Characterizing the Profiles of Children with Speech Sound Disorders

Children with speech sound disorders (SSDs) form a heterogeneous group, with respect to severity, etiology, proximal causes, speech error characteristics and response to treatment. Infants develop speech and language in interaction with neurological maturation, and general perceptual, motoric and cognitive skills in a social-emotional context. These dynamics have consequences for the diagnosis and further analysis of SSDs in children, making it difficult for SLPs to identify all the deficits that are present. Understanding and identifying all the underlying deficits is critical as this could form the basis for the type of treatment given. Analyses of mainstream treatments with respect to the treatment goals and the speech mechanisms addressed, show that treatment programs are quite transparent in their aims and approach and how they contribute to remediating specific deficits or mechanisms (Maassen & Terband, in press).

In this project, we aim to conduct a comprehensive evaluation through parent questionnaires and standardized assessments covering a full range of knowledge and skills involved in speech production and development. The speech evaluation will also include ultrasound imaging of the tongue movements of the children.

The purpose of the study is to understand the underlying deficits in children with speech-sound disorders (SSDs) by conducting a structured and evidence-based assessment protocol. The comprehensive assessment will allow us to identify the core deficits and compare performance across different tasks between different subgroups of speech sound disorders. This will aid speech-language pathologists (SLPs) in treatment planning leading to better outcomes in therapy. 

The comprehensive assessment will be conducted at the Wendell Johnson Speech & Hearing Center. The children's productions will be audio and video recorded and later transcribed in the International Phonetic Alphabet (IPA). A detailed analysis of the patterns of speech errors will be performed. Based on the results, different patterns of performance across tasks and between subgroups will be identified. This could help develop a complete profile of the child which would aid clinical decision-making and treatment outcomes for the child. 

The Role of Somatosensory Perception in Speech Sound Production and Speech Motor Learning in Children with CAS

Childhood apraxia of speech (CAS) is characterized by impairments in planning and programming leading to errors in speech production. There have been several case reports that the core deficits of childhood apraxia of speech (CAS) stem from reduced oral sensitivity of the tongue and the palate (Terband et al., 2009). Through computational modelling it has been hypothesized that poor somatosensory information would lead to degraded feed-forward commands and an increased reliance on feedback control (Terband et al., 2009).

We aim to test this hypothesis and understand the somatosensory acuity in children with CAS by measuring performance on two somatosensory measures; an oral stereognosis task and a force pressure matching task. The performance on these measures will be compared to typical children and children with other speech sound disorder. Additionally, the performance on these tasks would be correlated to various outcome measures that reflect speech production and tongue complexity. 

The present study allows us to achieve a more comprehensive picture of the challenges faced by children with CAS and identify potential diagnostic markers. A complete profile of the child’s sensorimotor abilities will allow speech-language pathologists to choose targeted interventions for children with CAS.