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Background: In response to the call for papers under the theme "What is in a name" proposed by the Scientific Child Speech Committee of the International Association of Communication Sciences and Disorders (IALP), the current paper discusses taxonomy and its relation to speech sound disorders (SSD) from a cross‐linguistic perspective. Aims: This paper starts with a brief description of specific SSD frameworks and nomenclature. Methods & Procedures: The authors draw from international theoretical and clinical research which underscore the importance of taxonomy systems in SSD. Outcomes & Results: The current papers stresses the importance of the contribution to differential diagnosis and prognosis of children with protracted speech profiles on the bases of taxonomy profiles and systems for SSD. Conclusions & Implications: The advantages and shortcomings of taxonomy in SSD are also discussed from a cross‐linguistic context. The language of focus includes the Greek dialectal variation of Cypriot‐Greek. WHAT THIS PAPER ADDS: The paper adds to the importance of taxonomy and SSD subsystems which allow differential diagnosis of SSD and the implementation of appropriate intervention methods. What is already known on this subject: The use of various taxonomy systems regarding SSD are widely available for English‐speaking populations. Such systems in the cross‐linguistic framework remain underexplored. What this paper adds to existing knowledge: The paper underscores the need for the development, adaptation and use of taxonomy systems that will add to the existing databases and taxonomy subsystems used in English What are the potential or actual clinical implications of this work?: Potential clinical implications include the development and implementation of taxonomy systems in profile SSD productions in children. [ABSTRACT FROM AUTHOR]

Background: At the beginning of the 21st century, international adoptions of children with cleft lip and/or palate increased dramatically in Sweden. Many children arrived partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. To date, the speech development of internationally adopted (IA) children has been described up to age 7–8 years, but later development remains unstudied. Aims: To investigate speech development between ages 5 and 10 years in children born with cleft lip and palate (CLP) adopted from China and to compare them with non‐adopted (NA) children with CLP. A secondary aim was to compare the frequencies of secondary palatal surgery and number of visits to a speech and language pathologist (SLP) between the groups. Methods & Procedures: In a longitudinal study, 23 IA children from China were included and matched with 23 NA children born in Sweden. Experienced SLPs blindly reassessed audio recordings from routine follow‐ups at ages 5 and 10 years. Velopharyngeal function (VPF) was assessed with the composite score for velopharyngeal competence (VPC‐Sum) for single words and rated on a three‐point scale (VPC‐Rate) in sentence repetition. Target sounds in words and sentences were phonetically transcribed. Per cent correct consonants (PCC) were calculated at word and sentence levels. For in‐depth analyses, articulation errors were divided into cleft speech characteristics (CSCs), developmental speech characteristics (DSCs) and s‐errors. Information on secondary palatal surgery and number of visits to an SLP was collected. Outcomes & Results: VPF differed significantly between the groups at both ages when assessed with VPC‐Sum, but not with VPC‐Rate. Regardless of the method for assessing VPF, a similar proportion in both groups had incompetent VPF but fewer IA than NA children had competent VPF at both ages. IA children had lower PCC at both ages at both word and sentence levels. More IA children had CSCs, DSCs and s‐errors at age 5 years, and CSCs and s‐errors at age 10. The development of PCC was significant in both groups between ages 5 and 10 years. The proportion of children receiving secondary palatal surgery did not differ significantly between the groups, nor did number of SLP visits. Conclusions & Implications: CSCs were more persistent in IA children than in NA children at age 10 years. Interventions should target both cleft and DSCs, be comprehensive and continue past the pre‐school years. WHAT THIS PAPER ADDS: What is already known on this subject: At the beginning of the 21st century, IA children with cleft lip and/or palate arrived in Sweden partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. Studies up to age 7–8 years show that adopted children, compared with NA peers, have poorer articulation skills, demonstrate both cleft‐related and developmental articulation errors, and are more likely to have velopharyngeal incompetence. Several studies also report that adopted children more often require secondary palatal surgery due to fistulas, dehiscence or velopharyngeal incompetence compared with NA peers. What this paper adds to existing knowledge: This longitudinal study provides additional knowledge based on longer follow‐ups than previous studies. It shows that the proportion of children assessed to have incompetent VPF was similar among IA and NA children. It was no significant difference between the groups regarding the proportion that received secondary palatal surgery. However, fewer IA children were assessed to have a competent VPF. Developmental articulation errors have ceased in most IA and all NA children at age 10 years, but significantly more adopted children than NA children still have cleft‐related articulation errors. What are the potential or actual clinical implications of this work?: Speech and language therapy should target both cleft‐related and developmental articulation errors. When needed, treatment must be initiated early, comprehensive, and continued past the pre‐school years, not least for adopted children. [ABSTRACT FROM AUTHOR]

Background: The current literature suggests a link between dummy (or pacifier) use and a number of both positive and detrimental consequences. Positive consequences include soothing effect and protection from sudden infant death syndrome (SIDS), while negative ones include increased risk of otitis media and dental malformation. However, there is little research surrounding the impact of dummy use on the development of speech sounds. Aims: To investigate whether duration (in number of months) and frequency per day of dummy use have an individual or combined effect on the development of a child's speech, and if so, in what way. Methods & Procedures: A total of 100 British‐English children aged 24–61 months and growing up in the UK were recruited through nurseries, playgroups and by word of mouth. Their parents were asked to complete a questionnaire about the duration and frequency of dummy use and factors known to influence the development of speech. Following this, the children's speech was assessed using the phonology section of the Diagnostic Evaluation of Articulation and Phonology (DEAP). Analysis of the DEAP was conducted to determine the percentage of consonants correct, number of age‐appropriate, delayed and atypical errors. Dummy use and speech outcome measures were then analysed qualitatively and quantitatively using mean and median group comparisons alongside multivariate generalized least squares and generalized negative binomial modelling approaches to test for significant associations. Outcomes & Results: The results showed that the majority of speech outcomes are not significantly associated with dummy use, however measured, in bivariate or multivariate analyses. However, there is a significant association between increased atypical errors and greater frequency of daytime dummy use. This association is strengthened by restricted sampling within the younger members of the sample, with this association not observable within children older than 38 months, the median sample age. Conclusions & Implications: The evidence base for any effects of dummy use on speech is very small. Dummy use may increase the number of atypical speech errors a young child makes. However, only the frequency of daytime use seems relevant, not the duration or night‐time use, and these errors may resolve over time. What this paper addsWhat is already known on this subjectThe use of a dummy with infants in Western countries is comparatively high (between 36‐85%). A number of positive and detrimental consequences of dummy use have been documented in the literature; however, research on the effect of dummy use on speech development is significantly lacking. Past studies have included small sample sizes or used single measures of speech outcomes, which may not be specific enough to reveal how speech may be affected. Many speech and language therapists speculate that the use of a dummy could be contributing to many of the conditions they treat, yet this claim remains largely unsubstantiated.Clinical implications of this studyThe study suggests that only prolonged use of a dummy over several hours and during the day may start to show any impact on speech; even then, professionals need to be aware that the evidence base for any speech effects is very small. Clinicians and other professionals who parents consult on dummy use should make sure to provide both the pros and cons of dummy use, in order to enable parents to make an informed decision. [ABSTRACT FROM AUTHOR]

Background: Speech‐sound development in preschoolers with unilateral cleft lip and palate (UCLP) as a group is delayed/disordered, and obstruents comprise the most vulnerable sound class. Aims: To evaluate the development of obstruent correctness (PCC‐obs) and error types (cleft speech characteristics (CSCs) and developmental speech characteristics (DSCs)) from ages 3–5 and to investigate possible predictors (error types, velopharyngeal dysfunction (VPD) and gender) of PCC‐obs at age 5 in two groups of children with UCLP. Methods & Procedures: Subgroup analysis was conducted within a multicentre randomized controlled trial (RCT) of primary surgery (Scandcleft Project). A total of 125 Danish children with UCLP received lip and soft palate repair around 4 months of age and early hard palate closure at 12 months (EHPC group) or late hard palate closure at 36 months (LHPC group). Audio and video recordings of a naming test were available for 108 children at ages 3 and 5, and recordings were transcribed phonetically by blinded raters. Outcomes & Results: PCC‐obs scores increased significantly from ages 3–5 in both groups, but with small effect sizes in the EHPC group that had higher scores at age 3 than the LHPC group. DSCs decreased in both groups whereas CSCs only decreased in the LHPC group that had more CSCs at age 3 than the EHPC group. The frequency of CSCs at age 3 was a significant predictor of PCC‐obs scores at age 5 in both groups. DSCs significantly improved the logistic regression model in the EHPC group, whereas VPD and gender did not significantly improve the model in either group. Conclusions & Implications: Although PCC‐obs developed significantly from ages 3 to 5, children with UCLP as a group did not catch up to typically developing Danish children at age 5. Furthermore, the LHPC group at age 5 did not reach the 3‐year level of the EHPC group, which means that delaying hard palate closure until age 3 is detrimental to obstruent development. Both CSCs and DSCs at age 3 were important predictors of PCC‐obs at age 5 and should be considered when determining need for intervention. [ABSTRACT FROM AUTHOR]

Background: Treatment outcome data for children with severe speech sound disorders with motor speech involvement (SSD‐MSI) are derived from Phase I clinical research studies. These studies have demonstrated positive improvements in speech production. Currently there is no research examining the optimal treatment dose frequency for this population. The results of this study, which is the first of its kind, will inform the delivery of effective services for this population. Aims: To investigate optimal treatment dose frequency for the Motor Speech Treatment Protocol (MSTP) for children with SSD‐MSI. Methods & Procedures: A total of 48 children (aged 43–47 months) with SSD‐MSI participated in the study. Participants received 45‐min MSTP intervention sessions either once per week (lower dose frequency) or twice per week (higher dose frequency) for a 10‐week period. Blinded outcome assessments were carried out at pre‐ and post‐intervention. Outcomes & Results: Treatment‐related change was assessed at body structures, functions and activities participation level as per the World Health Organization's International Classification of Functioning framework: Children and Youth Version (ICF‐CY) framework WHO (2007). These measures are related to articulation, functional communication and speech intelligibility. One‐way analysis of variance (ANOVA) revealed that for all variables the baseline scores were not statistically different (p > 0.05) between the two dose‐frequency groups. Overall, there was a significant main effect of Time (pre–post) across all variables (p < 0.01). However, repeated‐measures ANOVA did not result in any statistical interactions (Time × Dose frequency) for any of the variables tested (p > 0.05). Only marginal clinical advantages (< 4% change in intelligibility) were noted with the 10 extra sessions. Conclusions & Implications: Overall, the MSTP intervention approach in conjunction with home practice led to significant positive changes for all measures in children with SSD‐MSI. No statistical differences between high‐ and low‐dose‐frequency groups were observed for any of the variables. Clinical effects were examined using effect sizes, as well as changes in articulation, speech intelligibility and functional communication; these differed marginally between the two dose frequencies. This suggests limited benefits of 10 additional sessions per block. Thus, it is recommended that caregivers, speech–language therapists and policy‐makers perform a cost–benefit analysis before determining the dose frequency, when considering additional sessions per block. [ABSTRACT FROM AUTHOR]

Abstract: Background: Posterior nasal fricatives are a learned compensatory articulation error and commonly substituted for oral fricatives. Treatment of such articulation errors requires the modification or teaching of skilled movements. A motor‐based approach is designed to teach the complex motor skill movement sequences required in the production of sounds. Although motor learning research is well established, little has been done to determine how the approach changes the underlying physiology of articulatory movements. While the underlying anatomical configuration of the posterior nasal fricative has been described, no studies have quantified anatomic and physiological changes pre‐ and post‐treatment. Aims: To use magnetic resonance imaging (MRI) to visualize and quantify the results of motor‐based speech‐intervention approach on articulatory placement for the treatment of the posterior nasal fricative. Methods & Procedures: A 6‐year‐old male with a history of ear infections and posterior nasal fricative substitution for /s/ underwent six 1‐h sessions of a motor‐based treatment approach over the course of 2 weeks. Pre‐ and post‐treatment evaluation included perceptual and instrumental assessment of speech and resonance. Perceptual resonance was rated by two speech–language therapists and articulation was assessed at the single‐word level. Instrumental assessment included the See‐Scape, Nasometer II and MRI during the sustained phonation of /s/. Amira v5.6 Visualization and Volume modelling software used the midsagittal and oblique coronal plane to measure dimensions of the articulatory anatomy. Outcomes & Results: Interrater reliability was assessed using a Pearson product moment correlation (α = .05) and ranged from r = .91 to .95. Intra‐rater reliability was assessed using the intra‐class correlation coefficient (.976) demonstrating a high degree of reliability with a 95% confidence interval. Articulation improved from 0% accuracy for /s/ in isolation at baseline to 100% for /s/ at the word level and 95% accuracy during conversational speech by session 6. Post‐treatment results from this study revealed a greater shortening of the levator veli palatini (levator) muscle length during articulatory movements, more pronounced velar knee and dimple, decreased velar thickness, increased velar length and altered tongue position. Conclusions & Implications: This study demonstrated the use of pre‐ and post‐treatment imaging methodology to quantify articulatory changes following an intensive motor‐based treatment approach. MRI demonstrated quantifiable changes in articulatory placement. Individuals who exhibit non‐developmental and phoneme‐specific articulation errors, such as the posterior nasal fricative, may be excellent candidates for short‐term, intensive and frequent speech therapy sessions to remediate the production of the posterior nasal fricative. [ABSTRACT FROM AUTHOR]

Abstract: Background: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. Aims: To assess the influence of different timing of hard palate closure in a two‐stage procedure on articulation skills in 3‐year‐olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery, hearing and speech therapy. Methods & Procedures: A randomized controlled trial (RCT). Early hard palate closure (EHPC) at 12 months versus late hard palate closure (LHPC) at 36 months in a two‐stage procedure was tested in a cohort of 126 Danish‐speaking children born with non‐syndromic UCLP. All participants had the lip and soft palate closed around 4 months of age. Audio and video recordings of a naming test were available from 113 children (32 girls and 81 boys) and were transcribed phonetically. Recordings were obtained prior to hard palate closure in the LHPC group. The main outcome measures were percentage consonants correct adjusted (PCC‐A) and consonant errors from blinded assessments. Results from 36 Danish‐speaking children without CP obtained previously by Willadsen in 2012 were used for comparison. Outcomes & Results: Children with EHPC produced significantly more target consonants correctly (83%) than children with LHPC (48%; p < .001). In addition, children with LHPC produced significantly more active cleft speech characteristics than children with EHPC (p < .001). Boys achieved significantly lower PCC‐A scores than girls (p = .04) and produced significantly more consonant errors than girls (p = .02). No significant differences were found between groups regarding burden of treatment. The control group performed significantly better than the EHPC and LHPC groups on all compared variables. [ABSTRACT FROM AUTHOR]

Background In the last decade, a large number of children with cleft lip and palate have been adopted to Sweden. A majority of the children were born in China and they usually arrive in Sweden with an unoperated palate. There is currently a lack of knowledge regarding speech and articulation development in this group of children, who also have to deal with a late first language switch. Aims To study consonant proficiency in 3-year-old internationally adopted children with unilateral cleft lip and palate (UCLP) compared with peers with UCLP born in Sweden. Also to study the type and frequency of consonant errors and to perceptually compare velopharyngeal competence between the groups. Methods & Procedures Thirty-two children born between 2006 and 2010 with UCLP participated in the study-14 adopted from China and 18 children born in Sweden. Both groups were treated by the same cleft palate team. Audio recordings at 3 years of age were perceptually analysed by blinded listeners. Consonant proficiency was measured via per cent consonants correct adjusted for age (PCC-A), per cent correct manners (PCM) and per cent correct places (PCP). The prevalence of audible nasal air leakage and velopharyngeal competence were judged and compared between groups. The type and frequencies of consonant errors related to place and manner of articulation were also analysed. Outcomes & Results The internationally adopted children had significantly fewer correct consonants compared with the Swedish-born children. This was true for PCC-A, PCP and PCM. This group also had significantly higher prevalence of glottal stops/fricatives and deleted target consonants more often. Also the internationally adopted children had a higher prevalence of incompetent velopharyngeal function. The only outcome variable with similar results in the groups was audible nasal air leakage. Conclusions & Implications The present study indicated that there were significant differences regarding consonant proficiency and velopharyngeal competence between internationally adopted children with a UCLP and their Swedish-born peers with UCLP at the age of 3 years. Internationally adopted children with UCLP should be considered an at risk group for a higher prevalence of speech difficulties than non-adoptees. Thus, it is particularly important to follow this group of children over time. Longitudinal studies of speech and language development in internationally adopted children with UCLP are needed. [ABSTRACT FROM AUTHOR]

Background: Maintaining an external direction of focus during practice is reported to facilitate acquisition of non-speech motor skills, but it is not known whether these findings also apply to treatment for speech errors. This question has particular relevance for treatment incorporating visual biofeedback, where clinician cueing can direct the learner's attention either internally (i.e., to the movements of the articulators) or externally (i.e., to the visual biofeedback display). Aims: This study addressed two objectives. First, it aimed to use single-subject experimental methods to collect additional evidence regarding the efficacy of visual-acoustic biofeedback treatment for children with /r/ misarticulation. Second, it compared the efficacy of this biofeedback intervention under two cueing conditions. In the external focus (EF) condition, participants' attention was directed exclusively to the external biofeedback display. In the internal focus (IF) condition, participants viewed a biofeedback display, but they also received articulatory cues encouraging an internal direction of attentional focus. Methods & Procedures: Nine school-aged children were pseudo-randomly assigned to receive either IF or EF cues during 8 weeks of visual-acoustic biofeedback intervention. Accuracy in /r/ production at the word level was probed in three to five pre-treatment baseline sessions and in three post-treatment maintenance sessions. Outcomes were assessed using visual inspection and calculation of effect sizes for individual treatment trajectories. In addition, a mixed logistic model was used to examine across-subjects effects including phase (pre/post-treatment), /r/ variant (treated/untreated), and focus cue condition (internal/external). Outcomes & Results: Six out of nine participants showed sustained improvement on at least one treated /r/ variant; these six participants were evenly divided across EF and IF treatment groups. Regression results indicated that /r/ productions were significantly more likely to be rated accurate post- than pre-treatment. Internal versus external direction of focus cues was not a significant predictor of accuracy, nor did it interact significantly with other predictors. Conclusions: The results are consistent with previous literature reporting that visual-acoustic biofeedback can produce measurable treatment gains in children who have not responded to previous intervention. These findings are also in keeping with previous research suggesting that biofeedback may be sufficient to establish an external attentional focus, independent of verbal cues provided. The finding that explicit articulator placement cues were not necessary for progress in treatment has implications for intervention practices for speech-sound disorders in children. [ABSTRACT FROM AUTHOR]

Background Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate (UCLP) and its possible relationship with articulation/phonology at 3 and 5 years of age. Methods & Procedures A total of 49 children, 29 with UCLP treated according to three different procedures for primary palatal surgery and a comparison group of 20 children (COMP), were included. Longitudinally recorded audio files were used for analysis. At ages 3 and 5, the children were presented with a single-word test of word naming and at age 5 also the Bus Story Test (BST). The BST was assessed according to a test manual. The single-word test was phonetically transcribed and the percentage of consonants correct adjusted for age (PCC-A) was calculated. Differences regarding the BST results within the UCLP group were analysed. The results were compared with the results of the COMP group, and also with norm values. In addition, the relationship between the results of the BST and the PCC-A scores at ages 3 and 5 years was analysed. Outcomes & Results No significant group differences or correlations were found. However, 65.5% of the children in the UCLP group had an information score below 1 standard deviation from the norm value compared with 30% in the COMP group. Conclusions A larger proportion of children in the UCLP group than in the COMP group displayed problems with retelling but the differences between the two groups were not significant. There was no association between the BST results in the children with UCLP and previous or present articulatory/phonological competence. Since group size was small in both groups, the findings need to be verified in a larger study. [ABSTRACT FROM AUTHOR]

Improvement or maintenance of speech intelligibility is a central aim in a whole range of conditions in speech-language therapy, both developmental and acquired. Best clinical practice and pursuance of the evidence base for interventions would suggest measurement of intelligibility forms a vital role in clinical decision-making and monitoring. However, what should be measured to gauge intelligibility and how this is achieved and relates to clinical planning continues to be a topic of debate. This review considers the strengths and weaknesses of selected clinical approaches to intelligibility assessment, stressing the importance of explanatory, diagnostic testing as both a more sensitive and a clinically informative method. The worth of this, and any approach, is predicated, though, on awareness and control of key design, elicitation, transcription and listening/listener variables to maximize validity and reliability of assessments. These are discussed. A distinction is drawn between signal-dependent and -independent factors in intelligibility evaluation. Discussion broaches how these different perspectives might be reconciled to deliver comprehensive insights into intelligibility levels and their clinical/educational significance. The paper ends with a call for wider implementation of best practice around intelligibility assessment. [ABSTRACT FROM AUTHOR]

Background In Portugal, the routine clinical practice of speech and language therapists (SLTs) in treating children with all types of speech sound disorder (SSD) continues to be articulation therapy (AT). There is limited use of phonological therapy (PT) or phonological awareness training in Portugal. Additionally, at an international level there is a focus on collecting information on and differentiating between the effectiveness of PT and AT for children with different types of phonologically based SSD, as well as on the role of phonological awareness in remediating SSD. It is important to collect more evidence for the most effective and efficient type of intervention approach for different SSDs and for these data to be collected from diverse linguistic and cultural perspectives. Aims To evaluate the effectiveness of a PT and AT approach for treatment of 14 Portuguese children, aged 4.0-6.7 years, with a phonologically based SSD. Methods & Procedures The children were randomly assigned to one of the two treatment approaches (seven children in each group). All children were treated by the same SLT, blind to the aims of the study, over three blocks of a total of 25 weekly sessions of intervention. Outcome measures of phonological ability (percentage of consonants correct (PCC), percentage occurrence of different phonological processes and phonetic inventory) were taken before and after intervention. A qualitative assessment of intervention effectiveness from the perspective of the parents of participants was included. Outcomes & Results Both treatments were effective in improving the participants' speech, with the children receiving PT showing a more significant improvement in PCC score than those receiving the AT. Children in the PT group also showed greater generalization to untreated words than those receiving AT. Parents reported both intervention approaches to be as effective in improving their children's speech. Conclusions & Implications The PT (combination of expressive phonological tasks, phonological awareness, listening and discrimination activities) proved to be an effective integrated method of improving phonological SSD in children. These findings provide some evidence for Portuguese SLTs to employ PT with children with phonologically based SSD. [ABSTRACT FROM AUTHOR]

Background: School-aged children with persisting speech sound disorders (SSDs) may show little improvement in speech accuracy following phonological or articulation therapy. Aims: To determine the effects of establishing consonant production in facilitative vowel contexts for a 7-year-old boy (CD) with persisting post-alveolar fronting. CD had received phonological awareness therapy and traditional articulation therapy as part of a community caseload. However, his post-alveolar fronting showed resistance to therapy. Methods & Procedures: CD received individual therapy for nine 45–55-min sessions. A checklist of quality indicators for single-subject research was used to explore the likelihood that a community clinic could meet quality indicators. Fifteen test words in each of target, generalization and control sets were measured at five times pre-, during and post-therapy. A trend analysis was used to measure the statistical significance of the results and to demonstrate the efficacy of therapy. Outcomes & Results: Therapy was successful. Gains on treatment and generalization test items were rapid and significantly higher than gains on control test items. Only three of 21 single-subject research quality indicators were not met in this research. Conclusions & Implications: Targeting facilitative vowel contexts was successful for this 7-year-old boy with persisting post-alveolar fronting which had been resistant to other therapy techniques. Speech and language therapists are encouraged to ensure that quality indicators for single-subject interventions are built into regular practice. [ABSTRACT FROM AUTHOR]

Background: Visual biofeedback using electropalatography (EPG) has been beneficial in the treatment of some cases of lateral /s/ misarticulation. While EPG intervention is motorically based, studies have not commonly employed a motor learning approach to treatment. Furthermore, treatment success is measured primarily by change to EPG tongue-palate contact patterns and listener ratings conducted by speech-language therapists. Studies have not commonly measured articulatory change without the palate in-situ using acoustic analysis and non-professional listeners. Aims: To determine if an intensive treatment programme including both visual biofeedback (EPG) and traditional articulation techniques within a motor learning paradigm would result in functional improvement to /s/ articulation in an 11-year-old girl with persistent lateral misarticulation. Methods & Procedures: Treatment involved 12 sessions of therapist-delivered treatment over 4 weeks followed by a 6-week home programme. Outcomes of the treatment programme were measured primarily using naïve listener ratings and acoustic analysis of /s/ spectra. Outcomes & Results: Improvements to both the perceptual and spectral characteristics of /s/ articulation occurred following the treatment programme. Conclusions: The study highlighted the benefit of an intensive approach to intervention incorporating both visual biofeedback and traditional articulation approaches. The inclusion of a 6-week structured home-programme was beneficial and resulted in consolidation of treatment gains. [ABSTRACT FROM AUTHOR]

Background: Children with phonological problems are a significant proportion of many therapists' caseloads. However, little is known about current clinical practice with these children or whether research on the effects of therapy have influenced this practice. Aims: To investigate the methods of assessment and remediation used by therapists working in the UK. Methods & Procedures: A questionnaire was sent to therapists working with pre- and primary school-aged children. Outcomes & Results: Ninety-eight clinicians of varying experience responded. Most used the South Tyneside Assessment of Phonology to assess children, were confident in choosing therapy, and were aware of evidence that therapy is beneficial. They used a variety of therapies. Auditory discrimination, minimal contrast therapy, and phonological awareness were popular and often used in combination. Most involved parents. In planning therapy, clinicians were more influenced by children's language and cognitive abilities and the motivation of parents than by the nature of the impairment. Conclusions: Constraints upon clinicians make it difficult for them to convert research findings to practice. In particular, assessments that allow more individualized and targeted interventions appear little used. Clinicians are aware of research but there is a danger that clinical practice and research are diverging. [ABSTRACT FROM AUTHOR]

Background: The diadochokinetic (DDK) rate represents an index for assessing motor skills. It is commonly used in routine clinical evaluation of diseases of the central nervous system, disturbances of the peripheral sensory motor formations and immaturity of the speech mechanism. Oral DDK rates are a popular guideline for the assessment, diagnosis and treatment of patients with a neurological deficit of the speech mechanism. Baseline DDK rates have been published for English-speaking children, but not for Thai-speaking children. Thailand is situated in South East Asia, and the language belongs to the monosyllabic, tonal, Sino-Tibetan group with extensive multisyllabic borrowings from the non-tonal, Pali-Sanskrit group. Aims: To assess the oral DDK rates for normal Thai children aged between 6 and 13 attending primary schools in order to establish a baseline for assessing, diagnosing and treating patients. Methods & Procedures: Subjects included 197 students who repeated, in rapid succession, specified sounds representing different levels of physiologic complexity, as indicated by differences in the developmental schedule, articulatory placement and syllabic content. Twenty syllable repetitions were required for monosyllabic utterances, 15 for bisyllablics and 10 for trisyllablics. Visi Pitch ® Analysis was used to calculate the average time that subjects took to produce the sounds. Outcomes & Results: The time taken for the lip functions /pэ/, /a:-u:/, /u:-i/ and /i:-a:/ averaged 4.55, 6.67, 7.53 and 7.27 seconds, respectively. The tongue functions /tэ/, /lэ/, /kэ/ and click averaged 4.58, 4.82, 4.85 and 5.87 seconds, respectively. Tongue movement side-to-side between the corners of the mouth averaged 8.73 seconds, while the lip-tongue functions /pэ-tэ/, /pэ-kэ/ and /pэ-tэ-kэ/ were 6.97, 7.52 and 6.85 seconds, respectively. Sex and age influenced oral DDK time. The findings differ from those reported for English-speaking children. Conclusions: A basis for assessment of children with neuromotor deficits or oral structure impairment is provided for both Thai and South East Asian children with similar physiological development and languages with similar sounds. [ABSTRACT FROM AUTHOR]

Sixty-one children, aged 3;6-5;0, with developmental phonological disorders (PD) participated in a study comparing the effects of metaphonologically (MET) or articulation-based (ART) therapy. Maturational effects were controlled for by the inclusion of 59 normally speaking control children of the same age range. Measures of phonological (speech) output and phonological awareness were taken before and after therapy for all subjects and at 3 months post-therapy for PD children. Results showed that PD children improved significantly in both phonological output and awareness skills across the intervention period compared with control children, but that there was no significant difference on the awareness measure between ART and MET groups. ART and MET groups differed from each other on one measure of speech improvement only, with the ART group making more change than the MET group on individual probe scores. Follow-up measures for both therapy groups indicated that there was little difference between the groups on phonological awareness change or speech development 3 months after intervention, though there was a trend for MET children to continue to make more long-term change than the ART group on one output measure. Additional analysis showed that there were generally few significant implications for outcome between PD children with good initial phonological awareness skills and those who initially had poor phonological awareness skills. [ABSTRACT FROM AUTHOR]