Phono development disorders

• Inappropriate speech sound deletions and substitutions for age affecting multiple sounds.
• multiple consonant or vowel errors, intelligibility below 75%
• Phono deficits have academic, occupational and social consequences.
• Comorbidity w/SLI

• SD-GEN (genetic)
• SD-OME (otitus media with effusion)
• SD-DPI (developmental psychosocial involvment)
• SD=DYS (Dysarthria)
• SD-DAS (Developmental Apraxia of Speech)

• Problem age-inappropriate deletion/substition errors w/academic occupation or social consequences.
• Coexisting conditions:
• Expressive lang disorder from 3-5years: 40-60%
• Disorders of lang., spelling and reading after 6 years
• Percent of speech delay kids at 3-5 yrs: 56%
• 50-60% of kids have 1 or more family members with similiar problems; 20-40% have first degree relatives affected (sibling or parents)
• More males than females 3or5:1
• Typically do not have deplayed start of speech.

• 30% of SD children
• Frequent OM; at least 6 episodes from birth to 2 years
• At least 35dB threshod on 3-4 frequencies
• Problem age-inappropriate deletion/substitutionerrors w/academic occupational or social consequences
• Same portion of males to females
• Increased risk for express lang disorder and academic difficulties
• typically no delayed speech
• likely highly familial
• normalization unknown

typical phono processes profileMore relative omission errors compared to SD group as a wholeLow % of sibilant disorders compared to SD group as a wholeLow % of sibilant disorders compared to SD group as a whole

• backing of fricative and stops
• Small intelligibility-speech gap(PCC and intelligibility very similar)
• Epentheic vowels on glide consonants
• Frequent glottal stops in all positions and before vowels in initial position of words.
• Nasal interchanges/confusion
• Initial /h/ deletions, /h/ insertions on word initial vowels, /h/ initial substitutions.
• initial consonant deletions
• NOT a typical process kid'

• of SD 12% of SD children have this
• By 9years 75% have normal speech with intervention
• Typically no delayed start of speech
• No one set of speech dx markers separate this from another group

• Primary Continuum (must be excessive/extreme and break down social interaction
• Approach related negative affect
• aggressive, angry or manipulative/control seeking
• Withdrawal-related negative afffect
• Socially withdrawn, shy/fearful and extremely taciturn (disinclined to talk)
• Other temporal characteristics (secondary almost)
• Negative emotionally/mood
• easily upset and frustrated; sensitive about speech
• Task persistence/attention
• Unmotivated to work on general speech tasks, unwilling to try difficult speech tasks, and short attn. span
• Problem age-inappropriate deletion/substition errors w/academic occupational or social consequences
• Across board speech delay
• Coexisting conditions
• evidence of psychosocial or psychoeducational needs
• problem may stem from poor interactions or inability to account for listener needs
• May result in limited practice time, limited feedback, or both
• We are often first people to link families with other professionals

• Coexisting conditions, prevalence, delayed start of speech and normalization not known b/c new category
• Assoc with Cerebral Palsy
• Distortions and imprecise consonants

• Sensoriomotor task problems
• Oral function task problems
• higher proportion of imprecise production
• smaller oral area used for vowels
• slower speech rates
• lower speech intensity
• voice problems
• nasal resonance problems
• nasal emissions

• Problem with planning/organizing the movements of speech
• Coexisting conditions: expressive language and learning difficulties
• 1-2% of SD
• Delayed start of speech
• Normalization at 9 yrs is 75% with intervention
• Usually genetic/familial based

• Inappropriate lexical and sentential stress
• Inappropriate timing with isocrony (syllable segregation)
• Transpositional substition errors
• Proportionally increased sound and syllable deletions and vowels/dipthong errors relative to level of severity of involvement
• Articulatory struggles esp on onset

• Residual errors
• Children with moderate to sever speech sound involement when first identified during preschool period
• Average delay in achieving normalization is 5 years
• Two periods of rapid gains: 4-6 and 7-8.5; other times are slower growth
• Because of this kids may look normal because catch up will fall behind again, so don't dismiss from caseload right away (ie when 6 and look normal)
• Persistence of distortion errors past 9 yrs is likely for the following /s, z, r, l, stressed and unstressed er/

• Kids without preschool speech delay
• history of clinical distortion errors from 3-5 and 6-8 for fricatives/affricates and liquids
• No history of early speech delay (2-3) or speech delay (3-8)
• Normalization unknown
• No coexisting conditions
• Prevalence 5-8% of school age population
• No familial link
• Diagnostic markers; stressed er (boys>girls?), s(girls>boys)

• SD-GEN (Genetics)
• SD-OME (Otitis Media with effusion)
• SD-DPI (Developmental Psychosocial involvement)
• SD-DAS (Developmental Apraxia of Speech)
• SD-DYS (Dysarthria)
• RE-A (SD) (Residual Errors id preschool period)
• RE-B (SD) (Residual Errors no early preschool SD)
• Typical Development