Preschool Speech Research Articles

Public health aspects of phonological articulation disorders in preschool children - literature review

Speech communication is complex and is based on the integrity of the central nervous system (CNS) function, as well as the speech mechanisms that are conditioned and controlled by an auditory perception, verbal memory, intellectual activity, but also by the peripheral speech apparatus. If there is a deviation from this integrated complex system in its perfect functioning, speech disorders occur. The aim of the paper was to make a literature review that provides scientific evidence of the most frequent phonological articulation disorders in pre-school children and their public health impact. Materials and Methods: Search in the available databases, such as Pubmed, Google scholar, as well as a review of the references in the papers, doctoral dissertations and master thesis. The following search terms were used: speech, language, disorders, dysphasia, dyslalia, aphasia, public health. Results: A total of 90 abstracts were found, all of them were read and 15 were selected as appropriate for the purpose of our research, as well as in extenso papers that were found and analyzed for this review. Conclusions: According to the available scientific evidence, the development of speech and language is a useful indicator of the overall development of the child, and the cognitive ability is related to the success of the school, and therefore the academic development. This rationale supports pre-school speech and language screening as a part of the basic language routine care for children. Public health impact will be reduced through timely diagnosis, prompt detection, prevention and removal of all factors leading to permanent speech disorders.

Impact of visual means on the development of coherent speech of senior preschoolers

The ar cle deals with the issue of the development of senior preschoolers’ coherent speech through the use of visual means of teaching. It is determined that the effec ve method of development of senior preschoolers’ coherent speech is visual simula on. Due to this method, the children of this category form a logical, consecu ve expression of their own thoughts, children develop their vocabulary, syntac c and lexico-gramma cal language, sound-component analysis and synthesis, which contributes to competent speech expression. The course of the experimental methodology for the development of senior preschoolers’ coherent speech is highlighted by means of visibility. To iden fy the ini al level of the forma on of coherent speech of children, we selected four tasks for the survey, which, in our opinion, most fully reveal the depth of development of coherent speech preschoolers: drawing up proposals for individual «situa onal pictures» (ac on pictures); drawing up a sentence in three pictures related by meaning; transla on of the text (a familiar tale or a short story) drawing up a story from a picture or a series of plot pictures. As a result of the study, it was proved that visual teaching means (situa onal plot pictures, ac on pictures, graphic picture diagrams, mnemonics) using the visual simula on method (scale modeling) contribute to the crea ve development and improvement of the various language abili es of children, par cularly the children of the senior preschool age. The proposed experimental methods proved to be effec ve in the developing coherent speech for preschoolers, because children acquired the ability to consistently, meaningfully and logically express their posi on, developed communica on skills due to the expansion of vocabulary, syntac c and lexico-gramma cal structure of speech. Prospects for further research are seen in the search and selec on of various methods for the development of coherent speech, for senior preschool children, but also for children of other ages, not only by means of visualiza on, but also through speech-game ac vity, toys, logorhythmics, works of art (stories, tales) and suchlike.

Private Speech and Mutual Engagement in Preschoolers' Playtime Interaction : Talk and Embodiment

Private Speech and Mutual Engagement in Preschoolers' Playtime Interaction : Talk and Embodiment

Factors Contributing to Preschoolers' Communicative Participation Outcomes: Findings From a Population-Based Longitudinal Cohort Study in Ontario, Canada.

The aim of this study was to identify predictors of communicative participation outcomes for a large cohort of preschoolers with speech and language impairments. A secondary analysis of longitudinal program evaluation data from Ontario, Canada's Preschool Speech and Language Program was done. Data available for 46,872 children 18-67 months of age (M = 41.76 months, SD = 11.92; 68% boys, 32% girls) were previously used to predict children's communicative participation skill development in 5 levels of function. Demographic and intervention-based variables were added to the models to identify new predictors of growth. Three demographic and 3 intervention-based variables were statistically significant predictors of children's communicative participation outcomes. Clinically significant predictors included participation in an early learning environment, receipt of speech-language interventions, and the amount of time spent in intervention. These variables impacted predicted outcomes differently, depending on a child's level of communicative function. This population-based study of preschoolers with speech and language impairments identified predictors of growth in communicative participation skills-an outcome important and meaningful to families but not often explored. A broad picture emerged of factors that may influence the development of communicative participation skills and may be used to predict outcomes for preschoolers. Given the large sample size, these robust findings may be used to predict outcomes outside the Preschool Speech and Language Program as well. https://doi.org/10.23641/asha.6024422.

Irish School Entry Screening referral trends and cohort comparison with preschool specialist referrals

Objective: To analyse referral cohorts from School Entry Screening, Hearing (SHS) and Vision Screening (SVS) before and after documented changes. To compare referrals to pre-school specialists with subsequent group SHS outcomes. Design: Randomized cohort, audit analysis of Community Nursing Developmental and SES records (CHRs), plus Audiology file review for SHS referrals. Study sample: Six hundred and sixty-eight mainstream pupils’ CHRs were analysed in four birth cohorts, post-SES, using coded anonymized records. Results: Significant referral rate differences existed between SHS and SVS. SHS, not SVS, referrals were impacted by nursing staff changes but not by SHS protocol changes. Preschool Audiology referrals outnumbered SHS referrals. All PCHI children with amplification were detected prior to SHS. SHS program yielded conductive hearing loss only. Similar SHS referral rates occurred for pre-school Speech Language Therapy referrals compared to children not referred; just 16% of pre-school Speech Language Therapy primary referrals were referred on to Audiology. Conclusions: SHS referral percentage fell slightly; SVS referral percentage remained unchanged. Low referral rates and low SHS hearing loss yield has modest impact upon Audiology services, but audiometrically screened referrals deserve higher priority. UNHS children born after 2011 create bigger Audiology service impact. International comparisons and European SHS research collaboration are encouraged.

Cognitive Development of Pre-School Children With Language and Speech Disorders

The modern educational situation in Russia shows that the number of children with developmental problems, including speech disorders in primary school is increasing. Therefore, primary education is beginning to focus on the problem of training and adaptation of the senior preschool children with speech disorders. The knowledge of cognitive development of preschool children with speech disorders will provide a theoretical basis for the creation of more effective corrective speech therapy programs taking into account the complex interactions of the higher mental functions of the child in the ontogeny which can contribute in overcoming the difficulties of preschool speech and the formation of a fully-fledged readiness for school. Language is an expression of human communication through which we can share ideas, information, emotions, and beliefs. Usually developing children learn the basics of language and speech in the toddler-preschool era. Language and speech skills serve a pivotal role in learning and social relationships. Delays in the early development of language and speech skills, which are prevalent in the population, may affect several fields of activity. The purpose of the study is to identify the characteristics of cognitive development of senior preschool children with phonetic-phonemic and general underdevelopment of speech. The factor analysis has shown that senior preschool children with speech disorders are characterized by cognitive development and intellectual readiness for school that comprise two factors: the understanding of the quantitative and qualitative relationships as an important component of intellectual readiness for school and general awareness of vocabulary.

Sensitivity of expressive linguistic domains to surgery age and audibility of speech in preschoolers with cochlear implants

Objectives: To determine whether relative delays among domains exist in the conversational use of vocabulary, syntax, and morphology by children with cochlear implants (CIs) and whether these were differentially affected by age of implantation (AOI) and the audibility of speech.Methods: Participants in this short-term longitudinal study were 126 children with AOI of 6–38 months and a matched group of 30 children without hearing loss. Language samples of the same children at ages 3.5 and 4.5 were analyzed for the breadth of vocabulary and bound morphemes used, and sentence length.Results: At both test ages, expressive language domains were delayed equally. Higher performance across domains was independently associated with younger AOI and better pre-implant-aided thresholds. No domain was affected differently by very early implantation, but bound morpheme breadth was associated with better CI-aided thresholds. Between 63 and 78% of children with AOI of 6–11 months scored close to hearing age-mates by 4.5, a level achieved by fewer than 25% of those with AOI of 19–24 months or later ages.Discussion: Previous studies indicated greater language delays in the areas of morphology and syntax than those of vocabulary, with the earliest ages of implantation conferring the greatest benefit to those domains. The current design addressed inconsistency across studies in modes of communication used, presence/absence of other disabilities, and differences in language domains chosen as outcome measures.Conclusions: Linguistic domains benefitted equally from early implantation, regardless of the duration of auditory stimulation. Better pre-CI-aided hearing often compensated for later AOI. Bound morpheme use was greater with better CI-aided thresholds.

Developmental Screening in Pediatric Sickle Cell Disease: Disease-Related Risk and Screening Outcomes in 4 Year Olds.

Studies of early child development in sickle cell disease (SCD) have found modest associations between disease-related risks and developmental status in infants and toddlers, but such associations are evident by early elementary school. We screened 4-year-old children with SCD using 2 screening strategies to assess if biomedical risk factors for neurologic disease are related to developmental screening outcomes at this intermediate age. Seventy-seven 4-year-old children with SCD (M = 4.5 yrs, SD = 0.3 yrs) completed developmental screenings at routine hematology visits using child testing (Fluharty Preschool Speech and Language Screenings Test, 2nd edition) and parent-report (Ages and Stages Questionnaire, 2nd edition) procedures. Genotype and other biomedical variables were coded from medical records. Children with higher-risk SCD genotypes (n = 52) showed lower performance than children with lower-risk genotypes (n = 25) on a measure related to neurologic disease risk in older children (syntactic processing); genotype risk was also related to rates of positive screenings on parent-reported developmental milestones (52% positive screenings in high-risk genotypes vs 12% in low-risk genotypes). Screening outcomes were also related to transcranial Doppler ultrasound findings assessing cerebral blood flow. Developmental screening at age 4 may be a useful target age for identifying preschoolers with sickle cell-related neurodevelopmental concerns. Parent report of developmental milestones and behavioral testing each may have a role in screening for children in need of follow-up services to address potential neurodevelopmental effects from SCD.

FACILITATING ENGAGEMENT WITH SPEECH AND LANGUAGE SERVICES IN CHILDREN OF ADOLESCENT MOTHERS

BACKGROUND: The relationship between early language delay and lower socioeconomic status is well established. This trend is particularly troubling when considering the outcomes of children born to adolescent mothers, whose incomes tend to fall well below the poverty line and whose difficult social circumstances may undermine the provision of an enriching home literacy environment for their children. Among the children of adolescent mothers involved in a Teen-Tot clinic, almost half of the children were identified with an expressive speech and language delay by the age of 18 months. Despite the successes of early intervention, it is believed that less than 25% of adolescent mothers involved with the Teen-Tot clinic whose children were identified with a speech delay followed-up with the recommended hearing assessment and referral to preschool speech and language services. OBJECTIVES: The purpose of this study was to better understand factors that would facilitate engagement with speech and language services for children of adolescent mothers, and to explore alternative delivery models for this service. DESIGN/METHODS: Adolescent mothers receiving care at a Teen-Tot clinic were invited to: 1) complete a survey that asked about their home literacy environment, their perception of their child’s speech and language development, and perceived barriers to accessing community-based speech and language services; and 2) participate in a single speech and language education session followed by a focus group to elicit their feedback about alternative delivery models for speech and language services. Survey data were analyzed using descriptive statistics, and the focus group discussions were analysed using a descriptive qualitative approach. RESULTS: Survey data revealed significant barriers to engagement with community-based speech and language services. When asked about preferred delivery models for speech and language services, focus groups participants indicated that they were most interested in attending group speech and language sessions offered within the Teen-Tot clinic by a speech and language professional. CONCLUSION: There is a high prevalence of early speech and language delay among the children of adolescent mothers. Many of these mothers face difficulties engaging with traditional speech and language services due to systemic barriers and personal circumstances. Our study revealed that group speech and language sessions offered within the setting of a Teen-Tot clinic may be an effective strategy for engaging young mothers in addressing their children’s early speech and language delay and ultimately facilitating positive developmental and socio-economic outcomes.

A Brief Measure of Language Skills at 3 Years of Age and Special Education Use in Middle Childhood

To test whether a language screener administered during early childhood predicts special education referrals and placement in middle childhood. A series of logistic regressions was conducted in a longitudinal study of 731 children. Predictor variables included scores on the early language screener (Fluharty Preschool Speech and Language Screening Test-Second Edition [Fluharty-2]) at ages 3 and 4 years, a standardized measure of academic achievement at age 5 years, and parent report of special education services at ages 7.5, 8.5, and 9.5 years. Results showed that higher scores on the Fluharty-2 predicted a reduced likelihood of having an individualized education program (OR 0.48), being referred for special education (OR 0.55), and being held back a grade (OR 0.37). These findings did not vary by sex, race, or ethnicity, and remained significant after controlling for male sex, behavior problems, parental education, and family income. The Fluharty-2 remained predictive of special education outcomes even after controlling for children's academic skills at age 5 years. Results suggest that structured, brief assessments of language in early childhood are robust predictors of children's future engagement in special education services and low academic achievement. Primary care physicians may use a multipronged developmental surveillance and monitoring protocol designed to identify children who may need comprehensive evaluation and intervention. Early intervention may reduce the need for costly special education services in the future and reduce comorbid conditions.

Language emergence in early-implanted children

This study develops a model to differentiate early-implanted children with preschool language delays that persist into the elementary grades from children who achieve normal language as they gain auditory, linguistic, and academic experience. A nationwide sample of 60 children with congenital profound deafness, auditory-oral education, and early cochlear implantation (12–36 months) was assessed at average ages of 3.5, 4.5, and 10.5 years. Children were classified with: Normal Language Emergence (NLE: N = 19), Late Language Emergence (LLE: N = 22), or Persistent Language Delay (PLD: N = 19) based on standardized language test scores. Children with PLD did not differ from children with LLE on a number of variables that have previously been associated with post-implant outcome, including pre-implant hearing, age at first CI, gender, maternal education and nonverbal intelligence. Logistic regression analysis identified variables that predicted whether children with early language delay would catch up with hearing age-mates: (1) preschool speech and language level, (2) ear placement of first CI, (3) upgrades in speech processor technology, and (4) CI aided thresholds. A majority of the 60 children in this study reached age-appropriate levels of language, reading, and verbal reasoning and were placed in primary grades with hearing age-mates.

Promoting consistent use of the communication function classification system (CFCS)

Purpose: We developed a Knowledge Translation (KT) intervention to standardize the way speech-language pathologists working in Ontario Canada’s Preschool Speech and Language Program (PSLP) used the Communication Function Classification System (CFCS). This tool was being used as part of a provincial program evaluation and standardizing its use was critical for establishing reliability and validity within the provincial dataset. Method: Two theoretical foundations – Diffusion of Innovations and the Communication Persuasion Matrix – were used to develop and disseminate the intervention to standardize use of the CFCS among a cohort speech-language pathologists. A descriptive pre-test/post-test study was used to evaluate the intervention. Fifty-two participants completed an electronic pre-test survey, reviewed intervention materials online, and then immediately completed an electronic post-test survey. Results: The intervention improved clinicians’ understanding of how the CFCS should be used, their intentions to use the tool in the standardized way, and their abilities to make correct classifications using the tool. Conclusions: Findings from this work will be shared with representatives of the Ontario PSLP. The intervention may be disseminated to all speech-language pathologists working in the program. This study can be used as a model for developing and disseminating KT interventions for clinicians in paediatric rehabilitation.Implications for RehabilitationThe Communication Function Classification System (CFCS) is a new tool that allows speech-language pathologists to classify children’s skills into five meaningful levels of function.There is uncertainty and inconsistent practice in the field about the methods for using this tool.This study used combined two theoretical frameworks to develop an intervention to standardize use of the CFCS among a cohort of speech-language pathologists.The intervention effectively increased clinicians’ understanding of the methods for using the CFCS, ability to make correct classifications, and intention to use the tool in the standardized way in the future.

Impact of occupational, physical, and speech and language therapy in preschoolers with hyperactive/inattentive symptoms: A naturalistic 2-year follow-up study

ABSTRACTObjective: Impact of speech and language therapy (ST) and occupational/physical therapy (OT/PT) on language and motor skills was examined in hyperactive/inattentive children.Methods: Preschoolers were divided into those receiving and not receiving ST or OT/PT.Results: Children receiving ST showed no gains in language functioning relative to those not receiving ST. OT/PT yielded similar results for motor functions. Hours of a service did not predict improvement. However, children who received ST showed improvement in social skills.Discussion: The apparent lack of benefit suggests the need for further investigation into efficacy of these treatments in hyperactive/inattentive preschool children.

A Bioecological framework to evaluate communicative participation outcomes for preschoolers receiving speech-language therapy interventions in Ontario, Canada.

The Preschool Speech and Language Program (PSLP) in Ontario, Canada, is a publically funded intervention service for children from birth to 5 years with communication disorders. It has begun a population-level programme evaluation of children's communicative participation outcomes following therapy. Data are currently being collected for all children who access this service--over 50,000 children each year. To understand and evaluate how therapeutic interventions in speech-language therapy impact the everyday lives of children and families by applying a theoretical framework. This discussion paper critically examines how the Bioecological Model of Development can be applied to the study of communicative participation outcomes following speech and language therapy. This model will be used in future analyses of communicative participation outcomes data in Ontario's PSLP. The strengths and challenges of this approach are reviewed.

Speech sound disorder at 4 years: prevalence, comorbidities, and predictors in a community cohort of children.

The epidemiology of preschool speech sound disorder is poorly understood. Our aims were to determine: the prevalence of idiopathic speech sound disorder; the comorbidity of speech sound disorder with language and pre-literacy difficulties; and the factors contributing to speech outcome at 4years. One thousand four hundred and ninety-four participants from an Australian longitudinal cohort completed speech, language, and pre-literacy assessments at 4years. Prevalence of speech sound disorder (SSD) was defined by standard score performance of ≤79 on a speech assessment. Logistic regression examined predictors of SSD within four domains: child and family; parent-reported speech; cognitive-linguistic; and parent-reported motor skills. At 4years the prevalence of speech disorder in an Australian cohort was 3.4%. Comorbidity with SSD was 40.8% for language disorder and 20.8% for poor pre-literacy skills. Sex, maternal vocabulary, socio-economic status, and family history of speech and language difficulties predicted SSD, as did 2-year speech, language, and motor skills. Together these variables provided good discrimination of SSD (area under the curve=0.78). This is the first epidemiological study to demonstrate prevalence of SSD at 4years of age that was consistent with previous clinical studies. Early detection of SSD at 4years should focus on family variables and speech, language, and motor skills measured at 2years.

Preschool speech articulation and nonword repetition abilities may help predict eventual recovery or persistence of stuttering

PurposeIn preschool children, we investigated whether expressive and receptive language, phonological, articulatory, and/or verbal working memory proficiencies aid in predicting eventual recovery or persistence of stuttering. MethodsParticipants included 65 children, including 25 children who do not stutter (CWNS) and 40 who stutter (CWS) recruited at age 3;9–5;8. At initial testing, participants were administered the Test of Auditory Comprehension of Language, 3rd edition (TACL-3), Structured Photographic Expressive Language Test, 3rd edition (SPELT-3), Bankson–Bernthal Test of Phonology-Consonant Inventory subtest (BBTOP-CI), Nonword Repetition Test (NRT; Dollaghan & Campbell, 1998), and Test of Auditory Perceptual Skills-Revised (TAPS-R) auditory number memory and auditory word memory subtests. Stuttering behaviors of CWS were assessed in subsequent years, forming groups whose stuttering eventually persisted (CWS-Per; n=19) or recovered (CWS-Rec; n=21). Proficiency scores in morphosyntactic skills, consonant production, verbal working memory for known words, and phonological working memory and speech production for novel nonwords obtained at the initial testing were analyzed for each group. ResultsCWS-Per were less proficient than CWNS and CWS-Rec in measures of consonant production (BBTOP-CI) and repetition of novel phonological sequences (NRT). In contrast, receptive language, expressive language, and verbal working memory abilities did not distinguish CWS-Rec from CWS-Per. Binary logistic regression analysis indicated that preschool BBTOP-CI scores and overall NRT proficiency significantly predicted future recovery status. ConclusionResults suggest that phonological and speech articulation abilities in the preschool years should be considered with other predictive factors as part of a comprehensive risk assessment for the development of chronic stuttering.Educational objectives: At the end of this activity the reader will be able to: (1) describe the current status of nonlinguistic and linguistic predictors for recovery and persistence of stuttering; (2) summarize current evidence regarding the potential value of consonant cluster articulation and nonword repetition abilities in helping to predict stuttering outcome in preschool children; (3) discuss the current findings in relation to potential implications for theories of developmental stuttering; (4) discuss the current findings in relation to potential considerations for the evaluation and treatment of developmental stuttering.

Rethinking private speech in preschoolers: The effects of social presence.

Private speech utterances (PS) from 24 preschool children and 24 adults were obtained under (noninteracting) listener present and listener absent conditions using 2 tasks with an identical structure. Children produced significantly more PS in the listener present condition. Similar results were obtained with adults, albeit with a reduced incidence of private speech. The children's PS was further subdivided into 4 main categories: task irrelevant, task relevant general, task relevant focused, and incoherent mutterings. The last 2 of these categories accounted for 75% of PS in the absent condition, offering a more conservative coding of speech that could be regarded truly "private," i.e., only for "self." This subset of utterances, however, was still significantly more prevalent in the listener present condition. The results are interpreted as showing a social motive in talking out loud during problem solving and are considered in terms of a reappraisal of what is implied by the term "private speech."

Preschool speech intelligibility and vocabulary skills predict long-term speech and language outcomes following cochlear implantation in early childhood

Speech and language measures during grade school predict adolescent speech-language outcomes in children who receive cochlear implants (CIs), but no research has examined whether speech and language functioning at even younger ages is predictive of long-term outcomes in this population. The purpose of this study was to examine whether early preschool measures of speech and language performance predict speech-language functioning in long-term users of CIs. Early measures of speech intelligibility and receptive vocabulary (obtained during preschool ages of 3–6 years) in a sample of 35 prelingually deaf, early-implanted children predicted speech perception, language, and verbal working memory skills up to 18 years later. Age of onset of deafness and age at implantation added additional variance to preschool speech intelligibility in predicting some long-term outcome scores, but the relationship between preschool speech-language skills and later speech-language outcomes was not significantly attenuated by the addition of these hearing history variables. These findings suggest that speech and language development during the preschool years is predictive of long-term speech and language functioning in early-implanted, prelingually deaf children. As a result, measures of speech-language functioning at preschool ages can be used to identify and adjust interventions for very young CI users who may be at long-term risk for suboptimal speech and language outcomes.

The role of language and private speech in preschoolers’ self-regulation

The present study explored relations among language skills, private speech, and self-regulation in three- to five-year-old children. Language skills were assessed with a standardised measure of language ability and by teacher reports of adaptive use of language in the classroom. Private speech was measured by observing children during a challenging task and by asking teachers to report on children's typical use of private speech. Teachers also reported on children's self-regulation. Results indicated that language skills were positively related to self-regulation. However, private speech, particularly private speech that was relevant to the task, was negatively related to language skills and to self-regulation. The frequency of relevant private speech mediated the association between language ability and self-regulation. Children who had higher language skills used less private speech and, in turn, had better self-regulation. The adaptive use of language for self-regulation is discussed in light of these findings.

Preschool Speech Error Patterns Predict Articulation and Phonological Awareness Outcomes in Children With Histories of Speech Sound Disorders

To determine if speech error patterns in preschoolers with speech sound disorders (SSDs) predict articulation and phonological awareness (PA) outcomes almost 4 years later. Twenty-five children with histories of preschool SSDs (and normal receptive language) were tested at an average age of 4;6 (years;months) and were followed up at age 8;3. The frequency of occurrence of preschool distortion errors, typical substitution and syllable structure errors, and atypical substitution and syllable structure errors was used to predict later speech sound production, PA, and literacy outcomes. Group averages revealed below-average school-age articulation scores and low-average PA but age-appropriate reading and spelling. Preschool speech error patterns were related to school-age outcomes. Children for whom >10% of their speech sound errors were atypical had lower PA and literacy scores at school age than children who produced <10% atypical errors. Preschoolers who produced more distortion errors were likely to have lower school-age articulation scores than preschoolers who produced fewer distortion errors. Different preschool speech error patterns predict different school-age clinical outcomes. Many atypical speech sound errors in preschoolers may be indicative of weak phonological representations, leading to long-term PA weaknesses. Preschoolers' distortions may be resistant to change over time, leading to persisting speech sound production problems.