The Relationship Between the Phonological Loop and Receptive Language and Nonverbal Intelligence in Speech Sound Disorders

Rapid naming refers to the duration required to swiftly and accurately identify a set of familiar visual stimuli. Rapid naming serves as a significant indicator of the efficiency with which phonological information can be retrieved from memory, playing a crucial role in the advancement of language and literacy competencies. This research aimed to thoroughly investigate the rapid naming and language skills of children with speech sound disorders (SSDs) and to explain the correlations between these competencies. Our study consisted of 50 children diagnosed with SSD. The participants were categorized into two groups: those with articulation disorders (n = 23) and those with phonological disorders (n = 27). The Turkish Test of Language Development-Primary (TOLD-P:4), the Articulation Subtest (AST) and the Auditory Discrimination Subtest (ADT) of the Turkish Articulation and Phonology Test (SST), the Stimulability Test, and the Rapid Naming Test (RNT) were used to test the children's language, articulation, and rapid-naming skills. In our study, children with articulation disorders exhibited significantly higher scores on picture vocabulary, relational vocabulary, and morphological completion scales from the TOLD-P:4 subtests compared to children with phonological disorders (t(48) = 2.504, p = 0.016; t(48) = 2.249, p = 0.029; t(48) = 2.744, p = 0.009). Simultaneously, it was determined that the average duration of children with articulation disorders in the object, color, and number tests, which are subtests of the RNT, exhibited significant differences when compared to children with phonological disorders (t(48) = -3.567, p = 0.001; t(48) = -2.888, p = 0.006; t(19) = -3.134, p = 0.005). A statistically significant negative correlation was observed between the mean duration of children with SSD in the object subtest of RNT and the scores on the stimulability and morpheme subtests (r = -0.387, p = 0.005; r = -0.326, p = 0.021). A notable negative correlation was found between the average duration of the color, letter, and number subtests of RNT and the ADT, as well as the percentage of stimulability (p < 0.05). Children with phonological disorders exhibited differences in rapid naming and language skill compared to those with articulation disorders. At this point, professionals addressing SSD should assess the access speed to phonological information in the memory of preschool children with phonological difficulties, and phonological processing should be incorporated into speech production interventions. What is already known on this subject It is known that children diagnosed with speech sound disorders (SSDs) are at a markedly elevated risk of encountering language and reading difficulties during their school years. What this paper adds to the existing knowledge Retaining speech sounds in a child's language is also an integral part of phonological awareness. Rapid naming skills, which are an indicator of phonological processing skills, are very important. The fact that children with phonological disorders have a longer mean time in rapid naming skills indicates that these children have more difficulty accessing phonological representations from long-term memory. In addition, children with phonological disorders were found to have lower picture vocabulary, relational vocabulary, and morphological completion performances. What are the potential or clinical implications of this work? Professionals should integrate phonological processing into speech production interventions to strengthen their knowledge of functional language performance and rapid naming skills of children with SSDs and to pave the way for later reading success.

This study aimed to compare the effects of a non-linguistic auditory intervention approach with a phonological intervention approach on the phonological skills of children with speech sound disorder (SSD). A total of 17 children, aged 7–12 years, with SSD were randomly allocated to either the non-linguistic auditory temporal intervention group (n = 10, average age 7.7 ± 1.2) or phonological intervention group (n = 7, average age 8.6 ± 1.2). The intervention outcomes included auditory-sensory measures (auditory temporal processing skills) and cognitive measures (attention, short-term memory, speech production, and phonological awareness skills). The auditory approach focused on non-linguistic auditory training (e.g., backward masking and frequency discrimination), whereas the phonological approach focused on speech sound training (e.g., phonological organization and awareness). Both interventions consisted of 12 45-min sessions delivered twice per week, for a total of 9 h. Intra-group analysis demonstrated that the auditory intervention group showed significant gains in both auditory and cognitive measures, whereas no significant gain was observed in the phonological intervention group. No significant improvement on phonological skills was observed in any of the groups. Inter-group analysis demonstrated significant differences between the improvement following training for both groups, with a more pronounced gain for the non-linguistic auditory temporal intervention in one of the visual attention measures and both auditory measures. Therefore, both analyses suggest that although the non-linguistic auditory intervention approach appeared to be the most effective intervention approach, it was not sufficient to promote the enhancement of phonological skills.

In this study, the authors determined adolescent speech, language, and literacy outcomes of individuals with histories of early childhood speech sound disorders (SSD) with and without comorbid language impairment (LI) and examined factors associated with these outcomes. This study used a prospective longitudinal design. Participants with SSD (n = 170), enrolled at early childhood (4-6 years) were followed at adolescence (11-18 years) and were compared to individuals with no histories of speech or language impairment (no SSD; n = 146) on measures of speech, language, and literacy. Comparisons were made between adolescents with early childhood histories of no SSD, SSD only, and SSD plus LI as well as between adolescents with no SSD, resolved SSD, and persistent SSD. Individuals with early childhood SSD with comorbid LI had poorer outcomes than those with histories of SSD only or no SSD. Poorer language and literacy outcomes in adolescence were associated with multiple factors, including persistent speech sound problems, lower nonverbal intelligence, and lower socioeconomic status. Adolescents with persistent SSD had higher rates of comorbid LI and reading disability than the no SSD and resolved SSD groups. Risk factors for language and literacy problems in adolescence include an early history of LI, persistent SSD, lower nonverbal cognitive ability, and social disadvantage.

Proficiency of multisensory processing and motor skill are often associated with early cognitive, social, and language development. However, little research exists regarding the relationship between multisensory motor reaction times (MRTs) to auditory, visual and audiovisual stimuli, and classical measures of receptive language and expressive vocabulary development in school-age children. Thus, this study aimed to examine the concurrent development of performance in classical tests of receptive (Peabody Picture Vocabulary Test; abbreviated as PPVT) and expressive vocabulary (Expressive Vocabulary Test; abbreviated as EVT), nonverbal intelligence (NVIQ) (determined with the aid of Raven's Colored Progressive Matrices; abbreviated as RCPM), speed of visual-verbal processing in the Rapid Automatic Naming (RAN) test, Eye-Hand Co-ordination (EHC) in the SLURP task, and multisensory MRTs, in children (n = 75), aged between 5 and 10 years. Bayesian statistical analysis showed evidence for age group differences in EVT performance, while PPVT was only different for the youngest group of children aged 5-6, supporting different developmental trajectories in vocabulary acquisition. Bayesian correlations revealed evidence for associations between age, NVIQ, and vocabulary measures, with decisive evidence and a higher correlation (r = 0.57 to 0.68) between EVT, MRT tasks, and EHC visuomotor processing. This was further supported by regression analyses indicating that EVT performance was the strongest unique predictor of multisensory MRTs, EHC, and RAN time. Additionally, visual MRTs were found to predict both receptive and expressive vocabulary. The findings of the study have important implications as accessible school-based assessments of the concurrent development of NVIQ, language, and multisensory processing; and hence as rapid and timely measures of developmental and neurodevelopmental status.

Children born with cleft palate ± lip (CP ± L) are at risk of speech sound disorder (SSD). Up to 40% continue to have SSD at age 5-6 years. These difficulties are typically described as articulatory in nature and often include cleft speech characteristics (CSC) hypothesized to result from structural differences. In non-CP ± L SSD comorbidity with language difficulties is often reported. There is growing evidence of concomitant language difficulties in children with CP ± L and of a higher prevalence of developmental speech errors in children compared with non-CP ± L peers. The impact of underlying phonological and language skills on speech production in children with CP ± L is poorly understood. To investigate language outcomes in children with CP ± L and the relationship to speech production, by answering the following research questions: (1) Does the profile of language skills in children with CP ± L differ from normative samples? (2) Do children with CP ± L and SSD have poorer language skills than those with typically developing speech? (3) Is there an association between language skills and speech profile in children with CP ± L at age 5-8 years? In this prospective cross-sectional, observational study, 95 participants were recruited from regional cleft lip and palate services in the UK. They were aged 5;0-7;11 with non-syndromic CP ± L. Those with a syndromic diagnosis, global learning disability, sensorineural hearing loss and first language other than English were excluded. Assessments of speech (Diagnostic Evaluation of Articulation and Phonology-DEAP) and language (Clinical Evaluation of Language Fundamentals-5th UK edition-CELF) were completed. Language outcomes were analysed and compared with normative samples and according to speech error analysis. Average language scores were within the expected range. For those presenting with SSD, language scores were significantly lower than those with typically developing speech. Analysis of speech errors showed four distinct speech profiles: typical speech, CSC only, developmental speech characteristics (DSC), and combined CSC + DSC. Language scores were lower for participants with DSC (±CSC). A significant association was found between the presence of CSC + DSC and expressive language outcomes (odds ratio (OR) = 10.82; 95% confidence interval (CI) = 2.42, 48.32, p = 0.002). An association between language skills and speech production was observed. The distribution of speech errors in children with CP ± L varied with a high level of DSC as well as CSC. Those with CSC + DSC had significantly lower language scores than those with typically developing speech or CSC only. Speech and language therapists working with this caseload should be alerted to potential ongoing phonological and language difficulties in children presenting with this profile. What is already known on this subject Children born with CP ± L are known to be at risk of SSD. There is also evidence of language delay in the early years. Evidence for persistent language difficulties is equivocal but some studies have shown a higher than average prevalence of developmental phonological errors in addition to cleft articulation errors in speech production. What this paper adds to the existing knowledge This study investigates links between speech development and language skills in children aged 5-8 years with non-syndromic CP ± L. It adds to our understanding of the nature of SSD in children with CP ± L and in particular the relationship between language skills and speech production. It shows that children with CP ± L have varied speech profiles and that those presenting with delayed phonological processes are also at risk of language difficulties. What are the potential or actual clinical implications of this work? Speech and language therapists working with children with CP ± L should be aware of the varied nature of SSD in this population. They should be alert to the need for additional assessment of language for those presenting with delayed phonological processes and the implications this has for educational attainment.

Working memory span in Persian-speaking children with speech sound disorders and normal speech development

Language or motor: reviewing categorical etiologies of speech sound disorders

Children with speech sound disorders (SSD) are at higher risk of communication breakdown, but the impact of having an SSD may vary from child to child. Determining the severity of SSD helps speech-language therapists (SLTs) to recognise the extent of the problem and to identify and prioritise children who require intervention. This study aimed to identify severity factors for SSD in order to develop a multifactorial Speech Sound Disorder Severity Construct (SSDSC) using SLTs' views and the International Classification of Functioning, Disability and Health (ICF). In an explorative five-staged qualitative study, the research question was answered: 'How do SLTs determine the severity of SSD in children?'. A total of 91 SLTs from The Netherlands participated in data collection and analysis. The iterative process included three different qualitative research methodologies (thematic analysis [TA], constructivist grounded theory [CGT] and content analysis [CA]) to ensure validation of the results by means of method triangulation. SLTs considered nine themes: intelligibility, speech accuracy, persistence, the child's perception, impact, communicative participation, concomitant factors, professional point of view, and environmental factors. The themes were summarised in three main severity factors: (I) Speech accuracy, (II) The child's perception of the impact of their speech, and (III) Intelligibility in communication. Other severity factors were concomitant factors and impact. Expertise and support were identified as facilitators or barriers that may worsen or relieve the severity of SSD. This study highlights the need for SLTs to rethink how they think about severity as a simplistic construct reflecting only speech accuracy. It is recommended that a broader holistic approach to measuring severity is adopted. What is already known on the subject Although there are several proposals aiming to define the severity of SSD, the extent to which these align with clinical practice is not well understood. In recent years, speech accuracy and other factors such as intelligibility have been suggested as possible indicators of SSD severity. Flipsen etal. (2005) concluded that experienced clinicians evaluated the number, type and consistency of speech errors as well as intelligibility, considering articulatory competence at both the segmental and whole word level when determining severity. Enderby et al. (2013) developed ICF-based Therapy Outcome Measures (TOMs), including a TOM for phonological disorder. Although there is evidence in the literature that multiple factors should be considered when determining severity, there is still no clear guidance on this. In this discussion, the perspective of SLTs is an important contribution to the development of a measure of severity, but is lacking in the known literature. What this paper adds to the existing knowledge As a first step, this study examines SLT's perspectives on how they define and measure severity of SSD, and determines how those views align with the ICF in order to develop a severity construct that can be further tested and validated. Using the views of SLTs and the ICF, this qualitative study resulted in the multifactorial SSDSC. What are the potential or actual clinical implications of this work? The practical experience of SLTs, combined with what is known from the literature, provides insight into the different factors that may contribute to severity of SSD. These factors may be considered in developing a measure of SSD severity in the future.

Analysis of the errors in the Raven's Coloured Progressive Matrices (RCPM) has been previously performed for children with intellectual disabilities but has not been investigated for those with cerebral palsy (CP). This study aimed to investigate whether the types and positions of errors made by individuals with CP differed from those made by typically developing (TD) controls. Forty-five participants with CP aged 4-18years and 30 TD children aged 3-9years underwent RCPM testing. We first compared the RCPM performance and error characteristics between the groups and then examined the association between RCPM and the severity of CP and receptive vocabulary in the CP group. The results showed that while mean total scores in the two groups were comparable, the types and positions of errors made by individuals with CP differed from those of TD controls. The development of non-verbal intelligence in children with CP increased with age; when controlling for age, non-verbal intelligence was significantly correlated with all three functional levels of CP severity and receptive vocabulary. This study provides valuable insights into the problem-solving strategies employed by children with CP.

Phonological acquisition traditionally has been measured using constructs that focus on segments rather than the whole words. Findings from recent research have suggested whole-word productions be evaluated using measures such as phonological mean length of utterance (pMLU) and the proportion of whole-word proximity (PWP). These measures have been investigated mainly in typically-developing children, but their use with children with speech sound disorders has been limited. This study compares PMLU, PWP, and consonant accuracy in Spanish–English bilinguals with speech sound disorders (SSD) to age-matched monolingual peers. This study relates directly to the type of research that Adele Miccio favoured. First, it is focusing on bilingual children. For the past 5 years, she has been the principal investigator of a grant developing a comprehensive phonological assessment tool for bilingual speakers. Second, during her career, Miccio advocated using multiple analyses to gauge the phonological skills of children, especially those with speech sound disorders. Her work in stimulability is evidence of that perspective. This study examines one ‘raditional’ measure (consonant accuracy) and two newer ones (pMLU and PWP), thereby broadening the analyses of phonological skills in bilingual children with SSD and thus carrying out multiple analyses, just as Miccio recommended throughout her illustrious career.

The relationship between self-rated personality and nonverbal intelligence has been studied in young students, but these studies have generally not considered nested data, despite their allowing us to analyse between-classroom variability. The present cross-sectional study involved third- to sixth-grade students (n = 447) who were nested into their classrooms (n = 32). The participants completed the Raven's Coloured Progressive Matrices (CPM) as a measure of nonverbal intelligence and a personality questionnaire based on the Five Factor Model. At the class level, the study data included class size, class-average CPM scores, and class-homogeneity in CPM performances. Multilevel modelling with class-mean centring of personality predictors was applied to examine class-average differences in CPM scores and interaction effects between personality and class-homogeneity on CPM scores. The results showed significant differences in average CPM performances across classrooms, significant fixed and random slope effects linking nonverbal intelligence and Imagination, and a cross-level effect revealing that Imagination is a stronger predictor of CPM scores when class-homogeneity in intelligence is lower. Beyond confirming the intelligence-Imagination association generally observed in the literature, the present findings emphasise the importance of using nested structures when collecting personality and intelligence data in classrooms. More attention needs to be paid to how the classroom environment affects children's self-reported personality and intelligence test performances.

Cognitive dysfunction is frequent in Cerebral Palsy (CP). CP motor impairment and associated speech deficits often hinder cognitive assessment, with the result being that not all CP studies consider cognitive dysfunction. Raven's Coloured Progressive Matrices is a simple, rapid test which can be used in persons with severe motor impairment and speech limitations. We studied whether this test can offer a reliable measure of cognitive functioning in CP. Visuoperceptual, language, memory and frontal lobe functions were evaluated in 30 participants with severe motor impaired CP and a variety of speech difficulties. The relationship between Raven's Coloured Progressive Matrices and a variety of tests was analysed. Raven's Coloured Progressive Matrices performance was associated with visuoperceptual, language, visual and verbal memory but not with frontal functions. Receptive vocabulary and visuospatial measures were the best predictors of Raven's Coloured Progressive Matrices raw scores. Raven's Coloured Progressive Matrices is a fast, easy-to-administer test able to obtain a measure related with linguistic, visuoperceptual, and memory cognitive functioning in persons with CP despite their motor and speech disorders.

Pleiotropic Effects of a Chromosome 3 Locus on Speech-Sound Disorder and Reading

Objectives: This study aimed to examine nonword repetition (NWR) performance of children with speech sound disorders (SSD) compared with children with typical development (TD) and investigate the relationship between NWR and speech perception, phonological short-term and phonological working memory, and percentage of consonants correct (PCC). Methods: Participants included 8 children with Pure SSD, 7 children with SSD accompanied by language disorders (LD) and 9 children with TD aged 5 to 6 years. Children completed NWR tasks, speech perception tests focusing on initial and final consonants in one-syllable words, and immediate memory tasks examining forward and reverse recall of familiar words. NWR performances were examined according to the entire, retrieval and sequencing accuracies and analyzed by 9 error types. Results: Children with SSD and LD performed significantly lower total and retrieval accuracies of NWR than children with TD. Substitution errors of articulation place were most frequent in all groups. Only children with SSD exhibited syllable structure errors. No significant group differences existed in speech perception. Children with SSD and LD showed lower phonological short-term memory than children with TD. Both children with SSD and LD and with Pure SSD performed significantly lower phonological working memory than children with TD. NWR showed significant relationship with speech perception, phonological memory, and PCC. The relationships between NWR and phonological short-term memory and PCC were striking. Conclusion: This study underlines that children with SSD and LD show remarkable difficulties in NWR and supports the close relationship of NWR with phonological short-term memory and speech accuracy.

Children with Speech Sound Disorders (SSD) or a history of SSD are at risk of developing literacy problems later in life. However, there is limited research on SSD children at risk of literacy problems. This systematic review aimed to review 13 international articles on preschool-age SSD and its impact on literacy skills in middle childhood or adolescence. The results of this systematic review show that children who experience SSD in early childhood have poorer early literacy and literacy skills compared to typical children. Based on the literature review, it was found that the severity of speech sound disorder (SSD) does not have a significant correlation with literacy skills. Thus, it can be concluded that children with mild SSD are still at risk of future literacy problems.