Sarah Masso

Polysyllable productions in preschool children with speech sound disorders: Error categories and the Framework of Polysyllable Maturity

Abstract Purpose: Children with speech sound disorders (SSD) find polysyllables difficult; however, routine sampling and measurement of speech accuracy are insufficient to describe polysyllable accuracy and maturity. This study had two aims: (1) compare two speech production tasks and (2) describe polysyllable errors within the Framework of Polysyllable Maturity. Method: Ninety-three preschool children with SSD from the Sound Start Study (4;0–5;5 years) completed the Polysyllable Preschool Test (POP) and the Diagnostic Evaluation of Articulation and Phonology (DEAP-Phonology). Result: Vowel accuracy was significantly different between the POP and the DEAP-Phonology. Polysyllables were analysed using the seven Word-level Analysis of Polysyllables (WAP) error categories: (1) substitution of consonants or vowels (97.8% of children demonstrated common use), (2) deletion of syllables, consonants or vowels (65.6%), (3) distortion of consonants or vowels (0.0%), (4) addition of consonants or vowels (0.0%), (5) alteration of phonotactics (77.4%), (6) alteration of timing (63.4%) and (7) assimilation or alteration of sequence (0.0%). The Framework of Polysyllable Maturity described five levels of maturity based on children’s errors. Conclusions: Polysyllable productions of preschool children with SSD can be analysed and categorised using the WAP and interpreted using the Framework of Polysyllable Maturity.

Cluster-randomized controlled trial evaluating the effectiveness of computer-assisted intervention delivered by educators for children with speech sound disorders

Purpose The aim was to evaluate the effectiveness of computer-assisted input-based intervention for children with speech sound disorders (SSD). Method The Sound Start Study was a cluster-randomized controlled trial. Seventy-nine early childhood centers were invited to participate, 45 were recruited, and 1,205 parents and educators of 4- and 5-year-old children returned questionnaires. Children whose parents and educators had concerns about speech were assessed (n = 275); 132 children who were identified with phonological pattern-based errors underwent additional assessment. Children with SSD and no difficulties with receptive language or hearing, typical nonverbal intelligence, and English as their primary language were eligible; 123 were randomized into two groups (intervention n = 65; control n = 58), and 3 withdrew. The intervention group involved Phoneme Factory Sound Sorter software (Wren & Roulstone, 2013) administered by educators over 9 weeks; the control group involved typical classroom practices. Participants were reassessed twice by a speech-language pathologist who was unaware of the initial assessment and intervention conditions. Results For the primary outcome variable (percentage of consonants correct), the significant mean change from pre- to postintervention for the intervention group (mean change = +6.15, p < .001) was comparable in magnitude to the significant change for the control group (mean change = +5.43, p < .001) with a small between-groups effect size for change (Cohens d = 0.08). Similar results occurred for measures of emergent literacy, phonological processing, participation, and well-being. Conclusion Computer-assisted input-based intervention administered by educators did not result in greater improvement than typical classroom practices.

How do children with phonological impairment respond to requests for clarification containing polysyllables

Accurate production of polysyllables (words of three or more syllables) can be challenging for children with phonological impairment. Research with typically developing children has suggested that children can improve their polysyllable productions in response to requests for clarification containing an incorrect model of a target word (Gozzard et al., 2008). This study extends the work of Gozzard et al. (2008) by determining whether accuracy can improve in response to requests for clarification containing a correct (e.g. ‘did you say elephant?’) versus an incorrect (e.g. ‘did you say eresemp?’) model. Four children with phonological impairment (aged 3;10, 3;11, 4;3 and 5;4) had segmental and structural difficulties with polysyllables, in both single word and connected speech contexts. All participants revised their productions following requests for clarification containing the incorrect production, with 75.8% of suprasegmental and phonological revisions demonstrating increased accuracy. No phonological or suprasegmental revisions occurred following requests for clarification containing the correct model. The findings suggest that role of communication breakdown and repair in intervention targeting children’s polysyllable difficulties needs to be better understood.

Preschool children’s communication, motor and social development: Parents’ and educators’ concerns

Abstract Purpose: During early childhood, it is important to identify which children require intervention before they face the increased demands of school. This study aimed to: (1) compare parents’ and educators’ concerns, (2) examine inter-rater reliability between parents’ and educators’ concerns and (3) determine the group difference between level of concern and children’s performance on clinical testing. Method: Parents and educators of 1205 4- to 5-year-old children in the Sound Start Study completed the Parents’ Evaluation of Developmental Status. Children whose parents/educators were concerned about speech and language underwent direct assessment measuring speech accuracy (n = 275), receptive vocabulary (n = 131) and language (n = 274). Result: More parents/educators were concerned about children’s speech and expressive language, than behaviour, social–emotional, school readiness, receptive language, self-help, fine motor and gross motor skills. Parents’ and educators’ responses were significantly correlated (except gross motor). Parents’ and educators’ level of concern about expressive speech and language was significantly correlated with speech accuracy on direct assessment. Educators’ level of concern was significantly correlated with a screening measure of language. Scores on a test of receptive vocabulary significantly differed between those with concern and those without. Conclusion: Children’s communication skills concerned more parents and educators than other aspects of development and these concerns generally aligned with clinical testing.

Implementation fidelity of a computer-assisted intervention for children with speech sound disorders

Abstract Background: Implementation fidelity refers to the degree to which an intervention or programme adheres to its original design. This paper examines implementation fidelity in the Sound Start Study, a clustered randomised controlled trial of computer-assisted support for children with speech sound disorders (SSD). Method: Sixty-three children with SSD in 19 early childhood centres received computer-assisted support (Phoneme Factory Sound Sorter [PFSS] – Australian version). Educators facilitated the delivery of PFSS targeting phonological error patterns identified by a speech-language pathologist. Implementation data were gathered via (1) the computer software, which recorded when and how much intervention was completed over 9 weeks; (2) educators’ records of practice sessions; and (3) scoring of fidelity (intervention procedure, competence and quality of delivery) from videos of intervention sessions. Result: Less than one-third of children received the prescribed number of days of intervention, while approximately one-half participated in the prescribed number of intervention plays. Computer data differed from educators’ data for total number of days and plays in which children participated; the degree of match was lower as data became more specific. Fidelity to intervention procedures, competency and quality of delivery was high. Conclusion: Implementation fidelity may impact intervention outcomes and so needs to be measured in intervention research; however, the way in which it is measured may impact on data.

Educators’ perspectives on facilitating computer-assisted speech intervention in early childhood settings:

Early childhood educators are frequently called on to support preschool-aged children with speech sound disorders and to engage these children in activities that target their speech production. This study explored factors that acted as facilitators and/or barriers to the provision of computer-based support for children with speech sound disorders (SSD) in early childhood centres. Participants were 23 early childhood educators at 13 centres who participated in the Sound Start Study, a randomized controlled trial that examined the effectiveness of the Phoneme Factory Sound Sorter® (PFSS) computer program (Wren and Roulstone, 2013). Following the trial, participants completed a telephone interview discussing their experiences implementing the program. Transcripts from the interviews were analysed and three categories emerged as factors that influenced the provision of support: (1) personal factors that related to the children (engagement with PFSS, inclusion/exclusion experience), peers, and educators (service provision, educator engagement, support of child PFSS use); (2) environmental factors that related to policies and philosophies (child-centred practice, technology), the physical environment (inclusion/exclusion), and logistics (time, technology); and (3) program factors that related specifically to PFSS (program format, specific games, game duration). In order to best meet the needs of children, parents, educators, and clinicians, these factors need to be taken into consideration in the provision of speech and language therapy services in early childhood centres.

Profile of Australian preschool children with speech sound disorders at risk for literacy difficulties

Abstract Speech sound disorders are a common communication difficulty in preschool children. Teachers indicate difficulty identifying and supporting these children. The aim of this research was to describe speech and language characteristics of children identified by their parents and/or teachers as having possible communication concerns. 275 Australian 4- to 5-year-old children from 45 preschools whose parents and teachers were concerned about their talking participated in speech-language pathology assessments to examine speech, language, literacy, non-verbal intelligence, oromotor skills and hearing. The majority (71.3%) of children demonstrated lower consonant accuracy than expected for their age, 63.9% did not pass the language-screening task, 65.5% had not been assessed and 72.4% had not received intervention from a speech-language pathologist. The 132 children who were identified with speech sound disorder (phonological impairment) were more likely to be male (62.9%) who were unintelligible to unfamiliar listeners, and had poor emergent literacy and phonological processing skills, despite having typical hearing, oral structures, and intelligence. Children identified by parents and teachers with concerns may have a range of speech, language and communication needs requiring professional support.

Longitudinal changes in polysyllable maturity of preschool children with phonologically-based speech sound disorders

ABSTRACT Children’s polysyllables were investigated for changes in (1) consonant and vowel accuracy, (2) error frequency and (3) polysyllable maturity over time. Participants were 80 children (4;0-5;4) with phonologically-based speech sound disorders who participated in the Sound Start Study and completed the Polysyllable Preschool Test (Baker, 2013) three times. Polysyllable errors were categorised using the Word-level Analysis of Polysyllables (WAP, Masso, 2016a) and the Framework of Polysyllable Maturity (Framework, Masso, 2016b), which represents five maturity levels (Levels A-E). Participants demonstrated increased polysyllable accuracy over time as measured by consonant and vowel accuracy, and error frequency. Children in Level A, the lowest level of maturity, had frequent deletion errors, alterations of phonotactics and alterations of timing. Participants in Level B were 8.62 times more likely to improve than children in Level A at Time 1. Children who present with frequent deletion errors may be less likely to improve their polysyllable accuracy.

Digital Tools to Support Children’s Speech and Language Skill

Most children develop speech and language with ease and quickly become sophisticated communicators. For some children, however, these skills are acquired with difficulty and extra support is required. A range of digital tools are available to assist with this: some of these are based on theories of speech and language acquisition, while others have been developed in response to market demands. Few empirical studies of digital tools for speech and language development have been carried out though some success has been noted when facilitated by a speech-language pathologist (SLP). Given the interactional capabilities of digital tools, it would be helpful to identify whether they could achieve similar results independent of SLP support. One such tool, Phoneme Factory Sound Sorter®, was tested in a randomised controlled trial with early childhood educators delivering the intervention. Improvement in speech production varied across both groups and significant differences were not observed. However, supplementary investigations found that parents and educators were positive towards the use of digital tools, and findings relating to the implementation of the intervention have been identified, which provide useful information for settings looking to use digital tools to promote speech and language skills in children.

Innovations actively shaping speech-language pathology evidence-based practice

Evidence-based practice (EBP) is a central tenet of standard practice set out as a professional standard for speech-language pathologists (SLPs). The result of this professional focus on EBP is that speech-language pathology is an innovative profession that actively reflects on the outcomes of past practices and invests in our future practices to provide the best evidencebased care for our clients. Through challenging old assumptions and conventions, and striving for better evidence-based care, we ask ourselves, ‘‘Is this the best way?’’ and ‘‘Is there a better way to support this client?’’ The 2017 Speech Pathology Australia (SPA) National Conference theme, ‘‘Working and Investing in Future Innovations’’, embodied the spirit of innovation borne out of a desire for EBP. The myriad of ways that embodies the spirit of innovation borne out of a desire for EBP. The myriad of ways that SLPs are reflecting, questioning, and innovating to improve evidence-based care are reflected in the papers presented in the current special issue. The 2017 SPA National Conference theme attracted clinical and research workshops, presentations, and posters that demonstrated the strength of EBP and practice-based evidence. Fittingly, the conference was set in a new and innovative presentation space where participants were immersed in a melting pot of knowledge that seamlessly blended traditional conference procedures and protocols with new technologies (e.g. ePosters) and methods of knowledge dissemination (e.g. trending #SPAconf social media hashtag). Conference papers evaluated novel ways that SLPs are applying well-known assessment (e.g. conversation and traumatic brain injury communities; Brunner, Hemsley, Togher, Dann, & Palmer 2017), intervention (e.g. telehealth and social communication therapy; Garnett, Davidson, & Eadie, 2017), and research (e.g. Language Environment Analysis; Choo, Dettman, Dowell, & Cowan, 2017) methods. Especially engaging were opportunities to hear first-hand about the experiences of clients and their families who had worked with SLPs (Kitchin et al., 2017). The 2017 conference highlighted SLPs’ engagement in self-evaluation of practice and that we stand together to share, learn, and grow the knowledge base of our profession. The papers that are presented in this special issue of the International Journal of Speech-Language reflect the diversity of topics, settings, and professionals who presented at this conference. Eight articles appear in this special issue, with three of these representing the invited papers from the keynote speakers. In the Elizabeth Usher Memorial Lecture paper, Professor Tricia McCabe articulates principles from behavioural economics that inspire SLPs to practice what we preach; namely, to strive for evidence-based practice through understanding the tensions that exist in achieving this goal (McCabe, 2018). McCabe hypothesised that tensions and disconnect between evidence and practice can be managed more effectively when we take the time to analyse and recognise positive and negative behavioural patterns in our work. McCabe suggests that when we understand and embrace these behavioural patterns and challenges there is a collective advantage for our clients, colleagues and our profession as a whole. Associate Professor Emily Plowman’s keynote address on neural plasticity and rehabilitation challenged traditional conventions and thus resonated with Professor McCabe’s call to view our existing practices in new ways. The paper in this issue, by Plowman and Humbert, extends Plowman’s keynote and brings in material covered during an associated