Predictors of Speech Severity and Inconsistency Over Time in Children With Token-to-Token Inconsistency.

PURPOSE: The aim of this study was to describe and explain changes in severity of speech sound disorder (SSD) and token-to-token inconsistency in children with high levels of inconsistency. METHOD: Thirty-nine children (aged 4;6-7;11 [years;months]) with SSDs and high levels of token-to-token inconsistency were assessed every 6 months for 2 years (i.e., five assessment points). Growth modeling was used to assess relations among therapy support, receptive vocabulary, severity, and inconsistency over time. RESULTS: Children with the most severe SSDs and highest levels of token-to-token inconsistency showed the smallest improvements in speech accuracy over time. Therapy support did not predict changes in speech accuracy or token-to-token inconsistency over time. Receptive vocabulary (measured at the outset of the study) was also a significant predictor of speech accuracy and inconsistency. CONCLUSIONS: These findings suggest that an immediate start to intervention (rather than a wait-and-see approach) is recommended for children with inconsistent speech error patterns. The results also highlight the value of developing vocabulary knowledge in addition to improving speech accuracy for some children with inconsistent speech production.

Using the Experience Sampling Method to Examine the Details of Dosage in School-Based Speech Sound Therapy.

PURPOSE: The purpose of this project was to collect practice-based evidence regarding dosage in speech sound therapy sessions in school-based settings. Dosage is the number of trials within a therapy session for any one particular child. School-based speech-language pathologists (SLPs) face a variety of obstacles to service delivery, often making the implementation of evidence-based practices difficult. To that end, we were interested in exploring how therapy parameters, such as group size and session frequency were associated with dosage. METHOD: Using the experience sampling method, we queried school-based SLPs (n = 90) across the United States. SLPs participated via a phone application, which randomly alerted them to participate 3 times per day for 5 days. SLPs also completed a demographic questionnaire that included information regarding caseload size and job satisfaction. RESULTS: We report results from 670 therapy sessions. Results revealed that the therapy parameter of group size was negatively related to dosage. The SLP parameter of caseload size was positively related to dosage, but this was a small association. The child parameter of comorbidity was negatively related to dosage. CONCLUSIONS: Our results support that as group size increases, children receive smaller doses of speech sound practice. Similarly, children who have a reported comorbidity received smaller doses compared to children who have an isolated speech sound disorder. We discuss implications for school-based practitioners and researchers.

Predicting Language Performance From Narrative Language Samples.

PURPOSE: Analysis of narrative language samples is a recommended clinical practice in the assessment of children's language skills, but we know little about how results from such analyses relate to overall oral language ability across the early school years. We examined the relations between language sample metrics from a short narrative retell, collected in kindergarten, and an oral language factor in grades kindergarten through 3. Our specific questions were to determine the extent to which metrics from narrative language sample analysis are concurrently related to language in kindergarten and predict language through Grade 3. METHOD: Participants were a sample of 284 children who were administered a narrative retell task in kindergarten and a battery of vocabulary and grammar measures in kindergarten through Grade 3. Language samples were analyzed for number of different words, mean length of utterance, and a relatively new metric, percent grammatical utterances (PGUs). Structural equation models were used to estimate the concurrent and longitudinal relationships. RESULTS: The narrative language sample metrics were consistently correlated with the individual vocabulary and grammar measures as well as the language factor in each grade, and also consistently and uniquely predicted the language factor in each grade. Standardized path estimates in the structural equation models ranged from 0.20 to 0.39. CONCLUSIONS: This study found narrative language sample metrics to be predictive, concurrently and longitudinally, of a latent factor of language from kindergarten through Grade 3. These results further validate the importance of collecting and analyzing narrative language samples, to include PGU along with more traditional metrics, and point to directions for future research. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.17700980.

Is Bilingual Receptive Vocabulary Assessment via Telepractice Comparable to Face-to-Face?

PURPOSE: This study investigated the effect of delivery method (face-to-face or telepractice), time, home language, and language ability on bilingual children's receptive vocabulary scores in Spanish and English. METHOD: Participants included bilingual children with (n = 32) and without (n = 57) developmental language disorders (DLD) that were assessed at 2 time points about 1 year apart. All children participated in face-to-face assessment at Time 1. At Time 2, 41 children were assessed face-to-face and 48 children were assessed using telepractice. RESULTS: Delivery method was not a significant predictor of receptive scores in either Spanish or English. Spanish and English receptive vocabulary increased over time in both children with and without DLD. Children with DLD had lower receptive vocabulary raw scores than children with typical development. Children who spoke English-only at home had significantly higher English receptive scores than children who spoke Spanish-only or both Spanish and English at home. CONCLUSIONS: Face-to-face and telepractice assessments seem to be comparable methods for the assessments of Spanish and English receptive skills. Spanish and English receptive skills increased over time in children with and without DLD. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.17912297.

Predicting Dyslexia in Children With Developmental Language Disorder.

Purpose In this study, we examine how well kindergarten letter identification and phonological awareness predict 2nd grade word reading and dyslexia in children with developmental language disorder (DLD) and their age- and grade-matched peers with typical language (TL). Method We employ (a) logistic regression to determine how letter identification and phonological awareness predict dyslexia, that is, dichotomous categorization of good or poor word reading, in children with DLD and TL and (b) quantile regression to determine how letter identification and phonological awareness are associated with word reading abilities on a continuum in these groups of children. Results Logistic regression revealed that letter identification was the only significant, unique kindergarten predictor of dyslexia in 2nd grade children with DLD, when compared to phonological awareness. In children with TL, both kindergarten letter identification and phonological awareness significantly predicted dyslexia in 2nd grade. Quantile regression revealed that kindergarten letter identification was a stronger predictor of 2nd grade word reading for average and lower achieving word readers with DLD and their peers with TL compared to higher performing readers. Phonological awareness was weakly associated with word reading across the full continuum of word reading abilities in children with DLD. Conclusion Letter identification is a more accurate predictor of poor word reading and dyslexia than phonological awareness in kindergarten children with DLD, which has important implications for recent U.S. legislation around early identification of dyslexia in all children.

Relative laterality of the N170 to single letter stimuli is predicted by a concurrent neural index of implicit processing of letter names.

While previous research reports a consistently left-lateralized N170 to whole words relative to control stimuli, much less is known about the nature of single letter processing. Yet single letter processing is of both theoretical and practical interest, as letters form an initial unit of literacy learning for alphabetic scripts and may be particularly useful in the study of literacy development. In the present study, adult fluent readers completed an implicit processing one-back task while event-related brain potentials (ERPs) were recorded. Separate blocks included single letter or matched false-font stimuli. Results indicated that single letters elicited a bilateral (rather than left-lateralized) enhancement of the N170 relative to the false font stimuli. Although participants did not make overt rhyming judgments, letters preceded by a rhyming as compared to non-rhyming letter (e.g., e-b versus e-h) also tended to elicit an N450 rhyme effect, as previously reported in explicit letter rhyme tasks. Moreover, individuals with a larger N450 rhyme effect showed greater relative left-lateralization of the response to single letters. Taken together, these findings suggest that early neural specialization for orthographic stimuli extends to the case of single letters and, further, that automatic mappings between visual symbols and phonological codes can account for at least some portion of the relative left-lateralization of early neurophysiological responses to printed text. These findings help resolve discrepancies in the existing literature concerning relative laterality of early neural responses to single letters and provide critical baseline data for future developmental neuroimaging studies.