SACHL 2025

Dr Kate Margetson and I have a grant through the Rural Health Research Institute to develop the Speech Assessment of Children’s Home Languages (SACHL, Margetson & McLeod, 2025) https://www.csu.edu.au/research/multilingual-speech/speech-assessments/sachl and to ensure it is relevant to all speech pathologists including in rural and remote settings.

This morning we

• reflected on our presentation at the American Speech-Language-Hearing Association (Nov 2024)
• prepared our presentation for the (rural) Central West Speech Pathologists (7 Feb 2025)
• worked on our chapter for a book to be published in Italian
• looked at speech assessments in languages other than English (including the HKCAT that just arrived by mail from Prof Carol To in Hong Kong).

We have already been productive in our first week back from holidays!

 

Hong Kong workshop - Children's speech assessment and intervention: What works? What's new? What's the evidence?

Dr Kate Margetson and I presented a workshop (19-20 October 2024) in Hong Kong titled: Children's speech assessment and intervention: What works? What's new? What's the evidence? https://speechearing.org/en/products/speech-sound-disorder

We were invited by Prof Thomas Law, Prof Valerie Pereira, and Prof Kathy Lee from Chinese University of Hong Kong Speech and Hearing Social Enterprise.

This 2-day workshop will combine the latest evidence with clinical examples and opportunities to apply knowledge to your clinical practice based on the following topics

• Understanding children with speech sound disorders
• Children’s speech development: Latest evidence from 50 languages
• Children’s speech assessment, analysis, and differential diagnosis
• Speech assessment of children’s home language(s) (SACHL)*
• Twenty interventions: Selecting the right intervention approach for each child
• Listening to children to make a difference in their day-to-day lives.

Dr Kate Margetson presenting the SACHL

Chinese University of Hong Kong graduates attending our seminar

HongKong Speech Therapy Association executive committee at the end of our seminar

*The SACHL research is supported by the CSU Rural Health Research Institute.

Hong Kong hospitality

Thank you to Prof Thomas Law and the faculty at the Chinese University of Hong Kong for your fantastic hospitality showcasing Cantonese cuisine at its best. We were even treated to the harbour light show during dinner!

Dr Kate Margetson, Prof Sharynne McLeod, Prof Thomas Law in Kowloon

Peking duck with the faculty at CUHK

Chinese University of Hong Kong Staff Club

Yum cha lunch at the staff club!

Chinese University of Hong Kong lecture

This morning Dr Kate Margetson and I were honoured to be invited by Prof Valerie Pereira to give a 3-hour lecture to Masters students at Chinese University of Hong Kong. Their are studying the subject SLPA5207 Speech Sound Disorders and their textbooks are Children's Speech (McLeod & Baker, 2017) and Interventions for Speech Sound Disorders in Children (Williams, McLeod & McCauley, 2020).

What a pleasure to meet the future speech and language therapists of Hong Kong. Best wishes students! Thanks for letting us put your photo on my blog - and for having a multilingal superpower - speaking English, Cantonese, Mandarin/Putonghua (and some of you spoke even more languages!).

Academic staff at Chinese University of Hong Kong

Sharynne with Prof Thomas Law

Sharynne with Prof Valerie Pereira

Visiting colleagues at The University of Hong Kong

I had a wonderful day today re-connecting with my long-term colleague Prof Carol Kit Sum To in the Division of Speech and Hearing Sciences, Faculty of Education at The University of Hong Kong. Carol and I first began collaborating around 2010 - and since then have had grants and published a number of papers together and have further collaborations planned:

1. To, C. K. S., Cheung, P. S. P., & McLeod, S. (2013a). A population study of children's acquisition of Hong Kong Cantonese consonants, vowels, and tones. Journal of Speech, Language, and Hearing Research, 56(1), 103–122. https://doi.org/10.1044/1092-4388(2012/11-0080)
2. To, C. K. S., Cheung, P. S. P., & McLeod, S. (2013b). The impact of extrinsic demographic factors on Cantonese speech acquisition. Clinical Linguistics and Phonetics, 27(5), 323–338. https://doi.org/10.3109/02699206.2013.763385
3. To, C. K. S., McLeod, S., & Cheung, P. S. P. (2015). Phonetic variations and sound changes in Hong Kong Cantonese: Diachronic review, synchronic study and implications for speech sound assessment. Clinical Linguistics and Phonetics, 29(5), 333–353. https://doi.org/10.3109/02699206.2014.1003329
4. To, C. K. S., McLeod, S., Sam, K. L., & Law, T. (2022). Predicting which children will normalize without intervention for speech sound disorders. Journal of Speech, Language, and Hearing Research, 65(5), 1724-1741. https://doi.org/10.1044/2022_JSLHR-21-00444 
5. To, C. K. S., Cheung, P. S. P., & McLeod, S. (2025). English + Cantonese speech development. In S. McLeod (Ed.), The Oxford handbook of speech development in languages of the world. Oxford University Press. 
   

Prof Carol To at her speech lab

Sharynne and Carol at HKU

Carol is an Adjunct Research Professor at Charles Sturt University. 

I also met Dr Saira Ambreen, who completed her PhD with Carol in 2023 - and now is a postdoc at HKU. Saira's research has described children's acquisition of Urdu - and I have cited her work a number of times already. Saira and Carol have written a chapter on Urdu speech development in The Oxford Handbook of Speech Development in Languages of the World. It was inspiring to spend the day with Carol and Saira. Thank you for your hospitality.

Sharynne, Carol and Dr Saira Ambreen

Working (and celebrating) with Dr Kate Margetson in Sydney

What a joy to spend a whole day with my postdoc Dr Kate Margetson in Sydney. We had a lovely day celebrating her PhD graduation, working on her implementation science approach to disseminating the Speech Assessment of Children's Home Languages (SACHL), and planning our presentations to Hong Kong.

Congratulations Dr Kate Margetson!

Both of my PhD graduates - Kate Margetson and Marie Ireland - are in the same graduation booklet

Preparing to present in Hong Kong

Kate Margetson and I have been invited to present a workshop in Hong Kong titled: Children's speech assessment and intervention: What works? What's new? What's the evidence?

It is exciting to begin to develop the content with our colleagues Dr Thomas Law in Hong Kong.

 https://speechearing.org/en/products/speech-sound-disorder 

Discussing future collaborations in Hong Kong

I have been in contact with A/Prof Thomas Law over many years. I was pleased to receive a request to present a workshop to speech and language therapists in Hong Kong later this year. We had a productive discussion this afternoon about possible content that would be of maximum benefit to supporting children's speech in Hong Kong.

Predicting which children will normalize without intervention for speech sound disorders

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.

Natural history study of children with speech sound disorders

Dr Carol Kit Sum To and I have continued having regular meetings to work on writing up our grant to document a natural history study of children with speech sound disorders who do not receive speech-language pathology intervention in Hong Kong, SAR China. We are almost ready to submit the manuscript to be considered for publication. Here is a blog post about a meeting we held earlier this year: https://speakingmylanguages.blogspot.com/2021/04/investigating-prognosis-and-risk.html

Investigating prognosis and risk factors of speech sound disorder: A natural history study using a survival analysis

Some time ago, Dr Carol Kit Sum To and I collaborated (with others) on a grant to undertake a natural history study using a survival analysis approach of children with speech sound disorder in Hong Kong (see below).

To, C. K-S., Cheung, K. Y., Law, T., Lee, K. Y. S., McLeod, S., & Ng, M. L. (2014-2015). Investigating prognosis and risk factors of speech sound disorder: A natural history study using a survival analysis approach [利用存活分析調查構音問題的自然史 – 預後及誘發因素的研究 ]. General Research Fund, Research Grants Council (RGC) of Hong Kong, China (GRF 17409214). (HKD = 710,002; AUD = $104,256) (The order of the names of co-investigators is alphabetical)

Here is the "layman's summary of the completed report" that can be found here https://cerg1.ugc.edu.hk/ (Search: Year = 2014-2015, Surname = To, Subject = Psychology and linguistics): 

Speech sound disorder (SSD) is a prevalent childhood communication disorder and forms a significant caseload of speech-and-language-therapy services in Hong Kong. SSD in preschool children can be persistent and may lead to long-term literacy difficulties. At the other end of the spectrum, a sizable subgroup of children originally demonstrates speech problems outgrow their errors without clinical attention and follow the typical growth trajectory in later years. In the current study, we made use of a new statistical method known as survival analysis to enable us to predict if children, showing a slower start in speech sound ability but without any other developmental disorders will catch up later. We found that most children with an initial delay of speech sound production skills still showed speech normalization but the normalization process was protracted and takes about 80 months. Boys appeared to be more likely to show a longer normalization process. In addition, children’s perceptual sensitivity in the temperament scale is more predictive than a number of children’s language proficiency and family characteristics such as parental education level.

We met today to work on writing up one of the papers from the analysis. A paper that has been published from this analysis is:

Kok, E. C. E., & To, C. K. S. (2019). Revisiting the cutoff criteria of Intelligibility in Context Scale-Traditional Chinese. Language, Speech, and Hearing Services in Schools, 50(4), 629-638.  https://doi.org/10.1044/2019_LSHSS-18-0073

 

International Conference on Multilingual Acquisition and Multilingual Education

This week (23-24 June 2019) Dr Van Tran will present the following paper based on her VietSpeech research at the International Conference on Multilingual Acquisition and Multilingual Education, Hong Kong, SAR China:

Tran, V. H., McLeod, S., Wang, C., & Verdon, S. (2019, June) Factors affecting home language proficiency and use among Vietnamese-Australian children. International Conference on Multilingual Acquisition and Multilingual Education, Hong Kong, SAR China.

Dr Van Tran

Here is her abstract
Factors affecting home language proficiency and use among Vietnamese-Australian children
Objective: To identify factors associated with home language proficiency and use among Vietnamese-Australian children Background: With 300,000 speakers of Vietnamese in Australia, accounting for 1.2% of Australian population, Vietnamese is in the top four most common languages other than English spoken in the country. Studies in home language maintenance show a tendency of language loss from the second generation onwards. With the first wave of Vietnamese immigrants coming to Australia in the 1970-80s, the Vietnamese community in Australia is experiencing a critical time in terms of maintaining their home language. Home language maintenance can be observed through indicators including language use and language proficiency (with speaking and understanding as oral proficiency and writing and reading as written proficiency).
Method: A total of 271 Vietnamese-Australian families answered a survey regarding their children’s language proficiency and use and associated factors. Factors under examination belonged to four groups: child, parent, family, and community factors. Bivariate analyses including Chi-square and Analysis of Variance (ANOVA) were conducted to explore the associations between profiles and the range of factors. Multinomial logistic regression was later conducted to further explore the relative associations between significant factors and language proficiency and use profiles.
Outcomes: Factors found significantly affecting child language proficiency and use were more related to parents than to children, family, or community. Child-related factors that significantly impacted child language use were children’s Vietnamese and English proficiency. The child-related factor affecting their Vietnamese language proficiency was the children’s age. Parent-related factors significantly associated with child language use and child language proficiency (oral or written) included parent’s income, partner’s income, and partner’s age. Parent-related factors significantly associated with child language use and child language proficiency (oral and written) included parent’s Vietnamese language proficiency, partner’s Vietnamese and English proficiency, generation of immigration, number of years living in English-speaking countries, language use, attitudes towards home language maintenance, perceptions of cultural identity, intention of future residence in Vietnam, and the presence of language policies and rules as well as discussion of courtesy rules with children. There were no family or community factors that consistently affected children’s language use and proficiency in this study. A comprehensive understanding of factors associated with home language proficiency and the extent to which the Vietnamese language is used in Vietnamese-Australian families helps promote and exercise multilingual language policies and multilingual education.
Acknowledgment: Australian Research Council Discovery Grant (VietSpeech: DP180102848)

Phonetic variations and sound changes in Hong Kong Cantonese

The following paper has been accepted for publication:

To, C. K. -S., McLeod, S. & Cheung, P. S. -P. (2014, in press December). Phonetic variations and sound changes in Hong Kong Cantonese: Diachronic review, synchronic study, and implications for speech sound assessments. Clinical Linguistics and Phonetics.

 Here is the abstract:

The aim of this paper was to describe phonetic variations and sound changes in Hong Kong Cantonese (HKC) in order to provide speech-language pathologists with information about acceptable variants of standard pronunciations for speech sound assessments. Study 1 examined the pattern of variations and changes based on past diachronic research and historical written records. Nine phonetic variations were found. Five in syllable-initial and syllabic contexts: (1)[n-]→[l-], (2)[ŋ-]→Ø-, (3)Ø-→[ŋ-], (4)[k^wɔ-]→[kɔ-], (5)syllabic [ŋ̍]→[m̩]; and four in syllable-final contexts: (6)[-ŋ]→[-n], (7)[-n]→[-ŋ], (8)[-k]→[-t], (9)[-t]→[-k]. Historical records demonstrated the pattern of variation and changes in HKC across time. In study 2, a large-scale synchronic study of speakers of differing ages was undertaken to determine acceptable phonetic variations of HKC for speech sound assessments. In the synchronic study single-words were elicited from 138 children (10;8-12;4) and 112 adults (18-45 years) who spoke Cantonese and lived in Hong Kong. Synchronic evidence demonstrated five acceptable variants in syllable-initial and syllabic contexts: (1) [n-]→[l-], (2) [ŋ-]→Ø-, (3) Ø-→[ŋ-], (4) [k^wɔ-]→[kɔ-], and (5) syllabic [ŋ̍]→[m̩] and four incomplete sound changes in syllable-final contexts: (6) [-ŋ]→[-n], (7) [-n]→[-ŋ], (8) [-k]→[-t], and (9) [-t]→[-k]. The incomplete sound changes may still be accepted as variants in speech sound assessments unless related speech problems are indicated.

Success: Research Grants Council of Hong Kong

Carol To recently informed me of the success of our grant submission:
To, C. K-S., Cheung, K. Y., Law, T., Lee, K. Y. S., McLeod, S., & Ng, M. L. (2014-2015). 利用存活分析調查構音問題的自然史 – 預後及誘發因素的研究 [Investigating prognosis and risk factors of speech sound disorder: A natural history study using a survival analysis approach]. General Research Fund, Research Grants Council (RGC) of Hong Kong, China (GRF 17409214). 

Here is the abstract:

Speech sound disorder (SSD) is a prevalent childhood communication disorder and forms a significant caseload of speech-and-language-therapy services in Hong Kong (To, Law & Cheung, 2012). SSD in preschool children can be persistent and may lead to long-term literacy difficulties. Emerging evidence indicates possible speech processing deficits that underlie SSD and later reading disorder. At the other end of the spectrum, a sizable subgroup of children originally demonstrates speech problems outgrow their speech errors without clinical attention and follow the typical growth trajectory in later years. Previous studies using simple correlation and the logistic regression have successfully identified risk factors that are significantly associated with the occurrence of SSD. However, these studies did not include time aspect and did not address the speech processing problems which can explicate different presentations of SSD, i.e., transient and persisting SSDs. Given the large variability in the growth trajectory of speech development and its disorder, previous studies may not provide much strong evidence on prognosis. This current study will employ a research technique of the survival analysis with the use of Cox's regression model to investigate the evolution of speech sound development along with children’s speech processing ability in those with SSD. The statistical analysis method is particularly for longitudinal designs and has taken into account the major problem of subject drop due to lost to follow up. We recruit Cantonese-speaking preschoolers who demonstrate the concern of speech problems without other known developmental problems in Hong Kong. To achieve adequate statistical power for analysis, 76 preschoolers with SSD aged at 5 years old will be recruited at the baseline using a validated parental questionnaire. Children who fit the inclusion criteria will be reassessed at a 6-month interval for a period of 2 years or until they master their sound inventory. Besides the child-related and family risk factors, the child’s speech processing ability will also be investigated in the present study. At the theoretical level, the findings result from the present study on the speech processing ability may dissect possible points of processing constraint in children with persisting SSD. At a clinical level, such a predictive model can contribute towards the evidence for speech-language therapists (SLTs) to better predict outcomes and estimate prognosis for children with SSD, and to decide on the appropriate treatment options. This will eventually lead to improved clinical estimation of prognosis SSD and better allocation of resources to early intervention provision.