Is it necessary to assess fluent symptoms, duration of dysfluent events and physical concomitants when identifying children who have speech difficulties?

Riley’s (1994) Stuttering Severity Instrument version three (SSI-3) has three components: a symptom frequency measure (%SS), average duration of the three longest stutters and a physical concomitant (PC) score. An assessment of whether it was necessary to use all of these when using SSI-3 to identify which children are at risk of speech difficulty was performed. Participants were 879 reception class children aged 4-6 years from UK schools. The distributions of the separate components of SSI-3 were examined. Departures from normality were noted for each component. The features seen in the distribution of the individual components were also apparent in the distribution of overall scores (this was not normal and had multiple modes). These findings undermine the usefulness of the overall measure for identifying children at risk of speech difficulty. Prior work used a fixed SSI-3 threshold to identify at risk children. Classification of children as fluent or at risk based on this threshold was compared with classifications based on thresholds applied to the individual components. Classifications were comparable for %SS, but less satisfactory for duration and PC. These findings suggests that %SS performs similarly to overall SSI-3 scores when used to identify at risk children. Riley (1994) conducted correlation analyses to justify the inclusion of all components in SSI-3. This involved part (individual component) scores that were correlated with whole (overall SSI-3) scores. These results were replicated. However, correlations are spuriously inflated if this procedure is employed. Additional correlation analyses showed that part-‘whole’ correlations were low when the component used as the part was excluded from the ‘whole’. Thus Riley’s justification for using all components is questionable. Physical concomitants measured on five-point scales (as Riley specified) were no more sensitive than when the scale was collapsed to three or to two points. Since judgments were not affected when the scale was decimated, judges did not appear to be able to use the original scale. Procedures for identifying at risk children in schools need to be short and easy to administer. Thus, since there is no justification for including all components of SSI-3 and duration and physical concomitants are not sensitive measures of fluency, a procedure based on the frequency measure alone is appropriate for use in schools

Assessing Speech Fluency Problems in Typically Developing Children Aged 4 to 5 Years

This thesis addresses the identification of children with expressive speech difficulties with a focus on stuttering. It is based on theoretical work that investigated the symptoms associated with stuttering (Howell, 2013). It also has a practical goal: The procedures that have been developed should help determine the risk of a child acquiring some form of speech difficulty. The children examined had just entered school (4-year-olds). To ensure reliable results were obtained, large, representative samples of children were required. Most of the children do not have speech difficulty. A sample of speech was obtained and analysed. The approach taken in analysis was to use an instrument that has been standardised and is currently used in research (Riley, 1994) and to apply it to the assessment of speech difficulty. Howell (2013) showed that this instrument is effective in screening for stuttering. The background to the screening work with stuttering is given in the literature review in Chapter 1. The challenges that arise when screening (a form of risk factor modelling) a real-world sample are discussed. Definitions and general features of stuttering are presented and various theories concerning how stuttering symptoms arise are reviewed. Chapters 2 to 6 report background studies, fieldwork and analyses that were conducted. Chapter 2 reports the results of a survey that was conducted to determine whether there was a need for a screening instrument and, if so, what form it should take. Chapters 3 and 4 report studies that were conducted to balance the need to keep assessments in schools short with ensuring the procedures are reliable and valid when used to identify children with speech difficulty. The assessments were based on Riley’s (1994) Stuttering Severity Instrument. Chapter 3 determined the minimum length a sample of speech needed to be and whether a spontaneous speech sample was sufficient when using Riley (1994) for assessing children for speech difficulty. The Stuttering Severity Instrument has three components (percentage of syllables that are not fluent, duration of selected long stutters and a measure of physical concomitants to stuttering). Chapter 4 addressed whether all three components are required to identify children with speech difficulty, since assessing fewer components would keep the procedure simple for use in schools. Chapter 5 reports an extensive field study that used Riley (1994) for identifying children with speech difficulty. Chapter 6 examined whether adding additional symptoms to those available in the Stuttering Severity Instrument that are appropriate for other common paediatric forms of speech difficulty would enhance accuracy of screening performance. Chapter 7 summarizes the work, draws conclusions and identifies future directions this research should take

Identification of fluency and word-finding difficulty in samples of children with diverse language backgrounds

BACKGROUND: Stuttering and word-finding difficulty (WFD) are two types of communication difficulty that occur frequently in children who learn English as an additional language (EAL), as well as those who only speak English. The two disorders require different, specific forms of intervention. Prior research has described the symptoms of each type of difficulty. This paper describes the development of a non-word repetition test (UNWR), applicable across languages, that was validated by comparing groups of children identified by their speech and language symptoms as having either stuttering or WFD. AIMS: To evaluate whether non-word repetition scores using the UNWR test distinguished between children who stutter and those who have a WFD, irrespective of the children's first language. METHODS AND PROCEDURES UNWR was administered to ninety-six 4–5-year-old children attending UK schools (20.83% of whom had EAL). The children's speech samples in English were assessed for symptoms of stuttering and WFD. UNWR scores were calculated. OUTCOMES AND RESULTS: Regression models were fitted to establish whether language group (English only/EAL) and symptoms of (1) stuttering and (2) WFD predicted UNWR scores. Stuttering symptoms predicted UNWR, whereas WFD did not. These two findings suggest that UNWR scores dissociate stuttering from WFD. There were no differences between monolingual English-speakers and children who had EAL. CONCLUSIONS AND IMPLICATIONS: UNWR scores distinguish between stuttering and WFD irrespective of language(s) spoken, allowing future evaluation of a range of languages in clinics or schools

Splash: Speech and language assessment in schools and homes

Copyright © 2019 ISCA This paper presents a tablet-based app for Speech and Language Assessment in Schools and Homes (Splash) to provide a first screening for young children aged 4-6 years to assess their speech and language skills. The app aims to be easy-to-administer with an adult, such as a teacher or parent, directing the child through the tasks. Three fun games have been developed to assess receptive language, expressive language and connected speech, respectively. Currently in proof-of-concept mode, when complete Splash will use automatic spoken language processing to give an instant estimate of a child's communication ability and provide guidance on whether to speak specialist support. While not a diagnostic tool, the aim is for Splash to be used to provide immediate reassurance or direction to concerned parents, guardians or teachers as it can be administered by anyone, anywhere