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Purpose: Children with cochlear implants (CIs) have difficulty with literacy, and although it is established that phonological processing underlies literacy skills in children with typical hearing (TH), the relation of phonological processing and literacy in children with CIs is not fully understood. This study evaluated the contributions of phonological processing to word-level reading and spelling skills of children with CIs. Method: Thirty children with CIs and 31 children with TH in Grades 3 through 6 completed measures of word reading, spelling, and phonological processing. The contributions of phonological processing (phonological awareness, phonological memory, and phonological recoding) to reading and spelling were evaluated. Results: Children with CIs scored lower across measures of reading, spelling, phonological awareness, and phonological memory, but not phonological recoding, than children with TH. Phonological processing components were significant predictors of reading and spelling for children with CIs but not for children with TH. Conclusions: This study underscores the important contribution of phonological processing, particularly phonological awareness and phonological memory, in literacy development for children who use CIs. These results suggest an urgent need for research into not only the underlying mechanisms that predict literacy outcomes but also evidence-based interventions to support these students' literacy.

The purpose of this study was (a) to compare the single-word spelling performance of first graders across four groups that varied by speech and language status; and (b) to determine the linguistic predictors of first-grade spelling for children with speech and/or language impairment compared to children with typical development. First-grade children (N = 529) completed measures of spelling, early word reading, expressive vocabulary, phonological awareness, and morphosyntactic knowledge. Children with language impairment, with or without speech impairments, demonstrated lower spelling performance than children with typical development; children with speech impairment only did not differ from children with typical development. In addition, early word reading and phonological awareness predicted spelling performance, regardless of group. Study findings indicate that language status, but not speech status, is a risk factor for low spelling performance in first grade, and that first-grade spelling instruction should focus on developing early word reading and phonological awareness.

This study compared preschool spoken language outcomes for children with hearing loss who met the Early Hearing Detection and Intervention (EHDI) guidelines to those who did not, as well as compared outcomes for those who met the current EHDI guidelines to those who met the earlier benchmarks. Finally, the predictive role of meeting each component of the guidelines was evaluated relative to language outcomes. Children who met the EHDI guidelines had higher language scores than those who did not; however, there was no difference between children who met the current guidelines and those who met the earlier benchmarks. Entering early intervention by 6 months of age was the only unique predictor of spoken language outcomes. The findings suggest that EHDI programs should target increasing the number of children with hearing loss who meet the current 1-3-6 benchmarks with a particular focus on enrollment in early intervention by 6 months.

Purpose: The purpose of this study is to evaluate the effects of switching from in-person assessment to virtual assessment during the COVID-19 pandemic on the growth trajectories of children with hearing loss who are learning spoken language. Method: Sixty-eight children with typical hearing, 44 children with cochlear implants, and 47 children with hearing aids were assessed with a normreferenced measure of receptive vocabulary, a criterion-referenced measure of phonological awareness, and a criterion-referenced measure of conceptual print knowledge at least 4 times, at 6-month intervals, between the ages of 4 and 6 years. Of those participants, 26 children with typical hearing, 13 children with cochlear implants, and 13 children with hearing aids entered virtual testing as a result of the COVID-19 pandemic. The slopes of growth for children who entered virtual testing were compared to their own slopes prepandemic and to the growth slopes of children who completed all testing in-person, prepandemic. Results: Within-subject comparisons across all measures did not show a change in growth slopes prepandemic to postpandemic. For the measure of conceptual print knowledge, children who were tested during the pandemic showed slower overall growth than children who were tested prepandemic. No effects of hearing status were found across growth on any measure. Conclusion: These preliminary data support the use of virtual assessment to measure growth in receptive vocabulary, phonological awareness, and conceptual print knowledge in children with hearing loss learning spoken language.

The purpose of this study was to compare developmental trajectories of oral language acquisition of children who are deaf and hard of hearing (DHH) and children with typical hearing across the preschool years. Thirty children who are DHH who use amplification and spoken language and 31 children with typical hearing completed an early language and literacy assessment battery every six months from age 4 to age 6. The developmental trajectories of each group's language skills were examined via growth curve analysis. Oral language skills were lower for children who are DHH than for children with typical hearing at study entry. For vocabulary, children who are DHH demonstrated growth over the two years but did not close the gap in performance over time. For morphosyntax, specifically verb tense marking, children who are DHH demonstrated growth over preschool, becoming more adult-like in their productions.

Although reading outcomes for children with hearing loss are improving, too many of these children continue to display persistent reading difficulties. Because of these difficulties, there is an ongoing need to understand the nature of the relationships among decoding abilities, language skills, and reading achievement in this population more fully. Coincidentally, there has also been an emerging literature on the subjective fatigue in children with hearing loss, which could be directly or indirectly linked to reading ability. The purpose of this study was to examine associations among language abilities, reading skills, and subjective fatigue in 56 children with mild to moderate hearing loss (CMMHL). The results indicated that both phonological awareness and receptive language ability predicted reading achievement in CMMHL, which replicates findings for children without hearing loss. The results also indicated that CMMHL who had poor reading skills reported significantly higher levels of subjective fatigue relative to the other children with mild to moderate hearing loss in the sample.

The purpose of this study was to consider how living in an area that qualifies for a rural health grant interacts with a child's hearing status to affect early language and literacy development. Four-year-old children with hearing aids (n = 45), cochlear implants (n = 47), and with typical hearing (n = 66) completed measures of spoken language knowledge and of emergent literacy skills as part of a larger longitudinal investigation. A significant interaction effect between location (rural or urban/suburban) and amplification group was detected for letter knowledge: children with hearing aids exhibit a performance that is particularly affected by rural location. Overall, children with cochlear implants performed lower across all measures than children with typical hearing, and children with hearing aids performed lower than children with typical hearing on measures of phonological awareness, vocabulary, omnibus language knowledge and articulation.

Purpose: The COVID-19 pandemic has necessitated a quick shift to virtual speech-language services; however, only a small percentage of speech-language pathologists (SLPs) had previously engaged in telepractice. The purpose of this clinical tutorial is: (1) to describe how the Early Language and Literacy Acquisition in Children with Hearing Loss study, a longitudinal study involving speech-language assessment with children with and without hearing loss, transitioned from in-person to virtual assessment; and (2) to provide tips for optimizing virtual assessment procedures. Method: We provide an overview of our decision making during the transition to virtual assessment. Additionally, we report on a pilot study that calculated test-retest reliability from in-person to virtual assessment for a subset of our preschool-age participants. Results: Our pilot study revealed that most speech-language measures had high or adequate test-retest reliability when administered in a virtual environment. When low reliability occurred, generally the measures were timed. Conclusions: Speech-language assessment can be conducted successfully in a virtual environment for preschool children with hearing loss. We provide suggestions for clinicians to consider when preparing for virtual assessment sessions.

Purpose: The purpose of this study was to explore if academic training and/or on-the-job experience predicts general health literacy, hearing loss health literacy, and self confidence levels of speech-language pathologists (SLPs). Method: Participants included 423 SLPs with differing levels of academic training and on-the-job experience working with children who are deaf or hard of hearing (DHH). General health literacy, hearing loss health literacy, and confidence levels treating children who are DHH were assessed. Data were analyzed using SPSS, with descriptive statistics, Pearson’s r correlations, and multiple linear regression models. Results: SLPs had high levels of general health literacy but marginal to low levels of hearing loss health literacy. Neither academic training nor on-the-job experience predicted general health literacy, but they were predictive of hearing loss terminology knowledge. Only on-the-job experience predicted in-depth hearing loss content knowledge. There was an interaction of training and experience for confidence of SLPs in treating children who are DHH. SLPs with greater years of experience exhibited lower confidence with an increasing amount of coursework, whereas SLPs with fewer years of experience displayed higher confidence with an increasing amount of coursework. Conclusions: Results indicated that the driving factor for development of indepth hearing loss health literacy in SLPs is on-the-job experience. Methods of integrating experiential learning into academic training should be evaluated. [ABSTRACT FROM AUTHOR]

Objectives: The two-fold purpose of this feasibility study was to determine if (a) self-regulated strategy development intervention would improve the writing skills of a child who uses cochlear implants and (b) if self-regulated strategy development intervention would improve the reading comprehension skills of a child who uses cochlear implants. Methods: One eleven year-old child with bilateral sensorineural hearing loss who utilised bilateral cochlear implants participated in this single-subject, multiple baseline across behaviours design treatment study which examined the effectiveness of using writing intervention to improve reading comprehension in children who are deaf. The participant completed three seven-week writing interventions focused on narratives, opinion essays, and persuasive essays. The participant also completed progress monitoring in baseline, intervention, and maintenance conditions for each behaviour. Intervention was delivered one-on-one for 60 min one day per week. Results: Visual analysis of progress monitoring data indicated that writing performance improved in two out of the three styles of writing throughout the intervention and that the improvement for those two areas was maintained after intervention was complete. Comparison of pre- and post-test measures of reading comprehension indicated that the writing intervention was effective for improving reading comprehension for the participant. Conclusion: Self-regulated strategy development writing intervention may be a beneficial intervention strategy to improve writing skills, and potentially reading comprehension skills, in children who are deaf and use cochlear implants.

Purpose: The purpose of this study was to determine if group differences exist in spelling accuracy or spelling errors between kindergarten children with hearing loss and children with normal hearing loss. Method: Participants included 23 kindergarten children with hearing loss and 21 children with normal hearing. All children used spoken English as their primary language, and the children with hearing loss used amplification. Participants completed three single-word spelling assessments, a language assessment, and an oral reading assessment. Spelling was scored holistically and with two linguistic-based scoring systems. Results: Children with hearing loss did not differ significantly from children with normal hearing in spelling accuracy or linguistic-based spelling error analyses. Conclusions: The current study provides evidence that children with hearing loss in kindergarten do not differ significantly in their spelling errors compared to children with normal hearing, aside from a lower proportion of mental graphemic representation errors. With these data, in combination with previous research conducted, speech-language pathologists can further individualize treatment to focus on these specific error patterns. Additionally, this focus of treatment can help better prepare children with hearing loss for spelling and writing tasks in later grades. Future research should be conducted to determine when in elementary school the differences in spelling errors are initially seen.

Although speech-language pathologists increasingly make use of tablets in clinical practice, little research to date has evaluated the effectiveness or efficiency of tablet use for targeting speech sound goals. The twofold purpose of this study was to compare (a) the effectiveness and (b) the efficiency of speech sound intervention using tablets versus flashcards. Four kindergarten students with at least two similar speech sound errors participated in this adapted alternating treatments single subject design study that explored the functional relation between speech sound intervention that differed by modality of delivery (tablet vs. flashcards) and increased speech sound skill in elementary school children with speech sound errors. Flashcards and tablets were both effective single-word speech sound intervention modalities; however, for three of the four participants, flashcards were more efficient than tablets.

Purpose: Spelling is a skill that relies on an individual's linguistic awareness, the ability to overtly manipulate language. The ability to accurately spell is important for academic and career success into adulthood. The spelling skills of adults have received some attention in the literature, but there is limited information regarding which approach for analyzing adults' spelling is optimal for guiding instruction or intervention for those who struggle. Thus, we aimed to examine the concurrent validity of four different scoring methods for measuring adults' spellings (a dichotomous scoring method and three continuous methods) and to determine whether adults' linguistic awareness skills differentially predict spelling outcomes based on the scoring method employed. Method: Sixty undergraduate college students who were determined to be average readers as measured by a word reading and contextual word reading task were administered a spelling task as well as morphological, orthographic, phonemic, and syntactic awareness tasks. Results: All four scoring methods were highly correlated suggesting high concurrent validity among the measures. Two linguistic awareness skills, morphological awareness and syntactic awareness, predicted spelling performance on both the dichotomous and continuous scoring methods. Contrastively, phonemic awareness and orthographic awareness predicted spelling performance only when spelling was scored using a continuous measure error analysis. Conclusions: The results of this study confirm that multiple linguistic awareness skills are important for spelling in adults who are average readers. The results also highlight the need for using continuous measures of spelling when planning intervention or instruction, particularly in the areas of orthographic and phonemic awareness.

The purpose of this exploratory study was to evaluate the functional relation between initial sound awareness instruction and increased initial sound segmentation skill in children with hearing loss. Two preschool children with hearing loss participated in this multiple probe design single subject study. The children participated individually in initial sound awareness instruction (37-39 half-hour sessions). Assessment of children's initial sound segmentation skill occurred at the beginning of each session. Initial sound awareness training was associated with an increase in initial sound segmentation skill for the two children with hearing loss but performance did not consistently move to mastery level.

Home literacy practices reported by parents of preschool children with hearing loss were compared to those reported by parents of their peers with typical hearing. Parents completed a questionnaire from Boudreau, D. (2005. Use of a parent questionnaire in emergent and early literacy assessment of preschool children. Language, Speech, and Hearing Services in Schools, 36, 33-47. doi:10.1044/0161-1461(2005/004)) assessing home literacy practices across areas such as parent facilitation of literacy and time spent reading per week. As part of a larger study, children completed language and emergent literacy assessments. Parents of both groups reported similar amounts of time spent reading to their children and scored similarly on report of parent facilitation of literacy, even though children with hearing loss scored lower on measures of emergent literacy. However, parents of children with typical hearing reported that their children had higher engagement and interest in books than children with hearing loss. Additionally, only child engagement with books was correlated with emergent literacy skills and only for children with hearing loss. The results suggest that parent facilitation of literacy alone is not correlated with emergent literacy scores; children must take an active role in their reading development. Children with hearing loss must be active participants during shared book reading. It is therefore essential to develop ways to actively engage children with hearing loss during reading activities.

Purpose: The purpose of this study was to characterize the lexical-morphological networks of children with specific language impairment (SLI) compared to children with typical language by analyzing responses on a morphological derived form production task. Method: School-age children with SLI (n = 32) and peers with typical language (n = 40) completed an oral cloze derived form production task (Carlisle, 2000). On this task, children were expected to complete verbally presented sentences with a derived form of a provided morphological stem. Responses were coded as correct or incorrect following Carlisle's (2000) stated correct responses. Incorrect responses were coded as scorable or unscorable, and then scorable responses were coded as pseudowords or real words. Real words were further coded according to whether they were repetitions of the given stem. Results: There was a statistically significant between-group difference for mean correct responses (d = 1.43). The scorable incorrect responses of children with SLI included a lower mean proportion of pseudowords than did the incorrect responses of children with typical language (d = 0.76). Conclusion: Because children with SLI produced a lower proportion of pseudowords as scorable incorrect responses than peers with typical language, we conclude that they have less developed lexical--morphological networks and, thus, less derivational morphology knowledge than peers with typical language.

Purpose: The first aim of this study was to explore differences in profiles of morphosyntax production of preschool children with hearing loss (CHL) relative to age- and language-matched comparison groups. The second aim was to explore the potential of extending 2 long-standing theoretical accounts of morphosyntax weakness in children with specific language impairment to preschool CHL. Method: This study examined conversational language samples to describe the accuracy and type of inaccurate productions of Brown's grammatical morphemes in 18 preschool CHL as compared with an age-matched group (±3 months, n = 18) and a language-matched group (±1 raw score point on an expressive language subtest, n = 18). Age ranged from 45 to 62 months. Performance across groups was compared. In addition, production accuracy of CHL on morphemes that varied by tense and duration was compared to assess the validity of extending theoretical accounts of children with specific language impairment to CHL. Results: CHL exhibited particular difficulty with morphosyntax relative to other aspects of language. In addition, differences across groups on accuracy and type of inaccurate productions were observed. Finally, a unified approach to explaining morphosyntax weakness in CHL was more appropriate than a linguistic- or perceptual-only approach. Conclusions: Taken together, the findings of this study support a unified theoretical account of morphosyntax weakness in CHL in which both tense and duration of morphemes play a role in morphosyntax production accuracy, with a more robust role for tense than duration.

Purpose: The purpose of this study was twofold. The first aim was to explore differences in profiles of past tense marking in oral reading of school-age children with specific language impairment (SLI). The second aim was to explore the potential of past tense marking in oral reading as a clinical marker of SLI in school-age children. Method: This study examined oral readings of connected text to describe the frequency and type of reading errors on regular and irregular past tense verbs for 21 children with SLI as compared to 30 children with typical language in Grades 2 and 3. Each past tense verb token was categorized into 1 of 6 mutually exclusive response types: (a) correctly marked past tense, (b) overmarked past tense, (c) bare stem, (d) other verb inflection, (e) nonverb, or (f) no response. Performance across groups was compared. Additionally, classification statistics were calculated at several cutoffs for regular past tense accuracy and regular past tense finiteness marking. Results: For regular past tense, there was a significant group difference on accuracy. Children with SLI were less accurate at marking past tense when in oral reading than typical language peers; other response types did not differ. For irregular past tense, there were no group differences. In addition, there was a significant group difference on finiteness marking; this difference was driven by regular but not irregular verbs. A cutoff of 90% for regular past tense accuracy yielded moderate sensitivity and specificity; no cutoff for regular past tense finiteness marking yielded sensitivity above 70%. Conclusions: Regular past tense accuracy in oral reading provides promise as a clinical marker for diagnosing SLI in school-age children.

The purpose of this study was to evaluate the effects of phonetic transcription training on the explicit phonemic awareness of adults. Fifty undergraduate students enrolled in a phonetic transcription course and 107 control undergraduate students completed a paper-and-pencil measure of explicit phonemic awareness on the first and last days of class. Performance was analyzed for overall accuracy, as well as accuracy on easy-to-segment and hard-to-segment words. A MANCOVA revealed a main effect of group on each dependent variable. In addition, intervention-group pretest and posttest scores were not related. Thus, phonetic transcription training appears to be an effective method of increasing explicit phonemic awareness in adults, and initial skill level is not related to gains as a result of phonetic transcription training.

Purpose: The purpose of this study was to compare change in emergent literacy skills of preschool children with and without hearing loss over a 6-month period. Method: Participants included 19 children with hearing loss and 14 children with normal hearing. Children with hearing loss used amplification and spoken language. Participants completed measures of oral language, phonological processing, and print knowledge twice at a 6-month interval. A series of repeated-measures analyses of variance were used to compare change across groups. Results: Main effects of time were observed for all variables except phonological recoding. Main effects of group were observed for vocabulary, morphosyntax, phonological memory, and concepts of print. Interaction effects were observed for phonological awareness and concepts of print. Conclusions: Children with hearing loss performed more poorly than children with normal hearing on measures of oral language, phonological memory, and conceptual print knowledge. Two interaction effects were present. For phonological awareness and concepts of print, children with hearing loss demonstrated less positive change than children with normal hearing. Although children with hearing loss generally demonstrated a positive growth in emergent literacy skills, their initial performance was lower than that of children with normal hearing, and rates of change were not sufficient to catch up to the peers over time.

Purpose: The purpose of this preliminary study was to (a) compare the pattern of reading subtypes among a clinical sample of children with specific language impairment (SLI) and children with typical language and (b) evaluate phonological and nonphonological language deficits within each reading impairment subtype. Method: Participants were 32 children with SLI and 39 children with typical language in Grades 2 through 4. Each child was classified as demonstrating 1 of 4 reading subtypes on the basis of word-level and text-level skills: typical reading, dyslexia, specific reading comprehension impairment, or garden variety reading impairment. In addition, phonological and nonphonological language skills were evaluated. Results: Children with SLI were more likely to exhibit reading impairments than children with typical language. Children with SLI were more likely to exhibit text-level deficits than children with typical language. Phonological language deficits were observed in children with word-level deficits, and nonphonological language deficits were observed in children with text-level deficits. Conclusions: The results indicate that the patterns of reading subtypes differ among children with SLI and children with typical language. The findings highlight the importance of simultaneously but separately considering word-level and text-level skills in studies of reading impairment.

The purpose of this study was to compare three intervention conditions in virtual rapid word learning instruction for young children who are deaf and hard of hearing (DHH): traditional, general physical activity, and semantic richness physical activity. We focused on an initial step in learning a new word: mapping a word form to a referent. Fourteen children who were DHH and 14 children with typical hearing (TH) participated in a pseudoword-learning virtual session in each condition, and receptive and expressive knowledge of targeted pseudowords was assessed. Of interest was the impact of different types of physical activity on rapid learning of word-like forms. There was an interaction of group and condition for expressive production of pseudowords. Children who were DHH learned to produce more pseudowords in the general physical activity condition, whereas children with TH learned to produce more pseudowords in the semantic richness physical activity condition. There were no effects of group or condition on receptive learning of pseudowords. Children who are DHH can rapidly map word-like forms to referents via teleintervention, and physical activity may interact with word learning differently for children who are DHH and children with TH. [ABSTRACT FROM AUTHOR]

It is well established that students who have moderate to profound hearing loss may experience difficulty in learning how to read and write and can benefit from modifications to the classroom environment and curriculum, however, minimal hearing loss often goes undiagnosed, and its negative impact on literacy acquisition is less widely known. Minimal hearing loss encompasses the "slight" and "mild" hearing loss categories. Students with hearing loss in these ranges are able to hear environmental sounds and participate in conversations but may have difficulty with some specific speech sounds and soft speech. Minimal hearing loss can make listening in classrooms particularly difficult as background noise is a persistent problem within these environments. What steps can be taken to assist children experiencing difficulty with literacy who may have undiagnosed minimal hearing loss? In this article, Krystal L. Werfel and Alison Eisel Hendricks present four action steps that include: (1) Ensuring students receive hearing screenings; (2) Reducing background noise in the classroom, increasing the volume and clarity of the teacher's voice, and addressing the individual literacy needs for students with minimal hearing loss; (3) Talking to parents about the importance of managing minimal hearing loss; and (4) Fostering interprofessional collaboration. When teachers, parents, and other educational professionals work together, proper management of minimal hearing loss can help alleviate the literacy difficulties experienced by many students who struggle to learn to read and write.

This study evaluated the spelling of 3rd to 6th grade children with cochlear implants in written stories. Spelling was analysed using traditional correct/incorrect scoring as well as the Spelling Sensitivity Score, which provides linguistic information about spelling attempts. Children with cochlear implants spelled 86 per cent of words in stories correctly. SSS scores indicated that children on average represented all elements in words with logical letters but not always the conventional spelling. Spelling performance in stories was positively correlated with spelling in single-word contexts. Clinical and research implications are discussed.

This case report details a year-long phonological awareness (PA) intervention for pre-kindergarten children with hearing loss (CHL) who use listening and spoken language. All children wore cochlear implants and/or hearing aids. Intervention occurred for 15 min/day, 4 days per week across the pre-kindergarten school year and was delivered by classroom teachers of the deaf. At the beginning of the year, children's performance on measures of PA generally was low. After participating in the intervention, the majority of students performed within or above the developmental range. These findings indicate that PA training that is intense, modified for CHL, and transferable to mainstream setting is effective in increasing PA skills in CHL.

Purpose: The purpose of this study was to characterize general health literacy and hearing loss health literacy for mothers of children who are deaf and hard of hearing (DHH). Method: Participants included 25 mothers of 2-year-old and 3-year-old children who had a diagnosis of permanent, bilateral hearing loss for at least 1 year. Measures of general health literacy and hearing loss health literacy were collected. Results: Results indicated that mothers had high general health literacy but had lower hearing loss health literacy skills than expected. Although mothers had high education and experience of at least 1 year of having a child with hearing loss, performance on hearing loss health literacy measures was low. Conclusion: Caregiver understanding of hearing loss terminology and concepts is essential for decision making regarding their child's hearing loss health care. [ABSTRACT FROM AUTHOR]

Measures of print knowledge were compared across preschoolers with hearing loss and normal hearing. Alphabet knowledge did not differ between groups, but preschoolers with hearing loss performed lower on measures of print concepts and concepts of written words than preschoolers with normal hearing. Further study is needed in this area.

This pilot study compared the phonological awareness skills and vocabulary performance of English monolingual and Spanish-English bilingual children with and without hearing loss. Preschool children with varying degrees of hearing loss (n = 18) and preschool children without hearing loss (n = 19) completed measures of phonological awareness and receptive and expressive vocabulary knowledge. On phonological awareness tasks, the performance of bilingual children with hearing loss was significantly higher than bilingual children with normal hearing, but not higher than either monolingual group of children. On norm-referenced vocabulary knowledge measures, the performance of monolingual and bilingual children with hearing loss was significantly lower than monolingual and bilingual children with normal hearing. Correlations for phonological awareness and vocabulary knowledge were found for both groups of children with normal hearing, but not children with hearing loss. This study represents preliminary evidence that children with hearing loss may develop phonological awareness differently than children with normal hearing and that language and educational experience are critical to understanding the phonological awareness performance in children with hearing loss.

The purpose of this study was to examine the utility of the Spelling Sensitivity Score (SSS) beyond percentage correct scoring in analyzing the spellings of children with specific language impairment (SLI). Participants were 31 children with SLI and 28 children with typical language in grades 2-4. Spellings of individual words were scored using two methods: (1) percentage correct and (2) SSS. Children with SLI scored lower than children with typical language when spelling was analyzed with percentage correct scoring and with SSS scoring. In addition, SSS scoring highlighted group differences in the nature of spelling errors. Children with SLI were more likely than children with typical language to omit elements and to represent elements with an illegal grapheme in words, whereas children with typical language were more likely than children with SLI to represent all elements with correct letters.

Purpose: Written English is a morphophonemic language. Researchers have documented that a conscious awareness of the morphological structure of English morphology is predictive of students' written language skills and that morphological awareness instruction leads to improvements in morphological awareness and in other written language skills. The purpose of this tutorial is to provide specific information to clinical scientists and other educators for integrating morphological awareness instruction into their written language instruction. Method: The authors first define morphological awareness and provide an overview of the research on the effects of morphological awareness intervention on improving morphological awareness and written language skills. Measures used to assess morphological awareness ability are then discussed, followed by suggestions for how clinical scientists and other educators can provide morphological awareness instruction to improve the written language skills of the students they serve. Conclusion: By integrating morphological awareness instruction into the services they provide, clinical scientists and other educators will be providing their students with a strong tool to aid written language skills.

Purpose: The purpose of this study was to describe the growth of children's segmentation and representation of consonant blends in the kindergarten year and to evaluate the extent to which linguistic features influence segmentation and representation of consonant blends. Specifically, the roles of word position (initial blends, final blends), class of blends, homorganicity, and nasality were considered. Method: Forty kindergarten children completed a developmental spelling measure (26 words with initial or final blends) 3 times at 6-week intervals. Responses were analyzed for logical representation of speech sounds to describe developmental change and differential accuracy of segmentation and representation across blend types. Results: Kindergarten children showed varied ability to segment and represent consonant blends and were differentially successful depending on the linguistic features of the blends. Children were more likely to represent initial blends than final blends, final nonnasal blends than final nasal blends, nonhomorganic blends than homorganic blends, and initial nasal blends than final nasal blends. Conclusion: During the period of emergence, the properties of phonemes that comprise consonant blends influence children's ability to segment and represent blends. This finding has implications for how phonemic awareness and spelling instruction and intervention might proceed.