Current Beliefs of Speech-Language Pathologists Regarding Lateralization Errors

Lateralization errors (LEs) are defined as persistent speech sound errors in which sibilant sounds are distorted due to air flow exiting the mouth laterally, rather than centrally, as result of insufficient lingual pressure against the alveolar ridge and/or teeth. Prevalence of LEs is unknown, and there are no published data on contemporary assessment and treatment challenges. We developed six research questions addressing treatment and prevalence of LEs. Additional information about speech-language pathologists’ (SLPs’) perceptions and practices concerning LEs would facilitate understanding of current practice. Licensed SLPs (N=214, 98.12% female, Xage = 30-39 years) participated in a mixed-methods design online survey with 26 questions. The majority (98.13%) were Non-Hispanic White. Average age was 31-39 years, with 10-20 years of average experience in the field and an average caseload of 20-40 clients. Work settings varied between school, private practice, university clinic, outpatient clinic, and others. We found that the prevalence of LEs on caseloads was on average 1%-3%, though the national prevalence is believed to be slightly higher (1-5%). There was no clear consensus on what age treatment should begin, though 4-5% was selected most. Some (30.81%) clinicians cited 4 semesters as the best duration for therapy, but there was variation in beliefs. Nearly all SLPs (96.71%) agreed that LEs require remediation, possibly because structural and neuromuscular factors were considered major likely causes. The majority (88.27%) of clinicians believed that the public has a negative perception of LEs. There was considerable variation among clinicians regarding the most effective treatments, suggesting disagreement on best practice for lateralization treatment. Most (72.3%) of clinicians believed that LEs should be treated in an individual setting, but small group treatment was not unusual. Based on our results, it is clear that more research on this topic is needed for effective, evidence-based treatment for LEs

Impact and Perceived Benefits of a Problem-Based Learning Workshop for Continuing Education in Speech-Language Pathology: A Pilot Study

Even though speech-language pathologists (SLPs) must participate in continuing education programs, little is known about the effectiveness of these learning opportunities. This preliminary study provides empirical assessment of the impact of a problem-based learning (PBL) CE activity on SLPs as perceived by themselves and their Instructors. Twenty-five experienced SLPs participated in an intensive multi-day, PBL workshop on childhood apraxia of speech. Significant differences in the SLPs’ self-perceived clinical efficacy between T1 and T2, as well as T2 and T3. At T3, Instructors rated the clinical efficacy of the SLPs as “very good” to “excellent.” Qualitatively, SLPs reported increased confidence, critical thinking, and improved assessment/treatment skills following the training at T3. The SLPs also stated this workshop stood apart from other CE models due to the intensity of learning, the professionals and mentors available to them during and after the education experience, as well as instructional elements associated with PBL such as a focus on small group case-based discussion. Study limitations, implications and future directions are discussed

Comparison of Two Treatment Conditions for Young Children with Speech Sound Disorders

The purpose of this study was to compare treatment outcomes between stimulus presentation conditions to children with moderate to severe SSD: a traditional paper presentation versus a computer software generated presentation. The participants were four monolingual kindergarten children with moderate to severe SSD. A multiple baseline across behaviors single subject design was employed in the study. Two non-stimulable, non-cognate sounds from two different manner categories were selected as sound targets. One sound error was treated using paper stimuli presented in a traditional paper table-top presentation (TAB condition) while the other sound error was treated using stimuli presented on the computer (CBI condition). Picture stimuli for both conditions were generated by the SCIP (Sound Contrasts in Phonology) software program. Treatment followed the paradigm described by Williams (2003). The number of treatment sessions, final treatment performance, and highest generalization performance are summarized for both treatment conditions in Table 1. Although conditions were counterbalanced, data are arranged by condition for ease of interpretation

Research Priorities for Childhood Apraxia of Speech: A Long View

This article introduces the Journal of Speech, Language, and Hearing Research Special Issue: Selected Papers From the 2022 Apraxia Kids Research Symposium. The field of childhood apraxia of speech (CAS) has developed significantly in the past 15 years, with key improvements in understanding of basic biology including genetics, neuroscience, and computational modelling; development of diagnostic tools and methods; diversity of evidence-based interventions with increasingly rigorous experimental designs; and understanding of impacts beyond impairment-level measures. Papers in this special issue not only review and synthesize the some of the substantial progress to date but also present novel findings addressing critical research gaps and adding to the overall body of knowledge. A second aim of this prologue is to report the current research needs in CAS, which arose from symposium discussions involving researchers, clinicians, and Apraxia Kids community members (including parents of children with CAS). Four primary areas of need emerged from discussions at the symposium. These were: (a) What questions should we ask? (b) Who should be in the research? (c) How do we conduct the research? and (d) How do we move from research to practice? Across themes, symposium attendees emphasized the need for CAS research to better account for the diversity of people with CAS and improve the timeliness of implementation of high-level evidence-based practice across the lifespan. It is our goal that the articles and prologue discussion in this special issue provide an appreciation of advancements in CAS research and an updated view of the most pressing needs for future research

Relationships among speech sound perception, speech sound production, and phonological spelling in second grade children

This study examined the relationships among speech sound perception, speech sound production, and phonological spelling relative to seven phonemes in 15 pairs of 2nd grade children. Each pair consisted of one typically developing child and one child with speech sound disorder who presented at least one fricative, affricate, and/or liquid error. The pairs were matched for gender, nonverbal reasoning, and level of parent education. Speech sound perception was assessed with a modification of the Speech Assessment and Interactive Learning System, a computer program which assesses speech identification of phonemes. White noise and reverberation were introduced into the stimuli so listening conditions would resemble those in typical classrooms. Children\u27s speech sound production skill was determined by Percent of Consonants Correct-Revised while repeating multisyllabic words and pseudowords. Phonological spelling was assessed by comparing the phonological skeleton of 84 one syllable pseudowords to the child\u27s orthographic representation. Pseudowords were controlled for morpheme length, orthographic legality, vowel distribution, grapheme length, number of phonemes, position of phoneme, number of target singletons and clusters, frequency of nontarget consonants, and number of phonological neighbors. Results revealed significant differences in speech sound perception between typical and SSD children. Speech sound perception of typical children showed a small but significant relationship to phonological spelling, whereas children with SSD demonstrated a moderate relationship. The type of relationship between speech sound perception and phonological spelling could not be determined for typical children, but appeared quadratic for children with SSD. Speech sound repetition accuracy of typical children had a modest linear relationship to phonological spelling, whereas children with SSD demonstrated a small linear relationship. There was no significant relationship between speech sound perception and speech sound repetition accuracy for children with SSD. These results provide partial support for the Dual Route Model of Spelling and the Motor Theory of Speech Perception. In addition, these findings imply that spelling errors in 2nd grade children may result, in part, from poor speech sound perception and/or poor speech sound production

The Need for Increased Study of Infants and Toddlers Later Diagnosed With Childhood Apraxia of Speech

Purpose: This article examines the need for increased research into the prelinguistic trajectory of childhood apraxia of speech (CAS). We discuss the significant gains made in the early identification of disorders such as autism spectrum disorder, fragile X syndrome, and Rett syndrome that have resulted through the study of early (i.e., prelinguistic) developmental behaviors of infants and toddlers at risk for these disorders. We suggest that notable gains in understanding CAS could be made by increasing investigative focus on infants and toddlers later diagnosed with CAS or who are at risk for it (i.e., have an older sibling diagnosed with the disorder). Conclusions: Currently, there are few studies to guide clinical decision making for infants and toddlers who may have CAS. To address this gap, we present a call to action with recommendations for researchers and clinicians. We recommend more retrospective investigative designs be conducted, inclusive of retrospective parent questionnaires and retrospective home video analysis, as well as prospective longitudinal studies of at-risk infants. We suggest that studies not be limited to exploring an affected infant's vocal output, but that efforts be made to acquire a broad view of an affected infant's early developmental trajectory (e.g., social skills, eye gaze, and imitative skills). A more comprehensive understanding of CAS will guide clinicians not only in identification of the disorder but will inform treatment decisions as well

Preliteracy Speech Sound Production Skill and Linguistic Characteristics of Grade 3 Spellings: A Study Using the Templin Archive

Purpose: This archival investigation examined the relationship between preliteracy speech sound production skill (SSPS) and spelling in Grade 3 using a dataset in which children\u27s receptive vocabulary was generally within normal limits, speech therapy was not provided until Grade 2, and phonological awareness instruction was discouraged at the time data were collected. Method: Participants (N = 250), selected from the Templin Archive (Templin, 2004), varied on prekindergarten SSPS. Participants\u27 real word spellings in Grade 3 were evaluated using a metric of linguistic knowledge, the Computerized Spelling Sensitivity System (Masterson & Apel, 2013). Relationships between kindergarten speech error types and later spellings also were explored. Results: Prekindergarten children in the lowest SPSS (7th percentile) scored poorest among articulatory subgroups on both individual spelling elements (phonetic elements, junctures, and affixes) and acceptable spelling (using relatively more omissions and illegal spelling patterns). Within the 7th percentile subgroup, there were no statistical spelling differences between those with mostly atypical speech sound errors and those with mostly typical speech sound errors. Conclusions: Findings were consistent with predictions from dual route models of spelling that SSPS is one of many variables associated with spelling skill and that children with impaired SSPS are at risk for spelling difficulty