Speech Sound Disorders Research Articles

Facial Movements Extracted from Video for the Kinematic Classification of Speech

Speech Sound Disorders (SSDs) are prevalent communication problems in children that pose significant barriers to academic success and social participation. Accurate diagnosis is key to mitigating life-long impacts. We are developing a novel software solution—the Speech Movement and Acoustic Analysis Tracking (SMAAT) system to facilitate rapid and objective assessment of motor speech control issues underlying SSD. This study evaluates the feasibility of using automatically extracted three-dimensional (3D) facial measurements from single two-dimensional (2D) front-facing video cameras for classifying speech movements. Videos were recorded of 51 adults and 77 children between 3 and 4 years of age (all typically developed for age) saying 20 words from the mandibular and labial-facial levels of the Motor-Speech Hierarchy Probe Wordlist (MSH-PW). Measurements around the jaw and lips were automatically extracted from the 2D video frames using a state-of-the-art facial mesh detection and tracking algorithm, and each individual measurement was tested in a Leave-One-Out Cross-Validation (LOOCV) framework for its word classification performance. Statistics were evaluated at the α=0.05 significance level and several measurements were found to exhibit significant classification performance in both the adult and child cohorts. Importantly, measurements of depth indirectly inferred from the 2D video frames were among those found to be significant. The significant measurements were shown to match expectations of facial movements across the 20 words, demonstrating their potential applicability in supporting clinical evaluations of speech production.

Extending Complexity to Word-Final Position via Telepractice: Intervention Effects for English-Speaking Children With Speech Sound Disorder.

Phonologically complex targets (e.g., [pl-]) are understood to facilitate widespread gains following speech sound intervention, and yet, available research largely features word-initial clusters. The present study investigates intervention effects following treatment of complex clusters presented in word-final position. Importantly, this allows for an added layer of complexity via suffixes that mark tense and agreement. Eight English-speaking children with speech sound disorder (SSD; 3;3-6;9 [years;months]) participated in 18 one-on-one intervention sessions. Intervention was completed via telepractice, as were all pre- and post-intervention assessments. Intervention targets were word-final two-element consonant clusters that were unknown to the child prior to intervention. Targets were presented in verbs that were either monomorphemic (i.e., [-ks]; they mix) or bimorphemic (i.e., [-ks]; she pick/3s, marked for third-person singular). All participants demonstrated change across multiple phonological measures. More stringently, six of eight participants demonstrated generalization to untreated sounds and untreated words immediately following intervention, including four of four children with monomorphemic targets. Importantly, positive changes for children with both target types were observed following a relatively short course of intervention (18 sessions over 6 weeks), and mastery of the target cluster was not required for phonological growth to occur. Results align with available work featuring word-initial complex targets and indicate that word-final consonant clusters are feasible, effective targets for English-speaking children with SSD. Findings similarly affirm the use of telepractice to deliver research-based interventions. Speech-language pathologists may thus integrate these findings with their clinical judgment and client perspectives to implement such targets in clinical practice.

Linguistic, Metalinguistic and Psychiatric Characteristics of Children with Speech Sound Disorder

Abstract: Comparing the linguistic and metalinguistic profiles in common developmental speech and language disorders is important in advancing our understanding of their clinical symptoms, as well as potentially informing the conceptual basis of novel interventions. The purpose of the present review article is summarizing linguistic, metalinguistic and psychiatric characteristics of children with speech sound disorder (SSD). Clinically and theoretically, it is important that we can understand different error pattern uses among children with SSD only and children with co-occurring SSD and language impairment (LI). Identifying differences in error pattern use will help to discovering the underlying causes of the different types of patterns. In comparison with children with SSD, children with co-occurring SSD and LI use certain patterns more frequently that suggest more global linguistic deficits. The early identification of children who are at risk for development of co-occurring SSD and LI as well as later literacy problems needs to distinguish these patterns. Identification of speech error patterns and their underlying cognitive-linguistic processing deficits will contribute to diagnosis of children at risk of co-occurring SSD and LI and reading problems. Mounting studies have reported that children with SSD, with and without language impairment have differences in phonological processing, literacy skills, and speech production patterns. Children with both speech sound and language disorders are likely to have more severe literacy problems than those with isolated speech sound disorders. In addition, this paper focuses on the comorbidity between psychiatric disorders specially attention deficit/hyperactivity disorder (ADHD) symptoms and SSD.

Speech sound errors in adolescents with congenital hearing loss

Children with hearing impairment (HI) often have vowel and consonant errors. Speech-language pathologists need this information to correct articulation errors. Despite the prevalence of research on speech sound error patterns in hearing aid users, there is a lack of literature in the adolescent group. The present study aimed to investigate the common speech sound errors in HI adolescents from the Malayalam-speaking community who have severe to profound hearing loss and are digital hearing aid users. A total of 15 monolingual Malayalam-speaking children between the ages of 9 and 16 years were recruited who had been diagnosed with speech sound disorders secondary to congenital hearing impairment. The minimum language age for inclusion in the study was over three years. Articulatory error analysis was performed for all consonants and vowels of the Malayalam language, and frequently produced vowel and consonant errors were included in the SODA and PMV analyses. The consonants frequently produced speech sound errors and no vowel errors were found. The most commonly produced consonant errors were fricatives, trills, laterals, velars, and alveolars. Substitution and omission errors were the most common type of error. Place and manner errors were more common than other types of errors. The results of this study may help parents and rehabilitation professionals to understand the common errors that persist even after intensive intervention. It may also be a useful guide for AAC therapists and speech-language pathologists in setting appropriate speech production goals for adolescents with HI.

Toward Process-Oriented, Dimensional Approaches for Diagnosis and Treatment of Speech Sound Disorders in Children: Position Statement and Future Perspectives.

Children with speech sound disorders (SSD) form a heterogeneous group, with respect to severity, etiology, proximal causes, speech error characteristics, and response to treatment. Infants develop speech and language in interaction with neurological maturation and general perceptual, motoric, and cognitive skills in a social-emotional context. After a brief introduction into psycholinguistic models of speech production and levels of causation, in this review article, we present an in-depth overview of mechanisms and processes, and the dynamics thereof, which are crucial in typical speech development. These basic mechanisms and processes are: (a) neurophysiological motor refinement, that is, the maturational articulatory mechanisms that drive babbling and the more differentiated production of larger speech patterns; (b) sensorimotor integration, which forms the steering function from phonetics to phonology; and (c) motor hierarchy and articulatory phonology describing the gestural organization of syllables, which underlie fluent speech production. These dynamics have consequences for the diagnosis and further analysis of SSD in children. We argue that current diagnostic classification systems do not do justice to the multilevel, multifactorial, and interactive character of the underlying mechanisms and processes. This is illustrated by a recent Dutch study yielding distinct performance profiles among children with SSD, which allows for a dimensional interpretation of underlying processing deficits. Analyses of mainstream treatments with respect to the treatment goals and the speech mechanisms addressed show that treatment programs are quite transparent in their aims and approach and how they contribute to remediating specific deficits or mechanisms. Recent studies into clinical reasoning reveal that the clinical challenge for speech-language pathologists is how to select the most appropriate treatment at the most appropriate time for each individual child with SSD. We argue that a process-oriented approach has merits as compared to categorical diagnostics as a toolbox to aid in the interpretation of the speech profile in terms of underlying deficits and to connect these to a specific intervention approach and treatment target.

An Articulatory Analysis of American English Rhotics in Children With and Without a History of Residual Speech Sound Disorder.

This study investigated articulatory patterns for American English /ɹ/ in children with and without a history of residual speech sound disorder (RSSD). It was hypothesized that children without RSSD would favor bunched tongue shapes, similar to American adults reported in previous literature. Based on clinical cueing practices, it was hypothesized that children with RSSD might produce retroflex tongue shape patterns at a higher relative rate. Finally, it was hypothesized that, among children who use a mixture of bunched and retroflex shapes, phonetic context would impact tongue shape as reported in the adult literature. These hypotheses were tested using ultrasound data from a stimulability task eliciting /ɹ/ in syllabic, postvocalic, and onset contexts. Participants were two groups of children/adolescents aged 9-15 years: 36 with RSSD who completed a study of ultrasound biofeedback treatment and 33 with no history of RSSD. Tongue shapes were qualitatively coded as bunched or retroflex using a flowchart from previous research. Children with no history of RSSD were found to use bunched-only tongue shape patterns at a rate higher than adults, but those who used a mixture of shapes for /ɹ/ followed the expected phonetic contextual patterning. Children with RSSD were found to use retroflex-only patterns at a substantially higher rate than adults, and those using a mixture of shapes did not exhibit the expected patterning by phonetic context. These findings suggest that clients receiving ultrasound biofeedback treatment for /ɹ/ may be most responsive to clinician cueing of retroflex shapes, at least early on. However, retroflex-only cueing may be a limiting and insufficient strategy, particularly in light of our finding of a lack of typical variation across phonetic contexts in children with remediated /ɹ/. Future research should more specifically track cueing strategies to better understand the relationship between clinician cues, tongue shapes, and generalization across a range of contexts. https://doi.org/10.23641/asha.26801050.

Telehealth versus face-to-face delivery of speech language pathology services: A systematic review and meta-analysis.

There is an increasing demand for the provision of speech language pathology (SLP) services via telehealth. Therefore, we systematically reviewed randomized controlled trials comparing telehealth to face-to-face provision of SLP services. We searched Medline, Embase and Cochrane, clinical trial registries, and conducted a citation analysis to identify trials. We included randomized trials comparing similar care delivered live via telehealth (phone or video), to face-to-face. Primary outcomes included: % syllables stuttered (%SS) (for individuals who stutter); change in sound pressure levels monologue (for individuals with Parkinson's disease); and key function scores (for other areas). Where data were sufficient, mean differences were calculated. Nine randomized controlled trials were included; eight evaluated video and one evaluated phone telehealth. Risk of bias was generally low or unclear, excepting blinding. There were no significant differences at any time-point up to 18 months for %SS (mean difference, MD 0.1, 95% CI -0.4 to 0.6, p = 0.70). For people with Parkinson's disease, there was no difference between groups in change in sound pressure levels (monologue) (MD 0.6, 95% CI -1.2 to 2.5, p = 0.49). Four trials investigated interventions for speech sound disorder, voice disorder and post-stroke dysphagia and aphasia; they found no differences between telehealth service delivery and face-to-face delivery. Evidence suggests that the telehealth provision of SLP services may be a viable alternative to their provision face-to-face, particularly to people who stutter and people with Parkinson's disease. The key limitation is the small number of randomized controlled trials, as well as evidence on the quality of life, well-being and satisfaction and economic outcomes.

Velopharyngeal Timing and Speech Sound Disorders of Unknown Etiology

The purpose of the study was to investigate velopharyngeal timing in children with and without speech sound disorders (SSDs) of unknown etiology. Six preschool-aged children participated in the investigation. Three of the children had typically developing speech and language and three had SSDs of unknown etiology. Aerodynamic testing of the velopharyngeal mechanism was conducted during repetitions of the word “hamper” for six temporal variables. Two of the six temporal data points achieved statistical significance at the level of p < .05: duration of nasal airflow ( p = .024) and start of oral pressure to end of oral pressure ( p = .016). Per Cohen’s d, small effect sizes were noted for two variables, medium effect sizes were noted for one variable, and large effect sizes were noted for one variable.

Importance of copy number variants in childhood apraxia of speech and other speech sound disorders.

Childhood apraxia of speech (CAS) is a severe and rare form of speech sound disorder (SSD). CAS is typically sporadic, but may segregate in families with broader speech and language deficits. We hypothesize that genetic changes may be involved in the etiology of CAS. We conduct whole-genome sequencing in 27 families with CAS, 101 individuals in all. We identify 17 genomic regions including 19 unique copy number variants (CNVs). Three variants are shared across families, but the rest are unique; three events are de novo. In four families, siblings with milder phenotypes co-inherited the same CNVs, demonstrating variable expressivity. We independently validate eight CNVs using microarray technology and find many of these CNVs are present in children with milder forms of SSD. Bioinformatic investigation reveal four CNVs with substantial functional consequences (cytobands 2q24.3, 6p12.3-6p12.2, 11q23.2-11q23.3, and 16p11.2). These discoveries show that CNVs are a heterogeneous, but prevalent, cause of CAS.

Exploring vowel errors produced in nonword repetition in children with speech and language disorders.

Accurate nonword repetition (NWR) is contingent on many underlying skills, including encoding, memory and motor planning and programming. Though vowel errors are frequently associated with childhood apraxia of speech (CAS), several recent studies have found that children with developmental language disorder (DLD) produce high rates of vowel errors in NWR tasks. This retrospective analysis explored whether the overall frequency and types of vowel errors produced in NWR distinguish children with DLD, children with CAS, children with speech sound disorder (SSD) and children with typical development (TD). We present data for 24 children (six per DLD, CAS, SSD and TD groups), ranging in age from 50-92 months. Children with DLD, CAS and SSD showed similar articulation scores and children with DLD and children with CAS showed similar expressive language scores. Total vowel errors, total monophthong errors, monophthong substitutions, diphthongization errors, total diphthong errors, diphthong substitutions and diphthong reduction errors were calculated by syllable length and group. Repeated measures analyses of variance were used to examine group differences. Children with DLD and children with CAS produced a higher frequency of total vowel errors compared to children with TD. Children with DLD produced more total monophthong errors than children with TD. Children with DLD and children with CAS produced more total diphthong errors than children with TD. For children with DLD, these were characterised by diphthong substitutions. For children with CAS, these were characterised by diphthong substitutions and diphthong reduction errors. For all measures, error rates in children with SSD did not significantly differ from any of the other three groups. Preliminary evidence indicates that children with DLD and children with CAS both show high rates of vowel errors in NWR tasks and weaknesses in encoding and memory. For children with CAS, additional motor planning difficulties are associated with an increased likelihood to reduce diphthongs. Children with SSD show more mild processing difficulties than children with DLD and children with CAS, though they do not perform as well as TD peers. Future work should replicate and further specify the processing weaknesses that affect vowel accuracy in NWR tasks in a larger sample. What is already known on the subject Nonword repetition (NWR) tasks are often included in diagnostic batteries to identify children with developmental language disorder (DLD). Poor performance on these tasks have historically been attributed to phonological working memory deficits in children with DLD. However, repeating nonwords relies on a number of underlying processing skills and many of these skills are affected to varying degrees in children with speech and language disorders. An in-depth analysis of vowel errors has the potential to reveal the shared as well as specific underlying processing weaknesses in children with DLD, children with childhood apraxia of speech (CAS) and children with speech sound disorder (SSD). What this paper adds to existing knowledge We found that children with DLD and children with CAS show low vowel competence compared to children with typical development. A nuanced examination of vowel error types further revealed that children with DLD and children with CAS show weaknesses in encoding and memory. Motor planning and programming weaknesses were unique to CAS. Children with SSD show more mild processing deficits and their performance did not significantly differ from any of the other three groups. What are the clinical implications of this work? Examining the types of vowel errors produced by children with DLD, children with CAS and children with SSD in NWR allows us to further specify the underlying processing weaknesses that differentiate these three groups. This research informs theoretical accounts of language processing in children with different types of speech and language disorders and has the potential to improve the diagnostic utility of NWR tasks.

Gender and age biases in the assessment of speech accuracy: A study of speech-language clinicians' ratings of /s/ accuracy.

Typically developing children assigned male at birth (AMAB) and children assigned female at birth (AFAB) produce the fricative /s/ differently: AFAB children produce /s/ with a higher spectral peak frequency. This study examined whether implicit knowledge of these differences affects speech-language pathologists'/speech and language therapists' (SLPs'/SLTs') ratings of /s/ accuracy, by comparing ratings made in conditions where SLPs/SLTs were blind to children's sex assigned at birth (SAB) to conditions in which they were told this information. SLPs (n = 95) varying in clinical experience rated the accuracy of word-initial /s/ productions (n = 87) of eight children with speech sound disorder in one of four conditions: one in which no information about the children was revealed, one in which children's SAB was revealed, one in which children's age was revealed, and one in which both were revealed. Despite there being no statistically significant differences between AFAB and AMAB children's /s/ production in researcher-determined accuracy or in one acoustic characteristic, spectral centroid, SLPs in all four conditions judged the /s/ productions of AFAB children as more accurate than AMAB children. Listeners were significantly less likely to judge the productions of AMAB children to be inaccurate in the conditions in which age or age and SAB were revealed. These effects were consistent across SLPs with greatly varying levels of clinical experience. Knowing or imputing children's age and SAB can affect ratings of /s/ accuracy. Clinicians should be mindful of these potential effects. Future research should understand how expectations about sociolinguistic variation in speech affect appraisals of their speech and language. What is already known on the subject Adult men and women produce /s/ differently. A consensus is that these differences reflect sociolinguistic gender marking, rather than being the passive consequence of vocal-tract differences. Recent studies have shown that children assigned female at birth (AFAB) and those assigned male at birth (AMAB) produce /s/ differently in ways that mirror the differences between adult men and women, and which presumably reflect gender marking. What this paper adds to existing knowledge We asked whether US-based speech-language pathologists' (SLPs) ratings of the accuracy of /s/ differ depending on whether they are rating an AFAB or an AMAB child, and whether these differences are greater in conditions in which people are told the sex assigned at birth of the child being rated. We found that SLPs were more likely to judge AFAB children's /s/ productions to be more accurate than AMAB children's, even though the productions from the AMAB and AFAB children that were used as stimuli were matched for accuracy as determined by trained researchers. What are the clinical implications of this work? SLPs/speech-language therapists should be sensitive to the influence of social variables when assessing /s/. SLPs/speech-language therapists might rate children's productions differently depending on whether they believe they are rating an AFAB or an AMAB child.

Characteristics of Nasal Coarticulation by Nasality Visualization System in Children with Speech Sound Disorders

Objectives: In this study, we analyzed the nasal coarticulation characteristics of children with and without speech sound disorders by comparing nasalance scores according to speech contexts. Methods: The subjects of this study were 30 children, 15 children with speech sound disorder (SSD) and 15 typically developing (TD) children, aged 4 to 6 years old. Subjects were asked to speak stimuli in different speech contexts-low vs. high vowels, nasal consonant+vowel (NV) vs. vowel+nasal consonant (VN) syllables, words vs. nonwords - and nasalance scores were measured using the Nasality Visualization System (NVS) on their speech samples. Results: First, both groups showed significantly higher naslance scores for high vowels compared to low vowels, with a significant between-group difference in high vowel. Second, both groups showed significantly higher nasalance scores for VN syllables than for NV syllables, with no between-group difference. Third, both groups showed significantly lower nasalance scores in nonwords compared to words. While there was no group difference in the words, the nasalance scores of the SSD group was lower in the nonwords, which was significantly different from that of the TD groups. Conclusion: These results suggest that the SSD group exhibits somewhat different nasal characteristics than the TD group, and furthermore, that SSD children articulate phoneme sequences more segmentally in unlearned nonword contexts.

Attention Deficit Hyperactivity Disorder among Children with Speech Difficulties

Abstract: Speech sound disorders and attention deficit / hyperactivity disorder are developmental disorders that can significantly impact academic success. The comorbidity of these disorders may substantially add to the difficulties experienced by the child and require a combined treatment approach. Objectives: (1) to assess sociodemographic characteristics of children’s with speech difficulties (2) to assess attention deficit hyperactivity disorder and speech difficulties (3) to identify the relationship between attention deficit hyperactivity disorder and speech difficulties. Methodology: A descriptive cross-sectional study design was carried out in Baghdad Teaching Hospital. A non- probability (purposive) study sample of (300) child, who attended Hearing and Speech Center for the period from 12/April/2023 to 25/January/2024. The Questionnaire which is composed of: Socio-demographic characteristics, scales of behavioral problem, attention deficit hyperactivity disorder. Results: The study results reveal that the children experiencing severe attention deficit hyperactivity disorder and that significant relationship have been reported among speech sound disorder with attention deficit hyperactivity disorder at p-values= 0.046, also indicates that there was significant relationship among childhood apraxia and attention deficit hyperactivity disorder at p-values= 0.007. Conclusion: The children experience severe of attention deficit hyperactivity disorder, the significant relationship has been reported among speech sound disorder with attention deficit hyperactivity disorder, also indicates that there was significant relationship among childhood apraxia and attention deficit hyperactivity disorder.Recommendations: An intervention program to be planned accordingly and areas of deficit will be targeted in therapy. Liaison with parents and school teachers is indicated in order to achieve the child’s maximum potential.

Assessment of Behavioral Problems among Children with Speech Difficulties

Abstract: Behavioral problems can present differently for many children with speech difficulties, some common ones outbursts or tantrums, unwillingness to follow directions, being angry or irritable, purposefully annoying others and physical aggression toward others, such as hitting, kicking, or scratching, some children may show one of these behaviors, while other children may have many. Objectives: to assess sociodemographic characteristics, behavioral problems and speech difficulties among children with speech difficulties. Methodology: A descriptive cross-sectional study design was carried out in Baghdad Teaching Hospital. A non- probability (purposive) study sample of (300) child, who attended Hearing and Speech Center. The data were analyzed using descriptive and inferential statistical procedure for data analysis. Results: The study results reveal that (41.7%) of children with age group 6-less than 8 years (73%) of them were males and remaining (27%) were females, second born among (41%) of them while (28.7%) of them were not registered and (36.7%) of children having stuttering; speech sound disorders were prevalent among (39.7%); childhood apraxia of speech prevalent among (19.7%). Conclusion: The children experience mild behavioral problems regarding somatic complaints, thought problems, and rule-breaking behaviors, and experience moderate behavioral problems regarding anxious/depressed problems, withdrawal, social problems, and aggressive behavior, while experiencing severe behavioral problems regarding attention and hyperactivity. Recommendations: the child with speech difficulties to be seen by a speech language pathologist (SLP) to assess the child to obtain a clear idea of the child’s strengths and weaknesses in speech and language.

Artificial Intelligence-Assisted Speech Therapy for /ɹ/: A Single-Case Experimental Study.

This feasibility trial describes changes in rhotic production in residual speech sound disorder following ten 40-min sessions including artificial intelligence (AI)-assisted motor-based intervention with ChainingAI, a version of Speech Motor Chaining that predicts clinician perceptual judgment using the PERCEPT-R Classifier (Perceptual Error Rating for the Clinical Evaluation of Phonetic Targets). The primary purpose is to evaluate /ɹ/ productions directly after practice with ChainingAI versus directly before ChainingAI and to evaluate how the overall AI-assisted treatment package may lead to perceptual improvement in /ɹ/ productions compared to a no-treatment baseline phase. Five participants ages 10;7-19;3 (years;months) who were stimulable for /ɹ/ participated in a multiple (no-treatment)-baseline ABA single-case experiment. Prepractice activities were led by a human clinician, and drill-based motor learning practice was automated by ChainingAI. Study outcomes were derived from masked expert listener perceptual ratings of /ɹ/ from treated and untreated utterances recorded during baseline, treatment, and posttreatment sessions. Listeners perceived significantly more rhoticity in practiced utterances after 30 min of ChainingAI, without a clinician, than directly before ChainingAI. Three of five participants showed significant generalization of /ɹ/ to untreated words during the treatment phase compared to the no-treatment baseline. All five participants demonstrated statistically significant generalization of /ɹ/ to untreated words from pretreatment to posttreatment. PERCEPT-clinician rater agreement (i.e., F1 score) was largely within the range of human-human agreement for four of five participants. Survey data indicated that parents and participants felt hybrid computerized-clinician service delivery could facilitate at-home practice. This study provides evidence of participant improvement for /ɹ/ in untreated words in response to an AI-assisted treatment package. The continued development of AI-assisted treatments may someday mitigate barriers precluding access to sufficiently intense speech therapy for individuals with speech sound disorders. https://doi.org/10.23641/asha.26662807.

Accuracy of Speech Sound Analysis: Comparison of an Automatic Artificial Intelligence Algorithm With Clinician Assessment.

Automatic speech analysis (ASA) and automatic speech recognition systems are increasingly being used in the treatment of speech sound disorders (SSDs). When utilized as a home practice tool or in the absence of the clinician, the ASA system has the potential to facilitate treatment gains. However, the feedback accuracy of such systems varies, a factor that may impact these gains. The current research analyzes the feedback accuracy of a novel ASA algorithm (Amplio Learning Technologies), in comparison to clinician judgments. A total of 3,584 consonant stimuli, produced by 395 American English-speaking children and adolescents with SSDs (age range: 4-18 years), were analyzed with respect to automatic classification of the ASA algorithm, clinician-ASA agreement, and interclinician agreement. Further analysis of results as related to phoneme acquisition categories (early-, middle-, and late-acquired phonemes) was conducted. Agreement between clinicians and ASA classification for sounds produced accurately was above 80% for all phonemes, with some variation based on phoneme acquisition category (early, middle, late). This variation was also noted for ASA classification into "acceptable," "unacceptable," and "unknown" (which means no determination of phoneme accuracy) categories, as well as interclinician agreement. Clinician-ASA agreement was reduced for misarticulated sounds. The initial findings of Amplio's novel algorithm are promising for its potential use within the context of home practice, as it demonstrates high feedback accuracy for correctly produced sounds. Furthermore, complexity of sound influences consistency of perception, both by clinicians and by automated platforms, indicating variable performance of the ASA algorithm across phonemes. Taken together, the ASA algorithm may be effective in facilitating speech sound practice for children with SSDs, even in the absence of the clinician.

Considerations for identifying subtypes of speech sound disorder.

Speech sound disorders (SSDs) in children are heterogeneous. Differentiating children with SSDs into distinct subtypes is important so that each child receives a treatment approach well suited to the particular difficulties they are experiencing. To study the distinct underlying processes that differentiate phonological processing, phonological planning or motor planning deficits. The literature on the nature of SSDs is reviewed to reveal diagnostic signs at the level of distal causes, proximal factors and surface characteristics. Subtypes of SSDs may be identified by linking the surface characteristics of the children's speech to underlying explanatory proximal factors. The proximal factors may be revealed by measures of speech perception skills, phonological memory and speech-motor control. The evidence suggests that consistent phonological disorder (CPD) can be identified by predictable patterns of speech error associated with speech perception errors. Inconsistent phonological disorder (IPD) is associated with a deficit in the selection and sequencing of phonemes, that is, revealed as within-word inconsistency and poor phonological memory. The motor planning deficit that is specific to childhood apraxia of speech (CAS) is revealed by transcoding errors on the syllable repetition task and an inability to produce [pətəkə] accurately and rapidly. Children with SSDs form a heterogeneous population. Surface characteristics overlap considerably among those with severe disorders, but certain signs are unique to particular subtypes. Careful attention to underlying causal factors will support the accurate diagnosis and selection of personalized treatment options. What is already known on the subject SSD in children are heterogenous, with numerous subtypes of primary SSD proposed. Diagnosing the specific subtype of SSD is important in order to assign the most efficacious treatment approach for each child. Identifying the distinct subtype for each child is difficult because the surface characteristics of certain subtypes overlap among categories (e.g., CPD or IPD; CAS). What this paper adds to the existing knowledge The diagnostic challenge might be eased by systematic attention to explanatory factors in relation to the surface characteristics, using specific tests for this purpose. Word identification tasks tap speech perception skills; repetition of short versus long strings of nonsense syllables permits observation of phonological memory and phonological planning skills; and standard maximum performance tests provide considerable information about speech motor control. What are the potential or actual clinical implications of this work? Children with SSDs should receive comprehensive assessments of their phonological processing, phonological planning and motor planning skills frequently, alongside examinations of their error patterns in connected speech. Such assessments will serve to identify the child's primary challenges currently and as they change over developmental time.

Automatic detection of speech sound disorder in children using automatic speech recognition and audio classification*

Automatic detection of speech sound disorder in children using automatic speech recognition and audio classification*

Clinical Decision-making and Management for Children with Speech-Sound Disorders in Türkiye

Clinical Decision-making and Management for Children with Speech-Sound Disorders in Türkiye

Shared characteristics of intervention techniques for oral vocabulary and speech comprehensibility in preschool children with co-occurring features of developmental language disorder and speech sound disorder: a systematic review with narrative synthesis

ObjectivesTo descriptively compare and contrast intervention techniques for preschool children with features of developmental language disorder (outcome: oral vocabulary) and speech sound disorder (outcome: speech comprehensibility) and analyse them in...