Process-Oriented Profiling of Speech Sound Disorders

Diepeveen, Sanne; Terband, Hayo; Haaften, Leenke van; Zande, Anne Marie van de; Megens-Huigh, Charlotte; Swart, Bert de; Maassen, Ben

doi:10.3390/children9101502

Cited by 6 publications

(3 citation statements)

References 49 publications

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“…To make a diagnosis, speech-language pathologists use clinical reasoning to evaluate a range of signs and symptoms which are both directly observed and reported by others. These are obtained using procedures that may include case history, analysis of speech errors in single word and connected speech production, evaluation of the structure of the speech anatomy and the function of the relevant cranial nerves, and physiological measures including of respiration and phonation [4,27]. Clinicians may then conduct additional assessments to confirm or refute their diagnostic hypothesis.…”

Section: How Should a Speech Diagnosis Be Made?mentioning

confidence: 99%

Diagnostic Uncertainty in Childhood Motor Speech Disorders: A Review of Recent Tools and Approaches

McCabe,

Korkalainen,

Thomas

2024

Curr Dev Disord Rep

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Purpose Speech-language pathologists report difficulty in the accurate differential diagnosis of complex speech presentations. This paper explores possible reasons for diagnostic uncertainty and reviews new tools and recent approaches to address this concern. Recent Findings Children with motor speech disorders often have complex mixed presentations, comprising interacting motor-speech, cognitive-linguistic, and psychosocial factors, which may lead to clinicians having difficulty selecting appropriate interventions. Clinicians are frequently uncertain about differential diagnosis and lack time to complete comprehensive analysis required to understand the children’s complex speech profiles. This review examines papers that deal with this issue through identification of multiple speech disorders [5], consideration of impaired speech processes rather than discrete diagnoses [1], and the impact of new genetic understandings [20]. These insights will help to reduce the impact of this complexity on clinical decision-making. Summary New tools are emerging including clinical diagnostic pathways, genetic analysis, and theoretical modelling which may resolve many of the identified issues and improve clinical decision-making for children with complex motor speech disorders.

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Section: How Should a Speech Diagnosis Be Made?mentioning

confidence: 99%

Diagnostic Uncertainty in Childhood Motor Speech Disorders: A Review of Recent Tools and Approaches

McCabe,

Korkalainen,

Thomas

2024

Curr Dev Disord Rep

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“…C left-related lateral misarticulation is a common type of speech sound disorder (SSD) and also common speech disorder after cleft palate surgery, 1 and children with it have difficulty understanding semantics compared to other children of the same age. [2][3][4] It has been reported that children over 2 years old should have a clarity rate of around 50%, and those aged 2-2, and 6 should be able to speak more than 50 single words or phrases. Children aged 3-4 should have a clarity rate of about 75%, can say more than 200 words or phrases, and form sentences with 3 to 4 concepts.…”

mentioning

confidence: 99%

“…8 SSD represents the most common diagnosis for children's language pathologists. 9,10 Children with SSD are specific, and the severity of their unclear speech, the characteristics of their speech errors in cognitive and language abilities, and their response to speech intervention are also different, 2,11 and most children with SSD have this condition without any impairments in sensory, neural, organizational structure and psychological conditions. 12 This type of speech disorder after cleft palate surgery is very common in preschoolers and adolescents.…”

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confidence: 99%

Assessment Methods and Intervention Strategies for Cleft-Related Lateral Misarticulation in Chinese-Speaking Children

Zhang,

Wang,

Tang

et al. 2024

Journal of Craniofacial Surgery

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The aim of this study was to analyze the characteristics and error speech features of cleft-related lateral misarticulation and provide a basis for clinical evaluation and rational intervention. Participants who were diagnosed with lateral misarticulation after cleft palate repairment were 126 children aged 4, 6 to 16, and 11, and they had complete palatopharyngeal closure, no abnormalities in their speech organs and occlusion, and no hearing or intellectual impairments. The Chinese standard pronunciation clarity word list, the American KAY CSL4500, the Beijing Yangchen YF-16 computer speech analysis workstation, soundproof rooms, Wechsler scales of intelligence—fourth edition, and audiometers were used to evaluate the cleft-related lateral misarticulation. Statistical analysis was performed on the age, gender, error rate, corner of the mouth deviation direction, comorbidity, duration of intervention, period of treatment, and therapeutic effect of concentrated or normal intervention group in different patients. Our results showed that 2 to 3 straight stripes were visible at the onset of consonants /ti:/ /tʻi:/, and 3 clear straight lines were visible in /tʂ/, indicating that the lateralized sound had 2 or 3 bursts and lasted for 1 to 2 ms. The onset age of lateralized sound was mostly below 12 years old. Chinese lateralized sound mainly occurred in vowel /i:/, and the occurrence rate of consonants with tongue surface /tɕ]/ /tɕʻ/ /ɕ/ was the highest. In addition, the corner of the mouth deviation was also an indicator of lateralization sound, and other types of speech disorders mostly accompanied it. There was a significant difference in the improvement of speech clarity between the concentrated intervention group and the normal group before and after treatment. The 2 groups’ average duration and course of treatment were not significantly different. Still, the period of concentrated intervention was shortened considerably, and the speech clarity of both groups of children after treatment exceeded 96%, reaching a normal level.

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Toward Process-Oriented, Dimensional Approaches for Diagnosis and Treatment of Speech Sound Disorders in Children: Position Statement and Future Perspectives

Maassen,

Terband

2024

J Speech Lang Hear Res

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Background: Children with speech sound disorders (SSD) 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. Purpose: After a brief introduction into psycholinguistic models of speech production and levels of causation, in this review article, we present an in-depth overview of mechanisms and processes, and the dynamics thereof, which are crucial in typical speech development. These basic mechanisms and processes are: (a) neurophysiological motor refinement, that is, the maturational articulatory mechanisms that drive babbling and the more differentiated production of larger speech patterns; (b) sensorimotor integration, which forms the steering function from phonetics to phonology; and (c) motor hierarchy and articulatory phonology describing the gestural organization of syllables, which underlie fluent speech production. These dynamics have consequences for the diagnosis and further analysis of SSD in children. We argue that current diagnostic classification systems do not do justice to the multilevel, multifactorial, and interactive character of the underlying mechanisms and processes. This is illustrated by a recent Dutch study yielding distinct performance profiles among children with SSD, which allows for a dimensional interpretation of underlying processing deficits. Conclusions: 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. Recent studies into clinical reasoning reveal that the clinical challenge for speech-language pathologists is how to select the most appropriate treatment at the most appropriate time for each individual child with SSD. We argue that a process-oriented approach has merits as compared to categorical diagnostics as a toolbox to aid in the interpretation of the speech profile in terms of underlying deficits and to connect these to a specific intervention approach and treatment target.

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Process-Oriented Profiling of Speech Sound Disorders

Cited by 6 publications

References 49 publications

Diagnostic Uncertainty in Childhood Motor Speech Disorders: A Review of Recent Tools and Approaches

Diagnostic Uncertainty in Childhood Motor Speech Disorders: A Review of Recent Tools and Approaches

Assessment Methods and Intervention Strategies for Cleft-Related Lateral Misarticulation in Chinese-Speaking Children

Toward Process-Oriented, Dimensional Approaches for Diagnosis and Treatment of Speech Sound Disorders in Children: Position Statement and Future Perspectives

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