The Relationship Between Speech Accuracy and Linguistic Measures in Narrative Retells of Children With Speech Sound Disorders.

BACKGROUND: Speech and language are interconnected systems, and language disorder often co-occurs with childhood apraxia of speech (CAS) and non-CAS speech sound disorders (SSDs). Potential trade-off effects between speech and language in connected speech in children without overt language disorder have been less explored. METHOD: Story retell narratives from 24 children (aged 5;0-6;11 [years;months]) with CAS, non-CAS SSD, and typical development were analyzed in Systematic Analysis of Language Transcripts (SALT) regarding morphosyntactic complexity (mean length of C-unit in words [MLCU]), lexical diversity (moving-average type-token ratio [MATTR]), and linguistic accuracy (any linguistic error/bound morpheme omissions) and compared to 128 age-matched children from the SALT database. Linear and mixed-effects logistic regressions were performed with speech accuracy (percent phonemes correct [PPC]) and diagnostic group as predictors of the narrative variables. RESULTS: PPC predicted all narrative variables. Poorer PPC was associated with lower MLCU and MATTR as well as a higher likelihood of linguistic errors. Group differences were only observed for the error variables. Comparison to the SALT database indicated that 13 of 16 children with CAS and SSD showed a higher-than-expected proportion of linguistic errors, with a small proportion explained by individual speech errors only. CONCLUSIONS: The high occurrence of linguistic errors, combined with the relationship between PPC and linguistic errors in children with CAS/SSD, suggests a trade-off between speech accuracy and language output. Longitudinal studies are needed to investigate whether children with SSDs without language disorder show more language difficulties over time as linguistic demands increase.

Narrative retells in Swedish school-aged children - a clinical pilot study.

AIM: The aim of this pilot study was to evaluate two new retelling tasks intended for clinical use in terms of language sample size, effects of picture support, and order of presentation. METHODS: Forty Swedish-speaking children in grades 4-6 participated in the study, 31 children with typical language development (TLD, mean age 11;1), and nine children with developmental language disorder (DLD, mean age 11;5). Two oral retells, one with and one without picture support, were analyzed with regards to productivity, syntactic complexity, basic Story Grammar (SG) units, and Internal Responses (IR). RESULTS: Results showed no systematic order effects in the TLD group, although this needs to be investigated further, and good inter-rater reliability. Both tasks elicited sufficiently large language samples, except from one participant with DLD whose samples were excluded from subsequent comparisons. When appropriate, data were analyzed with ANOVA (productivity, mean length of C-unit/MLCU), otherwise t-tests (TLD-group) or non-parametric tests (DLD-group) were used. As expected, retells from participants with DLD were shorter, with shorter MLCU and fewer SG units compared to the TLD group. There were also task effects: in the task with picture support, all participants had longer MLCU, and participants with TLD also showed a higher proportion of subordinate clauses, indicating that pictures may function as a support for syntactic complexity. The task without picture support, on the other hand, elicited more C-units indicated by a significant main effect, and more SG units, which was a significant effect in the TLD group. CONCLUSIONS: >We conclude that both tasks might be useful for Swedish speech-language pathologists.

Factors affecting speech-language pathologists' language assessment procedures and tools - challenges and future directions in Sweden.

Purpose: National surveys of speech-language pathologists' (SLP) practices play an important role in professional development, and previous research show that many challenges faced by the profession are similar across the globe. This study aims to describe Swedish SLP assessment practices, examine factors that may affect this practice, and discuss the results in the light of international studies.Methods: Data from 584 SLPs were collected through an online questionnaire with multiple choice and open-ended questions. A mixed-method design was deployed where a deductive qualitative analysis of free-text responses complemented quantitative data.Results: In line with previous results from English-speaking countries, both standardized discrete skill tests and contextualized assessments were used by the respondents but fewer used language sample analysis and dynamic assessment procedures, despite international recommendations. There were few differences based on experience, work setting, proportion of multilingual assessments and socio-economic status of the health catchment area. Main challenges reported were lack of time and difficulty prioritizing, and assessment and/or diagnosis of multilingual/L2 children, which is similar to challenges faced by SLPs in other countries. Swedish SLPs also reported lack of national clinical guidelines as a main challenge. Factors contributing to better assessments included experience, and the combination of many sources of information, including professional and interprofessional discussions.Conclusions: The accumulated evidence from this and previous studies show that to address challenges and build on strengths, changes on a systemic level are needed. This includes more time and resources for continuing education and implementation of recommended assessment methods, as well as professional and interprofessional collaborations.

No learning loss in Sweden during the pandemic evidence from primary school reading assessments.

The COVID-19 pandemic has led to worldwide school closures, with a risk of learning loss. Sweden kept primary schools open, but it is unknown whether student and teacher absence and pandemic-related stress factors affected teaching and student progress negatively. In this study, reading assessment data from 97,073 Swedish primary school students (grades 1-3) were analysed to investigate potential learning loss. Results showed that word decoding and reading comprehension scores were not lower during the pandemic compared to before the pandemic, that students from low socio-economic backgrounds were not especially affected, and that the proportion of students with weak decoding skills did not increase during the pandemic. Study limitations are discussed. We conclude that open schools benefitted Swedish primary school students.

The effect of picture support on narrative retells in Swedish adolescents with ADHD.

ADHD is characterized by executive functioning (EF) deficits, which in turn may affect language, and therefore EF demands in language assessment tasks are important to consider. This study aims to inform clinical practice by 1) comparing and describing narrative retells in Swedish adolescents with and without ADHD, and 2) investigating the effects of picture support on narration in the two groups. Fifteen adolescents with ADHD and 31 with typical development (TD) participated. Two carefully matched narratives for retelling, one with and one without picture support were administered, transcribed, and analyzed regarding content and linguistic complexity (macro- and microlevel measures). The results showed that the ADHD group included less content than the TD group in both tasks, measured in fewer story grammar units and details. Both groups included more story grammar units in the task without picture support. The TD group had shorter retells with higher syntactic complexity in the task with picture support compared to the task without picture support. Compared to TD peers, retells without picture support from the ADHD group were significantly shorter and had a higher proportion of grammatical errors. These results show different strengths and weaknesses in the two groups and indicate that the narrative task without picture support, which places higher demands on EF, captured a linguistic vulnerability in the ADHD group. In conclusion, the choice of narrative task is important to consider in clinical practice to enable accurate descriptions of linguistic strengths and weaknesses in individuals with ADHD, and aid in differential diagnosis.

Error Type and Lexical Frequency Effects: Error Detection in Swedish Children With Language Impairment.

Purpose: The first aim of this study was to investigate if Swedish-speaking school-age children with language impairment (LI) show specific morphosyntactic vulnerabilities in error detection. The second aim was to investigate the effects of lexical frequency on error detection, an overlooked aspect of previous error detection studies. Method: Error sensitivity for grammatical structures vulnerable in Swedish-speaking preschool children with LI (omission of the indefinite article in a noun phrase with a neuter/common noun, and use of the infinitive instead of past-tense regular and irregular verbs) was compared to a control error (singular noun instead of plural). Target structures involved a high-frequency (HF) or a low-frequency (LF) noun/verb. Grammatical and ungrammatical sentences were presented in headphones, and responses were collected through button presses. Results: Children with LI had similar sensitivity to the plural control error as peers with typical language development, but lower sensitivity to past-tense errors and noun phrase errors. All children showed lexical frequency effects for errors involving verbs (HF > LF), and noun gender effects for noun phrase errors (common > neuter). Conclusions: School-age children with LI may have subtle difficulties with morphosyntactic processing that mirror expressive difficulties in preschool children with LI. Lexical frequency may affect morphosyntactic processing, which has clinical implications for assessment of grammatical knowledge.

Voice and speech range profiles and Voice Handicap Index for males--methodological issues and data.

Reference data for speech range profiles (SRP), voice range profiles (VRP), and Voice Handicap Index (VHI) are presented for Swedish males (n = 30). For comparisons, individual data for four male contact granuloma patients are also reported. For the vocally healthy group mean values were: speaking fundamental frequency 123 Hz (SD 12.1), speaking equivalent level, Leq, 72.2 dB (SD 2.1), SRP area 142 ST*dB (SD 24.1), and VRP area 1,706 ST*dB (SD 340). Mean VHI was 5 (SD 4.8). Test-retest recordings of VRP and SRP for three subjects suggested good reliability. SRP and VRP values for three of the patients fell more than 2 SD outside the reference values. Protocols and results are discussed and standardized recording and analyses procedures are suggested.