Deck 1: Children With Speech Sound Disorders

Question 1

What is the difference between the definition of speech sound disorders by the International Expert Panel on Multilingual Children's Speech (2012) (as used in McLeod & Baker, 2017) and the definition of speech sound disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) developed by the American Psychiatric Association (2013)?

Answer 1

The International Expert Panel on Multilingual Children's Speech (2012) defines speech sound disorders as difficulties with speech sound production that impact intelligibility and communication, and may include difficulties with articulation, phonological processes, and motor speech coordination. This definition emphasizes the impact on communication and includes a broader range of speech sound difficulties.

On the other hand, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) developed by the American Psychiatric Association (2013) defines speech sound disorder as a communication disorder where speech sound production is significantly below the appropriate level for the individual's age, and this impacts intelligibility. This definition focuses more on the specific speech sound production difficulties and their impact on intelligibility, without explicitly including phonological processes or motor speech coordination.

In summary, the main difference between the two definitions is the broader scope of speech sound disorders included in the International Expert Panel's definition, compared to the more specific focus on speech sound production in the DSM-5 definition.

Question 2

What prompted the shift in terminology from articulation to articulation and phonology, then to speech sound disorders?

Answer 2

The shift in terminology from "articulation" to "articulation and phonology," and then to "speech sound disorders" reflects the evolution of our understanding of the complexities involved in speech production and the nature of speech disorders.

Initially, the term "articulation" was used to describe difficulties with producing individual speech sounds. This term focused on the physical aspects of speech production, such as the movement of the tongue, lips, and other speech organs. It was primarily concerned with the accuracy of sound production and typically addressed errors like substitutions, omissions, additions, and distortions of sounds.

However, as research in the field of speech-language pathology advanced, it became clear that speech sound production involves more than just the accurate articulation of individual sounds. The term "articulation and phonology" emerged to acknowledge the role of phonology, which is the study of the sound system of a language and the rules that govern the sound combinations. Phonological disorders involve patterns of sound errors (such as fronting, backing, and cluster reduction) that are not just about the motor production of sounds but also about the linguistic and cognitive aspects of how sounds are organized and used in speech.

The broader term "speech sound disorders" encompasses both articulation and phonological disorders. This term is more inclusive and recognizes that there are a variety of factors that can affect a person's ability to produce speech sounds correctly. These factors include motor skills, phonological knowledge, linguistic abilities, and sometimes neurological or developmental issues. Speech sound disorders can be organic or functional in nature, meaning they might have a known physical or neurological cause, or they might be idiopathic, with no known cause.

By using the term "speech sound disorders," professionals in the field can more accurately describe a range of issues that affect a person's ability to produce speech sounds, and it allows for a more holistic approach to assessment and intervention. It also aligns with the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), which use similar terminology to classify and diagnose communication disorders.

In summary, the shift in terminology reflects a deeper understanding of the complexity of speech production and the various factors that can contribute to speech sound difficulties. It allows clinicians to diagnose and treat a wider range of speech disorders in a more nuanced and effective manner.

Question 3

What are five reasons why data regarding the prevalence of speech sound disorders vary?

Answer 3

1. Diagnostic criteria: Different professionals may use different criteria for diagnosing speech sound disorders, leading to variations in prevalence rates.

2. Population differences: Prevalence rates may vary based on the specific population being studied, such as age, gender, or cultural background.

3. Data collection methods: The methods used to collect data on speech sound disorders can vary, leading to differences in reported prevalence rates.

4. Regional differences: Prevalence rates may vary based on geographic location, as access to healthcare and diagnostic services can differ between regions.

5. Changes over time: Prevalence rates of speech sound disorders may change over time due to factors such as changes in diagnostic criteria, increased awareness, or improvements in data collection methods.

Question 4

Describe the speech outcomes for the 41 adolescents with persistent speech sound disorder, as reported by Lewis et al. (2015) in the Cleveland Family Speech and Language Study.

Question 5

List five types of speech errors that adolescents or adults with a history of childhood speech sound disorder might display in their speech.

Question 6

What are possible impacts of speech sound disorders on children's educational, social and occupational outcomes?

Question 7

State two important roles that siblings can play with children with speech sound disorders?

Question 8

What is the typical profile of a child referred with a suspected speech sound disorder?

Question 9

List the child, parent, and family factors considered in research on risk and protective factors for speech sound disorders.

Question 10

Define evidence-based practice and the three different types of evidence (external evidence, internal clinical evidence and internal patient/client evidence) used to make clinical decisions.

Question 11

Outline the historical changes in terminology associated with speech sound disorders in children and discuss the pros and cons of the changes in terminology on clinical practice.

Question 12

Discuss two reasons why some children with speech sound disorders do not receive speech-language pathology services, and propose possible solutions that could address each reason.

Question 13

Discuss what is known about the natural history of children with speech sound disorders and the challenges involved in conducting research on natural history.

Question 14

Discuss how speech sound disorders can manifest in late childhood, adolescence and adulthood.

Question 15

Compare and contrast two case history questionnaires (from an SLP, a local speech-language pathology service or the Internet), and discuss whether the questionnaires address the range of risk and protective factors discussed in

Question 16

Compare and contrast findings from three key longitudinal studies that have documented long-term outcomes for children with speech sound disorders.

Question 17

Discuss the pros and cons of pacifier use then justify your own position on pacifier use, in light of recent research on the topic.

Question 18

Discuss the possible educational, social, and occupational impacts of childhood speech sound disorders.

Question 19

Interview two adults (with no or limited knowledge about speech sound disorders in children or personal experience with speech sound disorders in children) to explore their attitudes about speech sound disorders in children. Compare and contrast their attitudes with published research on the attitudes of adults towards children and adolescence with speech sound disorders (see

Question 20

Discuss the challenges that parents can experience when raising a child with a speech sound disorder and the possible impact of a childhood speech sound disorder on their family.

Question 21

Caleb's speech can be difficult to understand. He is 4;4 years and his preschool teacher suspects that he has a speech sound disorder. This means that Caleb has:

A) a problem remembering words in everyday conversation.
B) difficulty perceiving, phonologically representing and/or articulating speech, impacting his speech intelligibility and acceptability.
C) a genetic syndrome.
D) a structural problem with his ears or palate requiring further investigation.

Question 22

Prevalence is a statistical concept referring to:

A) the number of children with speech sound disorders at one point in time.
B) the number new cases of children with speech sound disorders reported in a year.
C) the combined percentage of children who currently have a speech sound disorder and a history of SSD.
D) the pervasiveness of speech sound disorders in children.

Question 23

Prevalence reports about speech sound disorders vary because of differences in the:

A) age range of the children studied, definitions of speech sound disorders, data collection methods, procedures for sampling children, and cut-points used on a standardized test.
B) statistical procedures for calculating prevalence.
C) the qualifications of the researchers determining prevalence.
D) inclusion or exclusion of incidence data.

Question 24

Natural history refers to:

A) descriptions of children with speech sound disorders overtime.
B) the progression of a condition, such as speech sound disorders, without intervention.
C) chronological accounts of how SLPs have and have not been involved in a child's case overtime.
D) retrospective study of the changes in children's speech overtime.

Question 25

From the limited natural history research on speech sound disorders in children, it has been suggested that:

A) most children with speech sound disorders improve without intervention.
B) most children with speech sound disorders will not improve without intervention.
C) at least half of young children with speech sound disorders will not improve without intervention.
D) children should not be given intervention and left to improve naturally.

Question 26

Glen (4;10 years) has a concomitant language impairment and speech sound disorder. Fiona (4;9 years) has a speech sound disorder only. Which of the following statements is true?

A) Glen is less likely to improve without intervention compared to Fiona.
B) Fiona and Glen and equally likely to improve without intervention.
C) Fiona and Glen are equally unlikely to improve without intervention.
D) Glen will catch up while Fiona will not catch up.

Question 27

Riley (8;3 years) has a moderate-severe speech sound disorder. Based on the outcome research it is likely that Riley is:

A) having difficulty with reading, writing and spelling.
B) not having any literacy difficulties but is struggling with numeracy.
C) having difficulty remembering words.
D) not having any problems at school and he does not have a concomitant language impairment.

Question 28

Doug (32 years) has a history of childhood speech sound disorder. He received speech-language pathology intervention as a young child. His speech is now intelligible to unfamiliar listeners. During an assessment task designed to stress Doug's speech production skill, you would expect that Doug:

A) will have no speech difficulties.
B) may have subtle difficulties with polysyllabic words and tongue twisters, and may have errors on /, s, z/.
C) will be able to say polysyllabic words without error but may struggle with the speech sounds 11ee98b1_cbf8_3aad_a6de_7be584eb8648_TB9704_11, s, z/.
D) will have literacy difficulties.

Question 29

As part of the Templin Longitudinal Study reported by Felsenfeld, Broen, and McGue (1994), it was reported that:

A) adults with a history of speech sound disorder completed fewer years of education, received lower grades, and required more remedial education than those with no history of speech sound disorder.
B) adults with a history of speech sound disorder completed similar years of education but received lower grades, and required more remedial education than those with no history of speech sound disorder.
C) adults with a history of speech sound disorder had similar outcomes to adults with no history of speech sound disorder.
D) adults with a history of speech sound disorder were less satisfied with their educational and occupational outcomes compared to adults with no history of speech sound disorder.

Question 30

As part of the Ottawa Language Study reported by Johnson, Beitchman, and Brownlie (2010) it was reported that:

A) educational attainment was significantly higher for adults in the control group (i.e., no history of speech sound disorder or language impairment) compared to the adults with a history of speech sound disorder only and the adults with a history of language impairment.
B) educational attainment was significantly higher for adults in the control group (i.e., no history of speech sound disorder or language impairment) and adults with a history of speech sound disorder only compared to adults with language impairment (and possible concomitant speech sound disorder).
C) educational attainment was significantly higher for adults in the control group (i.e., no history of speech sound disorder or language impairment) and adults with a history of language impairment only compared to adults with speech sound disorder.
D) educational attainment was equivalent across the three groups studied: adults with no history of speech sound disorder or language impairment (control group), adults with a history of speech sound disorder only, and adults with a history of language impairment.

Question 31

As part of the Cleveland Family Study of Speech and Language Disorders, Lewis et al. (2015) reported that if speech sound disorder persists into adolescence, the speech errors can include:

A) errors of syllable omission and the insertion of glottal stops.
B) atypical production of velars.
C) polysyllable errors only, as all other consonants, vowels and stress patterns have been mastered.
D) polysyllable errors, distortions of /s, z, , l/, substitution errors, phonological processes (e.g., cluster reduction), and possible abnormal voice, prosody, and fluency.

Question 32

Compared to typically developing children, school-aged children identified at 4 to 5 years as having difficulty talking and making speech sounds may experience:

A) poorer peer relationships, significantly more instances of bullying, lower self-esteem, and less enjoyment of school.
B) enjoy school like their peers without speech sound disorders but experience more instances of bullying.
C) good peer relationships and no instances of bullying but lower self-esteem.
D) poorer peer relationships, lower self-esteem and less enjoyment of school but similar numbers of episodes of bullying to children.

Question 33

Based on research by Felsenfeld et al. (1994), adults with a history of speech sound disorder are:

A) more likely to be employed in semi-skilled or unskilled jobs compared with others of the same gender and no history of a speech sound disorder.
B) likely to be dissatisfied with their employment compared with others of the same gender with no history of a speech sound disorder.
C) likely to be employed in a variety of jobs regardless of skill level (i.e., skilled, semi-skilled and unskilled).
D) likely to be employed in skilled jobs but not satisfied with their employment when compared with others of the same gender with typical speech.

Question 34

Based on research by Barr, McLeod and Daniel (2008), siblings of children with speech sound disorders:

A) may feel jealousy, resentment, worry and concern about their brother or sister with a speech sound disorder.
B) are not usually impacted by their brother or sister with a speech sound disorder.
C) may feel anxious that they cannot understand their brother or sister and so avoid interacting with them.
D) can feel frustrated and annoyed that they cannot understand their brother or sister and so avoid supporting them when in need.

Question 35

The average age of referral for children with speech sound disorders is:

A) 2;6 years.
B) 5;6 years.
C) 4;3 years.
D) 3;4 years.

Question 36

The ratio of boys to girls with speech sound disorders is:

A) 1:1 - there is no difference in rates of SSD between boys and girls.
B) approximately 3:1 boys to girls.
C) approximately 2:1 boys to girls.
D) approximately 4:1 boys to girls.

Question 37

Temperament(s) that serve as protective factors regarding the identification of speech and language difficulties in children include:

A) reactive temperament.
B) persistent and sociable temperaments.
C) sociable and reactive temperament.
D) persistent and reactive temperament.

Question 38

Temperament(s) that serves as a risk factor regarding the identification of speech and language difficulties in children include:

A) reactive temperament.
B) persistent temperament.
C) sociable temperament.
D) persistent and sociable temperament.

Question 39

For children who are multilingual, it is true that:

A) speaking more than one language is a cause of speech sound disorders in children.
B) speaking phonologically similar languages causes speech sound disorders in children.
C) speaking more than one language is not a cause of speech sound disorders in children.
D) speaking phonologically different languages causes speech sound disorders in children.

Question 40

Using Dollaghan's (2007) conceptualization of E³BP, the three sources of evidence include:

A) internal research evidence, evidence from a clinical practice, and external evidence from patients/clients.
B) evidence from research, expert opinion, and evidence from patients/clients.
C) research evidence, case study evidence, and practice-based evidence.
D) external evidence, internal clinical evidence, and internal evidence from patients/clients.