This study investigated the link between expressive phonological impairments, phonological awareness, and literacy. Previous investigations of literacy skills in children with speech impairments have given mixed results; here we considered whether presence of additional language impairments or severity of the speech impairment was an important prognostic factor. Thirty-one children with expressive phonological impairments were compared with control children matched on age and nonverbal ability on three occasions, at mean ages of 70, 79, and 91 months. On each occasion they were given three tests of phonological awareness: one involved rime-matching and two involved onset-matching. At assessments 2 and 3 literacy skills were assessed. Children with phonological impairments scored well below their controls on phonological awareness and literacy, independent of whether or not they had other language problems. Although many of them knew letter sounds, they were poor at reading and writing nonwords as well as real words. It is suggested that both the speech impairment and the literacy problems arise from a failure to analyze syllables into smaller phonological units. The severity of the phonological problems in relation to age is an important determinant of literacy outcome; children who have severe expressive phonological impairments at the time they start school are at particular risk for reading and spelling problems.

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