Morphosyntactic profiles among preschoolers with and without speech sound disorders.

The aim of the current study was to identify whether certain morphosyntactic constructs are more difficult for children with speech sound disorder than children with typical speech development. In this post-hoc study, we used chi-square analyses to identify group differences on individual questions on a standardised test of expressive morphosyntax. Participants included 80 preschool-age children, 40 with typical speech and language development (TD), and 40 with speech sound disorder and typical language development (SSD). A chi-square analysis revealed group (TD vs. SSD) differences in usage of subject pronouns, irregular past tense verbs, and yes/no interrogative formation. Ordinal logistic regression revealed that phonological awareness was related to irregular past tense verb use. Children with SSD may present with subclinical morphosyntax difficulties. Speech-language pathologists should consider incorporating morphosyntax assessment into test batteries for children with SSD.

The Effect of Somatosensory Input on Word Recognition in Typical Children and Those With Speech Sound Disorder.

PURPOSE: Recent work suggests that speech perception is influenced by the somatosensory system and that oral sensorimotor disruption has specific effects on the perception of speech both in infants who have not yet begun to talk and in older children and adults with ample speech production experience; however, we do not know how such disruptions affect children with speech sound disorder (SSD). Response to disruption of would-be articulators during speech perception could reveal how sensorimotor linkages work for both typical and atypical speech and language development. Such linkages are crucial to advancing our knowledge on how both typically developing and atypically developing children produce and perceive speech. METHOD: Using a looking-while-listening task, we explored the impact of a sensorimotor restrictor on the recognition of words whose onsets involve late-developing sounds (s, ʃ) for both children with typical development (TD) and their peers with SSD. RESULTS: Children with SSD showed a decrement in performance when they held a restrictor in their mouths during the task, but this was not the case for children with TD. This effect on performance was only observed for the specific speech sounds blocked by the would-be articulators. CONCLUSION: We argue that these findings provide evidence for altered perceptual motor pathways in children with SSD. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21809442.

Speech Error Variability and Phonological Awareness in Preschoolers.

PURPOSE: The purpose of this article was to investigate the relationship between speech error variability and phonological awareness. METHOD: This article begins with a narrative review of the theoretical interpretation of speech error variability. The post hoc exploratory analysis of the relationship between speech error variability and phonological awareness included 40 children: 20 with typical speech and language and 20 with speech sound disorder and typical language. Groups were matched on gender, age, maternal education, receptive and expressive vocabulary, nonverbal intelligence, and expressive morphosyntax. Multiple regression was used to identify the best fit model for the relationship between vocabulary, speech errors, and phonological awareness. RESULTS: Segmental variability was associated with poor phonological awareness in preschool-aged children. CONCLUSION: Children with high levels of segmental variability have poor phonological awareness, likely due to unstable phonological representations.

Implementing Speech Perception and Phonological Awareness Intervention for Children With Speech Sound Disorders.

PURPOSE: Children with speech sound disorders have more difficulties producing speech sounds accurately than same-age peers. In addition, they often have difficulties with speech perception, and weaker phonological awareness skills than their peers and are at risk for negative long-term academic and socio-emotional outcomes. In this tutorial, we describe ways in which clinicians can target speech perception and/or phonological awareness within the context of speech production practice. METHOD: First, we briefly describe the speech perception and phonological awareness skills of children with speech sound disorders and summarize previous intervention studies that targeted speech production and speech perception and/or phonological awareness skills. Next, we demonstrate how clinicians may incorporate speech perception and phonological awareness intervention in speech therapy through example instructional objectives and activities and include a case study. CONCLUSION: Incorporating speech perception and phonological awareness into speech production intervention may improve speech and literacy outcomes for children with speech sound disorders.

Event-Related Potentials Elicited by Phonetic Errors Differentiate Children With Speech Sound Disorder and Typically Developing Peers.

PURPOSE: A growing body of research suggests that a deficit in speech perception abilities contributes to the development of speech sound disorder (SSD). However, little work has been done to characterize the neurophysiological processes indexing speech perception deficits in this population. The primary aim of this study was to compare the neural activity underlying speech perception in young children with SSD and with typical development (TD). METHOD: Twenty-eight children ages 4;1-6;0 (years;months) participated in this study. Event-related potentials (ERPs) were recorded while children completed a speech perception task that included phonetic (speech sound) and lexical (meaning) matches and mismatches. Groups were compared on their judgment accuracy for matches and mismatches as well as the mean amplitude of the phonological mapping negativity (PMN) and N400 ERP components. RESULTS: Children with SSD demonstrated lower judgment accuracy across the phonetic and lexical conditions compared to peers with TD. The ERPs elicited by lexical matches and mismatches did not distinguish the groups. However, in the phonetic condition, the SSD group exhibited a more consistent left-lateralized PMN effect and a delayed N400 effect over frontal sites compared to the TD group. CONCLUSIONS: These findings provide some of the first evidence of a delay in the neurophysiological processing of phonological information for young children with SSD compared to their peers with TD. This delay was not present for the processing of lexical information, indicating a unique difference between children with SSD and with TD related to speech perception of phonetic errors. Supplemental Material https://doi.org/10.23641/asha.16915579.

A Comprehensive Treatment Approach to Address Speech Production and Literacy Skills in School-Age Children with Speech Sound Disorders.

Children with speech sound disorders (SSDs) represent a large proportion of clients served by school-based speech-language pathologists (SLPs). While considerable evidence is available regarding the identification of SSD in school-age children, there is a paucity of information regarding service delivery aspects of school-based speech therapy, such as frequency of sessions, number of trials, distribution of sessions over time, and format (individual or group intervention) that impacts the ability of SLPs to effectively treat SSD in the schools. School-age children with SSD are at risk for later literacy deficits, and strategically addressing their language and emerging literacy needs in addition to speech production accuracy may lead to increased intelligibility and better educational outcomes. In this article, we discuss the heterogeneity of school-age children with SSD with regard to weaknesses in phonological processing skills and language skills. We summarize the information currently available regarding the aspects of service delivery that contribute to gains in speech production accuracy. We conclude by sharing an example of how school-based SLPs could target speech production, phonological awareness, and morphological awareness in the same session with a child with SSD to maximize gains in speech and literacy skills.

Vowel errors produced by preschool-age children on a single-word test of articulation.

Eighty-four children, age 4-5 years, with and without speech sound disorder (SSD) completed a battery of standardized speech and language tests, including the Goldman-Fristoe Test of Articulation, Third Edition (GFTA-3). Children with SSD produced more vowel errors than children with typical speech abilities. Percentage vowels correct and consonant error variability were highly correlated, suggesting that poorly specified phonological representations affect both consonants and vowels within a child's phonological system. However, the GFTA-3 did not contain sufficient target words to determine full vowel inventory. Using words from the GFTA-3, we present a case study of a child with vowel errors along with a sample analysis of these errors, primarily in terms of consonant-vowel feature interactions. Children who exhibit vowel errors on standardized single-word tests of speech accuracy may benefit from further vowel probes to determine how vowel and consonant errors interact in their phonological systems for more targeted therapy.

Perception of Correctly and Incorrectly Produced Words in Children With and Without Phonological Speech Sound Disorders.

Purpose The purpose of this study was to examine the perception of correctly and incorrectly produced words in children with and without phonological speech sound disorder (SSD) with similar vocabulary and language skills. Method Thirty-six monolingual English-speaking children aged 4 and 5 years, half with SSD and half with typical speech and language skills, participated in this study. Participants completed standardized speech and language tests as well as a mispronunciation detection task targeting omissions and substitutions of the phonemes /k, s, ɹ/ in five word positions/shapes. Results The children with SSD obtained significantly lower perceptual accuracy than the children with typical development. There was no statistically significant effect for phoneme. Omissions were more likely to be detected by both groups of participants compared with substitutions, and children with SSD had greater difficulty identifying substitutions as incorrectly produced words. Conclusions Speech perception difficulties may be a distinguishing feature of children with phonological SSD and without concomitant language difficulties. Further research is needed to investigate specific speech contexts in which perception predicts accurate production in children with SSD.

Perception of Medial Consonants by Preschoolers With and Without Speech Sound Disorders.

Purpose This study compared perception of consonants in medial position by preschoolers, with and without speech sound disorder (SSD), with similar vocabulary and language skills. In addition, we investigated the association between speech perception and production skills. Method Participants were 36 monolingual English-speaking children with similar vocabulary and language skills, half with SSD and half with typical speech and language development (TD). Participants completed a speech perception task targeting phonemes /p, k, s, ɹ/ in /aCa/ disyllables and a comprehensive battery of speech and language measures. Results Children with SSD were significantly less accurate in perceiving speech sound distinctions relative to peers with TD. The phoneme /p/ was perceived significantly more accurately than the three other target phonemes. The correlation between overall perceptual accuracy and overall production accuracy was significant. Furthermore, perceptual accuracy of targets /k, s, ɹ/ was significantly correlated with production accuracy of these phonemes. Conclusions Many children with SSD have greater difficulty perceiving the specific speech sounds they misarticulate. Nonetheless, most children with SSD present with broader perceptual difficulties than peers with TD with similar vocabulary and language skills.

The Speech "Bamana": Using the Syllable Repetition Task to Identify Underlying Phonological Deficits in Children With Speech and Language Impairments.

Purpose This study compared performance on the Syllable Repetition Task (SRT) by preschoolers with diverse speech and language abilities to identify underlying impairments in speech processes. Method Three groups of 13 children ages 4 and 5 years with (a) typically developing (TD) speech and language, (b) speech sound disorder (SSD), and (c) comorbid developmental language disorder and speech sound disorder (DLD + SSD) completed the SRT. We calculated competence, memory, encoding, and transcoding scores, as well as word-initial stress pattern and vowel accuracy. Results A 3 × 3 (Group × Syllable length) factorial multivariate analysis of covariance revealed group differences for all measures and syllable length differences for memory, transcoding, and competence. There were no interactions between group and syllable length. TD children obtained the highest scores on each measure, though children with DLD + SSD performed similarly to TD children on encoding when vocabulary was included as a covariate. Children with SSD only outperformed children with DLD + SSD on competence and transcoding, and these two groups performed similarly on memory. A separate exploratory analysis using a 3 × 3 multivariate analysis of covariance revealed that children with DLD + SSD were more likely than children in the other groups to produce weak word-initial stress and vowel errors during syllable repetition. Conclusion Children with SSD and DLD + SSD exhibit underlying phonological deficits on the SRT compared to TD children. Results support the claim that memory and encoding are deficits in SSD. In addition, transcoding deficits were identified among children with no known oromotor impairment. Therefore, more research is required to identify the relationship between SRT performance and explicit measures of phonological processing.

Perception of Medial Consonants by Children With and Without Speech and Language Disorders: A Preliminary Study.

Purpose The aim of this preliminary study was to investigate perception of the early-acquired consonant /p/ and later-acquired consonant /ʃ/ in medial word position by preschoolers with and without speech and language disorders. Method Twenty-four children, six with isolated speech sound disorder (SSD-only), six with SSD and concomitant developmental language disorder (SSD + DLD), and 12 with typical speech and language skills (TD) completed a battery of standardized speech and language tests as well as an identification task of /aCa/ disyllables. Targets and foils varied by only one place, manner, or voice feature. Mixed analysis of variance (participant groups × two target consonants) was conducted to compare performance of children in the three groups (between-subjects) and to compare performance on consonants that are early acquired or later acquired (within-subject). Results All groups of participants were more accurate in perceiving the early-acquired consonant than the later-acquired consonant. Overall performance by children with SSD-only did not differ significantly from children with TD. As a group, children with SSD + DLD were less accurate than children with TD and children with SSD-only for both target consonants. Conclusions Children with SSD + DLD performed less well than peers with SSD-only and with TD with both predictably easy and difficult sound contrasts. Children with SSD-only performed nominally less well than children with TD for the speech sound with which they have difficulty, but this difference did not reach statistical significance for these relatively small group sizes.

Identification of Foreign-Accented Words in Preschoolers With and Without Speech Sound Disorders.

Purpose The aim of this study was to investigate the ability of preschoolers with speech sound disorder (SSD) and with typical speech and language development (TD) to understand foreign-accented words, providing a window into the quality of their underlying phonological representations. We also investigated the relationship between vocabulary skills and the ability to identify words that are frequent and have few neighbors (lexically easy words) and words that are less frequent and have many neighbors (lexically hard words). Method Thirty-two monolingual English-speaking children (16 with SSD, 16 with TD), ages 4 and 5 years, completed standardized speech and language tests and a two-alternative forced-choice word identification task of English words produced by a native English speaker and a native Korean speaker. Results Children with SSD had more difficulty identifying words produced by both talkers than children with TD and showed a larger difficulty identifying Korean-accented words. Both groups of children identified lexically easy words more accurately than lexically hard words, although this difference was not significant when including receptive vocabulary skills in the analysis. Identification of lexically hard words, both those produced by the native English speaker and the nonnative English speaker, increased with vocabulary size. Conclusion Considering the performance of the children with SSD under ideal listening conditions in this study, we can assume that, as a group, children with SSD may experience greater difficulty identifying foreign-accented words in environments with background noise.

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.

Rhyme Production Strategies Distinguish Stuttering Recovery and Persistence.

Purpose The primary aim of the current study was to examine the developing phonological awareness of 4- to 5-year-old children who stutter (CWS) in relation to eventual recovery (CWS-eRec) or persistance (CWS-ePer) in stuttering, accounting for the presence of typical speech (TS) production or speech sound disorder (SSD). Method In the 1st year of a 5-year longitudinal study, 37 children who do not stutter (CWNS) and 48 CWS completed a rhyme discrimination and a rhyme production task from the Phonological Awareness Test-Second Edition (Robertson & Salter, 2007). Using data from their last year of participation, CWS were classified into CWS-ePer and CWS-eRec. Each CWS group was further divided into TS and SSD groups based on speech production abilities at the time of the rhyme tasks. Accuracy on the rhyme tasks was compared. Groups were also compared on strategies used to generate correct and incorrect responses for the rhyme production task (e.g., real-word correct, nonword correct, semantic association, repeated cues). Results All groups performed similarly on the rhyme discrimination task. On the rhyme production task, CWS-ePer-SSD and CWS-eRec-SSD performed with less accuracy than CWNS, but CWS-ePer-TS, CWS-eRec-TS, and CWNS achieved similar task accuracy. On correct rhyme production trials, CWS-ePer-TS created more nonword rhymes than real-word rhymes. CWS-ePer-TS used the nonword strategy at 1.88 times the CWNS rate. CWS-eRec-TS fell between CWS-ePer-TS and CWNS in use of the nonword strategy. Conclusions Reliance on a nonword strategy for rhyme production in CWS-ePer-TS may reflect differences in underlying phonological representations and ease of phonological access to the lexicon compared to CWNS.

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

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

Innovative Service Delivery Models for Serving Children with Speech Sound Disorders.

Service delivery variables that may have an impact on the treatment outcomes of children with speech sound disorders include the number and duration of intervention sessions, distribution of the sessions over time, and the format (group intervention or individual intervention). In this article, we briefly review these variables and the recommendations for the most effective service delivery components for children with speech sound disorders. We then describe innovative, collaborative service delivery models for preschoolers and school-age children with speech sound disorder. The models include "Quick Articulation!" conducted in a local elementary school by clinical MS-SLP students from Purdue University, as well as Summer Speech and Literacy Laboratory, which takes place in the department of Speech, Language, and Hearing Sciences at Purdue and involves participation from clinical and research faculty, and graduate and undergraduate students. The article provides useful information to help guide clinicians and clinical supervisors in implementing components of these models into their practice with children with speech sound disorder.

The impact of brief restriction to articulation on children's subsequent speech production.

This project explored whether disruption of articulation during listening impacts subsequent speech production in 4-yr-olds with and without speech sound disorder (SSD). During novel word learning, typically-developing children showed effects of articulatory disruption as revealed by larger differences between two acoustic cues to a sound contrast, but children with SSD were unaffected by articulatory disruption. Findings suggest that, when typically developing 4-yr-olds experience an articulatory disruption during a listening task, the children's subsequent production is affected. Children with SSD show less influence of articulatory experience during perception, which could be the result of impaired or attenuated ties between perception and articulation.

Underlying manifestations of developmental phonological disorders in French-speaking pre-schoolers.

This study examined the psycholinguistic profiles of Quebec French-speaking children with developmental phonological disorders (DPD). The purpose was to determine whether the endophenotypes that have been identified in English-speaking children with DPD are similarly associated with speech impairment in French-speaking children. Seventy-two children with DPD and ten children with normally developing speech, aged four to six years, received a comprehensive assessment battery that included measures at the phenotype level (i.e. measures of overt speech production skills) and endophenotype level (i.e. measures of potential underlying core deficits such as phonological processing or oral motor impairments). The majority of the children with DPD presented with a psycholinguistic profile indicative of difficulties with phonological processing. Phonological processing skills also explained unique variance in speech production accuracy, indicating that French-speaking children with DPD, who produce different surface speech errors than English-speaking children with DPD, are nonetheless very similar with regards to their underlying psycholinguistic profile.

A Randomized Trial of 12-Week Interventions for the Treatment of Developmental Phonological Disorder in Francophone Children.

PURPOSE: This study was designed to test the relative efficacy of different combinations of intervention approaches when targeting speech production accuracy and phonological awareness skills. All children received individual speech therapy, a home program, and a small-group phonological awareness intervention. METHOD: Sixty-five 4-year-olds with a developmental phonological disorder received these intervention components in different combinations over 12 weeks, resulting in 4 groups: output-oriented individual intervention and articulation practice home program, output-oriented individual intervention and dialogic reading home program, input-oriented individual intervention and articulation practice home program, and input-oriented individual intervention and dialogic reading home program. RESULTS: A significant interaction of the individual treatment condition and the home program condition was observed for 2 outcome measures: targeted feature match (which reflected changes in speech production accuracy for features and word shape structures that were targeted in therapy) and explicit phonological awareness skills. CONCLUSION: In this context, in which the children received a brief period of direct therapy and a home program component provided sequentially, the most effective strategy was to teach the parents to use treatment procedures at home that were congruent with the direct therapy component.

Cross-linguistic comparison of speech errors produced by English- and French-speaking preschool-age children with developmental phonological disorders.

Twenty-four French-speaking children with developmental phonological disorders (DPD) were matched on percentage of consonants correct (PCC)-conversation, age, and receptive vocabulary measures to English-speaking children with DPD in order to describe how speech errors are manifested differently in these two languages. The participants' productions of consonants on a single-word test of articulation were compared in terms of feature-match ratios for the production of target consonants, and type of errors produced. Results revealed that the French-speaking children had significantly lower match ratios for the major sound class features [+ consonantal] and [+ sonorant]. The French-speaking children also obtained significantly lower match ratios for [+ voice]. The most frequent type of errors produced by the French-speaking children was syllable structure errors, followed by segment errors, and a few distortion errors. On the other hand, the English-speaking children made more segment than syllable structure and distortion errors. The results of the study highlight the need to use test instruments with French-speaking children that reflect the phonological characteristics of French at multiple levels of the phonological hierarchy.