Kelly Farquharson

Stability of Language and Literacy Profiles of Children With Language Impairment in the Public Schools

PURPOSE The present study focused on the identification and stability of language and literacy profiles of primary school children receiving school-based language therapy over the course of one academic year. METHOD Participants included 272 early elementary school-age children (144 boys, 128 girls) who had been clinically identified as having a language impairment. A latent profile analysis was used to identify distinct profiles on the basis of a battery of language and literacy assessments in the fall and spring of the academic year. RESULTS Four profiles were identified in both fall and spring that could be best described as representing high, average, and low overall abilities. Two average groups were identified that differentiated according to phonological awareness abilities. Childrens profile membership was variable from fall to spring with nearly 60% of children shifting into a higher profile. The results of t tests comparing children who shifted into higher profiles from those who remained stable in profile membership revealed group differences regarding language severity, socio-economic status, and proportion of therapy sessions received in the classroom. CONCLUSION These results provide further evidence regarding the heterogeneity of children with language impairment served in the public schools, indicating that differences may be best conceptualized along a continuum of severity.

Phonological and lexical influences on phonological awareness in children with specific language impairment and dyslexia

Children with dyslexia and/or specific language impairment have marked deficits in phonological processing, putting them at an increased risk for reading deficits. The current study sought to examine the influence of word-level phonological and lexical characteristics on phonological awareness. Children with dyslexia and/or specific language impairment were tested using a phoneme deletion task in which stimuli differed orthogonally by sound similarity and neighborhood density. Phonological and lexical factors influenced performance differently across groups. Children with dyslexia appeared to have a more immature and aberrant pattern of phonological and lexical influence (e.g., favoring sparse and similar features). Children with SLI performed less well than children who were typically developing, but followed a similar pattern of performance (e.g., favoring dense and dissimilar features). Collectively, our results point to both quantitative and qualitative differences in lexical organization and phonological representations in children with SLI and in children with dyslexia.

Ten Steps to Conducting a Large, Multi-Site, Longitudinal Investigation of Language and Reading in Young Children

Purpose: This paper describes methodological procedures involving execution of a large-scale, multi-site longitudinal study of language and reading comprehension in young children. Researchers in the Language and Reading Research Consortium (LARRC) developed and implemented these procedures to ensure data integrity across multiple sites, schools, and grades. Specifically, major features of our approach, as well as lessons learned, are summarized in 10 steps essential for successful completion of a large-scale longitudinal investigation in early grades. Method: Over 5 years, children in preschool through third grade were administered a battery of 35 higher- and lower-level language, listening, and reading comprehension measures (RCM). Data were collected from children, their teachers, and their parents/guardians at four sites across the United States. Substantial and rigorous effort was aimed toward maintaining consistency in processes and data management across sites for children, assessors, and staff. Conclusion: With appropriate planning, flexibility, and communication strategies in place, LARRC developed and executed a successful multi-site longitudinal research study that will meet its goal of investigating the contribution and role of language skills in the development of childrens listening and reading comprehension. Through dissemination of our design strategies and lessons learned, research teams embarking on similar endeavors can be better equipped to anticipate the challenges.

Establishing Language Benchmarks for Children with Typically Developing Language and Children with Language Impairment.

Purpose Practitioners, researchers, and policymakers (i.e., stakeholders) have vested interests in childrens language growth yet currently do not have empirically driven methods for measuring such outcomes. The present study established language benchmarks for children with typically developing language (TDL) and children with language impairment (LI) from 3 to 9 years of age. Method Effect sizes for grammar, vocabulary, and overall language were calculated for children with TDL (n = 20,018) using raw score means and standard deviations from 8 norm-referenced measures of language. Effect sizes for children with LI were calculated using fall and spring norm-referenced language measures for 497 children with LI receiving business-as-usual therapy in the public schools. Results Considerable variability was found in expected change across both samples of children over time, with preschoolers exhibiting larger effect sizes (d = 0.82 and 0.70, respectively) compared with school-age children (d = 0.49 and 0.55, respectively). Conclusions This study provides a first step toward establishing empirically based language benchmarks for children. These data offer stakeholders an initial tool for setting goals based on expected growth (practitioners), making informed decisions on language-based curricula (policymakers), and measuring effectiveness of intervention research (researchers).

Speech Perception and Working Memory in Children with Residual Speech Errors: A Case Study Analysis

Some children with residual deficits in speech production also display characteristics of dyslexia; however, the causes of these disorders--in isolation or comorbidly--remain unknown. Presently, the role of phonological representations is an important construct for considering how the underlying system of phonology functions. In particular, two related skills--speech perception and phonological working memory--may provide insight into the nature of phonological representations. This study provides an exploratory investigation into the profiles of three 9-year-old children: one with residual speech errors, one with residual speech errors and dyslexia, and one who demonstrated typical, age-appropriate speech sound production and reading skills. We provide an in-depth examination of their relative abilities in the areas of speech perception, phonological working memory, vocabulary, and word reading. Based on these preliminary explorations, we suggest implications for the assessment and treatment of children with residual speech errors and/or dyslexia.

Working memory in school-age children with and without a persistent speech sound disorder

Abstract Purpose: The aim of this study was to explore the role of working memory processes as a possible cognitive underpinning of persistent speech sound disorders (SSD). Method: Forty school-aged children were enrolled; 20 children with persistent SSD (P-SSD) and 20 typically developing children. Children participated in three working memory tasks – one to target each of the components in Baddeley’s working memory model: phonological loop, visual spatial sketchpad and central executive. Result: Children with P-SSD performed poorly only on the phonological loop tasks compared to their typically developing age-matched peers. However, mediation analyses revealed that the relation between working memory and a P-SSD was reliant upon nonverbal intelligence. Conclusion: These results suggest that co-morbid low-average nonverbal intelligence are linked to poor working memory in children with P-SSD. Theoretical and clinical implications are discussed.

Exploring the Overlap Between Dyslexia and Speech Sound Production Deficits

Purpose Children with dyslexia have speech production deficits in a variety of spoken language contexts. In this article, we discuss the nature of speech production errors in children with dyslexia, including those who have a history of speech sound disorder and those who do not, to familiarize speech-language pathologists with speech production-specific risk factors that may help predict or identify dyslexia in young children. Method In this tutorial, we discuss the role of a phonological deficit in children with dyslexia and how this may manifest as speech production errors, sometimes in conjunction with a speech sound disorder but sometimes not. We also briefly review other factors outside the realm of phonology that may alert the speech-language pathologist to possible dyslexia. Results Speech-language pathologists possess unique knowledge that directly contributes to the identification and remediation of children with dyslexia. We present several clinical recommendations related to speech production deficits in children with dyslexia. We also review what is known about how and when children with speech sound disorder are most at risk for dyslexia. Conclusion Speech-language pathologists have a unique opportunity to assist in the identification of young children who are at risk for dyslexia.

Language or motor: reviewing categorical etiologies of speech sound disorders.

Children with speech sound disorders (SSDs) exhibit marked weakness with accurate production of age-appropriate speech sounds (Lewis et al., 2006). For some of these children, the etiology of the SSD is clear (e.g., cleft palate, a genetic syndrome, or hearing loss). For others, the cause of their aberrant speech development is unknown; this type of SSD is “functional.” Functional SSDs may eventually remediate after a course of treatment, but may also persist into adolescence or event adulthood (Felsenfeld et al., 1994). Regardless of the outcome, the underlying construct that contributes to this disorder remains elusive. The extant literature is comprised of two primary categorical constructs used to explain functional speech sound disorders: language-based deficits and motor-based deficits. Undeniably, all speech productions are both linguistic (speech sounds, meanings of words, syntax of context, etc.) and motoric (the muscle movement of the speech articulators—lips, tongue, jaw, soft palate, etc.) in nature. However, there are certainly competing theories that suggest language (Raitano et al., 2004; Sutherland and Gillon, 2005; Lewis et al., 2006; Preston and Edwards, 2007; Anthony et al., 2011) or motor (Webster et al., 2005; Newmeyer et al., 2007; Peter and Stoel-Gammon, 2008; Visscher et al., 2010; Redle et al., 2015) to be the predominant causal mechanism for persistent deficits in speech production abilities. I argue that the relation between motoric and linguistic ability is likely complimentary, rather than starkly categorical. Although on some levels, the distinction between these two constructs may seem trivial, it is clinically prudent to consider. Presently, many school districts across the country deny services to children who have “just” articulation (i.e., motor-based) impairments. Interestingly, even children with “just” an articulation impairment have been reported to experience academic difficulties, even once the child has remediated the speech production error (Raitano et al., 2004; Farquharson, 2012, 2015). Specifically, difficulties with reading, spelling, and phonological awareness persist often throughout schooling. Studies have supported that adults with a history of speech sound disorders have more often repeated a grade in school than adults with no history. Interestingly, some children with SSD who have spelling difficulties exhibit similar error patterns within their spelling as they do in their speech (e.g., substitution of a particular phoneme, such that a word like “rain” may be spelled “wain”). Such reports would suggest that speech sound disorders are not strictly motoric in nature. However, as a field, we remain unclear on the extent to which motoric deficits contribute to SSDs and the relationship between language ability and motoric ability. That is, although the speech articulators are not independently achieving correct placement for age-appropriate speech sounds, it is often the case that the child is able to correctly move the articulators, but does not do so in connected speech. Some research indicates that this discrepancy is related to phonological representations, or the process by which linguistic/phonological information is stored within memory. Phonological representations may be difficult to access for children with speech sound disorders due to underlying linguistic or cognitive deficits (Larrivee and Catts, 1999; Sutherland and Gillon, 2005; Farquharson, 2012, 2015). The development of phonological representations requires specification of phonological details as well as organization of the segments of a word (Swan and Goswami, 1997). For children who have phonological weaknesses, such as those with speech sound disorders and/or dyslexia these representations do not develop properly. As a result, activities that require repeated access to these representations—reading, speaking, spelling—are difficult or impossible (Sutherland and Gillon, 2005; Preston and Edwards, 2007). Phonological forms that are more complex, have more syllables, or are less familiar will be particularly difficult. This is educationally relevant because children encounter substantial amounts of new vocabulary as they progress through school. For children with speech sound disorders, their ability to access, store, and use those words is circumscribed by their phonological deficits. However, there is a separate body of work that has provided substantial evidence that children with speech sound disorders exhibit motoric weaknesses. Motor ability has been measured in children with speech sound disorders and has examined oral motor, fine motor, and gross motor abilities. For instance, Peter and Stoel-Gammon reported central timing deficits in children with SSD, as evidenced by weaknesses in non-word repetition, clapping imitation, and paced tapping. However, in that study, the researchers examined language skills but did not report them or use them for covariates in analyses. As such, the contribution of language, especially to non-word repetition skills, is not considered. Recently, Redle et al. (2015) reported neuroimaging and behavioral data examining the motoric abilities of children with SSDs. Their results revealed that children with SSDs exhibited weaker oral and fine motor skills compared to typically developing peers. Similar to other investigations of children with SSDs (Farquharson, 2012, 2015), Redle and colleagues found that persistent SSD group performed within the average range for language and cognitive skills, but still significantly differ from their peers. This was strong evidence to support a motoric deficit in children with an otherwise functional SSD. One caveat to this study is that the researchers gathered information regarding the childrens classroom performance via parent survey. It would be interesting to gather these data directly from the classroom teacher and examine how the child is truly performing academically. It remains unclear how these “subclinical” linguistic and cognitive deficits interact with the motoric weaknesses. In my opinion, it is very likely that language and motor have an intricate relationship in terms of speech production. For instance, a young child who exhibits difficulty with speech sound production due to motor-based deficits may eventually persist with the speech sound production errors as a result of eventual language deficits. That is, the motor deficits may have “snow-balled” into language deficits after repeated incorrect production of meaningful linguistic units. Over time, those incorrect productions may result in incorrect phonological representations—this causes difficulties with language and literacy-based skills. Certainly, this particular scenario needs empirical support. However, from my perspective, this seems to be a logical and plausible explanation of the relation between language and motor for children with speech sound disorders. Collectively, research supports that children with SSDs perform below their typically developing peers on measures requiring linguistic and motoric output. Thus, it is possible that the contributions of motor and language to speech production are not disparate, but are dynamically complimentary (see Nip et al., 2009; Iverson, 2010, for reviews). To date, there is not one comprehensive investigation of both of these constructs within the same population of children with SSDs. Such a study would substantiate the relationship between language and motor and potentially ascertain the direction of said relationship. In conclusion, it is evident that future work is necessary to better conceptualize the underlying mechanisms related to speech sound disorders—theoretical or otherwise. Such work will help to improve the quality of both assessment and treatment of this population of children. Further, it is hoped that this line of work will provide policy-makers and administrators with the evidence necessary to make appropriate decisions regarding service provision. It is unjust to regard any form of communication impairment as “just” a deficit that a child should deal with for life.

Decoding Skills in Children With Language Impairment: Contributions of Phonological Processing and Classroom Experiences

PURPOSE Children with language impairment (LI) often demonstrate difficulties with word decoding. Research suggests that child-level (i.e., phonological processing) and environmental-level (i.e., classroom quality) factors both contribute to decoding skills in typically developing children. The present study examined the extent to which these same factors influence the decoding skills of children with LI, and the extent to which classroom quality moderates the relationship between phonological processing and decoding. METHOD Kindergarten and first-grade children with LI (n = 198) were assessed on measures of phonological processing and decoding twice throughout the academic year. Live classroom observations were conducted to assess classroom quality with respect to emotional support and instructional support. RESULTS Hierarchical regression analyses revealed that of the 3 phonological processing variables included, only phonological awareness significantly predicted spring decoding outcomes when controlling for childrens age and previous decoding ability. One aspect of classroom quality (emotional support) was also predictive of decoding, but there was no significant interaction between classroom quality and phonological processing. CONCLUSIONS This study provides further evidence that phonological awareness is an important skill to assess in children with LI and that high-quality classroom environments can be positively associated with childrens decoding outcomes.

Are working memory and behavioral attention equally important for both reading and listening comprehension? A developmental comparison

We investigated the extent to which working memory and behavioral attention predicted reading and listening comprehension in grades 1 through 3 and, whether their relative contributions differed by modality and grade. Separate grade samples (N = 370; ns = 125, 123, and 122 for grades 1, 2, and 3 respectively) completed multiple measures of word reading, working memory, and parallel measures of reading and listening comprehension. Teachers and parents provided behavioral attention ratings. Concurrently, working memory was more important for listening than for reading comprehension and predicted significant variance in both modalities across grades, after controlling for background measures and behavioral attention ratings. For both modalities, working memory explained the greatest proportion of variance in grade 3. Behavioral attention predicted variance in grades 1 and 2 for reading comprehension and all grades for listening comprehension. Subsidiary analyses demonstrated that the influence of working memory and behavioral attention on reading comprehension was indirect, through word reading and listening comprehension both concurrently and also longitudinally between grades 1–3. These findings indicate that delivery of classroom materials orally will not always be beneficial to the young beginner reader or one who struggles with word decoding, and that children with poor working memory/attention may require additional support to access meaning from both written and spoken text.