Objective: The study was aimed at evaluating the effectiveness of a systematic population-based screening programme for specific language impairment (SLI) in preschool children in Germany. Methods: The study question was divided into a review of (1) evidence from studies evaluating screening programmes,(2) diagnostic instruments in the German language, and (3) studies evaluating speech and language interventions. A systematic database search was conducted between June and October 2007 and was updated in January and again in May 2008. Relevant studies were identified by 2 independent reviewers based on screened titles/abstracts and full texts. Results: 4,806 studies were screened. The only existing controlled screening study did not provide data for SLI. No diagnostic study met the inclusion criteria. Sixteen randomized intervention studies were included, 3 studies contributed to the appraisal of earlier against later initiation of treatment. Most studies were of limited quality. We found indications of short-term positive effects from language therapies in children with SLI. Long-term outcomes were not investigated. No evidence supporting the advantage of earlier treatment initiation was identified. Conclusions: The benefit of population-based language screening of preschool children with SLI is not proven. Controlled screening studies are therefore necessary. For Germany, the accuracy of existing diagnostic instruments has not yet been sufficiently examined.

Objective: Speech inconsistency is characterised by variable productions of the same lexical items within the same context. This study aimed to describe inconsistencies among Brazilian Portuguese (BP)-speaking children with and without phonological disorder (PD) as well as the effectiveness of a speech inconsistency test (SIT). Methods: The study sample included children between 5 years 0 months (5;0 years) and 10;10 years of age, both genders, 51 children with PD and 50 without speech-language disorders. The SIT includes 25 pictures, each named 3 times in different sequences within the same session. Results: The inconsistency average of children with PD (27.4%) was higher than that of typically developing children (9.8%). Linear regression showed age and gender effects, receiver operating characteristic curves were built for speech inconsistency with combined gender and age cutoff values. Inconsistent subjects among typically developing children included 2 younger boys and 2 older girls. Inconsistencies were found among children with PD, including 10 boys up to 7;6 years and 11 over this age, and 7 girls up to 7;6 years and 6 over this age. Conclusion: Speech inconsistency in BP-speaking children seems to be an effective measure for differentiating children with PD from those with typically developing phonology.

A single-subject alternating treatment design in combination with a staggered multiple baseline model across subjects was implemented with two 6:0 year-old girls, monozygotic twins, who were referred to a university clinic for evaluation and treatment. The treatment programme was structured according to variants of minimal pair contrast treatment in which the target sounds and their oppositions were selected according to either minimal or maximal opposition (including major-class differences) contrast treatments to evaluate which of the sound selection strategy would result in better learning. Independent variables were the minimal and maximal opposition conditions; dependent variables were the target phonemes treated. Consistent with the literature, maximal opposition treatment resulted in significantly greater changes in the sound systems of the twins than minimal opposition treatment.

The current study investigated the impact of a dual treatment approach that included stimulability training protocol (STP) paired with a modified core vocabulary treatment (mCVT) on the speech sounds produced by children with CAS. The combined treatment was assessed for changes in consistency and expansion of the phonetic inventories of four participants. The children participated in 20 treatment sessions over the course of 10 weeks. Each session was comprised of 10 minutes of stimulability training and 45 minutes of mCVT that included words that were chosen by the child and his or her parents. The words were restricted to contain at least one complex phoneme that was omitted from the child's inventory. All children evidenced inventory expansion (average of five sounds) and increased percentage consonants correct (PCC; average of 20% increase), and three of the four children evidenced increased consistency in sound use. The effectiveness of STP paired with mCVT is explained by principles of motor and phonological learning.

BACKGROUND: Phonological therapy in subjects with phonological disorders. AIM: To compare the efficacy of three contrastive approach models in three different severities of phonological disorder. METHOD: Participants of the study were nine subjects with phonological disorders, with ages ranging between 4:2 and 6:6 years. All subjects were evaluated prior to and after phonological therapy. Three groups, with three subjects each, were determined for treatment. Each group presented one individual with severe, one with moderate-severe and one with mild-moderate phonological disorder. Each group was treated using a different therapy model--Minimal Opposition, Maximal Oppositions/Empty Set and Multiple Opposition. Results were analyzed according to the Friedman Test, considering p < 0.05; a descriptive analysis was also performed among the models. RESULTS: There was no statistical difference among the models considering the severity of phonological disorder. The Minimal and Maximal Oppositions/Empty Set approaches favored a greater number of sound acquisitions in the phonetic inventory of subjects with severe and moderate-severe disorder. On the other hand, the Multiple Oppositions approach favored a better performance of sound acquisition in the phonological system and a decrease in the impaired distinctive features in severe and moderate-severe disorder. CONCLUSION: The models of therapy were effective in the treatment of different severities of phonological disorders observing the best performance in children with severe and moderate-severe disorder.

Objective: Stimulability is the ability to produce an adequate sound under specific conditions. This study aimed to describe the stimulability of Brazilian Portuguese-speaking children with and without phonological disorders for the production of liquid sounds with the aid of visual and tactile cues. Patients and Methods: The study sample included 36 children between 5;0 and 11;6 years of age, 18 with phonological disorder and 18 without any speech-language disorders. Stimulability was measured for syllable imitation. The stimulability test employed includes 63 syllables with the sounds [}],[y], and [2], as well as seven oral vowels. If the subject was unable to imitate a sound, a visual cue was given. When necessary, a tactile cue was also given. Results: The sound [y] required greater use of sensory cues. Children with phonological disorder needed a greater number of cues. Conclusion: The use of sensory cues seemed to facilitate sound stimulability, making it possible for the children with phonological disorder to accurately produce the sounds modeled.

Background: A survey of clinicians made by Joffe and Pring in 2008 revealed that different approaches exist between researchers and clinicians in the treatment of children with phonological problems. Researchers have examined specific approaches to treatment often giving substantial amounts of therapy and have obtained encouraging results; clinicians, with less time available, often use an eclectic approach mixing different treatment methods. The reasons for this difference are discussed. Aims: We examined the effectiveness of an eclectic approach giving amounts of therapy more consistent with clinical practice and involving parents in treating their children. Methods & Procedures: We report two small experiments conducted within Speech and Language Therapy clinics. In the first, a group of treated children are compared with a group of children whose treatment is delayed. Parents attended therapy sessions and were given homework tasks to do with their children. The second compared children treated as in the first experiment with children treated at home by their parents who had attended training sessions and with untreated children. Outcomes & Results: In the first experiment, a general trend towards improvement was seen in all children. Change during treatment periods was statistically significant. In the second experiment, children treated by therapists showed strongly significant gains. Lesser but significant gains were made by children treated by their parents; no change was found in untreated children. Conclusions & Implications: The findings offer encouragement to clinicians who use an eclectic approach and who are only able to offer limited amounts of therapy. They also suggest that parental involvement is helpful. However, we find the current incompatibility of research and clinical work worrying and a hindrance to our efforts to understand and treat these children.

To provide alternatives to the widespread use of nonspeech oral motor exercises for childhood speech sound disorders, speech intervention approaches that have received the highest level of experimental scrutiny are reviewed. Efficacy research over the past decade is critically evaluated according to hierarchical systems for quality and credibility. High standards for adherence to experimental methods are applied and reveal strong evidence for a variety of interventions that are effective. These approaches are organized according to whether their focus is directly on speech or indirectly on speech through language. Answers to the question,"What works?" with respect to features such as target selection strategies and teaching procedures are provided. Recommendations for selecting an evidence-based intervention are developed with consideration of developmental level and differential diagnostic evidence of speech sound disorder subtypes.

BACKGROUND: phonological therapy. AIM: to evaluate the effectiveness of three different therapy models regarding changes in the phonological system of subjects with different phonological disorder (PD) severity levels. METHOD: the research group was composed by 66 subjects, 43 males and 23 females, with ages between 4:4 and 8:2 years, who were part of a school clinic database. All subjects were evaluated, before and after a period of 15 to 25 sessions of phonological therapy, using the Child's Phonological Assessment. Based on this assessment, the severity level of the PD was determined using the Percentage Consonants Correct - PCC, and by calculating the number of Non-Acquired Segments -NAS and the percentage of Acquired Segments (AS) after treatment. The subjects were treated using the following approaches: ABAB-Withdrawal and Multiple Probes, Modified Maximum Opposition and Modified Cycles Models. For the statistical analysis the T-Test was used with a significance level of 5%. RESULTS: the statistical analysis indicated an increase in the PCC and in the percentage of AS, as well as a reduction in the number of NAS for all groups. These results were statistically significant for the majority of the groups. CONCLUSION: the results indicate that the three therapy approaches were effective in the treatment of children with PD, and were effective in treating different severity levels. Besides that, most of the changes occurred in the phonological system of the groups with more severe PD.

BACKGROUND Although children with speech disorder are at increased risk of literacy impairments, many learn to read and spell without difficulty. They are also a heterogeneous population in terms of the number and type of speech errors and their identified speech processing deficits. One problem lies in determining which preschool children with speech disorder will have difficulties acquiring literacy skills. AIMS Two studies are presented that investigate the relationship between speech disorders and literacy. The first examined the phonological awareness abilities of children with different types of speech difficulties. The second study investigated the literacy skills of children with a history of inconsistent speech disorder. METHODS & PROCEDURES Experiment 1 measured the syllable segmentation, rhyme awareness and alliteration awareness of 61 preschool children: 46 with speech disorder (14 with delayed development, 17 who made consistent non-developmental errors, and 15 who made inconsistent errors) and 15 typically developing controls. Experiment 2 assessed the reading accuracy, spelling and phonological awareness abilities of nine 7-year-old children with a history of inconsistent phonological errors. OUTCOMES & RESULTS The first study indicated unexpected patterns of performance. While the Delayed group performed less well than controls on all tasks, the Consistent group showed poor performance on rhyme and alliteration but appropriate performance on syllable segmentation. The Inconsistent group performed most poorly on syllable segmentation but no differently from controls on the other two tasks. The second study indicated that children with a history of inconsistent phonological disorder performed no differently from controls on measures of phonological awareness and reading, but less well on measures of spelling ability. CONCLUSIONS The results support classification of speech disorders and show a differentiation of phonological awareness skills across groups. Children with consistent atypical speech errors have poor phonological awareness and are most at risk for literacy difficulties. Those with inconsistent phonological disorder are at increased risk of spelling difficulties. The findings indicate that phonological awareness and spelling skill are distinct processing systems and highlight the role of phonological assembly skills (i.e. storing and/or retrieving phonological output plans) in spelling output. The interactive processes between reading and spelling are discussed.

BACKGROUND In young, typically developing children, some word production variability is expected, but highly inconsistent speech is considered a clinical marker for disorder. Speech-language pathologists need to identify variability versus inconsistency, yet these terms are not clearly differentiated. Not only is it important to identify inconsistency, but also it needs to be defined and measured so that clinical decisions are evidence based. In order to understand inconsistent speech production, typical variability must be described. AIMS This paper differentiates between variability and inconsistent productions. Variability is defined as productions that differ, but can be attributed to factors described in normal acquisition and use of speech. Inconsistency is speech characterized by a high proportion of differing repeated productions with multiple error types, both segmental (phoneme) and structural errors (consonant-vowel sequence within a syllable). The study describes and quantifies the consistency of word production in typically developing children aged between 3;0 and 6;11 years. METHODS AND PROCEDURES This paper reports a large cross-sectional study (n = 409) of the consistency of children's production of words within the same linguistic context. OUTCOMES AND RESULTS The study found that the speech of typically developing children is highly consistent. Children in the youngest age group demonstrated the highest levels of variability, but it remained below 13% with 10% reflecting maturational influences. CONCLUSIONS Inconsistent production cannot be considered a typical feature of speech development. The results inform differential diagnosis of speech disorder.

This paper reports a normative study on the phonological development of British English-speaking children. Speech samples of 684 children, aged between 3;0 and 6;11 years, randomly selected from nurseries and schools in eight different areas throughout the UK, were collected and analysed to obtain normative data. This paper reports on two aspects of speech development: the age of acquisition of sounds (phonetic acquisition) and the age that error patterns were suppressed (phonemic acquisition). It discusses the effects of age, gender and socio-economic status on speech sound development. The study found that older children had more accurate production and fewer error patterns in their speech. It found no gender differences in the younger age groups. However, in the oldest age group, it found the phonological accuracy measures of girls' better than boys. It found no significant effects of socio-economic status on any of the phonological accuracy measures.

ABSTRACT This study investigated cross-linguistic influence in acquisition of a second lexicon, evaluating Samoan-English sequentially bilingual children (initial mean age 4 ; 9) during their first 18 months of school. Receptive and Expressive Vocabulary tasks evaluated acquisition of four word types: cognates, matched nouns, phrasal nouns and holonyms. Each word type had varying phonological and conceptual difference between Samoan (L1) and English (L2). Results highlighted conceptual distance between L1 and L2 as a key factor in L2 lexical acquisition. The children acquired L2 lexical items earlier if their conceptual representation was similar to that of L1. Words with greater conceptual distance between L1 and L2 emerged more slowly. This suggests that L1 knowledge influences L2 lexical consolidation for sequential bilinguals. Words that require a conceptual shift from L1 take longer to consolidate and strengthen within the L2 lexicon.

This study examined the lexical development of nine Samoan-English bilingual children during their first year in English speaking preschools in Australia. Receptive and expressive lexicon in Samoan and English was assessed when the children had completed their first term of school (approximately 10 weeks) and then 6 months later. The bilingual children's scores in each language and composite scores were examined over time. Performance was also compared with typically developing, age-matched (4-5-year-old) monolingual English-speaking peers. Results indicated that the group made significant gains in both languages over time. The bilingual children's receptive composite scores were comparable to monolingual English scores, with clear changes in lexical composition (singlets and translation equivalents) over time. Expressive composite scores of bilingual children were lower than scores of monolingual peers. Results appeared to be highly influenced by the language environment and patterns of language use in this group. The potential use of composite score methodology as a clinical assessment tool in bilingual children is discussed.

Background: The majority of children born preterm are considered neurologically normal and free of disability. However, follow-up studies at school age report that preterm children born without major impairment have more subtle impairments, including language difficulties, which influence their ability to function. These findings indicate a need to examine specific language-processing skills in children born preterm across the school years. Aims: To compare oral narrative skills of children born preterm with their peers born at full term. Methods & Procedures: The research used an independent groups design to examine the narrative ability of 30 children aged between 9 years; 8 months and 10 years; 11 months: 15 children born before 33 weeks' gestation (preterm group) and 15 children matched for chronological age born at full gestation (greater than 38 weeks). Seven measures assessed productivity, structure, complexity, and formulation abilities. The research used univariate analysis to examine variations in outcomes based on group status (preterm versus full term). Outcomes & Results: The results showed group effects on the formulation measures but not the productivity, complexity or quality measures. Children born preterm produced more utterances with mazes and had more disruptions than children born at full term. The children born preterm demonstrated difficulties formulating a narrative even though they produced a similar amount and used similar structural aspects to their peers born full term. Conclusions & Implications: Children born preterm show subtle and specific linguistic deficits that continue to affect their ability to formulate a narrative in the upper primary school years.

BACKGROUND Although children with speech disorder are at increased risk of literacy impairments, many learn to read and spell without difficulty. They are also a heterogeneous population in terms of the number and type of speech errors and their identified speech processing deficits. One problem lies in determining which preschool children with speech disorder will have difficulties acquiring literacy skills. AIMS Two studies are presented that investigate the relationship between speech disorders and literacy. The first examined the phonological awareness abilities of children with different types of speech difficulties. The second study investigated the literacy skills of children with a history of inconsistent speech disorder. METHODS & PROCEDURES Experiment 1 measured the syllable segmentation, rhyme awareness and alliteration awareness of 61 preschool children: 46 with speech disorder (14 with delayed development, 17 who made consistent non-developmental errors, and 15 who made inconsistent errors) and 15 typically developing controls. Experiment 2 assessed the reading accuracy, spelling and phonological awareness abilities of nine 7-year-old children with a history of inconsistent phonological errors. OUTCOMES & RESULTS The first study indicated unexpected patterns of performance. While the Delayed group performed less well than controls on all tasks, the Consistent group showed poor performance on rhyme and alliteration but appropriate performance on syllable segmentation. The Inconsistent group performed most poorly on syllable segmentation but no differently from controls on the other two tasks. The second study indicated that children with a history of inconsistent phonological disorder performed no differently from controls on measures of phonological awareness and reading, but less well on measures of spelling ability. CONCLUSIONS The results support classification of speech disorders and show a differentiation of phonological awareness skills across groups. Children with consistent atypical speech errors have poor phonological awareness and are most at risk for literacy difficulties. Those with inconsistent phonological disorder are at increased risk of spelling difficulties. The findings indicate that phonological awareness and spelling skill are distinct processing systems and highlight the role of phonological assembly skills (i.e. storing and/or retrieving phonological output plans) in spelling output. The interactive processes between reading and spelling are discussed.

BACKGROUND Sentence construction and syntactic organization are known to be poor in children with specific language impairments (SLI), but little is known about the way in which children with SLI approach language tasks, and static standardized tests contribute little to the differentiation of skills within the population of children with language impairments (LI). Information about the nature and intensity of prompts that facilitate sentence construction for a particular child may be useful in planning effective intervention. AIMS This paper describes the development of a dynamic assessment (DA) task which requires implicit knowledge of syntactic structure. The aim was to formulate a valid and reliable procedure for the DA of sentence formulation that could yield useful information for planning intervention for children with LI. METHODS & PROCEDURES The Dynamic Assessment of Sentence Structure (DASS) was employed on 24 children aged 8-10 years, with identified language impairments, who were tested four times, at 4 monthly intervals. OUTCOMES & RESULTS A range of scores was elicited with no limiting ceiling or floor effects, and the test showed high internal reliability of α= 0.833. Inter-rater reliability was high. Concurrent validity was demonstrated by significant correlation with scores obtained on the CELF-3(UK) and predictive validity of the measure was also found to exceed that of the standardized test measure. Information about the ability of the children to use strategies and less directive prompts, and to transfer learning between items was elicited, and the information was thought to be useful by speech and language therapists involved in their management. CONCLUSIONS & IMPLICATIONS The application of DA principles to the assessment of children previously diagnosed with LI, for the purposes of finding out more information about their potential to benefit from language intervention, was found to be effective. The tool developed was shown to be valid and reliable, and it has potentially important applications for the planning of individual intervention programmes and service delivery.

BACKGROUND A randomized controlled trial was conducted of a whole-service cohort of children referred to the Paediatric Speech and Language Therapy Service of Middlesbrough Primary Care Trust between January 1999 and April 2000. The 730 children involved, aged up to 16 years, were diagnosed with primary speech and/or language impairment in the absence of any learning, physical or sensory difficulty. Aims: The study considered outcomes of treatment versus no treatment. METHODS & PROCEDURES Treatment involved clinic-based interventions, provided according to local departmental criteria and care pathways, averaging 5.5 h (range 0-24 h) of contact during the 6-month period immediately following initial assessment. Assessments occurred within 8 weeks of referral and intervention began immediately thereafter. OUTCOMES & RESULTS Treatment was significantly more effective than no treatment, over 6 months, both overall (p < 0.001) and for each of the three diagnostic categories (comprehension, expression and speech, each p < 0.001). CONCLUSIONS An average of 6 h of speech and language therapy in a 6-month period can produce significant improvement in performance, and it has been shown to be more effective than no treatment over the same 6-month period for children with primary speech and/or language impairment.

This article focuses on the development of a Literacy Assessment Battery for the diagnosis of Maltese children with specific learning difficulties. It forms part of a wider research study involving testing of 549 children in Malta as well as standardisation of the tool. Results of the children's performance and psychometric validation go beyond the scope of this article and therefore will not be recorded here.

BACKGROUND Sentence imitation has been identified as a good indicator of children's language skills, with performance differentiating children with specific language impairment and showing relationships with other language measures. It has a number of advantages over other methods of assessment. The assessment of morphosyntax in children who have severe speech difficulties presents unique challenges which currently available sentence imitation assessments do not address. AIMS This paper presents a new sentence imitation test (The Sentence Imitation Test (SIT-61)) and reports on an investigation which sets out to determine whether this test (1) reveals differences in performance between a group of children diagnosed with specific language impairment and a group of typically developing children (2) reveals distinct profiles of performance amongst children with different speech difficulties, and (3) provides information about morphosyntactic strengths and difficulties. METHODS & PROCEDURES SIT-61 is a finely graded sentence imitation test in which the phonotactic structure, segmental phonology and length of words were kept as developmentally simple as possible. Responses are scored for number of content words, function words and inflections correct. A novel scoring system was devised to credit a child where there was evidence of targeting a morpheme even if it was mispronounced. The test was administered to four groups of children between the ages of 4 and 6 years: 33 children with typical development, 13 children with known expressive morphosyntactic difficulties (specific language impairment), and two groups of 14 children with different types of speech disorder: a group with consistent phonological disorder, who used atypical phonological error patterns consistently; and a group with inconsistent phonological disorder, who produced atypical phonological errors inconsistently. OUTCOMES & RESULTS SIT-61 found differences in performance between the group of typically developing participants and the three clinic groups. While the consistent phonological disorder group obtained extremely high scores for content and function words, they obtained lower inflection scores reflective of their speech difficulties. The scores of the specific language impairment and inconsistent phonological disorder groups were comparable for content and function words, but the groups were differentiated through an analysis of their errors. Further analyses confirmed that low scores obtained by some children in the inconsistent phonological disorder group were due to morphosyntactic difficulties and not speech difficulties. CONCLUSIONS & IMPLICATIONS A new sentence imitation test, the SIT-61, is shown to be valuable tool for identifying expressive morphosyntactic difficulties in children. It is informative about the morphosyntactic abilities of children with speech disorders and raises questions as to the nature of their difficulties.

Interactions among psycholinguistic deficits and literacy difficulties in childhood apraxia of speech (CAS) have been inadequately studied. Comparisons with other disorders (Specific Language Impairment (SLI) and phonological dyslexia) and the possibility of reading remediation in CAS warrant further research. This case study describes the speech, language, cognitive, and literacy deficits and therapy gains in a girl aged 11;6 with severe CAS and borderline IQ. A comprehensive assessment of literacy-related cognitive skills, including phonological memory and working memory capacity, language, speech production and reading skills, was administered. Treatment from 6;0 to 11;6 targeted speech sounds, oral sequencing, phonological awareness (PA), speech-print connections, syllabic structure, and real and non-word decoding. Phonological memory was similar to that of children with SLI, but working memory was significantly worse. Unlike children with phonological dyslexia, our participant demonstrated relative strength in letter-sound correspondence rules. Despite deficits, she made progress in literacy with intensive long-term intervention. Results suggest that the underlying cognitive-linguistic profile of children with CAS may differ from those of children with SLI or dyslexia. Our results also show that long-term intensive intervention promotes acquisition of adequate literacy skills even in a child with a severe motor speech disorder and borderline IQ.

The current study investigated the impact of a dual treatment approach that included stimulability training protocol (STP) paired with a modified core vocabulary treatment (mCVT) on the speech sounds produced by children with CAS. The combined treatment was assessed for changes in consistency and expansion of the phonetic inventories of four participants. The children participated in 20 treatment sessions over the course of 10 weeks. Each session was comprised of 10 minutes of stimulability training and 45 minutes of mCVT that included words that were chosen by the child and his or her parents. The words were restricted to contain at least one complex phoneme that was omitted from the child's inventory. All children evidenced inventory expansion (average of five sounds) and increased percentage consonants correct (PCC; average of 20% increase), and three of the four children evidenced increased consistency in sound use. The effectiveness of STP paired with mCVT is explained by principles of motor and phonological learning.

The hydrated carborane acid H(CHB(11)I(11)).8H(2)O crystallizes in nanometer-diameter tubes of H(aq)(+) enclosed by walls of carborane anions. Three different types of H(aq)(+) clusters are found in these tubes: a symmetrical H(13)O(6)(+) ion with an unusually elongated Zundel-type H(5)O(2)(+) core, two hydrated H(7)O(3)(+) ions, and an unprecedented H(17)O(8)(+) ion having a nearly square core. All of the H(aq)(+) cations show unexpectedly longer O...O separations than in discrete H(aq)(+) ions, indicating greater delocalization of positive charge. The centrosymmetric H(aq)(+) ions are linked via short H bonds, forming a true one-dimensional proton wire.

There is a need for effective interventions to address the core symptoms and problems associated with autistic spectrum disorder (ASD). Behavior therapy improves communication and behavioral functioning. Additional treatment options include psychopharmacological and biomedical interventions. Although these approaches help children with autistic problems, they may be associated with side effects, risks or require ongoing or long-term treatment. Neurofeedback is a noninvasive approach shown to enhance neuroregulation and metabolic function in ASD. We present a review of the literature on the application of Neurofeedback to the multiple problems associated with ASD. Directions for future research are discussed.

PURPOSE This exploratory study examined predictive relationships between 5 types of behaviors and the trajectories of vocabulary and language development in young children with autism over 2 years. METHOD Participants were 69 children with autism assessed using standardized measures prior to the initiation of early intervention (T1) and 6 months (T2), 12 months (T3), and 24 months (T4) later. Growth curve modeling examined the extent to which behaviors at T1 and changes in behaviors between T1 and T2 predicted changes in development from T1 to T4. RESULTS Regardless of T1 nonverbal IQ and autism severity, high scores for inattentive behaviors at T1 predicted lower rates of change in vocabulary production and language comprehension over 2 years. High scores for social unresponsiveness at T1 predicted lower rates of change in vocabulary comprehension and production and in language comprehension over 2 years. Scores for insistence on sameness behaviors, repetitive stereotypic motor behaviors, and acting-out behaviors at T1 did not predict the rate of change of any child measure over 2 years beyond differences accounted for by T1 autism severity and nonverbal IQ status. CONCLUSIONS The results are discussed with regard to their implications for early intervention and understanding the complex factors that affect developmental outcomes.

Event-related brain potentials were examined in 6 to 8-year-old children with primary language disorder before and after a 5-week narrative-based language intervention. Participants listened to sentences ending with semantically congruous or incongruous words. By comparison with typical controls, the children with primary language disorder exhibited no pretreatment differences in their N400 responses to congruous and incongruous sentence-final words. After intervention, the typical incongruous-congruous difference was observable owing to a dramatic reduction in the amplitude of the N400 response to congruous words. These characteristic changes in brain responses may reflect a positive effect of the language intervention on the lexical-semantic processing skills in children with language impairment.

PURPOSE In this study, the authors evaluated literacy outcome in children with histories of speech sound disorder (SSD) who were characterized along 2 dimensions: broader language function and persistence of SSD. In previous studies, authors have demonstrated that each dimension relates to literacy but have not disentangled their effects. Methods Two groups of children (86 SSD and 37 controls) were recruited at ages 5-6 and were followed longitudinally. The authors report the literacy of children with SSD at ages 7-9, compared with controls and national norms, and relative to language skill and SSD persistence (both measured at age 5-6). RESULTS The SSD group demonstrated elevated rates of reading disability. Language skill but not SSD persistence predicted later literacy. However, SSD persistence was associated with phonological awareness impairments. Phonological awareness alone predicted literacy outcome less well than a model that also included syntax and nonverbal IQ. CONCLUSIONS Results support previous literature findings that SSD history predicts literacy difficulties and that the association is strongest for SSD + language impairment (LI). Magnitude of phonological impairment alone did not determine literacy outcome, as predicted by the core phonological deficit hypothesis. Instead, consistent with a multiple deficit approach, phonological deficits appeared to interact with other cognitive factors in literacy development.

BACKGROUND: phonological therapy. AIM: to evaluate the effectiveness of three different therapy models regarding changes in the phonological system of subjects with different phonological disorder (PD) severity levels. METHOD: the research group was composed by 66 subjects, 43 males and 23 females, with ages between 4:4 and 8:2 years, who were part of a school clinic database. All subjects were evaluated, before and after a period of 15 to 25 sessions of phonological therapy, using the Child's Phonological Assessment. Based on this assessment, the severity level of the PD was determined using the Percentage Consonants Correct - PCC, and by calculating the number of Non-Acquired Segments -NAS and the percentage of Acquired Segments (AS) after treatment. The subjects were treated using the following approaches: ABAB-Withdrawal and Multiple Probes, Modified Maximum Opposition and Modified Cycles Models. For the statistical analysis the T-Test was used with a significance level of 5%. RESULTS: the statistical analysis indicated an increase in the PCC and in the percentage of AS, as well as a reduction in the number of NAS for all groups. These results were statistically significant for the majority of the groups. CONCLUSION: the results indicate that the three therapy approaches were effective in the treatment of children with PD, and were effective in treating different severity levels. Besides that, most of the changes occurred in the phonological system of the groups with more severe PD.

Deficits in Joint Attention (JA) may be one of the earliest signs of Autism Spectrum Disorders (ASD). In this longitudinal study we investigated several types of JA behaviors at the age of 24 and 42 months, and their development over time. Eleven children with ASD, 10 children with other developmental disorders, and eight children without a developmental disorder participated. It was found that children with ASD showed significantly less JA at the age of 24 months. At this age, the various types of JA (Basic Joint Attention, Associated Joint Attention, Joint Visual Attention) were correlated with developmental level and number of autistic characteristics. However, at the age of 42 months, these associations were absent. Although children with ASD may show less JA at the age of 24 months compared to other groups of children, by the age of 42 months they reach about the same level of JA, except for joint visual attention. In fact, at both ages, children with ASD differed consistently only on JVA from the other groups. JVA may be a core component of an early screening device for ASD.

BACKGROUND In young, typically developing children, some word production variability is expected, but highly inconsistent speech is considered a clinical marker for disorder. Speech-language pathologists need to identify variability versus inconsistency, yet these terms are not clearly differentiated. Not only is it important to identify inconsistency, but also it needs to be defined and measured so that clinical decisions are evidence based. In order to understand inconsistent speech production, typical variability must be described. AIMS This paper differentiates between variability and inconsistent productions. Variability is defined as productions that differ, but can be attributed to factors described in normal acquisition and use of speech. Inconsistency is speech characterized by a high proportion of differing repeated productions with multiple error types, both segmental (phoneme) and structural errors (consonant-vowel sequence within a syllable). The study describes and quantifies the consistency of word production in typically developing children aged between 3;0 and 6;11 years. METHODS AND PROCEDURES This paper reports a large cross-sectional study (n = 409) of the consistency of children's production of words within the same linguistic context. OUTCOMES AND RESULTS The study found that the speech of typically developing children is highly consistent. Children in the youngest age group demonstrated the highest levels of variability, but it remained below 13% with 10% reflecting maturational influences. CONCLUSIONS Inconsistent production cannot be considered a typical feature of speech development. The results inform differential diagnosis of speech disorder.