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Background: Within cohorts of children with autism spectrum disorder (ASD) there is considerable variation in terms of language ability. In the past, it was believed that children with ASD either had delayed articulation and phonology skills or excelled in those areas compared to other language domains. Very little is known about speech sound ability in relation to language ability and non-verbal ability in Swedish preschool children with ASD., Aim: The current study aimed to describe language variation in a group of 4-6-year-old children with ASD, focusing on in-depth analyses of speech sound error patterns with and without non-phonological language disorder and concomitant non-verbal delays., Method & Procedures: We examined and analysed the speech sound skills (including consonant inventory, percentage of correct consonants and speech sound error patterns) in relation to receptive language skills in a sample of preschool children who had screened positive for ASD in a population-based screening at 2.5 years of age. Seventy-three children diagnosed with ASD participated and were divided into subgroups based on their receptive language (i.e., non-phonological language) and non-verbal abilities., Outcomes & Results: The subgroup division revealed that 29 children (40%) had language delay/disorder without concurrent non-verbal general cognitive delay (ALD), 27 children (37%) had language delay/disorder with non-verbal general cognitive delay (AGD), and 17 children (23%) had language and non-verbal abilities within the normal range (ALN). Results revealed that children with ALD and children with AGD both had atypical speech sound error patterns significantly more often than the children with ALN., Conclusions & Implications: This study showed that many children who had screened positive for ASD before age 3 years - with or without non-verbal general cognitive delays - had deficits in language as well as in speech sound ability. However, individual differences were considerable. Our results point to speech sound error patterns as a potential clinical marker for language problems (disorder/delay) in preschool children with ASD., What This Paper Adds: What is already known on the subject Children with autism spectrum disorder (ASD) have deficits in social communication, restricted interests and repetitive behaviour. They show very considerable variation in both receptive and expressive language abilities. Previously, articulation and phonology were viewed as either delayed in children with ASD or superior compared with other (non-phonological) language domains. What this paper adds to existing knowledge Children with ASD and language disorders also have problems with speech sound error patterns. What are the potential or actual clinical implications of this work? About 75% of children with ASD experience language delays/disorders, as well as speech sound problems, related to speech sound error patterns. Understanding/acknowledging these phonological patterns and their implications can help in the diagnosis and intervention of speech sound disorders in children with ASD. Direct intervention targeting phonology might lead to language gains, but more research is needed., (© 2024 The Author(s). International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

Objective: There is little information on speech and language development in pre-school children with mild, moderate or severe hearing impairment. The primary aim of the study is to establish a reference material for clinical use covering various aspects of speech and language functions and to relate test values to pure tone audiograms and parents' judgement of their children's hearing and language abilities., Methods: Nine speech and language tests were applied or modified, both classical tests and newly developed tests. Ninety-seven children with normal hearing and 156 with hearing impairment were tested. Hearing was 80 dB HL PTA or better in the best ear. Swedish was their strongest language. None had any additional diagnosed major handicaps. The children were 4-6 years of age. The material was divided into 10 categories of hearing impairment, 5 conductive and 5 sensorineural: unilateral; bilateral 0-20; 21-40; 41-60; 61-80 dB HL PTA. The tests, selected on the basis of a three component language model, are phoneme discrimination; rhyme matching; Peabody Picture Vocabulary Test (PPVT-III, word perception); Test for Reception of Grammar (TROG, grammar perception); prosodic phrase focus; rhyme construction; Word Finding Vocabulary Test (word production); Action Picture Test (grammar production); oral motor test., Results: Only categories with sensorineural loss showed significant differences from normal. Word production showed the most marked delay for 21-40 dB HL: 5 and 6 years p<0.01; for 41-60 dB: 4 years p<0.01 and 6 years p<0.01 and 61-80 dB: 5 years p<0.05. Phoneme discrimination 21-40 dB HL: 6 years p<0.05; 41-60 dB: 4 years p<0.01; 61-80 dB: 4 years p<0.001, 5 years p<0.001. Rhyme matching: no significant difference as compared to normal data. Word perception: sensorineural 41-60 dB HL: 6 years p<0.05; 61-80 dB: 4 years p<0.05; 5 years p<0.01. Grammar perception: sensorineural 41-60 dB HL: 6 years p<0.05; 61-80 dB: 5 years p<0.05. Prosodic phrase focus: 41-60 dB HL: 5 years p<0.01. Rhyme construction: 41-60 dB HL: 4 years p<0.05. Grammar production: 61-80 dB HL: 5 years p<0.01. Oral motor function: no differences. The Word production test showed a 1.5-2 years delay for sensorineural impairment 41-80 dB HL through 4-6 years of age. There were no differences between hearing-impaired boys and girls. Extended data for the screening test [E. Borg, A. Risberg, B. McAllister, B.M. Undemar, G. Edquist, A.C. Reinholdsson, et al., Language development in hearing-impaired children. Establishment of a reference material for a "Language test for hearing-impaired children", Int. J. Pediatr. Otorhinolaryngol. 65 (2002) 15-26] are presented., Conclusions: Reference values for expected speech and language development are presented that cover nearly 60% of the studied population. The effect of the peripheral hearing impairment is compensated for in many children with hearing impairment up to 60 dB HL. Above that degree of impairment, language delay is more pronounced, probably due to a loss of acuity. The importance of central cognitive functions, speech reading and signing for compensation of peripheral limitations is pointed out.

Objective: In Sweden, there has previously been no normalised test material for the evaluation of language development in individual hearing-impaired children, and for the assessment of various methods of auditory habilitation. The purpose of the present study was to compose, apply and evaluate a test for language development in hearing-impaired children, and to establish the first set of reference values related to age, sex, type and degree of hearing impairment., Methods: A test consisting of nine subtests was assembled and developed for, and subsequently applied to, hearing-impaired children in the age range 4-6 years. The inclusion criteria were a pure tone average of 80 dBHL or less and oral language (Swedish) as the first language. Two hundred and eleven hearing-impaired children and 87 normal hearing control children were tested., Results: The results show that: (1) children with hearing impairment-also unilateral-have a delayed language development; (2) the delay is greater in children with larger losses and tends to decrease with increasing age; (3) 6-year-olds with hearing loss greater than 60 dB have not reached the level of the control group; (4) no difference between right- or left sided deafness with respect to language development was observed; (5) a reference material, applicable during clinical assessment, was established for the most common types of hearing impairment., Conclusions: The test designed gave graded measures of important aspects of language development in hearing-impaired children. The results merit further application of the test material.