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

Child speech developmental norms in Greek monolinguals: whole word and consonant accuracy

Child phonological development in standard Greek is aptly represented by both single-case and cross-sectional studies. While some quantitative measures exist, such as the 75% criterion in the acquisition of singletons and clusters, reported norms require replication to fine-tune existing indicators, inform non-existent ones, and better reflect children's typical developmental speech in contemporary Greece. Our cross-sectional study addresses this gap, in terms of consonant inventory acquisition, and percentage accuracy of words, singletons, clusters, and cluster reductions. Phonological Assessment for Greek (PAel) procedures facilitated data elicitation from 254 Greek-speaking participants, aged 2;0-7;0, equally represented for gender. Our study comprehensively informs quantitative norms on whole word accuracy (WWA), percentage of consonants correct (PCC), PCC variation across the different age groups of children, and the WWA-PCC correlation along the developmental path in this cross-sectional study. A schematic representation models children's normative PCC-WWA profiles, facilitating the determination of phonological disorder in Greek with direct clinical application on diagnosis and intervention.

Substitution Errors and the Role of Markedness in Bilingual Phonological Acquisition

PURPOSE

The purpose of this study was to (a) provide evidence for a theoretical model of between-language interaction in bilingual phonological production through the examination of substitution error patterns and to (b) provide developmental data on bilingual children with and without speech sound impairments for use in clinical assessment and diagnosis. Through the lens of markedness, or relative featural complexity, patterns of between-language interaction were observed to provide a foundation for clinical decision making in phonological assessment.

METHOD

Seventy children, ages 3;11-6;7 (years; months), participated in this study: 63 typically developing bilingual Spanish-English-speaking children (x¯ = 5;2) and seven bilingual Spanish-English-speaking children with speech sound impairments (x¯ = 4;6). Substitution errors in single-word speech samples were analyzed in relation to their language-specific markedness values in terms of both targets avoided and substitutes produced. Both quantitative and descriptive analyses of substitution errors were performed.

RESULTS

Bilingual children, regardless of impairment status, abided by the phonological rules of their languages in English and Spanish productions. Findings indicated both typically developing children and children with speech sound impairments preferred the use of unmarked sounds that are shared across languages over the use of marked, language-specific sounds.

CONCLUSIONS

Through the examination of substitution errors, evidence of between-language interaction and recognition of relative complexity emerged. These results have implications for clinical assessment and diagnosis of speech sound impairments in bilingual children.

SUPPLEMENTAL MATERIAL AND PRESENTATION VIDEO

https://doi.org/10.23641/asha.24640200.

Variability, accuracy, and cross-linguistic transfer in bilingual children speaking Jamaican Creole and English

Due to the lack of normative data about bilingual speech development and limited availability of diagnostic tools optimised for this population, bilingual children under consideration for speech-language services are at an elevated risk of misdiagnosis. In the absence of validated assessment tools, speech-language pathologists may use measures of accuracy and variability of speech production to diagnose suspected speech sound disorders in bilingual children. Research in general motor development suggests that variability and accuracy may trade off in the course of maturation, whereby movement variability spikes before the transition to a more mature stage of motor control. Such variability-accuracy tradeoffs have been described in monolingual speech development but are understudied in bilingual populations, where cross-linguistic transfer occurs. This study aimed to examine variability, accuracy, and cross-linguistic transfer in the speech of 20 bilingual children speaking Jamaican Creole and English. We hypothesised that children who showed higher accuracy in their productions would also exhibit more variable speech, indicating a variability-accuracy tradeoff. The Word Inconsistency Assessment from the Diagnostic Evaluation of Articulation and Phonology was administered to measure accuracy and variability in the English context, where misdiagnosis is likely to occur. Contrary to our hypothesis, we observed that individuals with higher accuracy tended to be less variable in their productions. Future research should examine longitudinal trajectories of accuracy and variability and consider a more culturally-appropriate definition of 'accuracy' in documenting bilingual speech sound development.

Construct validity of the focus on the outcomes of communication under six (FOCUS) total and profile scores for multilingual preschoolers: Considering functional speech skills

PURPOSE

To conduct an exploratory study to establish construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS) in the Jamaican context for FOCUS Total and Profile scores.

METHOD

Parents of a representative sample of 3-to-6-year-old Jamaican Creole (JC)-English-speaking simultaneous bilingual children completed the FOCUS in English, and the Intelligibility in Context Scale (ICS) in JC and in English. Children completed the Diagnostic Evaluation of Articulation and Phonology (DEAP) in both languages. Percent phonemes, consonants, and vowels correct were calculated using single word responses to DEAP items. Pearson correlations were completed to describe relationships between measurement scores.

RESULT

Convergent validity was found for FOCUS Total and ICS/JC scores. Convergent and divergent validity were found for specific FOCUS Profile scores and ICS/JC scores. Minimal evidence of convergent validity was found with FOCUS Total scores and transcription-based measures of speech production in JC and in English. Convergent and divergent validity were found between specific FOCUS Profile scores and some transcription-based measures of speech production in JC and in English.

CONCLUSION

This study provides evidence of construct validity for FOCUS Total and Profile scores. It also provides validity evidence for FOCUS scores in a multilingual context using a representative sample of children that serves to broaden the range of applicability of the FOCUS.

Characterizing Communicative Participation in Multilingual Jamaican Preschoolers

PURPOSE

This study characterized communicative participation and related aspects of functional communication for Jamaican Creole (JC)-English-speaking preschoolers with and without functionally defined speech sound disorders (fSSDs). This study included parent reports and direct assessment measures from an existing corpus of baseline data collected prior to the COVID-19 pandemic.

METHOD

The communicative participation of typically developing (TD; n = 226) bilingual JC-English-speaking preschoolers and those with fSSDs (n = 39) was documented using the Focus on the Outcomes of Communication Under Six (FOCUS). Functional speech intelligibility was recorded using the Intelligibility in Context Scale (ICS) in English and JC (ICS-JC). Objective measures of speech production were collected through direct child assessment in both languages and then transcribed and calculated for percent of consonants (PCC), vowels (PVC), and phonemes correct (PPC). Within-group relationships were explored using association testing, and differences between groups were explored through multivariate analyses.

RESULTS

FOCUS scores and ICS and ICS-JC scores were found to be minimally to moderately related for Jamaican preschoolers in the TD group (r = .28-.34, p < .002) and strongly related in the fSSD group (r = .56-.60, p < .002). No relations were observed between the FOCUS scores and PCC/PVC/PPC in either language. There was a statistically significant difference between all FOCUS scores for Jamaican preschoolers in the TD and fSSD groups (p ≤ .002).

CONCLUSIONS

These findings provide additional evidence for using the FOCUS beyond documenting change in communicative participation to support clinical decision-making in planning and developing speech-language interventions. This study also documents an important characterization of JC-English-speaking children with and without fSSDs, offering data on children's abilities that can be used in future comparisons of communicative participation and speech functioning observed during the COVID-19 pandemic and beyond.

Linguistically Informed Acoustic and Perceptual Analysis of Bilingual Children's Speech Productions: An Exploratory Study in the Jamaican Context

PURPOSE

The aim of this study was to characterize speech acoustics in bilingual preschoolers who speak Jamaican Creole (JC) and English. We compared a standard approach with a culturally responsive approach for characterizing speech sound productions. Preschoolers' speech productions were compared to adult models from the same linguistic community as a means for providing confirmatory evidence of typical speech patterns specific to JC-English speakers.

METHOD

Two protocols were applied to the data collected using the Diagnostic Evaluation of Articulation and Phonology (DEAP) Articulation subtest: (a) the standardized DEAP protocol and (b) a culturally and linguistically adapted protocol reflective of the Jamaican post-Creole (English to Creole) continuum. The protocols were used to analyze responses from JC-English-speaking preschoolers (n = 119) and adults (n = 15). Responses were analyzed using acoustic (voice onset time, whole-word duration, and vowel duration) and perceptual (percentage of consonant correct-revised and response frequencies) measures.

RESULTS

The culturally responsive protocol captured variation in the frequency and acoustic differences produced in the post-Creole continuum, with higher amounts of "other" responses compared to "standard" target responses for both children and adults. Adults' whole-word durations were shorter and showed more consistent prevoicing during initial plosives compared to the children.

CONCLUSIONS

Applying culturally responsive methods, including knowledge of the variation produced in the post-Creole continuum and with adult models from the same linguistic community, improved the ecological validity of speech characterizations for JC-English preschoolers. Acoustic properties of speech should be investigated further as a means of describing bilingual development and distinguishing between difference and disorder.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20249382.

Speech Sound Disorder Treatment Approaches Used by School-Based Clinicians: An Application of the Experience Sampling Method

PURPOSE

Children with speech sound disorders (SSDs) comprise a large portion of caseloads for school-based speech-language pathologists (SLPs). Despite the existence of several evidence-based SSD intervention approaches, the translation from research to practice is often limited by ecological validity because of various factors unique to school settings (e.g., scheduling constraints, caseload size, child availability). The purpose of this study was to use the experience sampling method (ESM) to examine the current practices of school-based SLPs when treating children with SSDs on their caseloads.

METHOD

SLPs (N = 106) from 42 different states working full-time in school-based K-12 settings participated in this study. At the beginning of the study, each SLP completed a one-time demographic survey about treatment practices for children with SSDs. The SLPs then participated in a series of brief surveys every day for one workweek using a specialized ESM phone application that randomly alerted participants to report on their treatment practices for children with SSDs.

RESULTS

Findings revealed that although most SLPs reported using a variety of SSD intervention approaches in a one-time survey, the majority of SLPs reported using one of three approaches in situ: the traditional articulation therapy approach, cycles, and minimal pairs. We also report a significant negative relationship between the years of experience of an SLP and the number of different approaches used.

CONCLUSIONS

This study is the first to use the ESM to determine which approaches school-based SLPs use to treat children with SSDs. Findings demonstrate that SLPs have knowledge of many different SSD approaches but tend to utilize only a few in school-based settings.

Using big data from long-form recordings to study development and optimize societal impact

Big data are everywhere. In this chapter, we focus on one source: long-form, child-centered recordings collected using wearable technologies. Because these recordings are simultaneously unobtrusive and encompassing, they may be a breakthrough technology for clinicians and researchers from several diverse fields. We demonstrate this possibility by outlining three applications for the recordings-clinical treatment, large-scale interventions, and language documentation-where we see the greatest potential. We argue that incorporating these recordings into basic and applied research will result in more equitable treatment of patients, more reliable measurements of the effects of interventions on real-world behavior, and deeper scientific insights with less observational bias. We conclude by outlining a proposal for a semistructured online platform where vast numbers of long-form recordings could be hosted and more representative, less biased algorithms could be trained.

A Systematic Review of Interventions for Multilingual Preschoolers With Speech and Language Difficulties

Purpose There is a shortage of information on evidence-based interventions for supporting young multilingual children. The purpose of this review was to identify interventions that have been evaluated with preschool-age multilingual children with a speech and/or language disorder or who are at risk of poor speech, language, literacy, and/or educational outcomes. Method This review considered speech, language, and early literacy interventions evaluated with preschool-age multilingual children with a speech and/or language disorder or who have been identified as being at risk of language difficulties (PROSPERO ID: 165892). The following electronic databases were searched: EBSCO (CINAHL Plus, ERIC, PsycINFO, Medline, Education) and Linguistics, Language, and Behavior Abstracts. Data were extracted describing article, participant, methodological, and intervention variables, and effect sizes. The Council for Exceptional Children's (CEC) standards for evidence-based practice were used to examine the quality of studies. Results Fifty-six relevant studies were identified in 52 articles and these studies described 4,551 participants who had speech sound disorder (six articles), developmental language disorder (11 articles), or were considered to be at risk (36 articles). The interventions targeted speech production (seven studies), language (45 studies), and early literacy (11 studies) skills. Most studies reported positive effects. Only 15 studies met all quality indicators specified by the CEC (2014) and these described 18 interventions targeting language and literacy skills. The only intervention with sufficient evidence to be considered an evidence-based practice was Nuestros Niños [Our Children] for children's early literacy and phonological awareness skills. Conclusions A number of high-quality studies exist that describe speech, language and/or literacy interventions for preschool-age multilingual children with a speech and/or language disorder, or who have been identified as being at risk of language difficulties. However, there remains limited evidence for specific interventions as to their ability to inform evidence-based practices. Supplemental Material https://doi.org/10.23641/asha.16632649.

Phonological Measures for Bilingual Spanish-English-Speaking Preschoolers: The Language Combination Effect

Purpose The purpose of this study was to examine the diagnostic accuracy of traditional measures of phonological ability developed for monolingual English-speaking children with their bilingual peers in both English and Spanish. We predicted that a composite measure, derived from a combination of English and Spanish phonological measures, would result in higher diagnostic accuracy than examining the individual phonological measures of bilingual children separately by language. Method Sixty-six children, ages 3;3-6;3 (years;months), participated in this study: 29 typically developing bilingual Spanish-English-speaking children (x = 5;3), five bilingual Spanish-English-speaking children with speech sound disorders (x = 4;6), 26 typically developing monolingual English-speaking children (x = 4;8), and six monolingual English-speaking children with speech sound disorders (x = 4;9). Children were recorded producing single words using the Assessments of English and Spanish Phonology, and productions were phonetically transcribed and analyzed using the Logical International Phonetics Program. Overall consonants correct-revised; accuracy of early-, middle-, and late-developing sounds; and percent occurrence of phonological error patterns in both English and Spanish were calculated. Receiver operating characteristic curves and support vector machine models were applied to observe diagnostic accuracy, separately and combined, for each speaker group and each language. Results Findings indicated the combination of measures improved diagnostic accuracy within both the English and Spanish of bilingual children and significantly increased accuracy when measures from both languages of bilingual children were combined. Combining measures for the productions of monolingual English-speaking children did not increase diagnostic accuracy. Conclusion To prevent misdiagnosis of speech sound disorders in bilingual preschoolers, the composite phonological abilities of bilingual children need to be assessed across both gross and discrete measures of phonological ability. Supplemental Material https://doi.org/10.23641/asha.16632604.

Vocabulary and Phonological Abilities Affect Dual Language Learners' Consonant Production Accuracy Within and Across Languages: A Large-Scale Study of 3- to 6-Year-Old Spanish-English Dual Language Learners

Purpose This study examined factors of language ability that predict consonant production accuracy in young Spanish-English dual language learners (DLLs). Method Participants were 695 Latino DLLs, ages 3;0-6;5 (years;months). Single-word productions were elicited using the Bilingual Phonological Assessment (Miccio & Hammer, 2006). Children's consonant productions were assessed using Percentage of Consonants Correct-Revised (PCC-R; Shriberg et al., 1997a). Vocabulary abilities were assessed using the Woodcock-Muñoz Language Survey-Revised (Woodcock et al., 2005). Multiple linear regression analyses were used to determine the effects of vocabulary abilities and cross-language consonant production abilities on children's consonant production accuracy in each language. Results Large amounts of the variance in PCC-R scores for English (R ² = .65) and Spanish (R ² = .43) were predicted by children's age, vocabulary scores within the same language, and PCC-R scores across languages. Conclusion Spanish-English DLLs' consonant production abilities in both languages improve with age between 3;0 and 6;5. DLLs' accuracy in each language is also affected by vocabulary abilities within the same language and by their consonant production abilities in the other language. In particular, children's consonant production abilities in each language were highly predictive of their consonant production abilities in the other language, which suggests that shared phonological skills support their development across languages.

Spanish-English Bilingual Children's Relative Use of English Tense and Agreement Morphemes

Best practice for bilingual speakers involves considering performance in each language the client uses. To support this practice for young clients, a comprehensive understanding of how bilingual children develop skills in each language is needed. To that end, the present work investigates relative use of English tense and agreement (T/A) morphemes - a skill frequently considered as part of a complete language assessment - in Spanish-English developing bilingual preschoolers with varying levels of language ability. Results indicate that developing bilingual children with both typical and weak language skills demonstrate greater use of copula and auxiliary BE relative to third person singular, past tense and auxiliary DO. Findings thus reveal a relative ranking of T/A morphemes in developing bilingual children that differs from that of English monolingual children, who demonstrate relatively later emergence and productivity of auxiliary BE. In turn, findings demonstrate the importance of utilizing appropriate comparisons in clinical practice.

Standardized Tests and the Diagnosis of Speech Sound Disorders

Purpose

The purpose of this tutorial is to provide speech-language pathologists with the knowledge and tools to (a) evaluate standardized tests of articulation and phonology and (b) utilize criterion-referenced approaches to assessment in the absence of psychometrically strong standardized tests.

Method

Relevant literature on psychometrics of standardized tests used to diagnose speech sound disorders in children is discussed. Norm-referenced and criterion-referenced approaches to assessment are reviewed, and a step-by-step guide to a criterion-referenced assessment is provided. Published criterion references are provided as a quick and easy resource guide for professionals.

Results

Few psychometrically strong standardized tests exist for the evaluation of speech sound disorders for monolingual and bilingual populations. The use of criterion-referenced testing is encouraged to avoid diagnostic pitfalls.

Discussion

Speech-language pathologists who increase their use of criterion-referenced measures and decrease their use of standardized tests will arrive at more accurate diagnoses of speech sound disorders.