Speech sound disorder by Sajjal (2018) Definition A speech sound disorder (SSD) is a speech disorder in which some speech sounds (called phonemes) in a child's (or, sometimes, an adult's) language are either not produced, not produced correctly, or are not used correctly. Diagnostic Criteria A. Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages. B. The disturbance causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance, individually or in any combination. C. Onset of symptoms is in the early developmental period. D. The difficulties are not attributable to congenital or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medical or neurological conditions. Differential Diagnosis Normal variations in speech. Regional, social, or cultural/ethnic variations of speech should be considered before making the diagnosis. Hearing or other sensory impairment. Hearing impairment or deafness may result in abnormalities of speech. Deficits of speech sound production may be associated with a hearing impairment, other sensory deficit, or a speech-motor deficit. Structural deficits. Speech impairment may be due to structural deficits (e.g., cleft palate). Dysarthria. Speech impairment may be attributable to a motor disorder, such as cerebral palsy. Neurological signs, as well as distinctive features of voice, differentiate dysarthria from speech sound disorder. Selective mutism.
Limited use of speech may be a sign of selective mutism . Selective mutism may develop in children with a speech disorder because of embarassment about their impairments, but many children with selective mutism exhibit normal speech in "safe" settings, such as at home or with close friends . Screening/assessment Informal assessment Case History The case history typically includes gathering information about Family's concerns about the child's speech; History of middle ear infections; History of speech, language, and/or literacy difficulties in the family; Languages used in the home; Primary language spoken by the child; Teacher's perception of the child's intelligibility and participation in the school setting and how the child's speech compares with that of peers in the classroom; Hearing screening to rule out hearing loss as a possible contributing factor to speech difficulties, Screening of oral motor functioning, Facial exam to identify structural bases for speech sound disorders (e.g., sub mucous cleft palate) and to assess facial symmetry. Differences among speech sound disorders, accents, dialects, patterns of transfer from one language to another, and typical developmental patterns. Observation Speech perception Receptive and expressive language assessment, Phonological processing Sounds in various word positions (e.g., initial, within word, and final word position) and in different phonetic contexts,
Phoneme sequences (e.g., vowel combinations, consonant clusters), Speech sound errors, including Error type(s) (e.g., deletions, omissions, additions), Error distribution (e.g., position of sound in word), Error patterns (i.e., phonological patterns) Speech Sound Assessment/formal assessment Portage guide to early education The guide comes in three parts A checklist of behavior,a card file,a manual of directions. Areas It comprised of five developmental areas plus a section on infant stimulation.area include self help,motor,socialization,language and cognitive skills. Age -birth to 6 years Picture naming and imitation tests as tools for the diagnosis of phonological disorder Within the phonology tests, three types of tasks are commonly used: imitation, naming and spontaneous speech. METHOD: participants of this research were 50 phonologically disordered children, with no history of prior speech-language therapy and with ages between 4:0 and 12 years. The spontaneous speech may be elicited direct or indirectly. In direct conditions, questions are used to evoke answers. The indirect speech collecting may be done through a free situation (selected materials and topics; the topics may or may not be related to the materials) or through history (use of some selected material and topics chosen by the child); In the imitation tasks , the subject is requested to repeat a word or sentence. In the naming task it is expected that the subject say the equivalent word to the picture or object presented as stimulus. It's also usual to request the subject to produce the target word in a standard sentence (Wertzner & Galea, 2002). if he/she does not recognize the
picture/object, the examiner may say the respective name and request the naming again after showing some items.(Wertzner & Galea, 2002). AIM : to verify the association between the phonological performance in picture naming and imitation tasks, assessing the occurrence of phonological processes. Published tests of articulatoin Goldman-Fristo Published in 2000 by Pearson Ronald Goldman and Macalyn Fristoe Purpose -the GFTA3 is used to assess an individuals articulation of consonant sound of standard American . English- it samples spontaneous and imitative speech production. Norms -2,350 examinees total Males: 1798 Females :1723 Age- 2;0 to 21;11 Potensial uses -the GFTA3 can compare articulation at different levels of complexity. It can formally observe the production of vowels and as well as note deviations. In addition the test can screen for expressive language difficulties. Section1 :sounds in words. Section 2: sounds in sentences. Section 3 :the ability of the examinee to produce previously misarticulated phonemes correctly when given mximum stimulation. Pros -the test has large colorful pictures and addresses all sounds in a concise manner.versatility among varying developmental ages. for example.in the second part of the test ,there is a choice of two stories that can be read to the individual .story 1 is directed towards younger patients and story 2 can be enjoyed by older and younger clients. Reliability Evidence of inter rater reliability.
Evidence of test retest reliability. Evidence of internal consistency. Validity Evidence of content validity Evidence of construct validity Arizona Articulation Proficiency scale Developed by janet barker fudala Ages: 1-18 Grades : Infant-Adult Test all the major sounds in the English language including initial and final consonants and vowels, and diphthongs. Test Purpose The Arizona 3 provides a quick, reliable, and well-standardized measure of articulation proficiency in children. Additional Assessments Three Optional Assessment Tasks are available. Word Reading Administration Students read target words rather than naming objects on the Picture Cards. Language Screening Task On the back of almost every Picture Card is a follow-up question that can be used to elicit information about the students' vocabulary and language-based cognitive skills. Spontaneous Speech Task Two additional Picture Cards encourage spontaneous conversation. Testing Time- 2-10 minutes Test Procedure
The student names objects represented on 42 picture cards. Score each response according to simple, quantitative rules detailed in the manual. Examiner Qualifications This test may be administered and interpreted by licensed and certified speech-language pathologists or educational professionals familiar with speech sound disorders. Components Test Set includes: examiner's manual, picture test cards, and 25 test booklets - distributed item Diagnostic evaluation of articulation and phonology Author -Dodd, Barbara J. Hua, Zhu Crosbie, Sharon Holm, Alison Ozanne, Anne Place of Publication London, England It contains following. How to administer the Screen: The child names all 10 pictures, clinician phonetically transcribes each word. Imitations allowed if semantic cue fails, but ensure an imitated word is also imitated in Any speech sound produced in error is tested for stimulability. Interpret Articulation Phonology oromotor Articulation Assessment : This dynamic assessment investigates children found not to be stimulable for one or more speech sounds they should pronounce by their age, on the Screening Assessment. Administration time : 5 -10 minutes. How to administer the Articulation Assessment: Picture naming : What’s this? Use cues as necessary to elicit the word, if unsuccessful ask i. for imitation, marking with (i). Circle any sounds produced in error. ii. Speech Sound Stimulability : Attempt to elicit any speech sound produced incorrectly when picture naming: ‘I am going to say a word and I want you to say it after me’ Give the child three opportunities, getting them to watch your lips, and providing cues. If the CV syllable is not elicited, attempt to elicit the speech sound in isolation, using cues, up to three times. As examples, these instructions work for some children: /f/ ‘Put your top teeth on your bottom lip, like this The Oromotor Assessment : Administration time : 5-10 minutes.
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