Predicting resolution of speech sound errors

Producing speech sound errors early in development is normal. Many children make errors in the preschool years that they simply grow out of in early elementary school. However, some kids don’t grow out of their errors. These are the kids that need speech–language pathologists’ attention, but how do we know which kids these are?

This study aimed to answer exactly that question—which kids just need time, and which kids need speech therapy? They examined 93 children at age four (all “identified as speech impaired” with the GFTA-2 or DEAP), categorized the children’s error types, then looked again at age seven, and found the following:

  • Total number of errors didn’t predict spontaneous resolution of SSD.
  • Type of errors, however did! Kids with speech sound errors best described as “phonologically delayed” (that is, those who use error patterns consistent with younger children, e.g. stopping or cluster reduction) were nearly twice as likely to spontaneously resolve as kids with speech sound errors best described as “atypical” (e.g. backing or initial consonant deletion). The kids who made the fewest atypical errors were most likely to improve over time.

What does this mean for SLPs? First, looking at the types of errors kids make may make more sense than counting the number of consonants errors. This may aid us in predicting who is more or less likely to grow out of their speech errors!

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But, then what to do? Should we prioritize services for children with atypical errors, and wait it out for kids with more typical error patterns? Ehhh…. not so fast. First, we have to be cautious making decisions that apply to entire caseloads or entire school districts (as many of our supervisors want so badly to do!) To think on this, we also need to look more closely at the actual percentages, here: The authors state, “67% of phonologically delayed children had resolved by seven years (of age) compared to 35% of children making atypical speech errors.” So… if 67% of phonologically delayed children resolve, that’s great—but what about the 33% who don’t? Even though the authors have some nice data, here, categorizing kids this way clearly isn’t a perfect predictor of the future. There may be slightly better methods that are even more predictive than what was done in the current study (yay for more science!). Also—resolution of speech sound errors isn’t all that matters, here, when kids with phonological delay may be experiencing other difficulties as well (e.g. literacy). Clearly more data and more discussions are needed, before we attempt to make widespread procedural decisions. But this is a really good start!

Oh, and BTW—are you looking for research to justify working on speech sound errors at a young age, or single speech sound errors, because you have administrators who think the “speech kids” don’t need your attention? In the background of this paper, they review research on why we shouldn’t be framing this as just an articulation problem—“Children’s school achievement is often adversely affected (Hayiou-Thomas et al., 2016) as are their peer relationships, due to social, emotional and behavioral difficulties (Murphy et al., 2014). Persistent impairment in adolescence affects literacy, mental health and employment (Law et al., 2017).” You can get some real gems from this background of this paper!

 

Dodd, B., Ttofari-Eecen, K., Brommeyer, K., Ng, K., Reilly, S., Morgan, A. (2017). Delayed and disordered development of articulation and phonology between four and seven years. Child Language Teaching and Therapy. Advance online publication. doi: 10.1177/0265659017735958.