Speech Sound Disorders Research Articles

Evaluating acoustic representations and normalization for rhoticity classification in children with speech sound disorders.

The effects of different acoustic representations and normalizations were compared for classifiers predicting perception of children's rhotic versus derhotic /ɹ/. Formant and Mel frequency cepstral coefficient (MFCC) representations for 350 speakers were z-standardized, either relative to values in the same utterance or age-and-sex data for typical /ɹ/. Statistical modeling indicated age-and-sex normalization significantly increased classifier performances. Clinically interpretable formants performed similarly to MFCCs and were endorsed for deep neural network engineering, achieving mean test-participant-specific F1-score = 0.81 after personalization and replication (σx = 0.10, med = 0.83, n = 48). Shapley additive explanations analysis indicated the third formant most influenced fully rhotic predictions.

The Opinions and Working Experiences of Doctors from Different Branches of Medicine Working in Turkey Concerning Speech and Language Pathologists

Objective: This study aimed to examine the thoughts, knowledge, collaborative processes, and experiences of doctors in different branches of medicine, as these comprise the occupational groups in which speech-language pathologists/therapists (SLPs) work in interdisciplinary and multidisciplinary capacities. 
 Material and Method: A Google survey was created focusing on the opinions about and working experiences of doctors in different branches of medicine working in Turkey with SLPs. The questionnaire consisted of 18 questions and four parts. 
 Results: The study was conducted with 116 doctors, 28.4% of whom were neurologists, 28.4% were otorhinolaryngologists, 21.6% were pediatricians, and 21.6% were other specialists. Only 25.9% (n=30) have worked with an SLP before. Speech sound disorders, fluent speech disorders, and developmental language disorders were the most frequently chosen SLP study areas among all the specialties in which doctors in all branches of medicine work. The lowest number of doctors chose swallowing disorders, followed by cognitive communication disorders and X-linked language disorders, as the field of work of SLPs. 
 Conclusion: It was found that the number of SLPs working in doctors' institutions, the level of cooperation between doctors and SLPs, and doctors' knowledge about the working areas of SLPs were low. It has been observed that physicians' awareness, especially in swallowing and cognitive communication disorders, is lacking. A strong partnership between physicians and SLPs is vital for appropriate service delivery to patients. For this reason, the number of SLPs working in institutions should be increased, as should the level of knowledge among doctors in different branches of medicine concerning SLPs’ services.

Feasibility of using ultrasound visual biofeedback to treat persistent speech sound disorders in children with cleft palate- a case series

ABSTRACT The current study aimed to assess the effectiveness of incorporating ultrasound visual biofeedback (UVB) into a treatment programme addressing persistent speech sound disorders linked to cleft palate in children who have been unresponsive to traditional therapy approaches. Materials and Methods. A single-subject multiple baseline experiment was conducted with five children aged 6:5–13:5 over a period of 16 therapy sessions. Treatment focused on providing cues from real-time ultrasound images to assist children in modifying their tongue movements. Probe data were collected before, mid, and post-treatment to assess target consonant accuracy for 50 untreated words. The results of the statistical analysis suggested participants showed a significant increase in percent target consonant accuracy as a result of intervention using UVB. Although most of the participants exhibited progress in generalising learned phonemes to untreated words, some did not show improvement in gaining generalisation from treated phonemic contexts to those untreated ones. When traditional methods fail to yield significant progress, incorporating ultrasound biofeedback into the treatment programme emerges as a viable option to enhance sound accuracy in children with persistent speech sound disorders resulting from cleft palate.

Validity and Reliability Study of the Turkish Version of Focus on the Outcomes of Communication Under Six-34.

Speech and language disorders can negatively affect preschool children's communicative participation skills. Focus on the Outcomes of Communication Under Six-34 (FOCUS-34) is a valid and reliable scale that evaluates communicative participation in preschool children with speech and language disorders. This study aimed to establish the Turkish version of FOCUS-34 (FOCUS-34-TR) and investigate its validity and reliability. A total of 175 children with language disorders, speech sound disorders, and fluency disorders (aged 20-72 months) and their parents were included in the study. Parents were asked to complete the demographic information form, the FOCUS-34-TR scale, and the Ages and Stages Questionnaires: Social-Emotional (ASQ-SE) Turkish version. The construct validity, convergent and divergent validity, internal consistency, and test-retest reliability of the scale were investigated. The FOCUS-34-TR had high values for internal consistency (α = .97) and test-retest reliability (r = .95). The correlations between the FOCUS-34-TR total score and its subscales were between .77 and .90. A moderately significant negative correlation was found between the FOCUS-34-TR scale and the ASQ-SE. The Turkish version of FOCUS-34 is a valid and reliable scale that can be used in clinics and for research purposes to evaluate the communicative participation skills of Turkish-speaking preschool children with speech and language disorders.

Phonological Processes in Tamil Speaking Young Children

The present study aimed at identifying developmental pattern of phonological processes in 2 to 6:11 years typically developing Tamil speaking children. A total of 150 typically developing Tamil speaking children participated in the present study. They were divided into 5 groups with 30 children in each age group. Nine sentences in Tamil with increasing complexity and the pictures representing the sentences was developed. Each child was seated comfortably and pictures of sentences were randomly presented one after the other as the investigator said the sentence describing the picture. The child was instructed to repeat the sentences after the investigator and the same was audio recorded. The speech samples were transcribed and perceptually analysed by a speech language pathologist. Results revealed the occurrence of about thirty-four phonological processes in children’s speech and the processes were suppressed with increase in age. Among the type of phonological process, substitution processes occurred more frequently across the age groups than other processes. The findings of the study would aid in assessment, diagnosis and intervention of children with speech sound disorder.

Considering the role of speech processing in cleft-related speech sound disorders: Implications for causal pathways and classification systems.

Classification systems in healthcare support shared understanding of conditions for clinical communication, service monitoring and development, and research. Children born with cleft palate with or without cleft lip (CP+/-L) are at high risk of developing cleft-related speech sound disorder (SSD). The way cleft-related SSD is represented and described in SSD classification systems varies. Reflecting on the potential causal pathways for different cleft-related speech features, including the role of speech processing skills, may inform how cleft-related SSD is represented in classification systems. To explore and reflect on how cleft-related SSD is represented in current SSD classification systems in the context of considering how speech processing skills and other factors may be involved in causal pathways of cleft speech characteristics (CSCs). Variation in the representation of cleft-related SSD in classification systems is described. Potential causal pathways for passive cleft- related speech features and different active CSCs are explored. The factors involved in the development and/or persistence of different active CSCs may vary. Some factors may be specific to children born with CP+/-L, but if speech processing skills are also involved, this is an overlap with other SSD subtypes. Current evidence regarding relationships between different speech processing skills and active CSCs is limited. Implications for the representation of cleft-related SSD in SSD classification systems are discussed. There are different categories of cleft-related speech features which are essential to understand and identify in children with cleft-related SSD to ensure appropriate management. Representation of these feature categories in classification systems could support understanding of speech in this population. Speech processing skills could be involved in the development and/or persistence of different active CSCs in individual children. Reflection and discussion on how cleft-related SSD is represented in classification systems in relation to other SSD subtypes may inform future iterations of these systems. Further work is needed to understand factors influencing the development and/or persistence of active CSCs, including speech processing skills. What is already known on the subject Cleft-related speech sound disorder (SSD) is commonly described as being of known origin. The features of cleft-related SSD have been described extensively and several authors have also examined factors which may contribute to speech development and outcomes in children born with cleft palate +/- lip. There is limited evidence regarding the role of speech processing in the development and persistence of cleft-related SSD. What this study adds This paper reflects on how cleft-related SSD is represented in SSD classification systems in relation to key feature categories of cleft-related SSD and possible causal pathways for passive features and active cleft speech characteristics (CSCs). The role of cognitive speech processing skills is specifically considered alongside other factors that may contribute to the development of active CSCs. What are the clinical implications of this work? Causal pathways for different features of cleft-related SSD may vary, particularly between passive and active features, abut also between different active CSCs. Speech and language therapists (SLTs) need to differentially diagnose passive speech features and active CSCs. Consideration of the role of different speech processing skills and interactions with other potentially influencing factors in relation to active CSCs may inform clinical hypotheses and speech and language therapy (SLT) intervention. Representing key features of cleft-related SSD in classification systems may support understanding of cleft-related SSD in relation to other SSD subtypes.

What works, how and in which contexts when supporting parents to implement intensive speech and language therapy at home for children with speech sound disorder? A protocol for a realist review

IntroductionSpeech and language therapists (SLTs) worldwide report challenges with providing recommended, evidence-based intervention intensity for children with speech sound disorder (SSD). Challenges such as service constraints and/or family contexts impact...

Instrumento de Avaliação Fonológica: evidências de validade de construto

ABSTRACT Purpose To investigate evidence of construct validity for a Phonological Assessment Instrument for Brazilian Portuguese, based on the diagnostic data generated by its application from contrastive analysis and speech severity. Methods The sample consisted of 176 children, aged between five to nine years old. They were evaluated with the Phonological Assessment Instrument and then classified as having Speech Sound Disorder or in typical phonological development, comparing these results to the criteria described for the disorder in the DSM-5. The search for evidence of construct validity relied on the agreement between the two assessment methods while applying the Kappa Coefficient. To differentiate between groups, Student's t-test was used for independent samples. We sought to investigate the instrument indexes using the Receiver Operating Characteristic Curve statistics to obtain values for area, cut-off point, sensitivity, specificity, accuracy, and positive and negative predictive value. Results The instrument showed agreement and significant differentiation between the classifications. As for the performance parameters, it shows a cut-off point for diagnosis with results equal to or greater than 96.17%, an excellent area under the curve, as well as satisfactory percentages for the other analyses investigated. Conclusion The data indicated evidence for the construct validity of the Phonological Assessment Instrument, presenting a useful and valid contribution to the arsenal of clinical assessment and research involving the diagnosis of Speech Sound Disorder and, with its accuracy result, contributed to the properties of performance of instruments used in Speech, Language and Hearing Sciences.

Phonological Assessment Instrument: evidence of construct validity.

To investigate evidence of construct validity for a Phonological Assessment Instrument for Brazilian Portuguese, based on the diagnostic data generated by its application from contrastive analysis and speech severity. The sample consisted of 176 children, aged between five to nine years old. They were evaluated with the Phonological Assessment Instrument and then classified as having Speech Sound Disorder or in typical phonological development, comparing these results to the criteria described for the disorder in the DSM-5. The search for evidence of construct validity relied on the agreement between the two assessment methods while applying the Kappa Coefficient. To differentiate between groups, Student's t-test was used for independent samples. We sought to investigate the instrument indexes using the Receiver Operating Characteristic Curve statistics to obtain values for area, cut-off point, sensitivity, specificity, accuracy, and positive and negative predictive value. The instrument showed agreement and significant differentiation between the classifications. As for the performance parameters, it shows a cut-off point for diagnosis with results equal to or greater than 96.17%, an excellent area under the curve, as well as satisfactory percentages for the other analyses investigated. The data indicated evidence for the construct validity of the Phonological Assessment Instrument, presenting a useful and valid contribution to the arsenal of clinical assessment and research involving the diagnosis of Speech Sound Disorder and, with its accuracy result, contributed to the properties of performance of instruments used in Speech, Language and Hearing Sciences.

Speech perception in the Specific Learning Disorder with and without Persistent Speech Sound Disorder

Speech perception in the Specific Learning Disorder with and without Persistent Speech Sound Disorder

Speech perception in the Specific Learning Disorder with and without Persistent Speech Sound Disorder.

Investigate if speech perception skills can differentiate school children with Specific Reading Disorders (SRD) with and without Persistent Speech Sound Disorders (PSSD). 80 children, regularly enrolled in the 2nd (N=1), 3rd (N=28), 4th (N=29), 5th (N=15) and 6th (N=7) grades participated in the study. Control Group (CG) (N=48): no complaints, no speech alteration; and Resarch Group (RG) (N=32) - with SRD, RGI (N=15) without PSSD and RGII (N=17) with PSSD. Two tests evaluated auditory input reception: Simplified evaluation of auditory processing; and Perception task of nonwords, with Portuguese language structure (DNPLS). Data was analyzed by: Likelihood Ratio Test, Kruskal-Wallis test, Dunn test with Bonferroni correction, Mann-Whitney test, Spearman correlation, and construction of a ROC curve to obtain a threshold value for the correct answers in the perception of non-words test. Control and RGI showed higher correct answer scores than RGII. There was no difference between the correct answer distributions of the Control and RGI, and RGI and RGII in the test of DNPLS and the number of correct answers in the CG was higher than in the RGII. The ability to discriminate non-words enabled the differentiated between school-aged children with SRD associated with PSSD and typical children, thus characterizing this group for presenting a number of correct answers lower than 30.5, considering the task proposed to discriminate non-words. These results suggest that the presence of PSSD worsens the performance in speech perception of the schoolchildren with SRD.

Exploration of the Utility of the Generic ICHOM Standard Set Measures in Evaluating the Speech of Patients with Cleft Lip/Palate.

The International Consortium of Health Outcome Measurements (ICHOM) standard set for cleft care appraisal recommends clinicians assess articulation with percentage consonants correct (PCC) and velopharyngeal function with velopharyngeal competency rating (VPC-R). This study explores the utility and limitations of these generic measures in detecting cleft speech sound disorders by comparing them with two cleft-specific speech-rating systems, cleft audit protocol of speech-augmented Americleft modification (CAPS-A-AM) and Pittsburgh weighted speech scale (PWSS). Consecutive children with repaired, nonsyndromic cleft lip/palate, aged 5 years or older (n = 27) underwent prospective speech evaluations conducted at a single academic institution. These evaluations were conducted, recorded, and evaluated by blinded speech-language pathologists experienced with all tools. When comparing measures of articulation, PCC scores correlated better with scores for relevant subcomponents of CAPS-A-AM than PWSS. When comparing measures of velopharyngeal function, VPC-R scores correlated well with relevant components of both scales. Using a "screening test versus diagnostic test" analogy, VPC-R ratings were 87.5% sensitive and 73.7% specific for detecting velopharyngeal dysfunction according to subcomponents of CAPS-A-AM, and 70.6% sensitive and 100% specific according to subcomponents of PWSS. This exploratory study demonstrates that PCC and VPC-R perform moderately well in detecting articulatory and velopharyngeal dysfunction in patients with cleft lip/palate; however, these tools cannot describe nuances of cleft speech sound disorder. Thus, although PCC and VPC-R adequately track basic minimum outcomes, we encourage teams to consider extending the standard set by adopting a cleft-specific measurement system for further evaluation of the tools.

A prosthesis for speech sound disorders

A prosthesis for speech sound disorders

Automatic Detection of Speech Sound Disorder in Cantonese-Speaking Pre-School Children

Automatic Detection of Speech Sound Disorder in Cantonese-Speaking Pre-School Children

Differences in Language and Literacy Competence According to the Comorbidity of Speech Sound Disorder and Attention-Deficit/Hyperactivity Disorder: for Preschool 6-Year-Olds

Objectives: This study analyzed the differences in language and literacy skills in the groups (None, SSD, ADHD, and SSD+ADHD) classified according to the comorbidity of Speech Sound Disorder (SSD) and Attention Deficit/Hyperactivity Disorder (ADHD).Methods: The Korean Children’s Panel Study (PSKC) conducted SSD and ADHD screening tests on 1,489 6-year-old preschoolers. In this study, cross-analysis was conducted by dividing the two disability groups into Absent and Present to measure the significance of the degree of accompanying disability. In addition, multivariate covariance analysis (MANCOVA) was conducted using intelligence as covariance as the result of scoring language and literacy skills of the four groups (None, SSD, ADHD, and SSD+ADHD).Results: First, through the results of this study, it was confirmed that SSD and ADHD are significantly more likely to be comorbid. Second, both children with SSD and those with ADHD had significantly lower language skills than Typically Developing children. Third, there was a difference in the detailed items of the SSD and ADHD group literacy. A notable distinction between the two groups is that the ADHD group had a higher rate of writing problems. Fourth, the comorbidity of SSD and ADHD showed different characteristics from None, SSD, and ADHD in reasoning areas such as “predicting the next story”.Conclusion: Speech problems that receive a lot of attention in preschool age childhood should be able to be interpreted and diagnosed in relation to problems with language development and language learning delays in school age children. From this point of view, this study is expected to serve as a basic study on the early diagnosis of language academic ability development.

In an EFL Environment: Characteristics of Speech Sound Disorders in Children’s English Articulation

Objectives: In an EFL (English as a Foreign Language) environment like Korea, individuals learn English through education, and learning a foreign language is naturally influenced by the language system of the mother tongue. This study aimed to investigate the English speech characteristics and patterns of native language transfer in children with speech sound disorders (SSD).Methods: 20 Korean children aged 4-6 years participated in this study. The study divided participants into SSD and normal speech acquisition (NSA) groups, each comprising 10 children. Participants completed English word repetition task using the Diagnostic Evaluation of Articulation and Phonology (DEAP). Additionally, the SSD group was assessed using the Urimal Test of Articulation & Phonology (U-TAP) to compare differences in speech production based on language types. In both groups, the overall consonant accuracy, error types an error patterns in English were analyzed. English error types were categorized as substitution, vowel addition, consonant addition, vowel deletion, consonant deletion, inter-language distortion and intra-language distortion. Error patterns were further divided into developmental and non-developmental error patterns.Results: The SSD group demonstrated lower consonant accuracy compared to the NSA group in English articulation. Significant differences were observed between the two groups in vowel deletion rates and minor variations in consonant addition patterns. Error pattern analysis revealed that both groups exhibited a high proportion of stopping and final consonant deletion.Conclusion: This study directly confirmed the transfer of native language deficits in children with SSD to their English articulation and indirectly suggested that underlying deficits might impact English speech production.

Differences in Development of Activities, Participation during School Age (1st to 4th grade) According to Speech Sound Ability in Pre-school Age

Objectives: This study divided groups according to speech sound ability in the pre-school age and longitudinally examined the differences in the development patterns of activities from 1st grade to 4th grade.Methods: Longitudinal research data collected from the 7th to 11th year included in the Panel Study on Korean Child (PSKC) were used. The subjects of study were classified into three groups; Typically developing (TD), mild Speech Sound Disorder (SSD), and moderate SSD according to the results of the ‘Three Sentence Screening Test’ in the 7th year. Activities, participation are comprised of learning and applying knowledge, interaction and relationship, major life. A rating score based on the evaluation of each question by the teacher in charge of the child was used.Results: The average score of the TD group was high in all areas. The SSD group was found to show significant differences from the TD in learning and applying knowledge, major life.Conclusion: Children with speech sound disorders show difficulties not only learning skills such as literacy, mathematics, and attention, but also activities required for school education. In a clinical setting, areas that may present problems should be identified and included in the intervention plan in order to minimize not only speech problems but also related problems.

Assessing Speech Production in Mandarin–English Bilingual Children: Comparison of Mandarin and English Sound Systems and Special Considerations

Purpose: When assessing bilingual children's speech, it is important to determine whether the errors are indicative of a true speech sound disorder or a speech sound difference. The purpose of this tutorial is to provide cultural and linguistic background of Mandarin in comparison to English and to outline the process of speech production assessment for Mandarin–English bilingual children. Method: Pertinent literature was reviewed around varieties of Chinese, unique features of the Mandarin sound system, commonly used transcription methods (International Phonetic Alphabet and Pinyin ), and patterns of Mandarin-influenced English. Previous research findings on the acquisition of consonants, vowels, and tones in monolingual Mandarin-speaking children were summarized. Results: The assessment process including consonants, vowels, tones, syllable structures, and lexical stress was described and illustrated with flow charts. Recourses related to cultural and linguistic information of Mandarin and accessible assessment materials are referenced. Conclusions: A thorough knowledge of a child's language background is crucial in planning assessment of speech production for Mandarin–English bilingual children. A comparative understanding of the sound systems of Mandarin and English facilitates clinical decision making.

The Awareness of Speech and Language Therapy Among University Students

Although speech and language therapy has been improving in Türkiye since the early 2000s, there are few surveys of how much recognition of this profession has been achieved in the Turkish population. The first aim of this study was to determine the level of awareness of the speech and language therapy profession at Akdeniz University in Antalya. Secondary aims were to observe any differences when the students were evaluated in groups of health-related/non-health-related fields, and females/males. The study was conducted as a public awareness survey with 420 Akdeniz University students from 20 different faculties. Descriptive statistical analyses and Pearson Chi-squared test were performed. The results showed a low awareness of speech and language therapy profession in Akdeniz University students (n=124, 30%) and social media was the most common source of obtaining information. University students thought that speech and language therapists worked mostly in special education settings with children and adults who had speech sound disorders and stuttering. The recognition of speech and language therapy was greater among female students (x2 =7.665, p= .006) and students from medical majors (x2=13.219, p< .001). There is a clear need to raise awareness of speech and language therapy among university students in Antalya.

Considerations of dialect on the identification of speech sound disorder in Vietnamese-speaking children.

The dialect spoken by children influences diagnostic decision-making regarding the identification and severity of speech sound disorder (SSD). The primary objective was to review papers that examined the influence of dialect on the identification of SSD in Vietnamese-speaking children. Five studies of mono- and multilingual Vietnamese-speaking children living in Vietnam and Australia were reviewed to examine the influence of dialect on the assessment and analysis children's speech. The main Vietnamese dialects (Standard, Northern, Central, Southern) differ in the production of consonants, vowels and tones. Most speech assessments define correct production using the standard dialect of a language. Insights from recent studies of Vietnamese provide recommendations for also considering dialect in diagnostic decision-making. First, we recommend adding column(s) to the assessment score sheet that includes the dialectal variants spoken by adults in the child's family or community. Second, we calculate the accuracy of production twice, based on the standard form and dialectal form. Third, we report the percentage of consonants correct-standard (PCC-S) and percentage of consonants correct-dialect (PCC-D). Diagnostic decision-making is influenced by dialectal variation in children's speech, so speech and language therapists need to compare standard and dialectal productions when undertaking assessments, analysis and diagnostic decision-making. What is already known on the subject Most speech assessments use the standard form of a dialect as the correct production. The standard dialect is used for diagnosis of SSD and identification of intervention targets. What this paper adds to the existing knowledge This paper examines five research studies of Vietnamese to identify ways to consider dialect in speech and language therapy assessment and analysis. Vietnamese provides a complex environment for this examination since there are numerous Vietnamese dialects and they differ according to consonants, vowels and tones. What are the potential or actual clinical implications of this work? Speech and language therapists are encouraged to add column(s) to their assessment score sheet that includes the dialectal variants spoken by adults and to report the PCC-S and PCC-D.