Brad, 3 years 10 months old, was brought the Speech Therapy Centre by his mother. She is worried that he is not speaking as much as others of his age, and that his speech lacks clarity and fluency. He first spoke at 15 months old; two-word sequences appeared around 29 months of age. Brad’s preschool teacher states that although a social and jolly child, Brad’s schoolmates sometimes find it difficult to understand him. A recent hearing test shows his auditory perception at normal limits, without any infection. Brad’s speech and language assessment reports are as follows.
Independent Analysis
Phonetic Inventory-Brad has a decent percentage of single consonant usage. But he has an oddly high usage of affricates and consonants in particular sound classes, with a significant use of ?, ?, ? ,? , ?, and so on; with ? and g not appearing in initial emerging (Franken & Weisglas-Kuperus, 2012).
He has a relatively low usage of clustered consonants, with the (bw), (pw), (dl) and (bl) clusters in the initial emerging. No clustered consonant, especially no /s/ and /r/ clusters, were recorded in the final emergence; this indicates an infirmity of the same. Usage of vowels are fair and within normal limits (Conti-Ramsden & Durkin, 2012).
Syllable shape syllable stress and inventory- Recognition of syllable shapes are normal, while there are no difficulties in using syllable shape. Usage of syllables in terms of shape and stress are clearly within normal limits.
Word Length Inventory- Brad has no difficulty in his aptitude of using bi-, tri-, and quad-syllable words; hence, word lengths are within normal limits.
Vowel and consonant correctness- Like the independent analysis, Brad does not get his single consonants correct, with an overall percentage of correct consonants only 52.5 %. This indicates poor consonant usage, in relation to children of the same age-group (Dodd, 2013). Percentage of vowels correct is within normal limits. There are also no problems in syllable shapes, stress and word lengths, which are within normal limits.
Phonological Processes- Brad suffers from a few phonological defects like cluster reduction, stopping for fricatives and affricates, gliding of liquids, velar fronting. Problems of simplifying consonant clusters and simplification of fricatives are also evident. Other observations like phonation, speech rate, speech breathing and intonation are within normal limits. Findings on speech ratings are consistent and partially intelligible; which suggests that they are within accepted limits.
Diagnostics:
Brad’s language abilities are diagnosed to be bordering on normal, with a few infirmities in singular and clustered consonants, and getting consonants correct. Continuation of speech and language therapy is advisable.
Diagnostic Evaluation of Articulation and Phonology (DEAP) is method of speech-examination which evaluates and segregates between issues of articulation, hindered phonology and the correlation between inconsistent and consistent phonological disorders (Ramus et al., 2013).
There is a quantitative score summary derived from the previous test; and a qualitative analysis of patterns of errors a subject (here, Brad) tends to make (Waring & Knight, 2013). Brady’s DEAP Phonology results are as follows.
Brad, 3years 10 months old, suffers from a couple of delayed and unusual speech patterns.
Fronting of velars are evident in pronunciation of words like ‘crab’, ‘queen’, gloves, where the subject cannot produce velar sounds and replaces them with ‘t’ and ‘d’ sounds coming from the front of the tongue.
Cluster reduction is palpable in usage of ‘swing’, ‘biscuit’, ‘school’ and ‘square’, ‘strawberry’, ‘spider’ and so on.
Gliding is also a fairly obbservable flaw in Brad’s speech. This is evident in the way he pronounces the words ‘umbrella’, ‘train’,’ bread’, ‘crab’, ‘pram’, ‘rabbit’ etc. He fails to pronounce the ‘r’ consonant and replaces it with a semi-vowel, ‘w’ in these cases.
Diagnostics:
From a quantitative angle, Brad is diagnosed to have problems in pronouncing and articulating consonants, especially the single-clustered ones. As noted in the previous text result, he has a poor percentage of consonants spoken correctly, at 52.5%. The Diagnostic Evaluation of Articulation and Phonology explains this infirmity to pronounce such words. However, he has no problems as to pronouncing vowels with a Percent of Vowels correct at 100%, which is definitely within the acceptable range.
The CELF/P2 results reveal that Brad has fairly decent language and speech aptitudes, with a few notable problems here and there. He has a moderate Language Content Index value of 83 (reference interval- 72-86), while his Language Structure Index result is 69 (reference interval- 61-73). This portends average speech and language abilities, which is quite satisfactory at such a premature age of 3 years 10 months. However, he has poor consonant structuring and pronouncing abilities in spite of being good with vowels. This results in his incorrect pronunciation of some of the phonetic structures. The most frequent troubles he faces in this regard are fronting of velars, cluster reduction and gliding. This appears in quite a few of his results in the DEAP Evaluation. But as already stated, there is no reason to be alarmed as these are minor issues which can be dealt with through therapy and speech practice (Bishop, 2014).
Brad will continue to improve under speech and language therapy. Parents and/or guardians need to keep motivating him to practice speaking and pronounce the tricky clustered and single consonant sounds that he has been facing the most trouble with. Parents need to support him in the therapy procedure and encourage him constantly. They need to set small and realistic targets for him to achieve on a daily or weekly basis. Brad’s language perception and structure should be nurtured by asking open-end questions that require a full sentence rather than one word or monosyllabic replies. Parents should try to improve his utterances by constantly correcting his sentences and words which are likely to be inappropriate at this age. Special emphasis should be given to words and expressions involving clustered consonants, semi-vowels, fricatives etc. where he needs improvement (Wittle, Spaulding & Schechtman, 2013). Proper therapy and such encouraging measures on the home front are sure to enhance Brad’s speaking and linguistic aptitudes in the near future.
References:
Bishop, D. (2014). Uncommon Understanding (Classic Edition): Development and disorders of language comprehension in children. Psychology Press.
Conti-Ramsden, G., & Durkin, K. (2012). Language development and assessment in the preschool period. Neuropsychology Review, 22(4), 384-401.
Dodd, B. (2013). Differential diagnosis and treatment of children with speech disorder. John Wiley & Sons.
Franken, M. C. J., & Weisglas-Kuperus, N. (2012). Language functions in preterm-born children: a systematic review and meta-analysis. Pediatrics, 129(4), 745-754.
Ramus, F., Marshall, C. R., Rosen, S., & van der Lely, H. K. (2013). Phonological deficits in specific language impairment and developmental dyslexia: towards a multidimensional model. Brain, 136(2), 630-645.
Waring, R., & Knight, R. (2013). How should children with speech sound disorders be classified? A review and critical evaluation of current classification systems. International Journal of Language & Communication Disorders, 48(1), 25-40.
Wittke, K., Spaulding, T. J., & Schechtman, C. J. (2013). Specific language impairment and executive functioning: Parent and teacher ratings of behavior. American Journal of Speech-Language Pathology, 22(2), 161-172.
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