Speech Sound Disorders in Children SPCH2104
- Subject Code :
SPCH2104
AppendixA
Case1:LouiseMurrayisaged4:6years.Shewasrecentlyassessedusing:
- Speech sample during play with speech pathologist (rabbit, bag, books)
- DEAP Diagnostic Screen and Phonology Subtest (Dodd et2002)
Louisehasafamilyhistoryofspeechandliteracydifficulties.Shewasbornfulltermandliveswithhermother,Jenniandfather,Paul.Jenni worksparttimeasaclassroomassistantinalocalprimaryschool.Paulrunshisownsuccessfulplumbingbusiness.Jenniisduetohavetheir second baby in 2 months time.
No developmental concerns regarding Louises gross and fine motor development. She passed her newborn hearing screener. Early speech milestones include: babbling at 6 months, single words; 24 months, 2 word combinations; 26 months. Feeding milestones were achieved but she has lactose intolerance. Louise attends child care 3 days a week. Parents report nil concerns about comprehension. Parents report that Louise is sometimeshardtounderstandespeciallywhentheydontknowthecontextofwhatsheistalkingabout.Inthoseinstances,Louisewillshoutand repeat her attempt as a way of trying to communicate what she is wanting to say.Jenni and Paul are not sure if Louise is aware of her speech errors. Jenni and Paul would like Louise to start school next year and therefore would like to know if Louise has a speech problem and if so, to get some help with it before she starts school.
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- Speech Sample
- Complete the speech sample excerpt (Table 1) obtained during play Table 1: Speech Sample Excerpt
|
LouiseMurraySpeechSamplefromconversationwithSLPduringplay(rabbit,bagandbooks) |
|||||||||||||||||||
|
IPAandHCE |
Phonotactics |
ConsonantsCorrect |
Errorandsyllable/wordplace |
Voice |
Place |
Manner |
Errortype(SODA and/orPhonologicalProcess) |
SubstitutionorSyllableStructureorAssimilationprocess? |
Typicalandcommonortypicalandlesscommonoratypical? |
Ageofeliminationintypicallydevelopingchildren (includereference) |
Istheerrorlikelyto be anarticulationerrororaphonologicalerror(workinghypothesis)? |
||||||||
|
Utterance C=ChildSLP= speech-languagepathologist |
AdultProduction(AP) (target) |
ChildProduction(CP) |
AP |
CP |
No.ofconsonantsAP |
No.ofconsonantscorrect CP |
% consonantscorrectcompletefortotalutterancesatbottomoftable(notevery utterance) |
AP |
CP |
AP |
CP |
AP |
CP |
||||||
|
SLP: Tell meallaboutwhatyou have in yourbag. |
/t?lm??l??ba?tw?tj?hv?nj?rbg/ |
||||||||||||||||||
|
C:/m?e |
/m??/l |
/mae/ |
CV |
CV |
1 |
1 |
100% |
+ |
+ |
Bilia |
Bilia |
glide |
Substituti |
substitution |
Typicaland |
4yrs(Shipley |
Phonological |
||
|
wb?t?n h?? p?ti? dwet/ |
bial |
bial |
Nasa l |
on- gliding |
common |
&McAfee, 2021) |
|||||||||||||
|
/?rb? t/ |
/wb?t/ |
CV C.CVC |
CV C.CVC |
3 |
3 |
100% |
+ |
+ |
Alveolar |
Bilabial |
Appr oximant |
glide |
Substituti on-gliding |
substitution |
Typicalandcommon |
4yrs(Shipley &McAfee,2021) |
Phonological |
||
|
(myrabbitinherspottydress) |
/?n/ |
/?n/ |
VC |
VC |
1 |
1 |
100% |
+ |
+ |
Alveolar |
Alveolar |
nasal |
nasal |
- |
- |
- |
- |
- |
|
|
/h?r/ |
/h??/ |
CVC |
CVC |
2 |
1 |
50% |
- |
- |
Glottal |
Glottal |
friciative |
vowel |
Omissino -final |
Syllablestructure |
Typicalandcommon |
4yrs(Shipley& McAfee, |
Phonological |
||
|
consonan |
2021) |
||||||||||||||||||
|
tdeletion |
|||||||||||||||||||
|
/sp?ti/ |
/p?ti? / |
CCVC CV |
CCVC CV |
2 |
2 |
100% |
- |
- |
Alveolar |
Bilabial |
friciatve |
plosive |
Substitution-velar fronting |
substitution |
Typicalandcommon |
4yrs(Shipley& McAfee, 2021) |
Phonological |
||
|
LouiseMurraySpeechSamplefromconversationwithSLPduringplay(rabbit,bagandbooks) |
|||||||||||||||||||
|
IPAandHCE |
Phonotactics |
ConsonantsCorrect |
Errorandsyllable/wordplace |
Voice |
Place |
Manner |
Errortype(SODA and/orPhonologicalProcess) |
SubstitutionorSyllableStructureorAssimilationprocess? |
Typicalandcommonortypicalandlesscommonoratypical? |
Ageofeliminationintypicallydevelopingchildren(include reference) |
Istheerrorlikelyto be anarticulationerrororaphonologicalerror(workinghypothesis)? |
||||||||
|
Utterance C=ChildSLP= speech-languagepathologist |
AdultProduction(AP) (target) |
ChildProduction(CP) |
AP |
CP |
No.ofconsonantsAP |
No.ofconsonantscorrect CP |
% consonantscorrectcompletefortotalutterancesatbottomoftable(notevery utterance) |
AP |
CP |
AP |
CP |
AP |
CP |
||||||
|
/dr?s/ |
/dwet / |
CCVCC |
3 |
3 |
|||||||||||||||
|
SLP:She lookslikesheisgoing somewhere |
/?il?ksla?k???z?go????s?m?w?r/ |
||||||||||||||||||
|
/?i/ |
/?i/ |
CV |
CV |
1 |
1 |
100% |
- |
- |
palat |
Palat |
fricit |
fricia |
- |
- |
- |
- |
- |
||
|
al |
al |
ative |
tive |
||||||||||||||||
|
/?z/ |
/?d/ |
VC |
VC |
1 |
1 |
100% |
+ |
+ |
alveo |
alveo |
fricia |
plosi |
Substituti |
substitutino |
Typicaland |
3yrs(Shipley |
Phonologoical |
||
|
lar |
lar |
tive |
ve |
on- |
common |
&McAfee, |
|||||||||||||
|
stopping |
2021) |
||||||||||||||||||
|
/?go???/ |
/ga??n |
CV |
CV |
3 |
3 |
100% |
+ |
+ |
velar |
velar |
plosi |
nasal |
Omission |
Syllable |
Typicaland |
4yrs(Shipley |
Phonological |
||
|
C:/?i??d |
/ |
C |
C |
ve |
-final consonan |
structure |
common |
&McAfee, 2021) |
|||||||||||
|
g????tu?ku?l w??mi?/ |
tdeletion |
||||||||||||||||||
|
/tu?/ |
/tu?/ |
CV |
CV |
1 |
1 |
100% |
- |
- |
alveo |
alveo |
plosi |
plosi |
- |
- |
- |
- |
- |
||
|
(She is goingtoschoolwithme) |
lar |
lar |
ve |
ve |
|||||||||||||||
|
/sku?l/ |
/kul/ |
CCVC |
CVC |
3 |
2 |
66% |
- |
- |
velar |
velar |
plosive |
plosive |
Clusterreduction |
Syllablestructure |
Typicalandcommon |
4yrs(Shipley& McAfee, 2021) |
Phonological |
||
|
/w?/ |
/w??/ |
CV |
CV |
2 |
2 |
100% |
+ |
- |
inter |
inter |
fricia |
fricia |
Substituti |
substitution |
Typicaland |
5yrs(Shipley |
Phonological |
||
|
C |
C |
denta |
denta |
tive |
tive |
on- |
common |
&McAfee, |
|||||||||||
|
l |
l |
voicing |
2021) |
||||||||||||||||
|
/mi?/ |
/mi?/ |
CV |
CV |
1 |
1 |
100% |
+ |
+ |
bilab |
bilab |
nasal |
nasal |
- |
- |
- |
- |
- |
||
|
ial |
ail |
||||||||||||||||||
|
LouiseMurraySpeechSamplefromconversationwithSLPduringplay(rabbit,bagandbooks) |
|||||||||||||||||||
|
IPAandHCE |
Phonotactics |
ConsonantsCorrect |
Errorandsyllable/wordplace |
Voice |
Place |
Manner |
Errortype(SODA and/orPhonologicalProcess) |
SubstitutionorSyllableStructureorAssimilationprocess? |
Typicalandcommonortypicalandlesscommonoratypical? |
Ageofeliminationintypicallydevelopingchildren(include reference) |
Istheerrorlikelyto be anarticulationerrororaphonologicalerror(workinghypothesis)? |
||||||||
|
Utterance C=ChildSLP= speech-languagepathologist |
AdultProduction(AP) (target) |
ChildProduction(CP) |
AP |
CP |
No.ofconsonantsAP |
No.ofconsonantscorrect CP |
% consonantscorrectcompletefortotalutterancesatbottomoftable(notevery utterance) |
AP |
CP |
AP |
CP |
AP |
CP |
||||||
|
SLP:Ohtellmemore |
/o?t?lm?m?r/ |
||||||||||||||||||
|
/ma?/ |
/m/ |
CV |
CV |
1 |
1 |
100% |
Vowel |
Vowel |
Substitution |
Lesscommon |
3yrs(Shipley |
Phonological |
|||||||
|
C:/m?e ti?t???tedwb?tkn |
substitutio n |
Substitution |
&McAfee, 2021) |
||||||||||||||||
|
/?tit??rz/ |
/ti?t???/ |
4 |
2 |
25% |
Medial |
Substitution |
Deaffricationand |
Typical |
3yrs(Shipley |
Phonological |
|||||||||
|
k?mt??k??l/ |
/t?/?/t/ 2)/r/& /z/ |
and Omission |
finalconsonant deletion |
&McAfee, 2021) |
|||||||||||||||
|
(myteachers |
omitted |
||||||||||||||||||
|
saidrabbit |
(final) |
||||||||||||||||||
|
cancometo |
/s?d/ |
/t?d/ |
CV |
CV |
2 |
1 |
50% |
/s/?/t/ |
- |
- |
Al |
Al |
Fric |
sto |
Substitution |
Stoppingof |
Typicaland |
3-4yrs |
Phonological |
|
school) |
C |
C |
(initial) |
ve |
ve |
iativ |
p |
fricative |
Common |
(Shipley& |
|||||||||
|
ola |
ola |
e |
McAfee, |
||||||||||||||||
|
r |
r |
2021) |
|||||||||||||||||
|
fric |
sto |
||||||||||||||||||
|
iati |
p |
||||||||||||||||||
|
ve |
|||||||||||||||||||
|
/?rb?t/ |
/?wb |
3 |
2 |
67% |
/r/?/w/ |
+ |
+ |
Al |
Bil |
Glid |
Gli |
substitution |
gliding |
Typicaland |
5-6yrs |
Phonological |
|||
|
?t/ |
(initial) |
ve |
abi |
ing |
din |
common |
(Shipley& |
||||||||||||
|
ola |
al |
g |
McAfee, |
||||||||||||||||
|
r |
ap |
2021) |
|||||||||||||||||
|
ap |
pr |
||||||||||||||||||
|
pro |
oxi |
||||||||||||||||||
|
xi |
ma |
||||||||||||||||||
|
ma |
nt |
||||||||||||||||||
|
nt |
|||||||||||||||||||
|
/kn/ |
/kn/ |
CVC |
CVC |
2 |
2 |
100% |
Noerror |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
|
/k?m/ |
/k?m/ |
CVC |
CVC |
2 |
2 |
100% |
Vowelvariant (/?/?/?/) |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
Possiblevowel substitution |
Substitution |
Lesscommon |
3yrs(Shipley& McAfee, 2021) |
Possiblearticulation |
|
|
/t??/ |
/t??/ |
CV |
CV |
1 |
1 |
100% |
Noerror |
Nochange |
N ochan ge |
Nochange |
Nochange |
Nochange |
Nochange |
None |
n/a |
n/a |
n/a |
n/a |
|
|
/sku?l/ |
/ku?/ |
CCVC |
CVC |
3 |
1 |
33% |
/s/omitted(initialcluster) /l/omitted(final) |
- |
- |
Alveolarfricati ve |
Alveolarlatera l |
fricative |
omitted |
Omission |
Clusterreductionandfinalconsonantdeletion |
Typical |
3-4yrs(Shipley&McAfee,2021) |
Phonological |
|
|
SLP:Really? |
/?r?li?/ |
||||||||||||||||||
|
C:/?i?m?tt??n m?e bgt?ll?nt??/ |
/?i/ |
/?i/ |
CV |
CV |
1 |
1 |
100% |
Noerror |
Nochnage |
N ochnag e |
Nochnage |
Nochnage |
Nochnage |
Nochange |
none |
n/a |
n/a |
n/a |
n/a |
|
(shemust |
|||||||||||||||||||
|
stayinmy |
|||||||||||||||||||
|
bagtilllunch) |
|||||||||||||||||||
|
/m?st/ |
/m?t/ |
CV C |
CV C |
Omission |
Clusterreduction |
Typicaland common |
4yrs(Shipley &McAfee, |
Phonological |
|||||||||||
|
2021) |
|||||||||||||||||||
|
/ste?/ |
/t?/ |
CC V |
CV |
1 |
50% |
/s/omitted (initial) |
- |
- |
Al ve |
Al ve |
frici ativ |
omi tted |
omission |
Clusterreduction |
Typicaland common |
4yrs(Shipley &McAfee, |
Phonological |
||
|
ola |
ola |
e |
2021) |
||||||||||||||||
|
r |
r |
||||||||||||||||||
|
fric |
fri |
||||||||||||||||||
|
iati |
cat |
||||||||||||||||||
|
ve |
ive |
||||||||||||||||||
|
/?n/ |
/?n/ |
CV |
CV |
1 |
1 |
100% |
Noerror |
Nocha |
N ochang e |
Nocha |
Noch |
Nocha |
Nocha |
None |
n/a |
n/a |
n/a |
n/a |
|
|
nge |
ng |
an |
nge |
nge |
|||||||||||||||
|
e |
ge |
||||||||||||||||||
|
/ma?/ |
/m/ |
CV |
CV |
1 |
1 |
100% |
Vowel |
+ |
+ |
Bil |
Bil |
Nas |
Nas |
Substitution |
Substitution |
Lesstypical |
3yrs(Shipley |
Possiblyarticulation |
|
|
substitutio |
abi |
abi |
al |
al |
(vowel |
&McAfee, |
(ifisolated) |
||||||||||||
|
n |
al |
al |
error) |
2021) |
|||||||||||||||
|
(/a?/? //) |
nasal |
nasal |
|||||||||||||||||
|
/bg/ |
/bg/ |
CVC |
CVC |
2 |
2 |
100% |
Noerror |
+ |
+ |
bil abial |
bil abial |
Stop |
Stop |
None |
n/a |
n/a |
n/a |
n/a |
|
|
/t?l/ |
/t?l/ |
CVC |
CVC |
2 |
2 |
100% |
Noerror |
- |
- |
alv eolar |
alv eolar |
Stop |
Stop |
None |
n/a |
n/a |
n/a |
n/a |
|
|
/l?nt?/ |
/l?nt??/ |
CVC |
CVC |
3 |
3 |
100% |
Vowel/?/ ?/?/ /t/ ? [t?](voicedor tapped) |
- |
- |
alveolar |
alveolar |
Stop |
Stop |
Substitution(vowel&partialvoicing) |
Possibleminorvowelshift +tapping/voicingof/t/ |
Lesstypical |
3yrs(Shipley& McAfee,2021) |
Couldbearticifisolated(phonologicalifpatterned) |
|
|
SLP:What willyoudoatlunch? |
/w?tw?lj??d??t??nt?/ |
||||||||||||||||||
|
C: /wi? w?lpl?w??m?e |
/wi?/ |
/wi? / |
CV |
CV |
1 |
1 |
100% |
Noerror |
No change |
N ochang e |
No chang |
No chan |
No change |
No change |
None |
n/a |
n/a |
n/a |
n/a |
|
fwend?n?e |
e |
ge |
|||||||||||||||||
|
tndp?t/ |
|||||||||||||||||||
|
(Wewillplay |
|||||||||||||||||||
|
withmy |
|||||||||||||||||||
|
friendinthe sandpit). |
/w?l/ |
/w?l/ |
CV |
CV |
1 |
1 |
100% |
Noerror |
Nocha |
N ochan ge |
Nocha |
Noch |
Nocha |
Nocha |
None |
n/a |
n/a |
n/a |
n/a |
|
nge |
ng |
an |
nge |
nge |
|||||||||||||||
|
e |
ge |
||||||||||||||||||
|
/ple?/ |
/ple?/ |
CCV |
CCV |
2 |
2 |
100% |
Noerror |
Nochange |
N ochang e |
Nochang |
Nochan |
Nochange |
Nochange |
None |
n/a |
n/a |
n/a |
n/a |
|
|
e |
ge |
||||||||||||||||||
- Overall speechsamplerelationalanalysis
- summaris and interpret the data from the five utterances by completing Table 2; Phonological Process
Table2:PhonologicalProcessSummary
|
Processes evident (fromearliestageto latest age ofelimination) |
Wordpositione.g. SIWI, SFWF |
AgeofElimination (include referenceused) |
Number of OccurrencesofPhonological Process |
Percentage of Occurrence(oftotal numberofoccasions ofallprocessesinsample) |
Ageappropriate (insert ?), or delayed (D) or atypical (U) ? |
|
Clusterreduction |
SIWI |
4years(Shipley& McAfee,2021) |
7 |
25.9% |
? |
|
Frontingof velars |
SIWI |
4years(Shipley& McAfee,2021) |
4 |
14.8% |
D |
|
Initialconsonant deletion |
SIWI |
4years(Shipley& McAfee,2021) |
3 |
11.1% |
U |
|
Stopping of friciatives |
SIWI |
3years(Shipley& McAfee,2021) |
3 |
11.1% |
D |
|
Gliding |
SIWI |
4years(Shipley& McAfee,2021) |
5 |
18.5% |
? |
|
Total |
22 |
LouisesPVC=100%
- Using the results above from the connected speech sample, calculate Louises PCC (please ensure you include your working out).
- Total consonants elicited= 141
- Consonants in error= 29
- Total consonants correct= 141-29=112
- PCC=(112dividedby141)x100=4%
ThereforeLouisespercentconsonantscorrect(PCC)is79%.
PCC:Louiseused141consonantsintheoverallspeechsampleofwhich112wereproducedcorrectly.
- Provide a severity rating based on the PCC result from the connected speech sample above using the normative data available from Shriberg et , (1986)
- DEAP Results
Table 3: DEAP Results
- Complete an independent analysis using the data from Louises connected speech and single word samples in order to identify her current phonetic inventory of singleton consonants, consonant clusters, vowels, syllable shape, word length and stress patterns.
Table4:CHIRPAIndependentAnalysis
- Predominantly1-2syllables(withoccasional3-syllablewords)
StressPatterns:
- Primarily trochaic(stressedsyllablefollowedbyunstressedsyllable)
PositionalorSequenceConstraints:
- No clear constraints observed in the phonetic inventory; sounds are produced across word
ProblemAreas:
- Velar Fronting(asobservedinthesample),whichmayindicatedifficultywithbackconsonants,resultinginthesubstitutionoffront
Soundclassespresentforsingletonconsonants:
Fromtheearlierinformation,wenotedthesesingletonconsonantsinLouise'sspeechsample:
- Bilabials:/p,b,m/
- Alveolars:/t,d, n/
- Velars:/k,g/
Aretherepositionalorsequenceconstraintsforphoneticinventorysingletonconsonants,consonantclustersorwordlengthinventories?
Yes/ No
Yes:Somepositionalconstraintsmaybeobserved,particularlywithvelarfronting, where back consonants are replaced by front consonants in certain word positions (e.g., /k/ ? /t/).
- Based on both the connected speech and single-word sampling assessments, what do you think is Louises subtype of SSD? Explain
Based on a comprehensive analysis of both connected speech and single-word sampling assessments, Louises error patterns suggest she likely has a phonological delay. The evidence supporting this diagnosis includes her consistent use of phonological processes that typically resolve earlier in development, particularly fronting, cluster reduction, stopping of fricatives and gliding. Her profile demonstrates a mix of age- appropriate patterns (such as gliding) alongside delayed patterns (like fronting), indicating that her phonological system is developing typically but at a slower pace than expected for her age. The presence of these systematic error patterns across sampling contexts, rather than inconsistent articulation errors, further supports the classification of Phonological Delay rather than other SSD sub types.
F)Provide a comparison of Louises speech errors and PCC results from the two sampling contexts. Whats consistent across single word and connected speech samples? What is different between them? For example, what errors are observed in single word samplingbutnotconnectedspeechsamplingorviceversa?AretheredifferencesbetweenthePCCresults?
Whydoyouthinkthere are PCC differences? Explain whether both forms of assessment were useful in determining the subtype of SSD you suspect Louisehas.
The comparison of Lousies speech errors and PCC results reveals both consistencies and differences across sampling contexts. Gliding and cluster reduction errors were consistently observed in both connected speech and single-word contexts, indicating these are persistent features of Lousies speech disorder. However, certain error patterns, including stopping of fricatives and fronting were more pronounced during connected speech than in single word samples, suggesting that increased linguistic complexity triggers additional speech production difficulties. The PCC
inconnectedspeech(79%)wasslightlylowerthanwhatmightbeexpectedbasedonsingle-wordassessments,likelyreflectingtheincreased demands of connected speech, where factors such as syllable structure, coarticulation, and stress patterns create additional articulatory challenges. Both assessment formats proved valuable in determining Louises suspected SSD subtype, as they collectively provided a more comprehensive picture of her phonological abilities across varying levels of linguistic complexity.
G)Consideroneadditionalassessmentareathatyouwouldliketoassessforthiscaseandexplainwhy.Usereferencesfromthe literature and clinical reasoning from the case to justify your answer.
An area that may require further assessment is Lousies oral-motor function, as difficulties in motor planning or execution can affect speech production. Assessing her oral-motor skills will help determine if Lousies speech errors are related to motor planning defects or phonologicalprocessingdifficulties.(REFERENCE)statesthatoral-motorassessmentscanidentifysubtlemotorplanningdifficulties,which could influence speech sound production. This assessment could guide intervention for any underlying motor issues contributing to her speech difficulties.
