Speech Sound Development Research Articles

English Vowel Perception in Spanish-English Bilingual Preschoolers: Multiple-Talker Input Is Only Beneficial for Children With High Language Exposure Levels.

This study examines English vowel perception in Spanish-English bilingual preschoolers, comparing bilinguals' perception patterns to those of monolinguals and examining how child internal (age) and external variables (input quantity and input diversity) predict perceptual performance. Sixty children between 3;6 and 5;6 (years;months) of age participated in the study, 28 of whom were Spanish-English bilinguals and 32 English monolinguals. Perception was assessed through a forced-choice minimal-pair identification task in which children heard synthesized audio stimuli (i.e., "sheep" and "ship") that varied systematically along the /i-ɪ/ continuum and were asked to match them with one of two pictures. The data were analyzed with Bayesian mixed-effects logistic regression analyses, modeling responses as a function of continuum step, language background (monolingual or bilingual), age, English exposure (i.e., input quantity), and number of English input providers (i.e., input diversity). The results indicate that, despite displaying nonnative English stop voicing perception in a previous study, the same bilingual children showed English /i-ɪ/ perception patterns that did not differ from those of monolinguals. While age did not predict vowel perception, input quantity and diversity jointly interacted to moderate how well children perceived the /i-ɪ/ contrast. Specifically, diverse input promoted perceptual performance in children who received high levels of English exposure-and who presumably had more advanced English language skills, whereas it limited perceptual performance in children with more limited English exposure and skills. This study shows that bilingual children can show monolingual-like perception patterns for some sounds while displaying nontarget perception for others. This is the first study to demonstrate that language exposure mediates the role of input diversity on speech sound development, suggesting that varied input can be more or less beneficial for speech sound development based on the learner's language learning stage.

Speech sound development of young Dutch children with a developmental language disorder: A complex matter.

Approximately 50% of all young children with a developmental language disorder (DLD) also have problems with speech production. Research on speech sound development and clinical diagnostics of speech production difficulties focuses mostly on accuracy; it relates children's phonological realizations to adult models. Contrarily to these relational analyses, independent analyses indicate the sounds and structures children produce irrespective of accuracy. Such analyses are likely to provide more insight into a child's phonological strengths and limitations, and may thus provide better leads for treatment. Ram (1) To contribute to a more comprehensive overview of the speech sound development of young Dutch children with DLD by including independent and relational analyses, (2) to develop an independent measure to assess these children's speech production capacities; and (3) to examine the relation between independent and relational speech production measures for children with DLD. We describe the syllable structures and sounds of words elicited in two picture-naming tasks of 82 children with DLD and speech production difficulties between ages 2;7 and 6;8. The children were divided into four age groups to examine developmental patterns in a cross-sectional manner. Overviews of the children's productions on both independent and relational measures are provided. We conducted a Spearman correlation analysis to examine the relation between accuracy and independent measures. The overviews show these children are able to produce a greater variety of syllable structures and consonants irrespective of target positions than they can produce correctly in targets. This is especially true for children below the age of 4;5. The data indicate that children with DLD have difficulty with the production of clusters, fricatives, liquids and the velar nasal (/ŋ/). Based on existing literature and our results, we designed a Dutch version of an independent measure of word complexity, originally designed for English (word complexity measure-WCM) in which word productions receive points for specific word, syllable and sound characteristics, irrespective of accuracy. We found a strong positive correlation between accuracy scores and scores on this independent measure. The results indicate that the use of independent measures, including the proposed WCM, complement traditional relational measures by indicating which sounds and syllable structures a child can produce (irrespective of correctness). Therefore, the proposed measure can be used to monitor the speech sound development of children with DLD and to better identify treatment goals, in combination with existing relational measures. What is already known on the subject Speech production skills can be assessed in different ways: (1) using analyses indicating the structures and sounds a child produces irrespective of accuracy, that is, performance analyses; and (2) using analyses indicating how the productions of a child relate to the adult targets, that is, accuracy analyses. In scientific research as well as in clinical practice the focus is most often on accuracy analyses. As a consequence, we do not know if children who do not improve in accuracy scores, improve in other phonological aspects that are not captured in these analyses, but can be captured by performance analyses. What this study adds to the existing knowledge The overviews show these children are able to produce a greater variety of syllable structures and consonants irrespective of target positions than they can produce correctly in targets. Consequently, adding performance analyses to existing accuracy analyses provides a more complete picture of a child's speech sound development. What are the potential or actual clinical implications of this work? We propose a Dutch version of a WCM, originally designed for English, in which word productions receive points for word structures, syllable structures and sounds, irrespective of accuracy. This measure may be used by Dutch clinicians to monitor the speech sound development of children with DLD and to formulate better treatment goals, in addition to accuracy measures that are already used.

Speech Sounds Production, Narrative Skills, and Verbal Memory of Children with 22q11.2 Microdeletion.

22q11.2 deletion syndrome (22q11.2DS), the most frequent microdeletion syndrome in humans, is related to a high risk of developing neurodevelopmental disorders. About 95% of patients with 22q11.2DS have speech and language impairments. Global articulation, story generation, and verbal memory tests were applied to compare articulatory characteristics of speech sounds, spontaneous language abilities, and immediate verbal memory between four groups of Serbian-speaking children: patients with 22q11.2DS, children with clinical presentation of 22q11.2DS that do not have the microdeletion, children with non-syndromic congenital heart defects, and their peers with typical speech-sound development. The obtained results showed that children with this microdeletion have impaired articulation skills and expressive language abilities. However, we did not observe weaker receptive language skills and immediate verbal memory compared to healthy controls. Children with 22q11.2DS should be considered a risk category for the development of speech-sound pathology and expressive language abilities. Since speech intelligibility is an instrument of cognition and adequate peer socialization, and language impairment in school-aged children with 22q11DS might be an indicator of increased risk for later psychotic symptoms, patients with 22q11.2 microdeletion should be included in a program of early stimulation of speech-language development immediately after diagnosis is established.

Phonological processes in initial consonants of Putonghua in children in Jiangsu urban areas

Objective: To explore the phonological processes in initial consonants of Putonghua-speaking children in Jiangsu urban areas. Methods: A status survey was applied. From December 2014 to September 2015, a stratified random sampling method was used to select 958 children aged 1 to 6 years with Putonghua as their mother tongue in the urban area of Nanjing, Changzhou, Yangzhou and Xuzhou to examine their phonological performance. Speech samples were collected by the method of picture naming. The children were divided into 9 age groups (1.5-<2.0, 2.0-<2.5, 2.5-<3.0, 2.5-<3.0, 3.0-<3.5, 3.5-<4.0, 4.0-<4.5, 5.0-<6.0, 6.0-<7.0 years). Descriptive analysis method was used to analyze the phonological processes in initial consonants at different age groups. Results: Among the 958 children, there were 482 boys and 476 girls. The age of the children was (3.8±1.4) years. The number of children in the 9 age groups (1.5-<2.0, 2.0-<2.5, 2.5-<3.0, 2.5-<3.0, 3.0-<3.5, 3.5-<4.0, 4.0-<4.5, 5.0-<6.0, 6.0-<7.0 years) is 100, 110, 110, 114, 114, 114, 111, 119, and 66, separately. The process of substitution was found in the speech of 701 children (73.2%), syllable structure simplification was found in 194 children (20.3%), distortion was found in 41 children (4.3%), and assimilation was found in 17 children (1.8%). Among these 4 types of processes, the occurrence of substitution was highest in all the age groups, ranging from 30.3% (20/66) to 94.5% (104/110). The occurrence of syllable structure simplification ranged from 27.3% (30/110) to 91.0% (91/100) in the age groups of 1.5-<3.0 years and 0.9% (1/114) to 7.9% (9/114) in the age groups of 3.0-<7.0 years. The occurrence of distortion ranged from 7.3% (8/110) to 19.1% (21/110) in the age groups of 1.5-<3.0 years and 0 (0/114) to 2.7% (3/111) in the age groups of 3.0-<7.0 years. The occurrence of assimilation was very low in all age groups, ranging from 0 (0/114) to 3.0% (3/100) among all age groups. For substitution, the occurrence order of mainly individual processes from high to low was listed as follows: retroflexion 35.4% (339/958), deretroflexion 31.6% (303/958), lateralization 27.9% (267/958), stopping 17.8% (171/958), backing 14.2% (136/958), palatalization 10.9% (104/958), fronting 10.6% (102/958), and nasalization 5.8% (56/958). From the 4.0-<4.5 years of age group onwards, the phonological processes in initial consonants all met suppression criteria (the occurrence of processes was reduced to<10%) except retroflexion, deretroflexion, and lateralization. Conclusions: The processes of syllable structure simplification and distortion mainly appears in the early stage of speech sound development, while substitution is the major form of phonological pattern in initial consonants found in developmental speech errors. By 4 years of age, phonological processes in initial consonants almost disappear. The remaining processes that persisted for a longer period of time are retroflexion, deretroflexion, and lateralization.

Speech Sound Development in 18-Month-Old Children With Sex Chromosome Trisomies.

This study aimed to describe speech sound development in a group of 18-month-old children with sex chromosome trisomies (SCTs), compared with a group of typically developing (TD) peers. Concurrent and longitudinal relationships between speech sound abilities and lexical development were examined. A group of 76 children aged 18 months, 38 children prenatally diagnosed with SCTs (12 with XXY, 12 with XYY, and 14 with XXX) and 38 TD children, participated in the study. From video recordings of semistructured naturalistic parent-child play sessions, quantitative and qualitative measures of speech sound development were collected (e.g., the number of consonants, type and place of articulation, and syllable structures used), and group differences were observed. The relationships between the number of consonants produced and vocabulary size at 18 and 24 months were assessed. At 18 months, children with SCTs used a significantly lower number of consonants than TD children. Qualitatively, children with SCTs used significantly fewer articulatory complex consonants (fricative/affricates) and a more restricted inventory of syllable structures. The number of consonants used was significantly correlated with lexical development at 18 months. Moreover, in the SCTs group (but not in the TD group), the children with lower speech sound development at 18 months showed a significantly smaller vocabulary growth between 18 and 24 months than those with higher speech-sound development. Toddlers with SCTs showed a significantly delayed speech sound development pattern rather than an atypical one. Children with SCTs with low speech sound development also showed lower vocabulary growth between 18 and 24 months of age. These results can be clinically relevant for follow-up and treatment planning for children with SCTs.

Communication in fragile X syndrome: Patterns and implications for assessment and intervention.

Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability and is associated with a high rate of autism diagnosis. Language delays have been noted in the areas of overall communication and the specific areas of receptive, expressive, and pragmatic language, as well as in development of speech sounds and literacy. It has been widely noted that those individuals with a diagnosis of both FXS and autism tend to have more significant intellectual disability and language disorder. In this study, the research exploring the FXS language phenotype is presented, and the roles of cognition, autistic symptomatology, and gender are highlighted as possible. Implications for assessment and intervention approaches based on the strengths and weaknesses of the FXS language phenotype are provided.

A longitudinal investigation of letter-name knowledge in a semi-transparent orthography

ABSTRACT Children's ability to correctly name letters is a key predictor of later reading abilities and skills, but research on letter naming from Scandinavian orthographies is scarce. The aim of this study is to explore how child- and letter-related factors (i.e., gender, child name, phonemic awareness, letter position in the alphabet and frequency, and speech sound development) are associated with Norwegian children's letter-name knowledge over time. The sample comprises 185 Norwegian children with an average age of 51.59 months (SD = 2.12) who completed a letter-naming task on three separate occasions one year apart. Results from mixed-effects models show that children were more likely to name the first letter of their own name, however, this effect diminished over time. Further, letter frequency significantly predicted letter naming, and the letter frequency and letter position in alphabet effects were larger in older children. This study contributes important and relevant information for teachers and educators.

Consonant Production of an American-English Native Speaker from 3 to 6 Years Old: A Case Study on a Child named Brielle

ABSTRACTChildren’s phonological development is somewhat foreseeable, yet there are certain sounds that appear at different ages across children. However, there are some general guidelines which can be used to analyze the phonological development of a child. This study aims to examine the phonological development process of an American English native speaker named Brielle in producing consonants from the age of three to six using the speech sound development milestones provided by Sander (1972). The data are taken from youtube videos of Brielle when appearing on an American talkshow called “The Ellen Show”. A descriptive qualitative method is used in this study to elaborate the phonological development of Brielle. The result shows that Brielle completed her phonological development at the age of six. It can also be concluded from the study that some consonants appear earlier or later thatn the phonological development milestones set by Sander (1972). During the process of acquiring consonants, she replaced the consonant which she could not produce with another sound with similar features, such as replacing the liquid sound /l/ with the glide sound /j/.

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

ABSTRACT 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.

Moving Beyond Single Word Acquisition of Speech Sounds to Connected Speech Development With Dynamic Assessment.

The aim of this study was to document speech sound development across early childhood from a dynamic assessment (DA) perspective that captures a breadth of linguistic environments using the Glaspey Dynamic Assessment of Phonology (Glaspey, 2019), as well as to provide normative data for speech-language pathologists to compare speech skills when making clinical decisions and provide historical context. Targets of English were evaluated via DA for the (a) age of acquisition in single words; (b) continued development through connected speech; (c) early, mid, and late sequence; and (d) differences between single word and connected speech productions. Data were extracted from the reported results of the norming study for the Glaspey Dynamic Assessment of Phonology, which included a representative sample of 880 children ages 3 years to 10;11 (years;months). Comparisons were made with 49 items including multisyllabic words, clusters, and phonemes of English across word positions. Assessment with DA showed that acquisition in single words is nearly complete by age 6 years with a 90% mastery level, and the sequence suggests an Early-13, Mid-16, and Late-14 for items by word position. In connected speech, a wider range of progression is evident from the emergence of sound production at 50%, 75%, and 90% mastery levels with observed changes between ages 3 and 10 years. Given a DA approach across connected linguistic environments, children continue to progress in their development of speech sounds from early childhood well into their school-age years and for some sounds beyond the age of 10 years. DA challenges the language system to better reflect children's developmental progression.

Language Development in Sex Chromosome Trisomies: Developmental Profiles at 2 and 4 Years of Age, and Predictive Measures

ABSTRACT Purpose Describing language development in children with sex chromosome trisomies (SCT) and testing the predictive value of early language measures on later outcomes. Method Thirteen children with SCT were followed longitudinally. Their developmental profile was assessed, with particular attention to language, at 2 and 4 years. The predictive value of direct (spontaneous speech analysis) and indirect (communicative development inventory) language measures at 2 on performances at 4 was tested. Results Language performances at both ages were lower than non-verbal development. At 2, more than 50% of the group produced less than 50 words. At 4, impaired performances were observed in speech sound development and expressive morpho-syntax. Direct measures of Pre-syntactic development predicted later global language outcomes and Sentence Repetition. The number of consonants used at 2 was significantly related to Nonword Repetition at 4. Conclusions The study highlights the importance of early detection and careful follow-up for children with SCT.

A systematic review of early speech interventions for children with cleft palate.

Children with cleft palate with or without cleft lip (CP±L) are at high risk of problems with early speech sound production, and these difficulties can persist into later childhood. Early intervention could help to reduce the number of children whose problems become persistent. However, much research in the field to date has focused on older children. There is a need to determine if providing intervention during the phase of early typical speech development leads to better outcomes. To review the evidence for the effectiveness of interventions targeting speech, delivered in the first 3 years of life for children with CP±L, and discuss factors such as intervention type, facilitator, dosage, outcome measures and the age of the child. The systematic review was registered with PROSPERO (CRD42019121964). Eight bibliographic databases including CINAHL and MEDLINE were searched in August 2018. Studies were included if participants received speech and language interventions before 37 months and if they reported outcomes for speech. Two reviewers independently completed inclusion reviews, quality analysis and data extraction. The review included seven papers: one pilot randomized controlled trial, one controlled trial, four cohort studies and one case series report. Interventions largely took a naturalistic approach, namely focused stimulation and milieu teaching. The findings provide preliminary support for naturalistic interventions and suggest that these interventions can be delivered by parents with suitable training. Studies included in the review provided low-strength evidence with variation in both the type of intervention, the manner of delivery and in the risk of bias in the designs used. The papers included in this review suggest that early naturalistic interventions can have positive impacts on the speech development of children with CP±L. However, the reported methodological quality of the publications overall was weak, and the current evidence lacks clarity and specificity in terms of therapy technique, delivery and optimum age of delivery. Future research should use more robust methodological designs to determine whether early speech interventions are beneficial for children born with CP±L. What is already known on the subject Children with CP±L show difficulties with early speech development and often have restricted speech sound inventories. They may reach the canonical babbling stage later than children without CP±L and studies have shown that 20% of children with CP±L have speech which is considered unintelligible or barely intelligible at age 5. It has been proposed that early intervention can lessen the impact of CP±L on speech development. However, currently, the evidence for early interventions for children with CP±L is limited, with the majority of studies focusing on children aged 3 years and older. What this paper adds to existing knowledge This paper reviews the evidence for different types of early interventions for speech provided to children born with CP±L and whether these interventions are effective in supporting speech sound development. In this review, early intervention is defined as intervention provided to children in the first 3 years of life. This review describes intervention approaches and how they are delivered for this population. What are the potential or actual clinical implications of this work? In the UK, children born with CP±L and their families are supported by National Health Service (NHS) services over a 20-year period and speech and language therapy sessions may take place over many weeks and months. If providing early intervention in the first 3 years of life is effective, there is the potential for improved speech outcomes in early childhood and a reduced burden of care on children, families and services. This review considers the evidence for early speech intervention for children with CP±L in the first 3 years of life and identifies areas for future research.

Effects of mother’s imitation on speech sounds in infants with Down syndrome

BackgroundThe Down syndrome behavioral phenotype includes delays in making speech sounds, production of more non-speech sounds than speech sounds, and contrasting strengths in social development. Within a behavior analytic framework, we conceptualize characteristics of the Down syndrome behavioral phenotype as creating a context for impairments in speech sound development that suggest interventions caregivers can use to improve speech sounds. Aim and methodWe examined one intervention, the effects of mother’s contingent vocal imitation, on rate of speech and non-speech sound production in infants with Down syndrome using an ABAB design. ResultsMothers responded favorably to learning to imitate their infants’ vocalizations and their contingent vocal imitation was associated with increases in infant speech sounds. ConclusionsThe increases in infant speech sound suggest the promise of this approach and future research examining variations in contingent vocal imitation and additional outcomes.

Comparing the Informativeness of Single-Word Samples and Connected Speech Samples in Assessing Speech Sound Disorders.

Purpose Speech-language pathologists (SLPs) are faced with the challenge of quickly and accurately identifying children who present with speech sound disorders (SSD) compared to typically developing (TD) children. The goal of this study was to compare the clinical relevance of two speech sampling methods (single-word vs. connected speech samples) in how sensitive they are in detecting atypical speech sound development in children, and to know whether the information obtained from single-word samples is representative enough of children's overall speech sound performance. Method We compared the speech sound performance of 37 preschool children with SSD (M age = 4;11 years) and 37 age-sex-matched typically developing children (M age = 5;0 years) by eliciting their speech in two ways: (a) a picture-naming task to elicit single words, and (b) a story-retelling task to elicit connected speech. Four speech measures were compared across sample type (single words vs. connected speech) and across groups (SSD vs. TD): intelligibility, speech accuracy, phonemic inventory, and phonological patterns. Results Interaction effects were found between sample type and group on several speech sound performance measures. Single-word speech samples were found to differentiate the SSD group from the TD group, and were more sensitive than connected speech samples across various measures. The effect size of single-word samples was consistently higher than connected speech samples for three measures: intelligibility, speech accuracy, and phonemic inventory. The gap in sample type informativeness may be attributed to salience and avoidance effects, given that children tend to avoid producing unfamiliar phonemes in connected speech. The number of phonological patterns produced was the only measure that revealed no gap between two sampling types for both groups. Conclusions On measures of intelligibility, speech accuracy, and phonemic inventory, obtaining a single-word sample proved to be a more informative method of differentiating children with SSD from TD children than connected speech samples. This finding may guide SLPs in their choice of sampling type when they are under time pressure. We discuss how children's performance on the connected speech sample may be biased by salience and avoidance effects and/or task design, and may, therefore, not necessarily reveal a poorer performance than single-word samples, particularly in intelligibility, speech accuracy, and the number of phonological patterns, if these task limitations are circumvented. Our findings show that the performance gap, typically observed between the two sampling types, largely depends on which performance measures are evaluated with the speech sample. Our study is the first to address sampling type differences in SSD versus TD children and has significant clinical implications for SLPs looking for sampling types and measures that reliably identify SSD in preschool-aged children.

Bilingual phonological development across generations: Segmental accuracy and error patterns in second- and third-generation British Bengali children

IntroductionWhile developmental norms for speech sound development have been widely reported for monolingual children, and increasingly for bilingual children, little is known about speech sound development across different generations of children growing up in heritage language settings. The purpose of the present study was to gain a better understanding of inter-generational differences in the phonological development of British Bengali children. MethodsTypically-developing second-generation and third-generation Bengali heritage children living in Wales (n=19), aged between 4 and 5 years, participated in a picture-naming task in Sylheti and English. The single-word speech samples were transcribed phonetically and analyzed in terms of consonant and vowel accuracy measures, and error patterns. Subsequently, logistic mixed-effects regression models were fitted to identify the factors that predict accurate speech patterns in the children's productions. ResultsThe results revealed high levels of accuracy in consonant and vowel production by both sets of children, particularly in English. On Sylheti consonants, second-generation children significantly outperformed third-generation children, however only on language-specific sounds. In contrast, generation was not a significant predictor for accuracy on English consonants, but all children performed better on shared sounds than on English-specific categories, and on stops than affricates. The third-generation children exhibited a greater number of error types in Sylheti than the second-generation children, and more common replacement of Sylheti dental stops with alveolars. ConclusionThe results suggest that third-generation children have less developed pronunciation patterns in the heritage language, but not the majority language, than their age-matched second-generation peers, however only on language-specific sounds. These findings indicate that differentiating between the phonological norms of monolingual and bilingual children may not be clinically sufficiently sensitive, at least in the minority language, and that more fine-grained language use variables, such as the generation to which a bilingual child belongs, need to be considered.

Descriptive analysis of the development of the Arabic speech sounds among typically developing colloquial Egyptian Arabic-speaking children

BackgroundLiterature only mentioned a few kinds of research that did study the development of the speech sounds of the Colloquial Egyptian Arabic dialect. Moreover, these studies focused on describing the phonological processes that children undergo in early childhood rather than describing the exact time of acquisition of these sounds. Besides, no study involved a statistically enough sample size of children across the different age ranges. Thus, this study aimed to explore the development of the Arabic phonemes among 360 typically developing Egyptian children who speak the CEA dialect, between the ages of 1.6 years and ≤ 7.4 years.ResultsThe results of a 93-picture-naming test of children were analyzed. A phoneme is considered acquired when 90% of the children could properly utter the target phoneme in all word positions and mastered when 100% of children could correctly pronounce the target phoneme in all word positions. The results revealed that by the age of 1.6–2.0 years, the 6 long vowels of the CEA dialect, besides the /h/,/ʔ/, /b/, /w/, /j/, /m/, and /n/ were mastered. /t/ and /d/ sounds were mastered by the age of 2.6 years followed by /l/ sound by the age of 3.0 years. Then, /ħ/, /ʕ/ sounds were mastered followed by /k/, and /g/ at the age of 3.0 and 3.6 years, respectively. At the age of 5.0 years, /f/ sound was mastered, then /x / and /ʃ/ sounds were mastered by the age of 4.6 years, followed by /s/, /sˁ/, /tˁ/, /dˁ/. By the age of 5.6 and 6.0 years, /ɣ/, /r/, and /z/ were mastered. The /q/, /θ/, /ð/, and /ðˁ/ sounds were mastered by the age of 6.0–6.6 years. This study revealed that fricative sounds developed before the stop sounds and front stops before the back stops, and emphatic Arabic sounds were the last to develop at the school age (> 5 years).ConclusionsThis study presented a chart of the development of the Arabic phonemes of the CEA to be used as a guide to decide upon the correct trimming to start articulatory therapy for children with articulation and/or phonological disorders.

Maternal Cultural Orientation and Speech Sound Production in Spanish/English Dual Language Preschoolers

Empirical work has shown that maternal education is related to children’s language outcomes, especially in the societal language, among Spanish-English bilingual children growing up in the U.S. However, no study thus far has assessed the links between maternal cultural orientation and children’s speech sound production. This paper explores whether mothers’ orientation to American (acculturation) and Mexican culture (enculturation) and overall linear acculturation are related to children’s accuracy of production of consonants, of different sound classes, and of phonemes shared and unshared between languages in both English and Spanish at age 4;6 (4 years and 6 months). The results reveal a link between maternal acculturation and children’s segmental accuracy in English, but no relation was found between mothers’ enculturation and children’s speech sound production in Spanish. We interpreted the results in English as suggesting that more American-oriented mothers may have been using more English with their children, boosting their English production abilities and promoting English speech sound development. At the same time, we speculate that the results in Spanish were possibly due to the high and homogeneous levels of Mexican orientation among mothers, to language input differences attributable to distinct cultural practices, or to the status of Spanish as a minority language.

Assessment of Children With Hearing Loss and Co-Occurring Medical Disorders: Challenging Cases

Purpose Assessing children with hearing loss and co-occurring medical disorders can be challenging. The purpose of this clinical focus article is to highlight multidisciplinary decision making and evaluation considerations when assessing communication skills of children with hearing loss and co-occurring disorders: velopharyngeal insufficiency, childhood apraxia of speech, and autism spectrum disorder. Method Case examples are described to illustrate multidisciplinary decision-making processes for assessing the communication skills of children with hearing loss who have co-occurring velopharyngeal insufficiency, childhood apraxia of speech, or autism spectrum disorder. Conclusions Clinicians must have knowledge of speech sound development, language development, and social communication for differential diagnosis and treatment planning for children with hearing loss and co-occurring disorders. A team-based approach is recommended when assessing and treating children with hearing loss. Speech-language pathologists and audiologists should feel comfortable recommending other professionals to help with differential diagnosis and treatment considerations when appropriate. Continued assessment and monitoring by a multidisciplinary team for individuals with hearing loss is recommended across the life-span.

Spoken Vocabulary Outcomes of Toddlers With Developmental Delay After Parent-Implemented Augmented Language Intervention.

Purpose Early intervention using augmentative and alternative communication (AAC) supports both receptive and expressive language skills. However, many parents and clinicians still worry that augmented language intervention might delay or impair speech development. This study aimed to (a) characterize and analyze the speech sound development of toddlers with developmental delay who participated in a parent-implemented language intervention; (b) examine the accuracy of speech sounds among toddlers who participated in an augmented language intervention using speech-generating devices and toddlers who participated in a traditional, spoken language intervention; and (c) examine the relationship between baseline factors (i.e., receptive and expressive language skills, vocal imitation, and number of unintelligible utterances) and the number of spoken target vocabulary words after intervention. Method This study used extant data from two randomized control trials of parent-implemented language interventions using AAC or spoken language. Out of 109 children who completed the intervention, 45 children produced spoken target vocabulary words at the end of the intervention. We identified and phonetically transcribed spoken target vocabulary words for each child and then classified them based on Shriberg and Kwiatkowski's (1982) developmental sound classes. Results Children's speech sound accuracy was not significantly different across intervention groups. Overall, children who produced more words had more speech sound errors and higher baseline language scores. Intervention group and baseline receptive and expressive language skills significantly predicted the number of spoken target vocabulary words produced at the end of intervention. Conclusions Participation in AAC intervention resulted in significantly more spoken target vocabulary words and no statistically significant differences in speech sound errors when compared to children who received spoken language intervention without AAC. Results support using AAC interventions for very young children without the fear that it will delay speech or spoken language development. Supplemental Material https://doi.org/10.23641/asha.14265365.

Contralateral suppression of transient evoked otoacoustic emissions in children with phonological disorder.

BackgroundPerception of acoustic details in the speech signal is important for speech sound development. The medial olivocochlear pathway, a part of the auditory efferent system, plays a role in stimulus-related control of the cochlea. One clinical tool to evaluate the medial olivocochlear activity, which is thought to improve speech perception in noise, is the suppression of otoacoustic emissions.AimsThis study investigated the suppression of transient evoked otoacoustic emissions in children with phonological disorder in comparison with that in typically developing controls.Study DesignCase-control study.MethodsA total of 23 children with phonological disorder (aged 5–10 years) and 21 age- and sex-matched controls (P > 0.05) participated in the study. Participants had pure-tone thresholds ≤ 15 dB hearing loss and normal middle ear functions. Transient evoked otoacoustic emissions with and without contralateral acoustic stimulation were measured.ResultsAlthough the mean transient evoked otoacoustic emissions suppressions were lower in the group with phonological disorder than in the controls, these differences were not statistically significant (P > 0.05). No left/right ear asymmetry of transient evoked otoacoustic emissions suppression was detected in either of the groups (P > 0.05).ConclusionChildren with phonological disorder did not show alterations in medial olivocochlear functioning in the medial olivocochlear activity as measured by the contralateral suppression of transient evoked otoacoustic emissions.