RESUMEN

Purpose: There has been concern that a shift in disability funding to the National Disability Insurance Scheme (NDIS) in Australia may have influenced paediatric speech and language intervention to involve parents less in service delivery. This study aimed to describe paediatric speech-language pathologists' (SLPs) practices and perceptions of parent involvement in NDIS-funded speech and/or language intervention.Method: Seventy-two paediatric SLPs currently practicing in Australia with NDIS-funded speech and/or language clients completed an online survey. The survey assessed SLPs' self-reported practices supporting parent involvement through Likert scale responses and included open-text questions about perceived barriers and facilitators in NDIS-funded intervention services. Results from the survey were analysed using descriptive statistics, significance testing, and thematic analysis.Result: The majority of SLPs indicated commitment to involving parents in intervention. Experienced SLPs used more family-centred practices and Department of Education (DE)-based SLPs used fewer. Barriers arose from SLP, parent, and workplace characteristics. Facilitators included communication and rapport building, utilising a family-centred model of service delivery, and parent characteristics.Conclusion: This self-selected sample of Australian SLPs utilised many techniques to facilitate parent involvement within NDIS-funded paediatric speech and language intervention. Results indicate NDIS-funded SLP services for families are family focused.

RESUMEN

BACKGROUND: Previous studies have explored the size and word type composition (nouns, predicates, etc.) of expressive vocabularies of preschool children with Down syndrome, both spoken and signed. Separately, overall preferences for modality of expression have also been explored. AIMS: To extend previous findings by describing the relationships between expressive vocabulary size and both word type and modality of expression in the preschool period including changes to modality preference over time. METHODS & PROCEDURES: Mothers of 35 children with Down syndrome, aged 36-66 months and attending the same early intervention programme, completed a version - with both spoken word and sign options - of the New Zealand MacArthur-Bates Communicative Development Inventory (CDI): Words and Sentences. Most mothers completed the CDI on multiple occasions across the duration of the study. Completions (n = 114) were analysed cross-sectionally and longitudinally in terms of (1) word type relative to vocabulary size, (2) modality of expression relative to word type and vocabulary size, and (3) individual trajectories in vocabulary size and modality of expression. OUTCOMES & RESULTS: (1) Word type relative to vocabulary size was similar to previous studies with a greater proportion of the SOCIAL words being present in the children's vocabularies throughout, followed by NOUNS, PREDICATES and CLOSED class words, with proportions converging as vocabulary sizes increase. (2) An initial spoken word preference for SOCIAL and CLOSED class words and sign preference for NOUNS and PREDICATES was found, with more spoken words in larger vocabularies overall. (3) Individual trajectories were highly variable and also revealed temporary points of regression in overall expressive vocabulary size in some children. Children who shifted from reliance on sign to predominantly spoken word expression did so at different ages and at different vocabulary sizes. At school entry, while most of the children used both modalities, some children continued to rely on sign for most vocabulary items whereas others used only spoken words. CONCLUSIONS & IMPLICATIONS: An appreciation of both the general trends and potential for individual variation in vocabulary structure, modality of expression and change over time will better position clinicians and education specialists to provide individually tailored support to both preschool and school-aged children with Down syndrome. WHAT THIS STUDY ADDS: What is already known on this subject Preschool children with Down syndrome have been shown to demonstrate developmental patterns in overall conceptual vocabulary size and word type development broadly similar to typical development. The use of signed vocabulary has also been explored, but independently from word type development and with less attention to individual trajectories in either vocabulary size development or modality preferences throughout the preschool period than is necessary for clinical use. What this paper adds to existing knowledge This study found interactions between word type and modality of expression in relation to vocabulary size as well as a few temporary vocabulary size regressions similar to those found in much younger typically developing children. An initial spoken word preference for social and closed class words, and sign preference for nouns and predicates, was followed by a general trend towards spoken words for all word types as vocabulary (with some fluctuations) increased over time. Children demonstrated considerable individual variation in size of vocabulary and age at which they pivoted from a signed to a spoken word preference. Moreover, while most children used both modalities at school entry, a few retained a sign-only vocabulary and others had moved fully onto spoken word-only expression. What are the potential or actual clinical implications of this work? An understanding of both the general trends and individual variation in vocabulary structure and modality of expression development will better position clinicians and educational specialists to provide individually tailored support to children with Down syndrome.

Asunto(s)

RESUMEN

PURPOSE: The aim of this study was to describe and explain changes in severity of speech sound disorder (SSD) and token-to-token inconsistency in children with high levels of inconsistency. METHOD: Thirty-nine children (aged 4;6-7;11 [years;months]) with SSDs and high levels of token-to-token inconsistency were assessed every 6 months for 2 years (i.e., five assessment points). Growth modeling was used to assess relations among therapy support, receptive vocabulary, severity, and inconsistency over time. RESULTS: Children with the most severe SSDs and highest levels of token-to-token inconsistency showed the smallest improvements in speech accuracy over time. Therapy support did not predict changes in speech accuracy or token-to-token inconsistency over time. Receptive vocabulary (measured at the outset of the study) was also a significant predictor of speech accuracy and inconsistency. CONCLUSIONS: These findings suggest that an immediate start to intervention (rather than a wait-and-see approach) is recommended for children with inconsistent speech error patterns. The results also highlight the value of developing vocabulary knowledge in addition to improving speech accuracy for some children with inconsistent speech production.

Asunto(s)

RESUMEN

PURPOSE: The aim of this study was to compare word-initial and word-final consonant cluster productions in young children who speak African American English (AAE) and compare their productions to what we know about cluster productions in children who speak Mainstream American English (MAE), in order to minimize misdiagnosis of speech sound disorders. METHOD: Twenty-two children (ages 2;10-5;4 [years;months]) labeled pictures whose names contained at least one consonant cluster in word-initial and/or word-final position. Most two-element clusters of English were sampled, the majority in two or more words. The participants' responses were transcribed using a consensus transcription procedure. Each cluster attempt was analyzed for its similarity with MAE. RESULTS: Percentage matching scores were significantly higher for word-initial than word-final clusters. Word-final clusters produced as singletons were significantly more common than word-final cluster substitutions. However, word-initial cluster substitutions were significantly more common than word-initial clusters produced as singletons. Word-initial cluster mismatches were consistent with markedness theory and the sonority sequencing principle (SSP). By contrast, word-final cluster mismatches were not consistent with the SSP, while the voicing generalization seen in adult speakers of AAE was evident. CONCLUSION: Culturally and linguistically appropriate assessment of phonological development in children who speak AAE requires an understanding of the contrastive and noncontrastive features exemplified in their consonant cluster productions.

Asunto(s)

RESUMEN

While primary diagnosis is only one aspect of the presentation of a child with neurodevelopmental delay/disorder, the degree to which early expressive language reflects diagnostic divisions must be understood in order to reduce the risk of obscuring clinically important differences and similarities across diagnoses. We present original data from the New Zealand MacArthur-Bates Communicative Development Inventory (NZCDI) from 88 English-speaking children aged 2;6 to 5;6 years receiving multidisciplinary intervention within a single family-centered program. The children had one of six pediatrician-assigned genetic or behaviorally determined diagnoses: Down syndrome (DS); motor disorders (cerebral palsy and developmental coordination disorder); global development delay; disorders of relating and communicating (R&C); other genetically defined diagnoses; or language delay due to premature (PREM) birth. Morphological and lexical development were compared within and across diagnostic groups, using both data visualization and mixed-effects modeling. Groups varied in the amount of variation within and between them, but only prematurity reached significance, in interaction with age, as a predictor of morpho-lexical scores. Further analysis of longitudinal data available from a subset of the sample (n = 62) suggested that individual trajectories of vocabulary growth could not be reliably predicted by diagnosis. Moreover, the distribution of word types (nouns, predicates, etc.) only distinguished PREM children with language delay from those with DS and those in the R&C group. There were strong similarities in early morpho-lexical development across these clinical populations, with some differences. These findings align with research and clinical approaches which accommodate individual variation within diagnosis, and broad similarities across diagnostic groups.

RESUMEN

Purpose: This clinical focus article provides readers with a description of the stimulus characteristics of 12 popular tests of speech sound production. Method: Using significance testing and descriptive analyses, stimulus items were compared in terms of the number of opportunities for production of all consonant singletons, clusters, and rhotic and nonrhotic vowels of Standard American English; phonetic/phonological and structural complexity; and the presence of bound morphemes. Results: The tests varied widely in terms of the number of opportunities for production of consonant singletons, clusters, and rhotic and nonrhotic vowels. Most of the tests included only 1 opportunity, scored or unscored, to produce a majority of the consonant singletons in each word position. Only 3 of the tests included stimulus items with 3-element clusters. The majority contained limited opportunities to produce 3- or 4-syllable stimulus items. The tests provided sufficient opportunities for production of most vowels, although most did not score vowels. The tests differed significantly in the complexity of their stimulus items. Most, however, contained a negligible number of items that, with the addition of a bound morpheme, resulted in a word-final cluster. Conclusion: Most of the tests elicit an inadequate sample with which to conduct a comprehensive phonological analysis.

Asunto(s)

RESUMEN

The purpose of this study was to examine potential concurrent predictors and replicate rates of token-to-token inconsistency (inconsistency in repeated productions of the same word) in 43 children with typical speech-language development, ages 2;6 to 4;2. A standard linear regression was used to determine which variables, if any, among age, expressive and receptive vocabulary, and speech sound production abilities predicted token-to-token inconsistency. Inconsistency rates in children from one research site, reported elsewhere, were compared to rates in children from a second research site. The results revealed that expressive vocabulary was the only significant predictor of token-to-token inconsistency in these children. Furthermore, inconsistency rates were similarly high across the two research sites. The findings are discussed in terms of their implications for our theoretical understanding of token-to-token inconsistency and its role in the differential diagnosis of speech sound disorders in children.

Asunto(s)

RESUMEN

The purpose of this study was to determine the effectiveness of a motor learning guided (MLG) approach to speech treatment in a unique case of speech disturbance following surgery for stress velopharyngeal incompetence (SVPI). The patient was a 20-year-old female college student. Treatment took place over 6 sessions and focused on eliciting productions through a hierarchy of clinician support, with an emphasis on self-evaluation and -correction. Acoustic measurements and ratings from the treating clinician and unfamiliar listeners revealed a speech disturbance following surgery that was corrected following speech treatment. The patient's main difficulty appeared to be in producing the vocalic/postvocalic approximant, /r/, although vowel distortions were also noted. These difficulties may be explained by the structural alteration and formation of scar tissue as a result of surgery. The results provide initial support for an MLG approach to treating an acquired speech disturbance following SVPI surgery; however, additional research is warranted.

Asunto(s)

RESUMEN

PURPOSE: The authors compared preschool children with co-occurring speech sound disorder (SSD) and language impairment (LI) to children with SSD only in their numbers and types of speech sound errors. METHOD: In this post hoc quasi-experimental study, independent samples t tests were used to compare the groups in the standard score from different tests of articulation/phonology, percent consonants correct, and the number of omission, substitution, distortion, typical, and atypical error patterns used in the production of different wordlists that had similar levels of phonetic and structural complexity. RESULTS: In comparison with children with SSD only, children with SSD and LI used similar numbers but different types of errors, including more omission patterns ( p < .001, d = 1.55) and fewer distortion patterns ( p = .022, d = 1.03). There were no significant differences in substitution, typical, and atypical error pattern use. CONCLUSIONS: Frequent omission error pattern use may reflect a more compromised linguistic system characterized by absent phonological representations for target sounds (see Shriberg et al., 2005). Research is required to examine the diagnostic potential of early frequent omission error pattern use in predicting later diagnoses of co-occurring SSD and LI and/or reading problems.

Asunto(s)

RESUMEN

PURPOSE: The authors of this study examined relationships between measures of word and speech error variability and between these and other speech and language measures in preschool children with speech sound disorder (SSD). METHOD: In this correlational study, 18 preschool children with SSD, age-appropriate receptive vocabulary, and normal oral motor functioning and hearing were assessed across 2 sessions. Experimental measures included word and speech error variability, receptive vocabulary, nonword repetition (NWR), and expressive language. Pearson product­moment correlation coefficients were calculated among the experimental measures. RESULTS: The correlation between word and speech error variability was slight and nonsignificant. The correlation between word variability and receptive vocabulary was moderate and negative, although nonsignificant. High word variability was associated with small receptive vocabularies. The correlations between speech error variability and NWR and between speech error variability and the mean length of children's utterances were moderate and negative, although both were nonsignificant. High speech error variability was associated with poor NWR and language scores. CONCLUSION: High word variability may reflect unstable lexical representations, whereas high speech error variability may reflect indistinct phonological representations. Preschool children with SSD who show abnormally high levels of different types of speech variability may require slightly different approaches to intervention.

Asunto(s)

RESUMEN

The present study investigated the effects of lexical age of acquisition (AoA), phonological complexity, age and expressive vocabulary on spoken word variability and accuracy in typically developing infants, aged 1;9-3;1. It was hypothesized that later-acquired words and those with more complex speech sounds would be produced more variably and less accurately than earlier-acquired words and those with less complex speech sounds. It was also hypothesized that word variability would decrease and word accuracy would increase with increasing age and vocabulary knowledge. Participants' productions of 20 target words, experimentally controlled for AoA and phonological complexity, were audio-recorded during a play session. Results revealed a nonsignificant effect of AoA on variability and accuracy, a significant effect of phonological complexity on variability and accuracy, a significant effect of age on variability and accuracy and a significant effect of vocabulary on variability. Theoretical and clinical implications are discussed.

Asunto(s)

RESUMEN

In honour of Miccio's memory, this article revisits the topic of stimulability in children with speech sound disorders (SSD). Eighteen children with SSD, aged 3;6-5;5 (M = 4;8), were tested for their system-wide stimulability, percentage consonants correct (PCC), phonetic inventory size, and oral- and speech-motor skills. Pearson Product Moment Correlations were calculated to determine the nature of relations between stimulability and each of these other variables. Results revealed marked relations between stimulability and PCC and between stimulability and inventory size. Relations between stimulability and both multisyllabic nonsense and real word repetition rates were substantial. Findings suggest that stimulability, as measured for a group of sounds typically challenging for children with SSD, reflects both underlying phonological representations (UPRs) and phonetic imitative skill. The impact of poor stimulability skills in children with severe involvement of SSD and limited phonetic inventories implicates not only the potential difficulty non-stimulable sounds pose at the word level, but the need for increasing stimulability in these children. This, in turn, is a tribute to Miccio's intervention programme and the need for including it in both efficacy and efficiency investigations.

Asunto(s)