Factors associated with speech-sound stimulability

Predicting Which Children Will Normalize Without Intervention for Speech Sound Disorders

PURPOSE

The speech of some children does not follow a typical normalization trajectory, and they develop speech sound disorders (SSD). This study investigated predictive correlates of speech sound normalization in children who were at risk of SSD.

METHOD

A prospective population cohort study of 845 Cantonese-speaking preschoolers was conducted over 2.5 years to examine (a) children who resolved nonadult realizations of consonants (normalized) and (b) those who had persisting speech sound difficulties (did not normalize). From these 845, a sample of 82 participants characterized as having SSD (1.25 SDs below the mean in a standardized speech assessment, with a delay in initial consonant acquisition or with one or more atypical errors) was followed for 2 years at 6-month intervals or until the completion of their initial consonant inventory. Data from 43 children who did not receive speech-language pathology services were analyzed with survival analysis to model time to normalization while controlling for covariates. The target event (outcome) was the completion of their initial consonant inventory.

RESULTS

Under the no-intervention condition, the estimated median time to normalization was 6.59 years of age. Children who were more likely to normalize or normalized in a shorter time were stimulable to all errors and more intelligible as rated by caregivers using the Intelligibility in Context Scale. Those who showed atypical error patterns did not necessarily take longer to normalize. Similarly, expressive language ability was not significantly associated with speech normalization.

CONCLUSIONS

Stimulability and intelligibility were more useful prognostic factors of speech normalization when compared to (a)typicality of error patterns and expressive language ability. Children with low intelligibility and poor stimulability should be prioritized for speech-language pathology services given that their speech errors are less likely to resolve naturally.

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.

Development and validation of a new scale for assessment of speech stimulability in Persian speaking children

OBJECTIVES

Speech and language pathologists need to assess speech stimulability as a crucial component of assessment in clients with speech sound disorders. The purpose of the current survey was to develop and validate an instrument to assess speech stimulability in Persian speaking children.

METHODS

The present study was accomplished in two steps. In step I, the test material was developed based on extensive literature review, and five experts were requested to make judgment on the content validity of the test. We evaluated other psychometric properties in step II. A pilot study was performed by the administration of the test on 25 children, and then the correct answer percentages of 100 participants for each item of the Persian test of speech stimulability were calculated. The participants were divided into four groups by six-month intervals. Inter-rater reliability, test-retest, and internal consistency were computed for the reliability measures. Statistical Package for the Social Sciences, version 24.0 (SPSS, Inc., Chicago, IL) was used for the statistical analysis of the data. The significance level was (P < 0.05).

RESULTS

The final version of the test includes 132 items (consonant and vowel singleton words and sentences). There was no significant difference among experts' judgment in the content validity of the items (P > 0.05). All of the children could easily repeat the items in the pilot study. The participants were stimulable more than 80% for all of the consonants except/ʒ/and 100% for the vowels in the items of the final version of the Persian test of speech stimulability. All of the reliability values (inter-rater reliability, test-retest, and internal consistency) were higher than 0.8.

CONCLUSION

Investigation of psychometric properties of the Persian test of speech stimulability showed that this test is a valid and reliable scale to assess the speech stimulability in Persian speaking children.

Tutorial: Speech Assessment for Multilingual Children Who Do Not Speak the Same Language(s) as the Speech-Language Pathologist

PURPOSE

The aim of this tutorial is to support speech-language pathologists (SLPs) undertaking assessments of multilingual children with suspected speech sound disorders, particularly children who speak languages that are not shared with their SLP.

METHOD

The tutorial was written by the International Expert Panel on Multilingual Children's Speech, which comprises 46 researchers (SLPs, linguists, phoneticians, and speech scientists) who have worked in 43 countries and used 27 languages in professional practice. Seventeen panel members met for a 1-day workshop to identify key points for inclusion in the tutorial, 26 panel members contributed to writing this tutorial, and 34 members contributed to revising this tutorial online (some members contributed to more than 1 task).

RESULTS

This tutorial draws on international research evidence and professional expertise to provide a comprehensive overview of working with multilingual children with suspected speech sound disorders. This overview addresses referral, case history, assessment, analysis, diagnosis, and goal setting and the SLP's cultural competence and preparation for working with interpreters and multicultural support workers and dealing with organizational and government barriers to and facilitators of culturally competent practice.

CONCLUSION

The issues raised in this tutorial are applied in a hypothetical case study of an English-speaking SLP's assessment of a multilingual Cantonese- and English-speaking 4-year-old boy. Resources are listed throughout the tutorial.

Stimulability: auxiliary measure in the identification of difficulty in speech sounds production

PURPOSE

To analyze the effectiveness of stimulability as a complementary task to the diagnosis of speech sound disorders (SSD), and to describe the performance of children with absent sounds from the phonetic inventory according to stimulable absent sounds, severity, gender, age, and occurrence of different phonological processes.

METHODS

Participants were 130 male and female children with ages between 5 years and 10 years and 10 months, divided into two groups: Research Group (RG), comprising 55 children with SSD; and Control Group (CG), composed of 75 children with no speech and language disorders. Based on participants' performance on the Phonology test, the severity of the disorder was calculated through the Percentage of Consonants Correct - Revised (PCC-R), and the phonetic inventory was verified. The stimulability test was applied to each absent sound from the phonetic inventory, based on the imitation of single words. The RG was subdivided into RG1 (27 children who presented absent sounds) and RG2 (28 children with complete inventory).

RESULTS

None of the CG children presented absent sounds in the phonetic inventory, while 49% of the RG1 subjects presented absent sounds. There was absence of most language sounds. PCC-R means were lower for RG1, indicating higher severity. In the RG1, 22 children were stimulable, while five were not stimulable to any absent sound. There was association between the most occurring phonological processes and the need for stimulability assessment, indicating that the difficulty to produce absent sounds reflects difficulty with phonological representation. Stimulability is influenced by age, but not by gender.

CONCLUSION

The stimulability test is effective to identify stimulable children among those who present absent sounds from their phonetic inventory. Children with SSD and absent sounds have lower PCC-R, and therefore present more severe disorder. Most of the children with absent sounds are stimulable, but may not be stimulable for complex syllable structures or articulatory gestures. The difficulty to produce absent sounds reflects phonological representation deficit. Speech production is influenced by maturation in both boys and girls.

Using Standardized Tests to Inventory Consonant and Vowel Production: A Comparison of 11 Tests of Articulation and Phonology

Purpose

This report considered the validity of making conclusions about a child’s phonetic inventory (the sounds a child can and cannot produce spontaneously without a prior model or other stimulation) based on the data from standardized single-word tests of articulation or phonology.

Method

We evaluated the opportunities for production of word-initial consonants, word-final consonants, and vowels within the words included on 11 tests. Only words that met specific phonetic criteria (termed phonetically controlled words) were counted as opportunities for each consonant or vowel.

Results

None of the tests provided sufficient coverage of consonants or vowels for establishing a phonetic inventory and making conclusions about the segments that a child can and cannot produce.

Conclusion

Use of the data from a single standardized test of articulation or phonology would not be sufficient for completely inventorying a child’s consonant and vowel production and selecting targets for therapy. It is recommended that clinicians supplement test data by probing production in additional phonetically controlled words.

Stimulability: relationships to other characteristics of children's phonological systems

In honour of Miccio's memory, this article revisits the topic of stimulability in children with speech sound disorders (SSD). Eighteen children with SSD, aged 3;6-5;5 (M = 4;8), were tested for their system-wide stimulability, percentage consonants correct (PCC), phonetic inventory size, and oral- and speech-motor skills. Pearson Product Moment Correlations were calculated to determine the nature of relations between stimulability and each of these other variables. Results revealed marked relations between stimulability and PCC and between stimulability and inventory size. Relations between stimulability and both multisyllabic nonsense and real word repetition rates were substantial. Findings suggest that stimulability, as measured for a group of sounds typically challenging for children with SSD, reflects both underlying phonological representations (UPRs) and phonetic imitative skill. The impact of poor stimulability skills in children with severe involvement of SSD and limited phonetic inventories implicates not only the potential difficulty non-stimulable sounds pose at the word level, but the need for increasing stimulability in these children. This, in turn, is a tribute to Miccio's intervention programme and the need for including it in both efficacy and efficiency investigations.

A multi-dimensional approach to gradient change in phonological acquisition: a case study of disordered speech development

The purpose of the current study is to document phonological change from a multidimensional perspective for a 3-year-old boy with phonological disorder by comparing three measures: (1) accuracy of consonant productions, (2) dynamic assessment, and (3) acoustic analysis. The methods included collecting a sample of the targets /s, [symbol: see the text], t[symbol: see the text], and d[symbol: see the text]/ produced in single words and repeated over time. The samples were analysed using phonetic transcription and acoustic measures of duration, spectral mean, and spectral variance. A dynamic assessment was administered that showed change in response to cues and linguistic environments using a 15-point scale. The results from the three measures were compared for gradient change and evidence of covert contrasts. In conclusion, gradient change was illustrated across the three measures and contrasts were evident in the child's phonological system. Acoustic measures were most sensitive, followed by dynamic assessment; however, accuracy scores based on phonetic transcription showed little to no change for some targets.

Análise acústica e índice de estimulabilidade sons líquidos do português brasileiro

OBJETIVO: descrever as características acústicas obtidas por meio da análise acústica (AA) e do índice de estimulabilidade (IE) das líquidas [[l/]; [[r/]; [[lh/]. MÉTODOS: foram analisadas as produções de fala coletadas através da imitação de sílabas de dois sujeitos gemelares de 11:6 anos apresentando os processos de simplificação de líquidas e simplificação do encontro consonantal. As produções foram analisadas acusticamente e por meio do teste de estimulabilidade. RESULTADOS: os dois sujeitos produziram adequadamente o som [[l/]. O sujeito 1 não foi estimulável para o [[r/], tendo substituído-o pelo [[l/] independentemente da vogal subseqüente. O sujeito 2 foi estimulável ao som [[r/] e o produziu de forma correta em apenas uma imitação quando acompanhado da vogal /a/. A AA permitiu verificar que o som [[l/] foi produzido de maneiras diferentes quando emitido de maneira adequada e quando no lugar do som [[r/]. Os dois sujeitos foram estimuláveis para o [[lh/]. A AA das produções entre o som [[lh/] acompanhado da vogal /a/ e da vogal /u/ apresentou diferença estatisticamente significante. A vogal /i/ mostrou-se o contexto menos facilitador para o sujeito 2. CONCLUSÃO: o emprego conjunto desses dois procedimentos mostrou-se eficaz na identificação de alterações acústico-articulatórias fornecendo parâmetros facilitadores para a aquisição de um determinado som, seja ele um parâmetro motor ou acústico.

The effect of target-selection strategy on phonological learning

In this study, 48 children with moderate or severe delays in phonological ability received treatment for four phonemes, selected in accordance with either traditional or nontraditional target-selection criteria. Children who received treatment for phonemes that are early developing and associated with greater productive phonological knowledge showed greater progress toward acquisition of the target sounds than did children who received treatment for late-developing phonemes that were associated with little or no productive phonological knowledge. Between-group differences in generalization learning were not observed. Child enjoyment of therapy did not differ between groups, but parental satisfaction with treatment progress was greater for children in the traditional group than for children in the nontraditional group.