Beth McIntosh

Enhancing the phonological awareness and language skills of socially disadvantaged preschoolers: An interdisciplinary programme:

The research reported investigated the efficacy of intervention, developed by a speech-language therapist and implemented by a teacher, for the language and phonological awareness (PA) abilities of pre-school, socially disadvantaged children. One study established that children from low socio-economic (SES) backgrounds had poorer skills on both measures compared to children of average SES. Half of the low SES group received language and PA intervention programmes and their progress was compared to untreated SES matched controls. Both programmes were highly effective with post-intervention performance not only exceeding that of SES controls but also equalling the performance of controls of average SES.

The input processing, cognitive linguistic and oro-motor skills of children with speech difficulty

Children with speech difficulty of no known etiology are a heterogeneous group. While speech errors are often attributed to auditory processing or oro-motor skill, an alternative proposal is a cognitive-linguistic processing difficulty. Research studies most often focus on only one of these aspects of the speech processing chain. This study investigated abilities in all three domains in children with speech difficulty (n = 78) and matched controls (n = 87). It was hypothesized that groups of children with speech difficulty would perform less well than controls on all tasks, but that the proportion of children with speech difficulty performing within the normal range would differ across tasks. The input processing task required children to perceive the auditory-visual illusion in speech perception, where listeners perceive when they hear presented in synchrony with the lip movements for . Diadochokinetic, isolated and sequenced movements tasks assessed oro-motor skills. Two non-verbal tasks evaluated rule derivation. The results indicated that rule derivation best discriminated typically developing and speech difficulty groups. Few children were identified as having an input or output difficulty, whereas difficulties with rule-derivation were common. The data support the notion that speech difficulty is, most often, associated with a central processing difficulty.

Evaluation of Core Vocabulary intervention for treatment of inconsistent phonological disorder: Three treatment case studies

Children with unintelligible speech differ in severity, underlying deficit, type of surface error patterns and response to treatment. Detailed treatment case studies, evaluating specific intervention protocols for particular diagnostic groups, can identify best practice for children with speech disorder. Three treatment case studies evaluated the efficacy of Core Vocabulary intervention for three boys with inconsistent speech disorder. The cases examined the effects of previous intervention, use of default preferred word plans and behaviour disorder on intervention outcome. Inconsistent speech disorder was diagnosed after Diagnostic Evaluation of Articulation and Phonology assessment. A Core Vocabulary approach to intervention was selected to focus on planning whole word production rather than surface error patterns or specific sound features. Individual differences between cases led to different amounts of intervention and the number of words taught during intervention. All three boys showed gains in intelligibility, accuracy and consistency of word production. Core Vocabulary intervention was shown to be appropriate for all three children, although their individual differences required clinical adaptation of the approach.

Two-year-old phonology: impact of input, motor and cognitive abilities on development

Previous research has rarely compared the contributions of different underlying abilities to phonological acquisition. In this study, the auditory-visual speech perception, oro-motor and rule abstraction skills of 62 typically developing two-year olds were assessed and contrasted with the accuracy of their spoken phonology. Measures included auditory-visual speech perception, production of isolated and sequenced oro-motor movements, and verbal and non-verbal rule abstraction. Abilities in all three domains contributed to phonological acquisition. However, the use of atypical phonological rules was associated with lower levels of phonological accuracy and a linear regression indicated that this measure of rule abstraction had greater explanatory power than the measures of input processing and output skill.

Two-year-olds' phonological acquisition: Normative data

The study reported evaluated an assessment of phonology for 2-year-olds to establish normative data and determine if early identification of children with speech difficulties is possible. The study evaluated 62 2-year-old children on the Toddler Phonology Test (TPT). Children produced 32 words, spontaneously or in imitation. Ten of the children were assessed three times, on the third occasion, when they had reached 3 years, on another phonological assessment. The data indicated that older children performed better than younger children on quantitative measures. Girls and boys performed equally well. Their phonetic repertoires were missing some fricatives and all affricates, as well as /r/. Consistently used error patterns identified included cluster reduction, final consonant deletion, stopping, fronting, weak syllable, deletion, gliding and deaffrication. Correlation analyses indicated that performance at the first assessment on the TPT indicated performance on subsequent assessments. While quantitative data was not a reliable predictive indicator of speech disorder, qualitative analysis of error types was predictive, with children who made many atypical errors at 2 years being diagnosed as phonologically disordered at 3 years. The findings provide initial evidence that direct formal assessment of 2-year-old phonology is possible.

Perception of the auditory‐visual illusion in speech perception by children with phonological disorders

An example of the auditory‐visual illusion in speech perception, first described by McGurk and MacDonald, is the perception of [ta] when listeners hear [pa] in synchrony with the lip movements for [ka]. One account of the illusion is that lip‐read and heard speech are combined in an articulatory code since people who mispronounce words respond differently from controls on lip‐reading tasks. A same‐different judgment task assessing perception of the illusion showed no difference in performance between controls and children with speech difficulties. Another experiment compared children with delayed and disordered speech on perception of the illusion. While neither group perceived many illusions, a significant interaction indicated that children with disordered phonology were strongly biased to the auditory component while the delayed groups response was more evenly split between the auditory and visual components of the illusion. These findings suggest that phonological processing, rather than articulation, supports lip‐reading ability.

A core vocabulary approach for management of inconsistent speech disorder

Developmental speech disorder is accounted for by theories derived from psychology, psycholinguistics, linguistics and medicine, with researchers developing assessment protocols that reflect their theoretical perspective. How theory and data analyses lead to different therapy approaches, however, is sometimes unclear. Here, we present a case management plan for a 7 year old boy with unintelligible speech. Assessment data were analysed to address seven case management questions regarding need for intervention, service delivery, differential diagnosis, intervention goals, generalization of therapeutic gains, discharge criteria and evaluation of efficacy. Jarrod was diagnosed as having inconsistent speech disorder that required intervention. He pronounced 88% of words differently when asked to name each word in the 25 word inconsistency test of the Diagnostic Evaluation of Articulation and Phonology three times, each trial separated by another activity. Other standardized assessments supported the diagnosis of inconsistent speech disorder that, according to previous research, is associated with a deficit in phonological assembly. Core vocabulary intervention was chosen as the most appropriate therapy technique. Its nature and a possible protocol for implementation is described.

The impact of selecting different contrasts in phonological therapy

Previous research indicates that the extent of progress made by children with phonological disorders depends upon the nature of the word pairs contrasted in therapy. For example, phonemes that differ maximally in terms of place, manner, voicing and sound class (e.g., fan – man) in comparison to therapy where the word pairs presented differ minimally (e.g., fan – van). To investigate the implications of target selection within a typical clinical context (as opposed to a rigorous research setting) eight speech-language pathologists implemented intervention with appropriate children from their caseloads. Nineteen children each received 6 hours of therapy over one school term. They were randomly allocated to two groups. One group (of nine children) received intervention based on a traditional minimal pair approach, targeting homonymy as well as distinctive feature contrast. The other group (ten children) received intervention targeting contrasts differing across a range of distinctive features. Children made considerable progress in therapy in terms of speech accuracy and number of error patterns suppressed. However, there was no difference between the progress of the two groups. Follow-up assessment of 14 of the 19 children indicated maintenance of progress by both groups. Reasons for the lack of difference between the groups in the current study are considered and clinical implications are drawn.

Phonological awareness and language intervention in preschoolers from low socio-economic backgrounds: A longitudinal investigation

This study examines the literacy outcomes for children from socially disadvantaged backgrounds who had received specific whole-class phonological awareness (PA) and language intervention in preschool. The participants were 57 children who had been involved in the original intervention study. Their PA skills, letter-sound knowledge, real word and non-word spelling and reading comprehension were assessed in Grade 2. The results indicated that children who had received intervention in preschool performed similarly to the children who had not received intervention. The gains made in PA and language skills post intervention had failed to augment further literacy development. A post hoc examination of individual student profiles, however, revealed that a subgroup of children who had received intervention had maintained their enhanced performance and that the intervention cohort had similar scores on tests of PA ability to their age-matched peers in the population. It was concluded that whole-class, teacher-delivered, PA and language intervention, while effective in the short term, does not lead to a generalized improvement in literacy skills in Grade 2. Possible reasons for the failure of the program to produce medium term gains are discussed.

The literacy abilities of 11 year-old student from socially disadvantaged backgrounds

This study investigated the literacy skills of all children in Year 6 of a Queensland school in a socially disadvantaged area who were exposed to a “whole language” approach to the learning of written language. Standardized tests of non-word spelling and reading comprehension (including written sentence responses) revealed a large group of children with literacy difficulties. This group of 11-year-old children, and a group of matched controls, were further assessed on measures of phonological awareness and letter sound knowledge. The results indicated that the means of both groups were below those of the standardization populations, and that the children had particular difficulty writing short answers to questions. The group of children identified as performing poorly on the non-word spelling test was heterogeneous. Some had poor phonological awareness skills, some had limited sound-letter correspondence knowledge, some children had problems with both skills. The data demonstrated the need for assessment to identify the specific sub-skills with which individuals have difficulty, in order to allow for appropriate intervention rather than a generic phonological awareness intervention package for all children with literacy difficulties irrespective of age or social status.