than 500 children, infants, toddlers, and a few adolescents, (both male and female) (age = 0-17) representing speech impairment from more than 10 countries. It discusses the state-of-the-art speech assessment methods, including tools, techniques, and protocols for speech-impaired children. Additionally, this review summarizes notable outcomes in detecting speech impairments using said assessment methods and discusses various limitations such as universality, reliability, and validity. Finally, we consider the challenges and future directions for speech impairment assessment tool research.

Phonology, morphology and speech processing development in Greek-speaking children

Α psycholinguistic framework for speech processing was adopted to investigate the development of phonological and morphological skills in children learning Greek. It was investigated whether morphological items pose specific challenges in terms of speech processing. Two groups of typically developing children aged 3.0-3.5 years (N = 16) and 4.6-5.0 years (N = 22), respectively, were assessed longitudinally at three assessment points 6 months apart. A range of phonologically based and morphologically based experimental speech processing tasks was administered to address the research question, along with language comprehension and production assessments to ensure that the children were developmentally typical. Stimuli of minimal phonological difference and minimal morphological difference, respectively, were used. Phonologically based experimental stimuli were used to assess performance differences across properties such as voicing, manner and place of articulation, in addition to variation in phonotactic structure. Morphologically based experimental stimuli were used to assess the impact of characteristics such as verb tense and possessive pronouns. Stimuli were incorporated into tasks of real word and nonword auditory discrimination and repetition, to assess input and output processing. Items were matched across tasks so that comparisons could be made. On most of the matched tasks, there was no significant difference in performance accuracy between morphological and phonological conditions. Moreover, a significant relationship was found between domains. It is suggested that morphological items, compared to phonological items, do not pose specific challenges in terms of speech processing. The clinical implications of these findings for assessment and intervention are discussed.

Whole-word measures and the speech production of typically developing Dutch children

In this study, the phonological whole-word measure Phonological Mean Length of Utterance was applied to identify stages in the phonological acquisition of Dutch children. Ninety spontaneous speech samples of 47 typically developing Dutch children from a previous study were examined. Samples were distributed across nine age groups ranging between 1;3-4;0 years. Across all age groups, PMLU of word productions increased significantly with the largest increase found below age 2;0 years. PMLU of the target words showed no significant increase across age groups. Outcomes suggest that the phonological whole-word measure PMLU can be further developed for clinical purposes in Dutch-speaking children. In the future, this measure could become relevant for the diagnosis and evaluation of therapy on the basis of spontaneous language.

Model-Driven Treatment of Childhood Apraxia of Speech: Positive Effects of the Speech Motor Learning Approach

PURPOSE

The aim of the study was to propose the speech motor learning approach (Van der Merwe, 2011) as a treatment for childhood apraxia of speech and to determine if it will effect positive change in the ability of a 33-month-old child to produce untreated nonwords and words containing treated age-appropriate consonants (Set 1 sounds), untreated age-appropriate consonants (Set 2), and untreated age-inappropriate consonants (Set 3) and also to determine the nature and number of segmental speech errors before and after treatment.

METHOD

An A-B design with multiple target measures and follow-up was implemented to assess the effects of treatment of Set 1. Effect sizes for whole-word accuracy were determined, and two criterion lines were generated following the conservative dual criterion method. Speech errors were judged perceptually.

RESULTS

Conservative dual criterion analyses indicated no reliable treatment effect due to rising baseline scores. Effect sizes showed significant improvement in whole-word accuracy of untreated nonwords and real words containing age-appropriate treated sounds and real words containing age-appropriate untreated sounds. The number of errors for all three sound sets declined. Sound distortion was the most frequent error type.

CONCLUSIONS

Preliminary evidence suggests potentially positive treatment effects. However, rising baseline scores limit causal inference. Replication with more children of different ages is necessary.

SUPPLEMENTAL MATERIALS

https://doi.org/10.23641/asha.5596708.

Evaluation of multisyllabic word production in Canadian English- or French-speaking children within a non-linear phonological framework

Currently, there is no theoretically justified, evidence-based metric for evaluating segmental and prosodic components of multisyllabic words (MSWs). A pilot study evaluated a MSW metric embedded in non-linear phonological- and language-processing frameworks. Six MSWs were analyzed in 10 Canadian English-speaking 5-year-olds with typically developing speech, and eight French-speaking children, ages 3-4 years, with protracted phonological development (PPD). Mismatches were tallied (with and without vowels), with totals ranked by word and participant, then compared with ranks from Phonological Mean Length of Utterance (PMLU) and Percent Consonants Correct (PCC) tallies. For both groups, the number of different ranks was significant in comparisons of MSW metrics with PMLU and PCC. Rank orderings were systematically higher for English-speaking children using the MSW metric, with/without vowels, and for French-speaking children using the MSW metric with vowels. Overall, the MSW metric was particularly suitable for fine-grained differentiation of phonological accuracy in MSW production.

Introducing advanced clinical reasoning to an adult learning disability service

The advanced clinical reasoning approach is widely adopted in speech and language therapy practice. This article reports on the introduction of the approach across a multidisciplinary adult learning disability service and staff reports on the impact of this initiative. Staff in the service were offered training in the approach. Staff completed pre-course questionnaires, immediate post-course evaluations of the training and questionnaires a year after initial training. Semi-structured interviews took place with three team managers a year after the training. Staff and team managers reported that the training had a positive impact on their practice. All respondents demonstrated confidence in the use of the advanced clinical reasoning terminology and a clear understanding of the nature of duty of care and clinical risk. Enhanced knowledge about caseloads and greater confidence in managing episodes of care were reported by staff and team managers to have resulted in a more efficient and effective service.