Joy Stackhouse

Phonological dyslexia and dysgraphia—a developmental analysis

Abstract The present paper presents data from seven developmental dyslexics who exhibit the profile of abilities which can be described as “phonological” dyslexia. Three of the cases, all children, were of low reading age; four cases, one of which was an adult, had reading ages above ten years. Tests of reading, spelling and auditory processing revealed a range of phonological deficits amongst the dyslexics when they were compared with normal readers matched for RA. However, there were individual differences, and some cases were more prototypical than others. Variability within the dyslexic sample highlights difficulties for their classification as phonological dyslexics. It is argued that a more useful approach is to consider their difficulties within a developmental framework in which phonological deficits hinder and may alter the course of literacy development.

Speech, language, and cognitive development in children with isolated sagittal synostosis

This study investigated the occurrence, nature, and severity of speech, language, and cognitive impairment in 76 children (61 males, 15 females) with isolated sagittal synostosis (ISS) aged 9 months to 15 years 7 months. There was no increased prevalence of global cognitive impairment in the group but there was a high prevalence rate of speech and/or language impairment with 28 (37%) displaying impairment of whom 20 (71%) had moderate or severe impairments that fulfilled the criteria for specific impairments. Prevalence rates were only increased for children over two years of age. Expressive language impairment occurred most frequently. Raised intracranial pressure, peri-neonatal risk factors, otitis media, or being operated were not associated with impairment. Surgery at a later age and a family history of speech and language impairment were both associated with impairments but numbers were small. The findings suggest that children with ISS are at an increased risk of developing speech and language impairment.

Developmental verbal dyspraxia I: A review and critique

Developmental verbal dyspraxia is examined from four perspectives: clinical, phonetic, linguistic and cognitive. The paper critically discusses the problems encountered when criteria for identifying acquired speech disorders in the adult population are applied to childrens speech difficulties without modifications. It is argued that studies of verbal dyspraxia in children have ignored the unfolding nature of this condition and that a developmental perspective has been lacking in the literature. A need for the inclusion of appropriate control groups and longitudinal case studies is identified. The issue and process of differential diagnosis are addressed and a checklist of criteria for identifying developmental verbal dyspraxia is included. It is noted that this process will inevitably be lengthy with data needed from different aspects of a childs development. Phonetic characteristics alone may not be sufficient to recognise this medical condition with its complex psycholinguistic and educational consequences.

Rate, accuracy and consistency: diadochokinetic performance of young, normally developing children

This paper describes the performance of 30 normally developing children in the age range of 3-5 years on silent and spoken diadochokinetic (DDK) tasks. Issues of task design and scoring are explored and the findings are interpreted from a developmental and psycholinguistic perspective. Rate, accuracy and consistency measures of the childrens performance are used to make comparisons both with the adult model presented and with each childs own speech sound system. The results show that, in general, accuracy and consistency of response are more sensitive DDK assessment measures for pre-school children than the more traditionally used rate of production. However, in each age group, different profiles of performance emerged which can be used for comparison with children with speech difficulties. It is argued that this normative data is essential for understanding the nature of childrens speech difficulties, interpreting DDK assessment results, and for planning appropriate intervention.

SPELLING PERFORMANCE OF CHILDREN WITH DEVELOPMENTAL VERBAL DYSPRAXIA

The ability of four children with developmental verbal dyspraxia to imitate, spell, read and copy regular single‐syllable words was investigated. The children were found to have more difficulty in spelling and reading these words than a group of children with normal speech who were matched for reading age. It is suggested that ‘dyspraxie’ children are subject to a phonetic spelling deficit which arises because of a difficulty in segmenting words at a speech‐sound level.

Psycholinguistic assessment of developmental speech disorders

Although various psycholinguistic models of speech and language processing have been developed to account for levels of breakdown in developmental speech disorders, it is not obvious how they are to be applied in clinical practice. At the same time, speech and language therapists have routinely been using a wide range of procedures, including published tests, that tap different levels of phonological processing in the child. When analysed and classified appropriately, these procedures can form the basis for a comprehensive psycholinguistic investigation of developmental speech disorders. The aim of this paper is to present a clinically usable, needs-driven but theoretically motivated framework for investigation. The framework is organised in terms of a series of questions that the clinician can pose about the levels of deficit in processing that may be giving rise to the childs speech problems. It is illustrated by means of a case study of a child with a severe developmental speech disorder, which reveals a complex pattern of deficits within the speech processing chain. As the main purpose of the framework is to provide a useful clinical tool to facilitate the planning of appropriate therapy for the individual child, some therapy objectives deriving from the assessment are outlined.

Developmental verbal dyspraxia II: A developmental perspective on two case studies

A longitudinal study of the speech errors of two school-age children with what was described as developmental verbal dyspraxia is presented. By comparing them with a group of normally developing children matched on articulation age, it was possible to identify speech errors not typical of earlier speech development, involving problems with syllable structure planning and vocal tract coordination. The speech-disordered children could produce more words correctly than the controls, but, when they did make speech errors, these were more serious than those found in the younger children. The speech-disordered children were followed up 4 years later. Although their speech had improved, they presented with the same profile of error types. They had increased intelligibility by adding more word-specific articulations but still had difficulties with novel and complex material. The adoption of a developmental framework in this study allowed the identification of different levels of breakdown within the speech production process. The case-study method is recommended to investigate how these levels may interact and the clinical implications of the findings are outlined.

Educational consequences of developmental speech disorder: Key Stage 1 National Curriculum assessment results in English and mathematics.

BACKGROUND Children with speech difficulties may have associated educational problems. This paper reports a study examining the educational attainment of children at Key Stage 1 of the National Curriculum who had previously been identified with a speech difficulty. AIMS (1) To examine the educational attainment at Key Stage 1 of children diagnosed with speech difficulties two/three years prior to the present study. (2) To compare the Key Stage 1 assessment results of children whose speech problems had resolved at the time of assessment with those whose problems persisted. SAMPLE(S) Data were available from 39 children who had an earlier diagnosis of speech difficulties at age 4/5 (from an original cohort of 47) at the age of 7. A control group of 35 children identified and matched at preschool on age, nonverbal ability and gender provided comparative data. METHODS Results of Statutory Assessment Tests (SATs) in reading, reading comprehension, spelling, writing and maths, administered to children at the end of Year 2 of school were analysed. Performance across the two groups was compared. Performance was also compared to published statistics on national levels of attainment. RESULTS Children with a history of speech difficulties performed less well than controls on reading, spelling and maths. However, children whose speech problems had resolved by the time of assessment performed no differently to controls. Children with persisting speech problems performed less well than controls on tests of literacy and maths. Spelling performance was a particular area of difficulty for children with persisting speech problems. CONCLUSIONS Children with speech difficulties are likely to perform less well than expected on literacy and maths SATs at age 7. Performance is related to whether the speech problem resolves early on and whether associated language problems exist. Whilst it is unclear whether poorer performance on maths is because of the language components of this task, the results indicate that speech problems, especially persisting ones, can affect the ability to access the National Curriculum to expected levels.

Speech‐production skills in children aged 3–7 years

BACKGROUND In recent years, clinicians have been using a psycholinguistic approach to the assessment and remediation of childrens developmental speech disorders. This requires the comparison of a childs performance across a range of speech-production tasks. AIMS To describe the profile of performance across different speech-production tasks in normal development and to discuss the application of such data to clinical findings. METHODS & PROCEDURES Three speech-production tasks, picture naming, word repetition and non-word repetition, were presented to 100 children with normal speech development, aged between 3 and 7 years of age. The speech-processing demands of the different tasks were considered using a developmental speech-processing model. Stimuli used in the three task paradigms were carefully matched so that childrens performance across the tasks could be directly compared. OUTCOMES & RESULTS Within the context of normal speech development, there were significant improvements in performance for all three tasks as children get older. There were also significant differences in performance across the three tasks, and the pattern of these relationships changed with age. Significant differences were found in the accuracy of production of words of increasing length. CONCLUSIONS Profiles of speech-production task performance are presented within the context of normal development. Comparison of performance across three different speech-production tasks might provide useful insight into the nature of a childs speech disorder.

Barriers to literacy development in two cases of developmental verbal dyspraxia

Abstract Two cases of children with developmental verbal dyspraxia with dyslexic difficulties are presented. When first tested Michael was 10 years 7 months and Caroline was 11 years of age. At this time, their reading errors were primarily visual in nature and they were unable to read nonwords. Spelling was predominantly nonphonetic. Investigation of their auditory processing and segmentation skills showed pervasive deficits in the auditory modality. At follow-up 4 years later, although some progress had been made, the pattern of errors was similar. It is argued that their problems with phonological processing militated against the successful development of segmentation and blending skills and phonological reading and spelling strategies and that their limited literacy development consisted of the accumulation of word-specific knowledge.