Speech impairments: the case for early intervention
Dr Julia Carroll

Dr Julia Carroll of the University of Warwick discusses her research comparing children with a history of dyslexia with children with speech difficulties, and the implications of these impairments for literacy development.

When I first met Millie she was a friendly, chatty four-year-old, though I found her difficult to understand. While her vocabulary was good, she made many errors in speech. Those who knew her, including her peers and the nursery staff, could understand her well. Given this and her good vocabulary, there was a general feeling that she would "grow out" of her difficulties and she was not receiving speech therapy.

One year later, Millie had been in the Reception class for six months, and seemed to have lost much of her confidence. Her speech remained difficult to understand, and she was much less chatty. Her knowledge of letters and words was very low and she became visibly upset when asked to "sound out". In short, she showed many of the early signs of dyslexia.

The motivation behind my research is the question of whether it is possible to predict, or even prevent, literacy problems in children like Millie. Informally, many parents of dyslexic children report that these children were late talkers or that their speech was indistinct. Conversely, many children with early speech difficulties go on to have literacy problems. My recent study compares children with a family history of dyslexia with children with speech difficulties to assess how similar these two groups are.

The children in my study were between four and six years old and were matched for age, vocabulary level and education. They completed tasks in four areas: early literacy, phonological awareness, speech processing and new word learning. Since dyslexia has an established genetic component, we would expect that children with a family history of dyslexia should show poor literacy attainments. Given that dyslexia is generally thought to be caused by difficulties in phonological awareness (awareness of the sounds or "phonics"' of words), we would also expect difficulties in this area. The children with speech impairments, who were referred by speech therapists, would be expected to have difficulties in speech processing, and in learning the sound structure of new words.

We found that the two "high-risk"' groups (dyslexia and speech impairments) showed lower scores in all areas than control children of the same age and educational background. Not only did children with a family history of dyslexia show weak literacy and phonological processing, they also showed weak speech processing and new word learning. So did the children with speech difficulties. The two groups showed very similar difficulties in the areas found to be most important for early literacy. There seems to be a great deal of crossover between the two disorders.

While the kind of speech difficulties Millie showed are closely associated with literacy difficulties, the relationship is not simple. Not all children with early speech difficulties go on to have literacy difficulties, and not all children with literacy difficulties had pre-school speech difficulties. Still, we can say that Millie was in a high-risk group and would have benefited from some further support upon her transition to Reception.

Research does suggest some extra warning signs. The first one is severity. The more severe a child's speech difficulties, the more likely they are to go on to have literacy difficulties. Secondly, consider the type of errors a child makes. Children who make 'unusual' speech errors - errors that do not occur in the speech of younger, normally-developing children - are more likely to have ongoing difficulties. Thirdly, it seems that children with both speech difficulties and a family history of dyslexia are particularly at risk.

So what extra support can be given? Research in this area is still developing. My own experience suggests that it is not enough to teach letters alone. Several children in my sample had average letter knowledge, but weak phonological awareness and "sounding out" skills. I would recommend selecting one programme that concentrates on teaching segmenting and blending phonemes, with a focus on letter sounds. Jolly Phonics and PiPs are both excellent examples of this type of programme. Mixing and matching different programmes, while it is interesting for the teacher and for typically-developing children, can be confusing for this group.

Our next project will investigate two further factors: the importance of developing vocabulary and basic language skills; and the effectiveness of a phonics programme that includes articulation training, in which children "feel" the sound they are making with their mouth as they learn it. In time, we hope to integrate these techniques, often used in speech and language therapy, with standard literacy and phonics teaching.

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