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Purpose: Diversity considerations are of paramount significance in the clinical assessment and treatment of speech disorders in bilingual children and adults who speak a less common language (and/or its dialects). While comprehensive assessment is essential for culturally and linguistically diverse (CLD) populations, this is clinically challenging due to the indeterminacy entailed in the process and incumbrances in access to resources. This clinical tutorial outlines key considerations necessary for holistic, ecological, and dynamic assessments of speech disorders internationally, focusing on Greek. Method: Pertinent literature is reviewed to provide the relevant theoretical backdrop for the ecosystemic protocol, both conceptually and schematically. Greek is utilized as an example language, aiming to underscore knowledge, tools, and other resources on clinically relevant aspects of dialectal, interlanguage (adult second language [L2]), and child multilingual (L2/third language) variation in Greek-dominant speakers. Results: The tutorial highlights facets of Greek speech and scripts a primary assessment model for clinical use mostly targeting clinicians that are not speakers or cognizant of the language, also viewing speech in linguistic diversity as a sociolinguistic construct. Recommendations for clinical practices are outlined proposing a specific action plan, exemplified by a case scenario. Conclusions: The demonstrated ecosystemic paradigm in holistic, ecological protocols for clinical assessment of speech disorder in CLD speakers addresses the need for nonlinear, multilevel assessment of variable language exposure and use; being sensitive to individual speaker specificities; the sociolinguistic environment; and employing people-first, culturally sensitive, and dynamic strategies in clinical assessment. The stance also simplifies disambiguation tasks regarding the difference disorder dichotomy, enhancing existing clinical procedures. [ABSTRACT FROM AUTHOR]

Well-specified phonological representations are important for the development of spoken and written language. This study investigates the types of speech errors and the quality of phonological representations in Greek-speaking school-age children with high-functioning autism spectrum disorder (HF-ASD), as well as the relationship between stored phonological representations and speech output in this sample, according to Stackhouse and Wells' (1997) model. All participants completed a phonological and a naming test, and a non-word repetition task. A receptive phonological task was administered to a subgroup of HF-ASD and typically developing (TD) participants. According to performance in the phonological test, the HF-ASD children were categorised as ASD with Speech Sound Disorder (SSD) or ASD without SSD. The HF-ASD children made significantly more speech errors and showed significant difficulties in the repetition of non-words and the stored phonological representations compared to the TD group but had the same naming abilities with their TD peers. The ASD children with SSD and without SSD performed alike in the receptive task, indicating that both groups had unspecified phonological representations. These results support the hypothesis of distinct phonological representations for speech input and output and highlight the need of using receptive tasks to evaluate underlying phonological knowledge, a process which could allow clinicians to identify the level of speech breakdown. [ABSTRACT FROM AUTHOR]

The study aimed at evaluating the diadochokinetic (DDK) skills of Greek-speaking preschool children with phonological disorder (PD) by means of a structured evaluation protocol and at proposing cut-off points for children at risk of speech impairment. The participants were 36 children with PD and 60 typically developing (TD) peers. The groups were matched on age and gender. The PD group performed significantly slower than the TD group in all speech DDK tasks but not in the oral-motor tasks. The ROC analysis showed a statistically significant positive discrimination for all speech tasks. The internal consistency of the protocol was excellent (Cronbach's α =.844), while complex stimuli showed a better discriminatory ability. The obtained results agree with Dodd's classification for speech sound disorders (SSDs). Different types of speech stimuli must be included in the evaluation of DDK performance as a clinical predictor for preschoolers with SSDs who face difficulties in speech maturation. [ABSTRACT FROM AUTHOR]

Intervention with children with speech and language difficulties has been proven beneficial compared with no treatment yet, knowing what type of intervention to provide remains a challenge. Studies of English-speaking children indicate that intervention targeting the production of morphological targets may have a positive effect on phonological aspects and vice versa. However, studies have not reported on generalization effects to untreated morphemes and little is yet known about morphological intervention in the context of a highly inflected language. The purpose of the current intervention case study was to investigate the effect of intervention in relation to phonological and morphological targets in Greek, a language characterized by complex inflectional morphology. A single subject research design was used with pre- and post-intervention assessment carried out. The participant was a four-year-old Greek-speaking boy with speech difficulties. The production of /s/, a phoneme used in multiple phonological and morphological contexts was targeted with alternating focus of intervention between phonological and morphological targets. Assessment took place at two levels: macro-assessment to monitor broad changes in speech; micro-assessment to measure therapy-specific changes in the production of treated targets and generalization to untreated targets and control items. There were four phases of intervention with a total of 24 hours of therapy. Significant improvement in performance accuracy was found between assessment scores immediately pre- and post-intervention. Intervention targeting the production of a phoneme in the word stem was not sufficient to accomplish the accurate production of morphemes requiring the same phoneme; intervention directly targeting morphemes was successful. Within-domain generalization was observed in both domains. Improved naming accuracy was observed post-intervention that was maintained at follow-up. The present study supports the case for morphophonological intervention. Morphological elements should be addressed in a comprehensive intervention for speech sound disorders. [ABSTRACT FROM AUTHOR]