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Language Seminar

Relationship Between Speech-Sound Disorders and Early Literacy Skills in Preschool-Age Children: Impact of Comorbid Language Impairment

Lee Ann Lefebvre

on 21 March 2013

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Transcript of Language Seminar

Background Information Methods Discussion Relationship Between Speech-Sound Disorders and Early Literacy Skills in Preschool-Age Children Impact of Comorbid Language Impairment Speech-Sound Disorders -Impairments in speech-sound production, which include:
-errors of articulation and phonetic structure (errors caused by poor motor abilities associated with the production of speech sounds)
-phonologic errors (errors in applying linguistic rules to combine sounds to form words)
-prevalence is highest for preschool-age children
-condition appears to resolve in 75% of children by age 6 They range from: Mild articulation issues, which involve a limited number of speech sounds

Severe phonologic disorders, which involve multiple errors in speech-sound production and reduced intelligibility Participants Procedures Design & Analysis -125 children, 3 to 6 years of age, diagnosed with a moderate to severe speech-sound disorder (SSD) to: Key Terms -Language Disorders
-Speech-Sound Disorders
-Language Impairment
-Preschool Literacy Skills
-Print Concept Knowledge Preschool Literacy Skills Participants Table 1: Demographic Characteristics of Study Participants (n=125) Inclusion: -Children with a history of neurologic disorders or developmental delays other than speech and language (as reported by the parent)
-Children with a Performance IQ (PIQ) score below 80 on the WPPSI-R Exclusion: -Only families who spoke Standard American English as their first language Speech-Sound Disorder (moderate to severe): 1. Speech Criteria
a. Score at or below 10th percentile on Sounds in Words subtest on the GFTA
b. Three or more types of phonologic processing errors identified by the KLPA
2. Normal Hearing Acuity = pure tone autiometric screening
3. Normal Oral-Motor Structure = Oral and Speech Motor Control Protocol Language Impairment: 1. Based on scores > 1.5 SD below the mean on TOLD-P2 or CELF-P
2. Parent report that the child was receiving language therapy for a language problem SSD with co-existing LI = 66 (53%)
SSD (isolated) without LI = 59 (47%) Participants Demographic Characteristics: -SES = Hollingshead Four Factor Index of Social Class
-64% male, 87% white, mainly of middle to higher SES Implications Results Implications... -value in assessing and incorporating instruction in preliteracy skills into treatment programs for preschool children with LI ...for professionals providing services to children with LI ...concerning SES and preliteracy skills: ...for pediatricians: -children with speech and language disorders may not be identified until school age -value in enriching young children's literacy opportunities This study has provided an added incentive to screen young children for language delays because these children are at risk for language difficulties and may be at a disadvantage in the development of preliteracy skills . Limitations Limitations -limited representation of families with lower SES in the sample

-data is cross-sectional, which does not indicate a causal relation between speech and language skills and reading/writing skills

-absence of a control group of children without SSD

-severity of SSD is greater in the group with comorbid LI than in the group without LI Procedures -tested individually in home environment over two sessions to reduce the effect of fatigue on test results Speech-Sound Production Skills -used to measure articulation of single words elicited through pictures Phonologic Production Skills -used to measure phonologic processes and syllable structure Speech and Language Measures Lexical and Grammatical Skills -used to measure sentence recall and imitation, knowledge of word structure, receptive vocabulary, expressive vocabulary, and narrative skills Procedures Phonologic Processing Measures -used to measure phonologic awareness, rapid naming skills, and a task that asked participants to repeat 15 nonsense multisyllabic words presented by audiotape Nonverbal IQ -Performance IQ (WPPSI-R) subtest assesses nonverbal intelligence Outcome Measures TERA: Test of Early Reading Ability-2 -used to measure pre-academic reading readiness in children ages 3 to 9 years, such as:
1. constructing meaning from printed symbols
2. knowledge of the alphabet
3. understanding of the conventions of written language (print concept knowledge) TEWL: Test of Early Written Language-2 -used to measure pre-academic writing readiness in children ages 3 to 11 years, such as:
1. basic writing ability
2. focusing on the functional components of writing
3. contextual writing ability
4. focusing on story construction and structure Discussion Discussion Speech & Language Disorders -among the most common developmental conditions in early childhood -may affect up to 4% to 10% of children
1. phonologic processing
2. print concept knowledge
3. the rule-governed system of orthography and written language best predictors of children's early reading success -understanding print conventions, such as left-to-right directionality and alphabet knowledge Print Concept Knowledge Development of Later Reading Skills 1. role of phonologic processing
2. ability to deconstruct spoken and written language into phonemes
3. reading decoding skills Important literacy skills that influence how rapidly and well children acquire literacy: Significant emphasis on: Additional Information Preliteracy Skills Five factors at kindergarten predict reading outcome in second grade: -letter identification
-sentence imitation
-phonologic awareness
-rapid naming
-mother's educational attainment Risk Factors -may increase the risk for speech and language disorders and problems with literacy Male Sex Low Socioeconomic Status (SES) is associated with: -increased risk for speech and language disorders compared with girls -less frequent parental language input
-poorer phonemic awareness
-poorer reading skills in childhood
-participation in fewer literacy-related activities
-less adult modeling of reading
-decreased access to printed materials Goal of the Study 1. To determine how preschool-age children with moderate to severe SSD perform on measures of early reading and writing.
2. To determine factors associated with early literacy skills among children with SSD, including co-existing LI.
3. To characterize early reading and writing skills of preschool-age children. Language Impairment Hypothesis 1 Hypothesis 2 Hypothesis 3 Hypotheses -no association between the severity of a child's SSD and scores on measures of early reading and writing readiness -children with SSD who have comorbid LI will perform more poorly on measures of reading and writing readiness, as well as on measures of speech and language skills, than those without LI -performance on composite measures of language and phonologic processing skills, but not speech skills, will be associated with early reading and writing readiness SSD (only) -better print concept knowledge SSD + LI -performed more poorly on measures of print concept knowledge
-associated with poorer performance on measures of speech and language skills
-more severe SSD than SSD (only) Word Knowledge and Grammar Skills -language-related skills associated with better performance on early reading and writing measures -at risk for later decoding and spelling difficulties Poor phonologic representations and phonologic memory limitations are hypothesized to underlie both SSD and reading disorders. Articulation and Narrative Skills -speech-related skills not associated with early reading and writing outcomes SES Male Sex -has been found to be associated with poorer language and reading skills
-TEWL: male sex predicted poorer performance -has been found to be a significant predictor of both language and literacy skills
-higher SES associated with the development of early literacy skills Hypothesis 1: Association Between Severity of Speech-Sound Disorder and Early Reading/Writing Readiness -severity of SSD associated with TERA, not TEWL Hypothesis 2: Associations of Language Impairment with Reading/Writing Readiness -LI associated with lower scores on TERA and TEWL
-lower SES associated with lower scores on TERA Hypothesis 3: Association of Speech/Language Composites and Phonologic Processing with Reading/Writing Readiness -grammar skills and word knowledge predicted performance on the TERA and TEWL
-articulation and narrative skills not associated with TERA scores
-higher SES predicted higher TERA scores
-higher SES and female sex predicted higher TEWL scores Design & Analysis 1. an articulation factor (two articulation measures and two measures of phonologic production)
2. a narrative factor (Narrative Task: content items, factual questions, inferrential questions)
3. a grammar factor (grammatical completion, sentence imitation, and expressive morphology)
4. a word knowledge factor (expressive and receptive vocabulary, Segmentation Task) -cross-sectional, correlational design Factor Analysis yielded four groups of speech and language skills: -used to examine the association between SSD severity and TERA and TEWL scores Analysis of Variance -used to examine the effect of comorbid LI Factor Analysis -used to examine performance on a battery of speech and language measures Language Disorders -involve delays or deficits in expressive or receptive language development, or both
-estimated prevalence of 7% at kindergarten age Delay(s) in Language Development -may have negative effects on a young child's social and emotional functioning, including an increased risk for:
1. social problems
2. anxiety
3. depression
4. attention problems -common in early childhood
-may be at risk for reading difficulties
-may have poor auditory, phonologic, and verbal memory skills Disorders of Articulation or Speech-Sound Disorders (SSD) Linear Regression -early reading and writing scores significantly lower for children with comorbid LI, but not related to SSD severity

-composites for grammar and word knowledge related to peformance on TERA and TEWL

-below average language skills in preschool place a child at risk for deficits in preliteracy skills Results Results Sices, L., Taylor, G., Freebairn, L., Hansen, A., and Lewis, B. (2007). Relationship between speech-sound disorders and early literacy skills in preschool-age children: Impact of co-morbid language impairment. Journal of Developmental and Behavioural Pediatrics, 28(6): 438-447. Reference List -possess language skills, rather than articulation skills, and this is related to early reading and writing skills -language disorder that delays the mastery of language skills
-strong relationship between LI in early childhood and reading comprehension difficulties at school age
-increased risk for reading problems or reading impairment
-more likely to show a delay in the understanding of print concept knowledge Group: SSD (only) Group: SSD + LI -do not appear to be at higher risk for reading disabilities, but found to be at risk for spelling difficulties -significantly increased risk for reading disabilities at school age Table 3
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