The following manuscript has been accepted for publication:
To, C. K. S., McLeod, S., Sam, K. L & Law, T. (2022, in press). Predicting which children will normalize without intervention for speech sound disorders. Journal of Speech, Language, and Hearing Research.
During peer review we received the following very positive comments:
Editor:
- “We are all enthusiastic about this rigorously conducted work and believe that the topic has important clinical implications and will be of substantial interest to the JSLHR readership”
Reviewers:
- “This is one of the most clinically significant and important papers I have read in a while. My impression of this paper is highly positive…”
- “The paper was prepared … with exceptional clarity, as well as a rigorous statistical and quantitative methods.”
- “...this is the nicest paper with the clearest set of impactful results that I have seen in a while. I think it has potential to "make a splash" in the field, and I hope it gets read a lot.”
- “This is a standout study in terms of quantitative rigor and clinical usefulness and value. The study design is careful and overall very clear. The authors executed the research design carefully and prepared the paper with exceptional clarity, as well as used rigorous statistical and quantitative methods. I am pleased to endorse this paper toward publication in JSLHR.”
Here is the abstract:
Purpose: The speech of some children does not follow a typical normalization trajectory and they develop speech sound disorders (SSD). The current study investigated predictive correlates of speech sound normalization in children who were at risk of SSD.
Method: A prospective population cohort study of 845 Cantonese-speaking preschoolers was conducted over 2.5 years to examine children (a) who resolved non-adult realizations of consonants (normalized) and (b) those who had persisting speech sound difficulties (did not normalize). From these 845, a sample of 82 participants characterized as having SSD (1.25 SD below the mean in a standardized speech assessment, with a delay in initial consonant acquisition, or with one or more atypical errors) were followed for 2 years at six-month intervals or until the completion of their initial consonant inventory. Data from 43 children who did not receive speech-language pathology services were analysed with survival analysis to model time-to-normalization while controlling for covariates. The target event (outcome) was completion of their initial consonant inventory.
Results: Under the no-intervention condition, the estimated median time-to-normalization was 6.59 years of age. Children who were more likely to normalize or normalized in a shorter time were stimulable to all errors and more intelligible as rated by caregivers using the Intelligibility in Context Scale. Those who showed atypical error patterns did not necessarily take longer to normalize. Similarly, expressive language ability was not significantly associated with speech normalization.
Conclusion: Stimulability and intelligibility were more useful prognostic factors of speech normalization when compared to (a)typicality of error patterns and expressive language ability. Children with low intelligibility and poor stimulability and should be prioritized for speech-language pathology services given that their speech errors are less likely to resolve naturally.
