Developmental dyslexia in Hindi readers: Is consistent sound-symbol mapping an asset in reading? Evidence from phonological and visuospatial working memory.

Phonological processing deficit is a hallmark of developmental dyslexia indicating a core cognitive dysfunction. Importance of working memory in reading and its association with the tasks measuring phonological processing is also debated in research. The present study investigates the role of working memory, phonological, and orthographic processing in Hindi-speaking dyslexic children (22 dyslexic and 23 control, of Grade 4). Hindi has a consistent symbol-sound mapping with an extensive list of visually complex graphemes. Although consistent symbol-sound mapping facilitates reading, graphemic complexity has its cost on memory. A range of tasks measuring phonological processing, working memory, and orthographic knowledge was designed and administered. Dyslexic children scored significantly lower than controls not only on working memory tasks but also on the tasks of phonological processing and orthographic knowledge. Moreover, the difference in working memory between dyslexic and normal children was more pronounced with increased task complexity. These results highlight complex relationships between working memory, phonological and orthographic processing together with visual attentional processing in Hindi, that contribute to the reading deficits encountered by children with dyslexia. Their respective contributions are considered in the discussion with some of the visual and phonological features of Hindi orthography and their associated effects in reading.

Misophonia and comorbid psychiatric symptoms: a preliminary study of clinical findings.

Objective: Misophonia is a neurophysiological disorder, phenotypically characterized by heightened autonomic nervous system arousal which is accompanied by a high magnitude of emotional reactivity to repetitive and pattern-based auditory stimuli. This study identifies the prevalence of psychiatric symptoms in misophonia sufferers, the association between severity of misophonia and psychiatric symptoms, and the association between misophonia severity and gender. Methods: Fifty-two misophonia sufferers, 30 females (mean age = 40.93 ± 15.29) and 22 males (mean age = 51.18 ± 15.91) were recruited in our study and they were diagnosed according the criteria proposed by Schröder et al. The participants were evaluated by the A-MISO-S for the severity of misophonia and the MINI to assess the presence of psychiatric symptoms. Results: The most common comorbid symptoms reported by the misophonia patients were respectively PTSD (N = 8, 15.38%), OCD (N = 6, 11.53%), MDD (N = 5, 9.61%), and anorexia (N = 5, 9.61%). Misophonia severity was associated with the symptoms of MDD, OCD, and PTSD as well as anorexia. There was an indication of a significant difference between men and women in the severity of misophonic symptoms. Conclusion: Our findings highlight the importance of recognizing psychiatric comorbidity among misophonia sufferers. The presence of these varying psychiatric disorders' features in individuals with misophonia suggests that while misophonia has unique clinical characteristics with an underlying neurophysiological mechanism, may be associated with psychiatric symptoms. Therefore, when assessing individuals with misophonia symptoms, it is important to screen for psychiatric symptoms. This will assist researchers and clinicians to better understand the nature of the symptoms and how they may be interacting and ultimately allocating the most effective therapeutic strategies.

What Do Children with Speech Sound Disorders Think about Their Talking?

Investigating children's feelings and attitudes toward talking assists speech-language pathologists (SLPs) to understand experiences of communication and the impact of speech sound disorders (SSD). This, in turn, can assist SLPs in identifying appropriate intervention for children with SSD that addresses the needs of children, and their communication partners. This paper draws on data from the Sound Start Study in Australia to explore the attitudes toward talking of 132 preschool-aged children with SSD and the relationship between children's attitudes, speech accuracy, and parent-reported intelligibility and participation. The study revealed most of the children with SSD had a positive attitude toward talking. There was a significant relationship between children's attitudes toward talking and speech accuracy. Furthermore, there was a significant relationship between speech accuracy and parents' perceptions of intelligibility and participation. However, there was no significant relationship between children's attitudes and parents' perceptions. These results highlight similarities and differences between attitudes and experiences of preschool-aged children, their performance on clinical measures, and their parents' perceptions, indicating the need for SLPs to consider each of these areas during assessment and intervention.

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.

The German Intelligibility in Context Scale (ICS-G): reliability and validity evidence.

BACKGROUND: In 2012 the Intelligibility in Context Scale (ICS) was published as a parent-report screening assessment that considers parents' perceptions of their children's functional intelligibility with a range of communication partners that differ in levels of authority and familiarity in real-life situations. To date, the ICS has been translated into 60 languages (including German). AIMS: To evaluate the psychometric properties of the German translation of the ICS ( = ICS-G), especially its reliability and validity, using four objective measures of speech sound disorder (SSD) severity: percentage of consonants correct (PCC); percentage of initial consonants correct (PICC); percentage of vowels correct (PVC); and percentage of phonemes correct (PPC). METHODS & PROCEDURES: Children who were typically developing (TD) and children with SSD (n = 181; 90 males, 81 females; mean age = 4.18 years, SD = 0.79 years, range = 3;0-5;11 years) were recruited through 13 kindergartens and 15 speech-language pathologists (SLPs) in Germany. All children's parents completed the ICS-G. To obtain an insight into the severity of SSD (n = 30), children's speech skills were assessed with PLAKSS-II. For the analysis of test-retest reliability the ICS-G was re-administered with a subsample of parents (n = 36) after 1 week. OUTCOMES & RESULTS: The ICS-G had high internal consistency (α = .95, p < .001) and high test-retest reliability (r = .998, p < .001). The ICS-G total scores and item scores for both samples showed significant correlations, indicating good construct validity. Analyses revealed low but significant correlations with external factors (e.g., age, social class). Criterion validity was established through significant correlations between the ICS-G and scores for PCC (r = .43), PICC (r = .43), PVC (r = .62) and PPC (r = .47). The discriminatory ability of the ICS-G was indicated by significantly higher mean scores for the TD group (mean = 4.49, SD = 0.47) than the SSD group (mean = 3.97, SD = 0.63). CONCLUSIONS & IMPLICATIONS: The overall good psychometric properties of the ICS-G support its use by SLPs for clinical and research purposes with German-speaking children.

Acoustic and perceptual evaluation of category goodness of /t/ and /k/ in typical and misarticulated children's speech.

This investigation explores perceptual and acoustic characteristics of children's successful and unsuccessful productions of /t/ and /k/, with a specific aim of exploring perceptual sensitivity to phonetic detail, and the extent to which this sensitivity is reflected in the acoustic domain. Recordings were collected from 4- to 8-year-old children with a speech sound disorder (SSD) who misarticulated one of the target plosives, and compared to productions recorded from peers with typical speech development (TD). Perceptual responses were registered with regards to a visual-analog scale, ranging from "clear [t]" to "clear [k]." Statistical models of prototypical productions were built, based on spectral moments and discrete cosine transform features, and used in the scoring of SSD productions. In the perceptual evaluation, "clear substitutions" were rated as less prototypical than correct productions. Moreover, target-appropriate productions of /t/ and /k/ produced by children with SSD were rated as less prototypical than those produced by TD peers. The acoustical modeling could to a large extent discriminate between the gross categories /t/ and /k/, and scored the SSD utterances on a continuous scale that was largely consistent with the category of production. However, none of the methods exhibited the same sensitivity to phonetic detail as the human listeners.

Word production inconsistency of Singaporean-English-speaking adolescents with Down Syndrome.

BACKGROUND: The nature of speech disorders in individuals with Down Syndrome (DS) remains controversial despite various explanations put forth in the literature to account for the observed speech profiles. A high level of word production inconsistency in children with DS has led researchers to query whether the inconsistency continues into adolescence, and if the inconsistency stems from inconsistent phonological disorder (IPD) or childhood apraxia of speech (CAS). Of the studies that have been published, most suggest that the speech profile of individuals with DS is delayed, while a few recent studies suggest a combination of delayed and disordered patterns. However, no studies have explored the nature of word production inconsistency in this population, and the relationship between word production inconsistency, receptive vocabulary and severity of speech disorder. AIMS: To investigate in a pilot study the extent of word production inconsistency in adolescents with DS and to examine the correlations between word production inconsistency, measures of receptive vocabulary, severity of speech disorder and oromotor skills in adolescents with DS. METHODS & PROCEDURES: The participants were 32 native speakers of Singaporean-English adolescents, comprising 16 participants with DS and 16 typically developing (TD) participants. The participants completed a battery of standardized speech and language assessments, including The Diagnostic Evaluation of Articulation and Phonology (DEAP) assessment. Results from each test were correlated to determine relationships. Qualitative analyses were also carried out on all the data collected. OUTCOMES & RESULTS: In this study, seven out of 16 participants with DS scored above 40% on word production inconsistency, a diagnostic criterion for IPD. In addition, all participants with DS performed poorly on the oromotor assessment of DEAP. The overall speech profile observed did not exactly correspond with the cluster symptoms observed in children with IPD or CAS. CONCLUSIONS & IMPLICATIONS: Word production inconsistency is a noticeable feature in the speech of individuals with DS. In addition, the speech profiles of individuals with DS consist of atypical and unusual errors alongside developmental errors. Significant correlations were found between the measures investigated, suggesting that speech disorder in DS is multifactorial. The results from this study will help to improve differential diagnosis of speech disorders and individualized treatment plans in the population with DS.

Social, Emotional, and Academic Impact of Residual Speech Errors in School-Aged Children: A Survey Study.

Children with residual speech errors face an increased risk of social, emotional, and/or academic challenges relative to their peers with typical speech. Previous research has shown that the effects of speech sound disorder may persist into adulthood and span multiple domains of activity limitations and/or participation restrictions, as defined by the World Health Organization's International Classification of Functioning, Disability and Health model. However, the nature and extent of these influences varies widely across children. This study aimed to expand the evidence base on the social, emotional, and academic impact of residual speech errors by collecting survey data from parents of children receiving treatment for /r/ misarticulation. By examining the relationship between an overall measure of impact (weighted summed score) and responses to 11 survey items, the present study offers preliminary suggestions for factors that could be considered when making decisions pertaining to treatment allocation in this population.

Morphological Awareness Skills of Second- and Third-Grade Students With and Without Speech Sound Disorders.

Purpose Morphological awareness is the ability to consciously manipulate the smallest units of meaning in language. Morphological awareness contributes to success with literacy skills for children with typical language and those with language impairment. However, little research has focused on the morphological awareness skills of children with speech sound disorders (SSD), who may be at risk for literacy impairments. No researcher has examined the morphological awareness skills of children with SSD and compared their skills to children with typical speech using tasks representing a comprehensive definition of morphological awareness, which was the main purpose of this study. Method Thirty second- and third-grade students with SSD and 30 with typical speech skills, matched on age and receptive vocabulary, completed four morphological awareness tasks and measures of receptive vocabulary, real-word reading, pseudoword reading, and word-level spelling. Results Results indicated there was no difference between the morphological awareness skills of students with and without SSD. Although morphological awareness was moderately to strongly related to the students' literacy skills, performance on the morphological awareness tasks contributed little to no additional variance to the children's real-word reading and spelling skills beyond what was accounted for by pseudoword reading. Conclusions Findings suggest that early elementary-age students with SSD may not present with concomitant morphological awareness difficulties and that the morphological awareness skills of these students may not play a unique role in their word-level literacy skills. Limitations and suggestions for future research on the morphological awareness skills of children with SSD are discussed.

Montgomery T-tube for management of tracheomalacia: Impact on voice-related quality of life.

INTRODUCTION: Tracheostomy is a common procedure for management of tracheomalacia. However, the limitation to speak related to tracheostomy cannula could affect the quality of life. OBJECTIVES: we reported a new minimally invasive procedure to replace tracheostomy cannula with Montgomery T-tube to improve the ability of speaking. METHODS: This is a single center study including all consecutive patients undergoing the replacement of standard tracheostomy cannula with T-tube for management of tracheomalacia. The end-points were to evaluate (a) the changes in Voice-related quality of Life (V-RQOL) before and after T-tube placement; and (b) the complications related to T-tube. RESULTS: Eleven patients were included in the study. T-tube was placed using flexible bronchoscopy and laryngeal mask airway. A suture was inserted through the proximal end of T-tube. Once the stent was introduced with a clamp into the trachea, a traction was applied on the suture to facilitate the alignment of the upper end of the stent. The comparison of V-RQOL values before and after T-tube insertion showed a significant improvement in social/emotional (39.2 ± 6.1 vs 66.8 ± 1.9; P = .0001); physical functioning (21 ± 5.7 vs 56.4 ± 5.3; P = 0.0001) and total V-RQOL scores (33.9 + 5.4 vs 61.3 + 6.1; P = 0.0001). No complications were seen during the insertion of the stent. In two patients, T-tube was obstructed by mucus that resolved with aspiration using flexible bronchoscopy (mean follow-up: 18 ± 10 months). CONCLUSIONS: Our technique is simple and safe, not needing specific skills and/or cumbersome devices. The replacement of tracheostomy cannula with T-tube seems to improve the quality of voice without adding major complications.

Speech Perception Skills of Children With Speech Sound Disorders: A Systematic Review and Meta-Analysis.

Purpose The aim of this study was to conduct a systematic review and meta-analysis to investigate whether preschool- and early school-age children with speech sound disorders (SSDs) have difficulties with speech perception. Method Systematic searching of 8 electronic databases identified 73 eligible studies across 71 articles examining the speech perception skills of children with SSDs. The findings and methodological characteristics of each study were reviewed, and the reporting of methodological information in each article was rated. A meta-analysis was conducted with studies that used the most common type of speech perception assessment task-lexical and/or phonetic judgment tasks. Results Across 60 of 73 studies, some or all children with SSDs were reported to have difficulties with speech perception. The meta-analysis showed a significant difference between children with SSDs and children with typically developing speech on lexical and/or phonetic judgment tasks. Conclusion Results from the meta-analysis demonstrate that children with SSDs have difficulties with speech perception. This appears to be the case for some but not all children with SSDs. The findings from this systematic review and meta-analysis also provide insight into the complex range of methodological issues involved in the study of speech perception in children with SSDs and the need for further research. Supplemental Material https://doi.org/10.23641/asha.9808361.

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.

Reading Outcomes for Individuals With Histories of Suspected Childhood Apraxia of Speech.

Purpose The primary aims of this study were to examine the speech-language correlates of decoding difficulties in children with histories of suspected childhood apraxia of speech (sCAS) and to identify predictors of low-proficiency reading levels. Method Participants were school-age children and adolescents, 7-18 years of age, diagnosed with sCAS (n = 40) or speech sound disorder but no sCAS (SSD-no sCAS; n = 119). The sCAS and SSD-no sCAS reading groups were compared on measures of performance IQ, oral language, phonological awareness, rapid automatic naming, diadochokinetic rates, single word articulation, and multisyllable and nonsense word repetition. Logistic regression analyses were employed to identify predictors of low-proficiency reading in the sCAS and SSD-no sCAS groups. Results Sixty-five percent of the participants with sCAS compared to 24% of those with SSD-no sCAS were classified as low-proficiency readers based on nonsense and single word decoding. Analysis failed to reveal significant differences in reading, oral language, or phonological awareness between low-proficiency readers with sCAS and low-proficiency readers with SSD-no sCAS. Oral language and phonological awareness skills were the best predictors of reading level for all participants, followed by performance on multisyllabic word repetition and diadochokinetic rate. Conclusions The language and phonological awareness deficits of children with sCAS are related to their risks for reading failure. To a lesser degree, motor speech deficits and speech sound production also increase risks for reading difficulties. The findings justify early intervention for this subset of children.

Differential Long-Term Outcomes for Individuals With Histories of Preschool Speech Sound Disorders.

Purpose The goal of this study was to determine whether adolescent outcomes for individuals with histories of early speech sound disorders (SSD) could be differentiated by speech and language skills at earlier ages (preschool, 4-6 years, and school age, 7-10 years). Method The study used a retrospective longitudinal design. Participants with and without histories of early SSD were classified in adolescence as having no SSD, resolved SSD, low multisyllabic word (MSW; difficulty with MSW repetition but no errors in conversational speech), or persistent speech disorders (errors in both conversational speech and MSW repetition). Analysis of variance was employed to determine whether early speech, language, and literacy skills distinguished these adolescent outcome groups. Results Preschool and school-age skills differed for adolescents whose SSD had resolved from those who had persistent speech errors. Adolescents with errors solely in production of MSWs (Low MSW) did not differ in early speech and language skills from adolescents who had difficulty with both MSWs and persistent errors in conversation. Conclusions Speech and language assessments earlier in childhood can help establish risks for persistent SSD and other language and literacy difficulties in adolescence. Early identification of these clinically relevant subgroups of SSD may allow for early targeted interventions. Supplemental Material https://doi.org/10.23641/asha.9932279.

Tongue Strength in Children With and Without Speech Sound Disorders.

Purpose The purpose of this cross-sectional investigation was to expand the comparative database of pediatric tongue strength for children and adolescents with typical development, ages 3-17 years, and compare tongue strength among children with typical development, speech sound delay/disorders (SD), and motor speech disorders (MSDs). Method Tongue strength was measured using the Iowa Oral Performance Instrument in a total of 286 children and adolescents, 228 with typical development, 16 with SD, and 42 with MSDs, including classic galactosemia, a known risk factor for MSD ( n = 33) and idiopathic MSD ( n = 9). Results For all groups, tongue strength increased rapidly from 3 to 6.5 years of age and then continued to increase with age at a slower rate until 17 years of age. Children with SD's tongue strength did not differ from their typically developing (TD) peers. Children and adolescents with MSDs had decreased tongue strength compared to children with typical development or SD. Tongue strength was not related to severity of speech sound disorders in SD or MSD. Conclusion Weak tongue strength does not appear to contribute to speech errors in children with speech sound delays but does appear to be related to speech sound disorders that are neurologic in origin (developmental MSD).

The Complexity Approach to Phonological Treatment: How to Select Treatment Targets.

Purpose: There are a number of evidence-based treatments for preschool children with phonological disorders (Baker & McLeod, 2011). However, a recent survey by Brumbaugh and Smit (2013) suggests that speech-language pathologists are not equally familiar with all evidence-based treatment alternatives, particularly the complexity approach. The goal of this clinical tutorial is to provide coaching on the implementation of the complexity approach in clinical practice, focusing on treatment target selection. Method: Evidence related to selecting targets for treatment based on characteristics of the targets (i.e., developmental norms, implicational universals) and characteristics of children's knowledge of the targets (i.e., accuracy, stimulability) is reviewed. Free resources are provided to aid clinicians in assessing accuracy and stimulability of singletons and clusters. Use of treatment target selection and generalization prediction worksheets is illustrated with 3 preschool children. Results: Clinicians can integrate multiple pieces of information to select complex targets and successfully apply the complexity approach to their own clinical practice. Conclusion: Incorporating the complexity approach into clinical practice will expand the range of evidence-based treatment options that clinicians can use when treating preschool children with phonological disorders. Supplemental Material S1: https://doi.org/10.23641/asha.6007562. KU ScholarWorks Supplemental Material: http://hdl.handle.net/1808/24767.

Diagnostic Accuracy of Traditional Measures of Phonological Ability for Bilingual Preschoolers and Kindergarteners.

Purpose: Bilingual children whose phonological skills are evaluated using measures designed for monolingual English speakers are at risk for misdiagnosis of speech sound disorders (De Lamo White & Jin, 2011). Method: Forty-four children participated in this study: 15 typically developing monolingual English speakers, 7 monolingual English speakers with phonological disorders, 14 typically developing bilingual Spanish-English speakers, and 8 bilingual children with phonological disorders. Children's single-word speech productions were examined on Percentage Consonants Correct-Revised (Shriberg, Austin, Lewis, McSweeny, & Wilson, 1997a) and accuracy of early-, middle-, and late-developing sounds (Shriberg, 1993) in English. Consonant accuracy in English was compared between monolinguals and bilinguals with and without speech sound disorders. Logistic regression and receiver operating characteristic curves were used to observe diagnostic accuracy of the measures examined. Results: Percentage Consonants Correct-Revised was found to be a good indicator of phonological ability in both monolingual and bilingual English-speaking children at the age of 5;0. No significant differences were found between language groups on any of the measures examined. Conclusions: Our results suggest that traditional measures of phonological ability for monolinguals could provide good diagnostic accuracy for bilingual children at the age of 5;0 years. These findings are preliminary, and children younger than 5;0 years should be examined for risk of misdiagnosis.

Parent-child interaction in motor speech therapy.

PURPOSE: This study measures the reliability and sensitivity of a modified Parent-Child Interaction Observation scale (PCIOs) used to monitor the quality of parent-child interaction. The scale is part of a home-training program employed with direct motor speech intervention for children with speech sound disorders. METHOD: Eighty-four preschool age children with speech sound disorders were provided either high- (2×/week/10 weeks) or low-intensity (1×/week/10 weeks) motor speech intervention. Clinicians completed the PCIOs at the beginning, middle, and end of treatment. Inter-rater reliability (Kappa scores) was determined by an independent speech-language pathologist who assessed videotaped sessions at the midpoint of the treatment block. Intervention sensitivity of the scale was evaluated using a Friedman test for each item and then followed up with Wilcoxon pairwise comparisons where appropriate. RESULTS: We obtained fair-to-good inter-rater reliability (Kappa = 0.33-0.64) for the PCIOs using only video-based scoring. Child-related items were more strongly influenced by differences in treatment intensity than parent-related items, where a greater number of sessions positively influenced parent learning of treatment skills and child behaviors. CONCLUSION: The adapted PCIOs is reliable and sensitive to monitor the quality of parent-child interactions in a 10-week block of motor speech intervention with adjunct home therapy. Implications for rehabilitation Parent-centered therapy is considered a cost effective method of speech and language service delivery. However, parent-centered models may be difficult to implement for treatments such as developmental motor speech interventions that require a high degree of skill and training. For children with speech sound disorders and motor speech difficulties, a translated and adapted version of the parent-child observation scale was found to be sufficiently reliable and sensitive to assess changes in the quality of the parent-child interactions during intervention. In developmental motor speech interventions, high-intensity treatment (2×/week/10 weeks) facilitates greater changes in the parent-child interactions than low intensity treatment (1×/week/10 weeks). On one hand, parents may need to attend more than five sessions with the clinician to learn how to observe and address their child's speech difficulties. On the other hand, children with speech sound disorders may need more than 10 sessions to adapt to structured play settings even when activities and therapy materials are age-appropriate.

Treatment of Phonological Disorder: A Feasibility Study With Focus on Outcome Measures.

Purpose: In a feasibility study for a randomized controlled trial of treatments for phonological disorders conducted over a period of 8 months, we examined 6 clinically relevant outcome measures. We took steps to reduce error variance and to maximize systematic variance. Method: Six children received traditional treatment (Van Riper, 1939), and 7 received expansion points (Smit, 2000), a treatment program with both phonological and traditional elements. Outcome measures, which were applied to both word list and conversational samples, included percentage of consonants correct (PCC; Shriberg & Kwiatkowski, 1982), PCC for late and/or difficult (L/D) consonants and number of L/D consonants acquired. Results: In repeated-measures analyses of variance, all measures showed significant differences from pretreatment to posttreatment, and the word list measures were associated with very high power values. In analyses of covariance for between-groups contrasts, the adjusted expansion points mean exceeded the adjusted traditional treatment mean for every measure; however, no differences reached significance. For the L/D PCC (conversation) measure, the contrast between groups was associated with a large effect size. Conclusion: We recommend that practitioners use outcome measures related to a word list. We recommend that researchers consider using L/D PCC on the basis of conversational samples to detect differences among treatment groups. Supplemental Materials: https://doi.org/10.23641/asha.5872677.

Exploring the Overlap Between Dyslexia and Speech Sound Production Deficits.

Purpose: Children with dyslexia have speech production deficits in a variety of spoken language contexts. In this article, we discuss the nature of speech production errors in children with dyslexia, including those who have a history of speech sound disorder and those who do not, to familiarize speech-language pathologists with speech production-specific risk factors that may help predict or identify dyslexia in young children. Method: In this tutorial, we discuss the role of a phonological deficit in children with dyslexia and how this may manifest as speech production errors, sometimes in conjunction with a speech sound disorder but sometimes not. We also briefly review other factors outside the realm of phonology that may alert the speech-language pathologist to possible dyslexia. Results: Speech-language pathologists possess unique knowledge that directly contributes to the identification and remediation of children with dyslexia. We present several clinical recommendations related to speech production deficits in children with dyslexia. We also review what is known about how and when children with speech sound disorder are most at risk for dyslexia. Conclusion: Speech-language pathologists have a unique opportunity to assist in the identification of young children who are at risk for dyslexia.