Comorbid morphological disorder apparent in some children aged 4-5 years with childhood apraxia of speech: findings from standardised testing

Abstract

There is continuing debate about the origins of productive morphological errors in children with speech sound disorders. This is the case for children with theorised phonetic and motor disorders, such as children with childhood apraxia of speech (CAS, e.g., Ekelman & Aram, 1983; McNeill & Gillon, 2013 ). The morphological skills of children with CAS remain relatively unexplored in pre-schoolers. We investigated English morphology in a retrospective, cross-sectional design of 26 children aged 4-5 years who completed the Clinical Evaluation of Language Fundamentals-Preschool (2nd edition; Wiig, Secord & Semel, 2006). The research aims were to determine: (1) the language profile of the children, (2) the accuracy of each morpheme type produced, and (3) how many of those morphological errors are explained by speech errors (clusters, late developing phonemes, central vowels or weak syllable stress)? The results indicate the group of children with CAS had poorer expressive language skills than receptive skills and 48% demonstrated difficulties with morphology in word structure and recalling sentences subtests. The children had poor accuracy and inconsistent production of a range of morphemes and despite many errors due to the speech characteristics of the stimuli on the CELF-P2, motor speech concerns could not explain all the child's morphological errors. The results suggest morphological difficulties are co-morbid to CAS and when this occurs, treatment for morphosyntax is indicated. There are also significant clinical implications in the assessment of morphosyntax for children with CAS which are discussed.

Orofacial Function, Articulation Proficiency, and Intelligibility in 5-Year-Old Children Born With Cleft Lip and Palate

“…Rosenbek & Wertz, 1972). This gap has also been reported in a more recent study (Murray et al, 2019). In that study, morphological disorder was found in 48% of 4-5-year old children with CAS.…”

“…The reported gap between receptive and expressive language competence in children with CAS (e.g. Rosenbek & Wertz, 1972;Murray et al, 2019) was confirmed in study IV. The proportion of children having an expressive language disorder (67%) was similar to the reported proportions of Dutch and English-speaking children (46-82%) (Thoonen et al, 1997;Lewis et al, 2004;Iuzzini, 2012;Vuolo and Goffman, 2018;Zuk et al, 2018;Murray et al, 2019).…”

“…Rosenbek & Wertz, 1972;Murray et al, 2019) was confirmed in study IV. The proportion of children having an expressive language disorder (67%) was similar to the reported proportions of Dutch and English-speaking children (46-82%) (Thoonen et al, 1997;Lewis et al, 2004;Iuzzini, 2012;Vuolo and Goffman, 2018;Zuk et al, 2018;Murray et al, 2019). Receptive language competence in children with CAS could be considered a relative strength.…”

“…Possibly, the search for reliable diagnostic markers and defining the speech disorder per se has had priority. The reported cooccurrence of CAS with language disorder varies from 46 to 82% (Thoonen, Maassen, Gabreels, Schreuder, & de Swart, 1997;Lewis, Freebairn, Hansen, Iyengar, & Taylor, 2004;Iuzzini, 2012;Vuolo & Goffman, 2018;Zuk, Iuzzini-Seigel, Cabbage, Green, & Hogan, 2018;Murray, Thomas, & McKechnie, 2019). Research in the 1970s described a gap between receptive and expressive language ability in patients with CAS, with better receptive than expressive abilities (e.g.…”

“…In that study, morphological disorder was found in 48% of 4-5-year old children with CAS. The question raised was whether the cooccurrence of difficulties with motor speech and morphology was to be seen as speech motor difficulties affecting language or cooccurrence of both speech and language disorder (Murray et al, 2019).…”