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Who to Refer for Speech Therapy at 4 Years of Age Versus Who to "Watch and Wait"?
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Early identification, prediction, and classification of speech sound disorders in the preschool years
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Abstract:
© 2011 Dr. Kyriaki Ttofari Eecen ; Speech sound disorders (SSD) are often diagnosed at 4 to 5 years of age; however, it may be possible to identify children at risk of SSD earlier. One possible method of early identification involves using parent description of their children’s speech sound production, however, there is paucity in the literature on the validity of parent description of speech sound production, and whether early parent description can be used to predict later speech sound production and disorders. Furthermore, a wide range of prevalence rates of SSD have been reported in the literature, partly due to different definitions of SSD, and lack of agreement on a universally accepted classification system of SSD. This research was embedded within the Early Language in Victoria Study (ELVS), a prospective cohort study based in Melbourne, Australia. The research focused on data collected when the children were aged between 8 months and 4 years. Data were collected via parent questionnaires and face-to-face assessments, and different subsamples participated in the three phases of the research (n = 163 to 1689). In Phase 1 (Validation), there was a poor relationship between parent description and a face-to-face assessment of sound production at 12 months of age. At 4 years of age, there was a relationship between parent description of speech sound production and a face-to-face assessment of speech sound production. Parent description at 4 years of age did not identify an appropriate number of children with SSD (sensitivity); however, it was able to identify an appropriate number of children with typical speech (specificity). In Phase 2 of this research (Prediction), neither parent description of speech sound production at 8 or 12 months of age, nor a face-to-face assessment of sound production at 12 months were able to predict the results on a face-to-face assessment of speech sound production at 4 years. At 2 and 3 years of age, however, parent description of speech was able to predict results on a face-to-face assessment of speech sound production at 4 years, however, although specificity was appropriate, sensitivity was not. In Phase 3 (Classification), the prevalence of suspected SSD in a community sample was 27.0%. Two existing classification systems of SSD were applied to a group of children with mild-moderate to severe SSD in this study (n = 163). Not all participants could be classified according to each classification system; 84.0% were classified according to Dodd’s Subgroups of Speech Disorder (Dodd, 1995), whereas 59.62% were classified according to the Speech Disorders Classification System (Shriberg, 1993; Shriberg, 1994; Shriberg, Austin, Lewis, McSweeny, & Wilson, 1997; Shriberg et al., 2010; Shriberg & Kwiatkowski, 1982; Shriberg, Tomblin, & McSweeny, 1999). Of the participants who could be classified, they were classified according to Dodd’s Subgroups of Speech Disorder at similar proportions to what has been reported elsewhere in the literature. A framework for describing speech sound development and disorders was proposed. This framework is intended to be used by speech pathologists (clinicians and researchers) when assessing speech sound production. A number of critical parameters are suggested for consideration when assessing speech sound production: disorder/delay, inconsistency of speech sound production, parent concern, speech intelligibility, and risk and protective factors.
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Keyword:
children; classification; cohort; community sample; early identification; parent; parent description; parent report; parents; prediction; preschool; prevalence; prospective; speech; speech sound development; speech sound disorders; speech sound production; validity
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URL: http://hdl.handle.net/11343/37011
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