Considerations for identifying subtypes of speech sound disorder.

BACKGROUND: Speech sound disorders (SSDs) in children are heterogeneous. Differentiating children with SSDs into distinct subtypes is important so that each child receives a treatment approach well suited to the particular difficulties they are experiencing. AIMS: To study the distinct underlying processes that differentiate phonological processing, phonological planning or motor planning deficits. METHOD: The literature on the nature of SSDs is reviewed to reveal diagnostic signs at the level of distal causes, proximal factors and surface characteristics. MAIN CONTRIBUTION: Subtypes of SSDs may be identified by linking the surface characteristics of the children's speech to underlying explanatory proximal factors. The proximal factors may be revealed by measures of speech perception skills, phonological memory and speech-motor control. The evidence suggests that consistent phonological disorder (CPD) can be identified by predictable patterns of speech error associated with speech perception errors. Inconsistent phonological disorder (IPD) is associated with a deficit in the selection and sequencing of phonemes, that is, revealed as within-word inconsistency and poor phonological memory. The motor planning deficit that is specific to childhood apraxia of speech (CAS) is revealed by transcoding errors on the syllable repetition task and an inability to produce [pətəkə] accurately and rapidly. CONCLUSIONS & IMPLICATIONS: Children with SSDs form a heterogeneous population. Surface characteristics overlap considerably among those with severe disorders, but certain signs are unique to particular subtypes. Careful attention to underlying causal factors will support the accurate diagnosis and selection of personalized treatment options. WHAT THIS PAPER ADDS: What is already known on the subject SSD in children are heterogenous, with numerous subtypes of primary SSD proposed. Diagnosing the specific subtype of SSD is important in order to assign the most efficacious treatment approach for each child. Identifying the distinct subtype for each child is difficult because the surface characteristics of certain subtypes overlap among categories (e.g., CPD or IPD; CAS). What this paper adds to the existing knowledge The diagnostic challenge might be eased by systematic attention to explanatory factors in relation to the surface characteristics, using specific tests for this purpose. Word identification tasks tap speech perception skills; repetition of short versus long strings of nonsense syllables permits observation of phonological memory and phonological planning skills; and standard maximum performance tests provide considerable information about speech motor control. What are the potential or actual clinical implications of this work? Children with SSDs should receive comprehensive assessments of their phonological processing, phonological planning and motor planning skills frequently, alongside examinations of their error patterns in connected speech. Such assessments will serve to identify the child's primary challenges currently and as they change over developmental time.

Speech perception: Auditory and visual cue integration in children with and without phonological disorder in voiceless fricatives.

The literature reports contradictory results regarding the influence of visual cues on speech perception tasks in children with phonological disorder (PD). This study aimed to compare the performance of children with (n = 15) and without PD (n = 15) in audiovisual perception task in voiceless fricatives. Assuming that PD could be associated with an inability to integrate phonological information from two sensory sources, we presumed that children with PD would present difficulties in integrating auditory and visual cues compared to typical children. A syllable identification task was conducted. The stimuli were presented according to four conditions: auditory-only (AO); visual-only (VO); audiovisual congruent (AV+); and audiovisual incongruent (AV-). The percentages of correct answers and the respective reaction times in the AO, VO, and AV+ conditions were considered for the analysis. The correct percentage of auditory stimuli was considered for the AV- condition, as well as the percentage of perceptual preference: auditory, visual, and/or illusion (McGurk effect), with the respective reaction time. In comparing the four conditions, children with PD presented a lower number of correct answers and longer reaction time than children with typical development, mainly for the VO. Both groups showed a preference for auditory stimuli for the AV- condition. However, children with PD showed higher percentages for visual perceptual preference and the McGurk effect than typical children. The superiority of typical children over PD children in auditory-visual speech perception depends on type of stimuli and condition of presentation.

How to cut the pie is no piece of cake: Toward a process-oriented approach to assessment and diagnosis of speech sound disorders.

BACKGROUND: 'Speech sound disorder' is an umbrella term that encompasses dysarthria, articulation disorders, childhood apraxia of speech and phonological disorders. However, differential diagnosis between these disorders is a persistent challenge in speech pathology, as many diagnostic procedures use symptom clusters instead of identifying an origin of breakdown in the speech and language system. AIMS: This article reviews typical and disordered speech through the lens of two well-developed models of production-one focused on phonological encoding and one focused on speech motor planning. We illustrate potential breakdown locations within these models that may relate to childhood apraxia of speech and phonological disorders. MAIN CONTRIBUTION: This paper presents an overview of an approach to conceptualisation of speech sound disorders that is grounded in current models of speech production and emphasises consideration of underlying processes. The paper also sketches a research agenda for the development of valid, reliable and clinically feasible assessment protocols for children with speech sound disorders. CONCLUSION: The process-oriented approach outlined here is in the early stages of development but holds promise for developing a more detailed and comprehensive understanding of, and assessment protocols for speech sound disorders that go beyond broad diagnostic labels based on error analysis. Directions for future research are discussed. WHAT THIS PAPER ADDS: What is already known on the subject Speech sound disorders (SSD) are heterogeneous, and there is agreement that some children have a phonological impairment (phonological disorders, PD) whereas others have an impairment of speech motor planning (childhood apraxia of speech, CAS). There is also recognition that speech production involves multiple processes, and several approaches to the assessment and diagnosis of SSD have been proposed. What this paper adds to existing knowledge This paper provides a more detailed conceptualisation of potential impairments in children with SSD that is grounded in current models of speech production and encourages greater consideration of underlying processes. The paper illustrates this approach and provides guidance for further development. One consequence of this perspective is the notion that broad diagnostic category labels (PD, CAS) may each comprise different subtypes or profiles depending on the processes that are affected. What are the potential or actual clinical implications of this work? Although the approach is in the early stages of development and no comprehensive validated set of tasks and measures is available to assess all processes, clinicians may find the conceptualisation of different underlying processes and the notion of potential subtypes within PD and CAS informative when evaluating SSD. In addition, this perspective discourages either/or thinking (PD or CAS) and instead encourages consideration of the possibility that children may have different combinations of impairments at different processing stages.

Atypical phonological processes in naming errors of children with language impairment.

The current study explored the characteristics of phonological errors of preschool children with DLD (Developmental Language Disorder), distinguishing between typical versus atypical phonological processes in segmental, syllabic and word levels. The analysis included 87 responses of words with phonological errors from a naming test, produced by 13 preschool children with DLD, aged 4;4-6;3 years. These responses included 166 phonological processes, which were classified into typical and atypical processes at the levels of: segments, syllables, and prosodic words. The findings revealed that 70% of the phonological processes were atypical. Furthermore, ten children produced more atypical processes, and there were more atypical than typical processes in segmental and word levels. It is suggested that some children with DLD represent phonological processes that are similar to those that children with speech and sound disorders produce. Therefore, clinically, the results emphasise the importance of analysing the typical and atypical characteristics of phonological errors as part of language assessment.

Word-final complexity in speech sound intervention: two case studies.

In speech sound intervention, consonant clusters promote generalisation (i.e. improvement in untreated sounds and words), ostensibly due to their relative complexity compared to other phonological targets. However, our understanding of clusters as intervention targets is largely restricted to those in word-initial position (e.g. [fl-], flip). The present study extends available work to consider the effects of word-final consonant cluster targets (e.g. [-ks]). Phonologically complex word-final clusters may be morphologically simple (e.g. mix) or morphologically complex (e.g. packs, inflected with third-person singular) - yet this cross-domain complexity remains an understudied phenomenon. Presently, two case studies provide an initial investigation of word-final cluster intervention targets for children with phonologically based speech sound disorders. Intervention targets for both Anna (3;7 [years;months]) and David (4;1) featured the phonologically complex word-final cluster [-ks], with Anna's target being morphologically simple and David's being morphologically complex. Intervention was provided in 45-minute, individual sessions three times per week for a maximum of 18 sessions. Both children demonstrated high target accuracy by intervention's end. Following intervention, both children demonstrated progress in intelligibility and ability to produce word-final consonant clusters; David further demonstrated generalisation across multiple measures. Results are interpreted with consideration of individual differences and existing research on complexity in phonological intervention. Overall, present findings motivate continued research, as manipulation of word-final complexity allows for emphasis on a context that is relevant for children with speech sound disorders, for peers with difficulties in morphology (including word-final grammatical morphemes) and for the substantial proportion of children demonstrating weaknesses in both domains.

Articulatory and segmental performance in children with and without speech disorder: A multiple case pilot study.

This multiple case pilot study explored how nonword imitation influences articulatory and segmental performance in children with and without speech disorder. Eight children, ages 4- to 8-years-old, participated, including two children with childhood apraxia of speech (CAS), four children with phonological disorder (PD), and two children with typical development (TD). Tokens included two complexity types and were presented in random order. Minimal feedback was provided and nonwords were never associated with a referent. Kinematic and transcription data were analysed to examine articulatory variability, segmental accuracy, and segmental variability in session 1 and session 5. Descriptive statistics, percent change, effect sizes, and Pearson correlations are reported. In session 1, the two participants with CAS showed high articulatory variability, low segmental accuracy, and high segmental variability compared to the participants with PD and TD. By session 5, both participants with CAS, two with PD, and one with TD showed increased articulatory variability in the lowest complexity nonword. Segmental accuracy remained low and variability remained high for the two participants with CAS in session 5, whereas several participants with PD and TD showed improved segmental performance. Articulatory and segmental variability were not significantly correlated. The results of this study suggest that motor practice with minimal feedback and no assignment of a lexical referent can instantiate positive changes to segmental performance for children without apraxia. Positive changes to segmental performance are not necessarily related to increased articulatory control; these two processing levels can show distinct and disparate learning trajectories.

A temporal-based therapy for children with inconsistent phonological disorder: A case-series.

Deficits in temporal auditory processing, and in particular higher gap detection thresholds have been reported in children with inconsistent phonological disorder (IPD). Here we hypothesized that providing these children with extra time for phoneme identification may in turn enhance their phonological planning abilities for production, and accordingly improve not only consistency but also accuracy of their speech. We designed and tested a new temporal-based therapy, inspired by Core Vocabulary Therapy and called it T-CVT, where we digitally lengthened formant transitions between phonemes of words used for therapy. This allowed to target both temporal auditory processing and word phonological planning. Four preschool Persian native children with IPD received T-CVT for eight weeks. We measured changes in speech consistency (% inconsistency) and accuracy (percentage of consonants correct PCC) to assess the effects of the intervention. Therapy significantly improved both consistency and accuracy of word production in the four children: % inconsistency decreased from 59% on average before therapy to 2% post-T-CVT, and PCC increased from 61% to 92% on average. Consistency and accuracy were furthermore maintained or even still improved at three-month follow-up (2% inconsistency and 99% PCC). Results in a nonword repetition task showed the generalization of these effects to non-treated material: % inconsistency for nonwords decreased from 67% to 10% post-therapy, and PCC increased from 63% to 90%. These preliminary findings support the efficacy of the T-CVT intervention for children with IPD who show temporal auditory processing deficits as reflected by higher gap detection thresholds.

Differentiating phonological delay from phonological disorder: Executive function performance in preschoolers.

BACKGROUND: The conversational speech of most children can be understood by people outside the family by the time they reach 4 years. However, for some children, speech sound disorders (SSDs) persist into their early school years, and beyond, despite adequate hearing, oromotor function, and language learning opportunities. One explanation for children's SSDs are domain-general cognitive-linguistic deficits that impair the child's ability to correctly derive rules governing how speech sounds legally combine to form words in a specific language. AIMS: To explore whether there are differences in performance on executive function tasks between children who make speech errors characteristic of phonological delay and those who make speech errors characteristic of phonological disorder. METHODS & PROCEDURES: Twenty-six children aged from 3;6 to 5;2 (13 with phonological delay and 13 with phonological disorder), matched pairwise for age and sex (nine males), were assessed on tasks measuring cognitive flexibility (rule abstraction and cognitive shift) and phonological working memory. OUTCOME & RESULTS: For the cognitive flexibility tasks, the performance of children with phonological delay was significantly better than that for children with phonological disorder, but there were no group differences for the phonological working memory task. CONCLUSIONS & IMPLICATIONS: Children with phonological disorders might benefit from intervention programmes that incorporate training in cognitive flexibility. WHAT IS ALREADY KNOWN ON THE SUBJECT: Children with phonological delay and phonological disorder comprise the two largest SSD subgroups that present to speech-language therapy clinics. Evidence suggests domain-general cognitive processes (e.g., phonological working memory, ability to revise faulty underlying representations, rule abstraction, and cognitive shift) influence phonological development. Differences between the two subgroups in the types of speech errors, linguistic abilities, developmental trajectories, and responses to intervention have been reported, yet little is known about the underlying cognitive-linguistic deficits. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE: The results of this study suggest that children with phonological delay and phonological disorder have distinct patterns of performance on executive function tasks: Children with phonological disorder showed deficits in domain general rule-abstraction and cognitive shift when compared to children with phonological delay. WHAT ARE THE POTENTIAL OR ACTUAL CLINICAL IMPLICATIONS OF THIS WORK?: The findings draw attention to: (1) the importance of differential diagnosis of phonological delay and phonological disorder; (2) the role of domain-general cognitive processes in explaining why children make particular types of errors; and (3) the need to develop innovative and tailored intervention techniques that target specific underlying deficits.

Automated phonological analysis and treatment target selection using AutoPATT.

Automated analyses of speech samples can offer improved accuracy and timesaving advantages that streamline clinical assessment for children with a suspected speech sound disorder. In this paper, we introduce AutoPATT, an automated tool for clinical analysis of speech samples. This free, open-source tool was developed as a plug-in for Phon and follows the procedures of the Phonological Analysis and Treatment Target Selection protocol, including extraction of a phonetic inventory, phonemic inventory with corresponding minimal pairs, and initial consonant cluster inventory. AutoPATT also provides suggestions for complex treatment targets using evidence-based guidelines. Automated analyses and target suggestions were compared to manual analyses of 25 speech samples from children with phonological disorder. Results indicate that AutoPATT inventory analyses are more accurate than manual analyses. However, treatment targets generated by AutoPATT should be viewed as suggestions and not used to substitute necessary clinical judgement in the target selection process.

Phonological complexity in intervention for Spanish-speaking children with speech sound disorder.

The efficiency of intervention for children with speech sound disorder may be influenced by linguistic complexity of the phonological intervention target. Complex targets, particularly, later-acquired, less-known consonants and consonant clusters, have been linked to greater post-intervention generalization to untargeted phonological structures. Yet there is little direct evidence to support target selection based on linguistic complexity for Spanish-speaking children with speech sound disorder. This intervention study utilizes an experimental single-case design to examine the efficacy of intervention in Spanish using different complex targets (i.e. /ɡɾ/, /bɾ/, and /l/). For each of the four Spanish-speaking children with speech sound disorder, sounds at 0% accuracy during baseline were monitored across the baseline period, during and post-intervention, and at one- and two-month follow-up visits. Over the course of intervention, only one participant achieved mastery of the targeted structure in practiced words. However, all participants demonstrated some amount of broad phonological generalization to untargeted consonants or clusters. Variable learning trajectories and broad phonological generalization are discussed as they relate to participant characteristics and linguistic complexity.

Quantifying phonological knowledge in children with phonological disorder.

Generative phonologists use contrastive minimal pairs to determine functional phonological units in a language. This technique has been extended for clinical purposes to derive phonemic inventories for children with phonological disorder, providing a qualitative analysis of a given child's phonological system that is useful for assessment, treatment, and progress monitoring. In this study, we examine the single-word productions of 275 children with phonological disorder from the Learnability Project (Gierut, 2015b) to confirm the relationship between phonemic inventory - a measure of phonological knowledge - and consonant accuracy - a quantitative, relational measure that directly compares a child's phonological productions to the target (i.e. adult-like) form. Further, we identify potential percentage accuracy cutoff scores that reliably classify sounds as in or out of a child's phonemic inventory in speech-sound probes of varying length. Our findings indicate that the phonemic function of up to 90% of English consonants can be identified from percentage accuracy for preschool-age children with phonological disorder when a sufficiently large and thorough speech sample is used.

Articulation or phonology? Evidence from longitudinal error data.

Children's speech difficulties can be motor (phone misarticulation) or linguistic (impaired knowledge of phonological contrasts and constraints). These two difficulties sometimes co-occur. This paper reports longitudinal data from the Early Language in Victoria Study (ELVS) at 4 and 7 years of age. Of 1494 participants, 93 made non-age appropriate speech errors on standardised assessments at 4 years, and were able to be reassessed at 7 years. At 4 years, 85% of these children only made phonological errors, 14% made both articulation and phonological errors and one child only made articulation errors (a lateral lisp). In total, 8 of 13 children making both articulation and phonological errors at 4 years had resolved by 7 years. Unexpectedly, eight children who had demonstrated articulation of fricatives at 4 years, acquired distorted production of ≥ 50% of occurrences of/s, z/ by 7 years. In total, then, 22 children (24% of children with speech difficulties) made articulatory errors at one or both assessments. Case data for all children are presented. Theoretical and clinical implications are considered.

The phonological memory profile of preschool children who make atypical speech sound errors.

Previous research indicates that children with speech sound disorders (SSD) have underlying phonological memory deficits. The SSD population, however, is diverse. While children who make consistent atypical speech errors (phonological disorder/PhDis) are known to have executive function deficits in rule abstraction and cognitive flexibility, little is known about their memory profile. Sixteen monolingual preschool children with atypical speech errors (PhDis) were matched individually to age-and-gender peers with typically developing speech (TDS). The two groups were compared on forward recall of familiar words (pointing response), reverse recall of familiar words (pointing response), and reverse recall of digits (spoken response) and a receptive vocabulary task. There were no differences between children with TDS and children with PhDis on forward recall or vocabulary tasks. However, children with TDS significantly outperformed children with PhDis on the two reverse recall tasks. Findings suggest that atypical speech errors are associated with impaired phonological working memory, implicating executive function impairment in specific subtypes of SSD.

Listening and Processing Skills in Young School Children with a History of Developmental Phonological Disorder.

There is a lack of longitudinal studies on the broad-based outcomes in children with Developmental Phonological Disorder (DPD). The aim of this study was to investigate listening and processing skills in a clinical sample of 7-to-10-year-old children diagnosed with DPD in their preschool years and compare these to same-aged typically developing (TD) children. The Evaluation of Children's Listening and Processing Skills (ECLiPS) was completed by parents of 115 children with DPD and by parents of 46 TD children. The total ECLiPS mean score, and the five subscale mean scores, the proportion of children with clinically significant difficulties (≤10th percentile), and the proportion of children with co-occurrence of clinically significant difficulties on more than one subscale, were calculated. Results showed that the ECLiPS mean scores did not differ between the groups. There was no difference between groups regarding language and literacy, but a higher proportion of children with DPD than TD had difficulties in the total score, speech, and auditory processing, environmental and auditory sensitivity, and pragmatic and social skills. In addition, 33.9% of children with DPD had clinically significant difficulties in two or more subscales compared to 10.9% of TD children.

Complexity and cross-linguistic transfer in intervention for Spanish-English bilingual children with speech sound disorder.

With bilingual children, intervention for speech sound disorders must consider both of the child's phonological systems, which are known to interact with each other in development. Further, cross-linguistic generalization following intervention for bilingual children with speech sound disorders (i.e., the impact of treatment in one language on the other) has been documented to varying degrees in some prior studies. However, none to date have documented the cross-linguistic impact of treatment with complex targets (e.g., consonant clusters) for bilingual children. Because complex phonological targets have been shown to induce system-wide generalization within a single language, the potential for bilingual children to generalize learning across languages could impact the efficiency of intervention in this population. This pilot intervention study examines the system-wide, cross-linguistic effects of treatment targeting consonant clusters in Spanish for two Spanish-English bilingual children with phonological disorder. Treatment was provided with 45-minute sessions in Spanish via teletherapy, three times per week for six weeks. Comprehensive phonological probes were administered in English and Spanish prior to intervention and across multiple baselines. Pre-intervention data were compared to data from probes administered during and after intervention to generate qualitative and quantitative measures of treatment outcomes and cross-linguistic generalization. Results indicate a medium effect size for system-wide generalization in Spanish (the language of treatment) and English (not targeted in treatment), for both participants (mean effect size in Spanish: 3.6; English 4.3). These findings have implications for across-language transfer and system-wide generalization in treatment for bilingual children.

Important aspects in the assessment of bilingual children with suspected language impairment: The Vienna Model.

BACKGROUND: Due to demographic changes over the last few decades, the number of multilingual children has grown rapidly. Many of them face problems in learning their second language. Similarities between linguistic manifestations of stages of second language acquisition and an impairment of language acquisition cause a diagnostic dilemma. The Vienna Model of language assessment in multilingual children will be presented. METHODS: A key feature of our procedure is the integration of medical students as native speakers in diagnosing acquisition of the first language. A case study of a boy with Russian as first language illustrates the procedure. RESULTS: The Vienna Model of language assessment in multilingual children offers the possibility to evaluate language competence in a differentiated manner with support of medical students as native speakers. Based on the bilingual assessment on different linguistic levels the diagnosis ICD-10 F80.0 is given. The subsequent short therapy showed an improvement regarding phonological competence.

Phonological development in school-aged Kuwaiti Arabic children with Down syndrome: A pilot study.

BACKGROUND: Studies on atypical phonological development are very limited for Arabic, and to date no studies on Arabic have investigated the development of phonology in children with conditions such as Down Syndrome. Arabic, like other Semitic languages, is rich in consonants and consonantal variation. However, it differs greatly from region to region, and so reports on individual dialects or regional dialects are necessary. Kuwaiti Arabic, the focus of the present paper, is similar to other dialects in the Gulf region. AIM: This is a preliminary study to examine the phonological development of school-aged Kuwaiti Arabic-speaking children with Down Syndrome in order to start to address the research gap noted above. METHODS & PROCEDURES: Six Kuwaiti Arabic-speaking children were recruited for this pilot study from integrated public schools where children with disabilities and typically developing children are enrolled in the State of Kuwait: three male and three female students, age range of 5;10-12;3 years. All participants had the same single word speech test of 100 words. The first author, a native speaker of Kuwaiti Arabic, audio-recorded and phonetically transcribed the sample with the help of two speech-language pathologists from Kuwait. Reliability was confirmed by the first author and another expert rater. Both match and mismatch analyses were performed and compared to existing literature. OUTCOMES & RESULTS: Overall consonant accuracy across participants was 50%, with a variety of matches across consonant categories. However, the participants also exhibited a wide range of mismatches across positions in words and phonological features (place, manner, and laryngeal features). Place substitutions were the most frequent. Some sounds exhibited double (place and manner) mismatches. The most common word structure mismatch was consonant cluster reduction (no matches for word-initial clusters). Mismatch patterns resembled both those of normally developing Kuwaiti children and those of English speakers with Down Syndrome in certain ways. CONCLUSIONS & IMPLICATIONS: This pilot study provides preliminary information for clinicians regarding the speech or children with Down Syndrome (DS), not only in Kuwait but also in the Gulf region where there are similarities to Kuwaiti Arabic.

Evidence for [Coronal] Underspecification in Typical and Atypical Phonological Development.

The Featurally Underspecified Lexicon (FUL) theory predicts that [coronal] is the language universal default place of articulation for phonemes. This assumption has been consistently supported with adult behavioral and event-related potential (ERP) data; however, this underspecification claim has not been tested in developmental populations. The purpose of this study was to determine whether children demonstrate [coronal] underspecification patterns similar to those of adults. Two English consonants differing in place of articulation, [labial] /b/ and [coronal] /d/, were presented to 24 children (ages 4-6 years) characterized by either a typically developing phonological system (TD) or a phonological disorder (PD). Two syllables, /bɑ/ and /dɑ/, were presented in an ERP oddball paradigm where both syllables served as the standard and deviant stimulus in opposite stimulus sets. Underspecification was examined with three analyses: traditional mean amplitude measurements, cluster-based permutation tests, and single-trial general linear model (GLM) analyses of single-subject data. Contrary to previous adult findings, children with PD demonstrated a large positive mismatch response (PMR) to /bɑ/ while the children with TD exhibited a negative mismatch response (MMN); significant group differences were not observed in the /dɑ/ responses. Moreover, the /bɑ/ deviant ERP response was significantly larger in the TD children than in the children with PD. At the single-subject level, more children demonstrated mismatch responses to /dɑ/ than to /bɑ/, though some children had a /bɑ/ mismatch response and no /dɑ/ mismatch response. While both groups of children demonstrated similar responses to the underspecified /dɑ/, their neural responses to the more specified /bɑ/ varied. These findings are interpreted within a proposed developmental model of phonological underspecification, wherein children with PD are functioning at a developmentally less mature stage of phonological acquisition than their same-aged TD peers. Thus, phonological underspecification is a phenomenon that likely develops over time with experience and exposure to language.

Mismatch Negativity in children with Phonological Disorders.

OBJECTIVE: to characterize the latency, amplitude and area variables of the Mismatch Negativity (MMN) elicited with verbal stimuli in children with PD, in addition to assessing whether this potential can be a useful tool in capturing auditory perception and discrimination deficits related to this disorder. METHODS: MMN was recorded using a combination of speech contrast consisting of acoustic syllables [da vs ta], as the standard and deviant stimuli, in 34 children aged between 5 and 8 years. 14 children of the sample were already diagnosed with Phonological Disorder (PD) while 19 were characterized with typical development. RESULTS: No statistically significant differences were observed for the MMN responses recorded between children with PD and their typically developed peers. CONCLUSION: The results suggest that the MMN may not be the most suitable procedure to assess auditory perception and discrimination deficits that could potentially be related to PD.

Behavioral Interventions to Treat Speech Sound Disorders in Children With Autism.

Children with autism are at a higher risk of being affected by speech disorders and often require remedial intervention. Eikeseth and Nesset (Journal of Applied Behavior Analysis, 36(3), 325-337, 2003) used sufficient-response exemplar training of vocal imitation in conjunction with prompting, chaining, and shaping procedures to successfully teach 2 typically developing children to articulate several Norwegian words with blends. The present study extends and adapts these procedures to children with autism. Participants were TA, an 11-year-old boy, and KS, a 15-year-old girl, both with autism and speech sound disorders. For each participant, 3 sets of 10 words with specific blends in the initial position were targeted for training. Vocal imitation training with within-stimulus prompts was used for both participants. For KS, lip-tongue-teeth position prompts and chaining were added during the training of certain words. A multiple-baseline across-behaviors (word sets with target blends) design demonstrated improvement in the articulation of trained words and generalization of correct articulation to untrained words with both participants. The findings suggest that speech sound disorders in children with autism can be addressed with behavioral interventions.