No AccessAmerican Journal of Speech-Language PathologyResearch Article1 Aug 2013

Speech Sound Disorders in a Community Study of Preschool Children

    Purpose

    To undertake a community (nonclinical) study to describe the speech of preschool children who had been identified by parents/teachers as having difficulties “talking and making speech sounds” and compare the speech characteristics of those who had and had not accessed the services of a speech-language pathologist (SLP).

    Method

    Stage 1: Parent/teacher concern regarding the speech skills of 1,097 4- to 5-year-old children attending early childhood centers was documented. Stage 2a: One hundred forty-three children who had been identified with concerns were assessed. Stage 2b: Parents returned questionnaires about service access for 109 children.

    Results

    The majority of the 143 children (86.7%) achieved a standard score below the normal range for the percentage of consonants correct (PCC) on the Diagnostic Evaluation of Articulation and Phonology (Dodd, Hua, Crosbie, Holm, & Ozanne, 2002). Consonants produced incorrectly were consistent with the late-8 phonemes (Shriberg, 1993). Common phonological patterns were fricative simplification (82.5%), cluster simplification (49.0%)/reduction (19.6%), gliding (41.3%), and palatal fronting (15.4%). Interdental lisps on /s/ and /z/ were produced by 39.9% of the children, dentalization of other sibilants by 17.5%, and lateral lisps by 13.3%. Despite parent/teacher concern, only 41/109 children had contact with an SLP. These children were more likely to be unintelligible to strangers, to express distress about their speech, and to have a lower PCC and a smaller consonant inventory compared to the children who had no contact with an SLP.

    Conclusion

    A significant number of preschool-age children with speech sound disorders (SSD) have not had contact with an SLP. These children have mild-severe SSD and would benefit from SLP intervention. Integrated SLP services within early childhood communities would enable earlier identification of SSD and access to intervention to reduce potential educational and social impacts affiliated with SSD.

    References

    • American Speech-Language-Hearing Association (1985). Guidelines for identification audiometry.The ASHA Leader 49–52.
    • Anderson, C. A., & van der Gaag, A. (2000). An examination of the pattern of preschool referrals to speech and language therapy.Child Language Teaching and Therapy, 16(1), 59–71.
    • Australian Bureau of Statistics. (2008). 2033.0.55.001—Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA). Retrieved from http://www.abs.gov.au/ausstats/[email protected]/mediareleasesbytitle/87E66027D6856FD6CA257417001A550A?OpenDocument
    • Baker, E., & McLeod, S. (2011). Evidence-based practice for children with speech sound disorders: Part 1. Narrative review.Language, Speech, and Hearing Services in Schools, 42, 102–139.
    • Bishop, D. V. M., & McDonald, D. (2009). Identifying language impairment in children: Combining language test scores with parental report.International Journal of Language and Communication Disorders, 44(5), 600–615.
    • Broomfield, J., & Dodd, B. (2004a). Children with speech and language disability: Caseload characteristics.International Journal of Language and Communication Disorders, 39(3), 303–324.
    • Broomfield, J., & Dodd, B. (2004b). The nature of referred subtypes of primary speech disability.Child Language Teaching and Therapy, 20(2), 135–151.
    • Chirlian, N. S., & Sharpley, C. F. (1982). Children's articulation development: Some regional differences.Australian Journal of Human Communication Disorders, 10, 23–30.
    • Cox, F. (2008). Vowel transcription systems: An Australian perspective.International Journal of Speech-Language Pathology, 10(5), 327–333.
    • De Lemos, M., & Doig, B. (1999). Who am I?. Melbourne, Australia: The Australian Council for Educational Research.
    • Department of Health and Aged Care.. (2001). Measuring remoteness: Accessibility/Remoteness Index of Australia (ARIA) (Rev. ed.). Canberra, Australia: Portfolio Strategies Division.
    • Dodd, B., & Bradford, A. (2000). A comparison of three therapy methods for children with different types of developmental phonological disorder.International Journal of Language and Communication Disorders, 35(2), 189–209.
    • Dodd, B., Crosbie, S., McIntosh, B., Teitzel, T., & Ozanne, A. (2000). Pre-reading Inventory of Phonological Awareness. London, UK: The Psychological Corporation.
    • Dodd, B., Holm, A., Hua, Z., & Crosbie, S. (2003). Phonological development: A normative study of British English-speaking children.Clinical Linguistics and Phonetics, 17(8), 617–643.
    • Dodd, B., Hua, Z., Crosbie, S., Holm, A., & Ozanne, A. (2002). Diagnostic Evaluation of Articulation and Phonology. London, UK: The Psychological Corporation.
    • Dunn, L. M., & Dunn, L. M. (1997). Peabody Picture Vocabulary Test (3rd ed.). Circle Pines, MN: AGS.
    • Felsenfeld, S., Broen, P. A., & McGue, M. (1992). A 28-year follow-up of adults with a history of moderate phonological disorder: Linguistic and personality results.Journal of Speech and Hearing Research, 35, 1114–1125.
    • Felsenfeld, S., Broen, P. A., & McGue, M. (1994). A 28-year follow-up of adults with a history of moderate phonological disorder: Educational and occupational results.Journal of Speech and Hearing Research, 37, 1341–1353.
    • Flipsen, P., Jr. (2006). Measuring the intelligibility of conversational speech in children.Clinical Linguistics and Phonetics, 20(4), 303–312.
    • Flipsen, P., Jr., Hammer, J. B., & Yost, K. M. (2005). Measuring severity of involvement in speech delay: Segmental and whole-word measures.American Journal of Speech-Language Pathology, 14, 298–312.
    • Glascoe, F. P. (2000). Parents' Evaluation of Developmental Status: Authorized Australian Version. Parkville, Victoria, Australia: Centre for Community Child Health.
    • Glogowska, M., Roulstone, S., Enderby, P., & Peters, T. J. (2000, October14). Randomised controlled trial of community based speech and language therapy in preschool children.British Medical Journal, 321, 1–5.
    • Goldman, R., & Fristoe, M. (2000). Goldman Fristoe Test of Articulation 2. Circle Pines, MN: AGS.
    • Grunwell, P. (1997). Natural phonology.In M. Ball, & R. Kent (Eds.), The new phonologies: Developments in clinical linguistics (pp. 35–75). San Diego, CA: Singular.
    • Harcourt, D., & Conroy, H. (2005). Informed assent: Ethics and processes when researching with young children.Early Child Development and Care, 175(6), 567–577.
    • Harrington, J., Cox, F., & Evans, Z. (1997). An acoustic phonetic study of broad, general, and cultivated Australian English vowels.Australian Journal of Linguistics, 17, 155–184.
    • Harrison, L. J., McLeod, S., Berthelsen, D., & Walker, S. (2009). Literacy, numeracy and learning in school-aged children identified as having speech and language impairment in early childhood.International Journal of Speech-Language Pathology, 11(5), 392–403.
    • Harrison, L. J., Ungerer, J. A., Smith, G. J., Zubrick, S. R., Wise, S., & Press, F., & the LSAC Research Consortium. (2009). Child care and early education in Australia: The Longitudinal Study of Australian Children (Social Policy Research Paper No. 40). Canberra, Australia: Department of Families, Housing, Community Service and Indigenous Affairs.
    • Hesketh, A. (2004). Early literacy achievement of children with a history of speech problems.International Journal of Language and Communication Disorders, 39, 453–468.
    • Hodson, B. W. (1994). Helping individuals become intelligible, literate, and articulate: The role of phonology.Topics in Language Disorders, 14, 1–16.
    • Hodson, B. W., & Paden, E. P. (1981). Phonological processes which characterize unintelligible and intelligible speech in early childhood.Journal of Speech and Hearing Disorders, 46, 369–373.
    • Ingram, D., & Ingram, K. D. (2001). A whole-word approach to phonological analysis and intervention.Language, Speech, and Hearing Services in Schools, 32, 271–283.
    • James, D. G. H. (2001). The use of phonological processes in Australian children aged 2 to 7:11 years.International Journal of Speech-Language Pathology, 3, 109–128.
    • James, D. G. H., van Doorn, J., McLeod, S., & Esterman, A. (2008). Patterns of consonant deletion in typically developing children aged 3 to 7 years.International Journal of Speech-Language Pathology, 10(3), 179–192.
    • Keegstra, A. L., Knijff, W. A., Post, W. J., & Goorhuis-Brouwer, S. M. (2007). Children with language problems in a speech and hearing clinic: Background variables and extent of language problems.International Journal of Pediatric Otorhinolaryngology, 71, 815–821.
    • Kilminster, M. G. E., & Laird, E. M. (1978). Articulation development in children aged three to nine years.Australian Journal of Human Communication Disorders, 6, 23–30.
    • Law, J., Boyle, J., Harris, F., Harkness, A., & Nye, C. (1998). Screening for speech and language delay: A systematic review of the literature.Health Technology and Assessment, 2(9), 1–183.
    • Law, J., Boyle, J., Harris, F., Harkness, A., & Nye, C. (2000). Prevalence and natural history of primary speech and language delay: Findings from a systematic review of the literature.International Journal of Language and Communication Disorders, 35(2), 165–188.
    • Leitão, S., & Fletcher, J. (2004). Literacy outcomes for students with speech impairment: Long-term follow-up.International Journal of Language and Communication Disorders, 39, 245–256.
    • Lewis, B. A., Freebairn, L. A., Hansen, A. J., Iyengar, S. K., & Taylor, H. G. (2004). School-age follow-up of children with childhood apraxia of speech.Language, Speech, and Hearing Services in Schools, 35(2), 122–140.
    • Long, S. H., Fey, M. E., & Channell, R. W. (2006). Computerized Profiling (MS-DOS version 9.7) [Computer software].Milwaukee, WI: Marquette University.
    • McAllister, L., McCormack, J., McLeod, S., & Harrison, L. J. (2011). Expectations and experiences of accessing and participating in services for childhood speech impairment.International Journal of Speech-Language Pathology, 13(3), 251–267.
    • McCormack, J., Harrison, L. J., McLeod, S., & McAllister, L. (2011). A nationally representative study of the association between communication impairment at 4–5 years and children's life activities at 7–9 years.Journal of Speech, Language, and Hearing Research, 54, 1328–1348.
    • McCormack, J., McLeod, S., McAllister, L., & Harrison, L. J. (2009). A systematic review of the association between childhood speech impairment and participation across the lifespan.International Journal of Speech-Language Pathology, 11(2), 155–170.
    • McLeod, S. (2007). Australian English speech acquisition.In S. McLeod (Ed.), The international guide to speech acquisition (pp. 241–256). Clifton Park, NY: Thomson Delmar Learning.
    • McLeod, S. (2013). Speech sound acquisition.In J. E. Bernthal, N. W. Bankson, & P. Flipsen (Eds.), Articulation and phonological disorders: Speech sound disorders in children (7th ed., pp. 58–113). Boston, MA: Pearson Education.
    • McLeod, S., & Arciuli, J. (2009). School-aged children's production of /s/ and /r/ consonant clusters.Folia Phoniatrica et Logopaedica, 61(6), 336–341.
    • McLeod, S., & Harrison, L. J. (2009). Epidemiology of speech and language impairment in a nationally representative sample of 4- to 5-year-old children.Journal of Speech, Language, and Hearing Research, 52, 1213–1229.
    • McLeod, S., Harrison, L. J., & McCormack, J. (2012). Intelligibility in Context Scale: Validity and reliability of a subjective rating measure.Journal of Speech, Language, and Hearing Research, 55, 648–656.
    • McLeod, S., & McCormack, J. (2007). Application of the ICF and ICF—Children and Youth in children with speech impairment.Seminars in Speech and Language, 28, 254–264.
    • McLeod, S., Press, F., & Phelan, C. (2010). The (in)visibility of children with communication impairment in Australian health, education, and disability legislation and policies.Asia Pacific Journal of Speech, Language, and Hearing, 13(1), 67–75.
    • Mitchell, A. G., & Delbridge, A. (1965). The pronunciation of English in Australia. Sydney, Australia: Angus & Robertson.
    • Nathan, L., Stackhouse, J., Goulandris, N., & Snowling, M. J. (2004a). The development of early literacy skills among children with speech difficulties: A test of the “critical age hypothesis”.Journal of Speech, Language, and Hearing Research, 47, 377–391.
    • Nathan, L., Stackhouse, J., Goulandris, N., & Snowling, M. J. (2004b). Educational consequences of developmental speech disorder: Key Stage 1 National Curriculum assessment results in English and mathematics.British Journal of Educational Psychology, 74, 173–186.
    • PASW Statistics (2009). Statistical Program for the Social Sciences (Version 17.0.2) [Computer software].Chicago, IL: SPSS.
    • Paul, R. (2001). Language disorders from infancy through adolescence: Assessment and intervention (3rd ed.). St. Louis, MO: Mosby.
    • Paul, R., & Alforde, S. (1993). Grammatical morpheme acquisition in 4-year-olds with normal, impaired, and late-developing language.Journal of Speech and Hearing Research, 36, 1271–1275.
    • Paul, R., & Smith, R. L. (1993). Narrative skills in 4-year-olds with normal, impaired, and late-developing language.Journal of Speech and Hearing Research, 36, 592–598.
    • Peña, E. D., Spaulding, T. J., & Plante, E. (2006). The composition of normative groups and diagnostic decision making: Shooting ourselves in the foot.American Journal of Speech-Language Pathology, 15, 247–254.
    • Perry, A., & Skeat, J. (2004). Australian Therapy Outcome Measures for Speech Pathology. Melbourne, Australia: La Trobe University.
    • Renfrew, C. (1997a). The Action Picture Test (3rd ed.). London, UK: Speechmark.
    • Renfrew, C. (1997b). The Bus Story. London, UK: Speechmark.
    • Rothman, S. (2003, June). An Australian version of the Adapted PPVT–III for use in research. Unpublished paper, Australian Council for Educational Research, Melbourne, Australia
    • Roulstone, S., Miller, L. L., Wren, Y., & Peters, T. J. (2009). The natural history of speech impairment of 8-year-old children in the Avon Longitudinal Study of Parents and Children: Error rates at 2 and 5 years.International Journal of Speech-Language Pathology, 11(5), 381–391.
    • Ruben, R. J. (2000). Redefining the survival of the fittest: Communication disorders in the 21st century.Laryngoscope, 110, 241–245.
    • Shriberg, L. D. (1993). Four new speech and prosody-voice measures for genetics research and other studies in developmental phonological disorders.Journal of Speech and Hearing Research, 36, 105–140.
    • Shriberg, L. D., & Kwiatkowski, J. (1982). Phonological disorders III: A procedure for assessing severity of involvement.Journal of Speech and Hearing Disorders, 47, 256–270.
    • Shriberg, L. D., Kwiatkowski, J., Best, S., Hengst, J., & Terselic-Weber, B. (1986). Characteristics of children with phonologic disorders of unknown origin.Journal of Speech and Hearing Disorders, 51, 140–161.
    • Silverman, F. H., & Paulus, P. G. (1989). Peer reactions to teenagers who substitute /w/ for /r/.Language, Speech, and Hearing Services in Schools, 20, 219–221.
    • Smit, A. B., Hand, L., Freilinger, J. J., Bernthal, J. E., & Bird, A. (1990). The Iowa articulation norms project and its Nebraska replication.Journal of Speech and Hearing Disorders, 55, 779–798.
    • Teverovsky, E. G., Bickel, J. O., & Feldman, H. M. (2009). Functional characteristics of children diagnosed with childhood apraxia of speech.Disability and Rehabilitation, 31(2), 94–102.
    • Tomblin, J. B. (2010). The EpiSLI database: A publicly available database on speech and language.Language, Speech, and Hearing Services in Schools, 41, 108–117.
    • Tomblin, J. B., Records, N. L., Buckwalter, P., Zhang, X., Smith, E., & O'Brien, M. (1997). Prevalence of specific language impairment in kindergarten children.Journal of Speech, Language, and Hearing Research, 40, 1245–1260.
    • Zhang, X., & Tomblin, J. B. (2000). The association of intervention receipt with speech-language profiles and social–demographic variables.American Journal of Speech-Language Pathology, 9(4), 345–357.

    Additional Resources