"Eye ayee oo a eye a aya uh," said a 3-year-old client, while playing with a toy firetruck.
"Your daddy used to drive a fire truck," I responded.
Children who are learning to speak often employ simplification patterns as a way to manage complex sound production or sound combinations. These patterns of simplification are known as phonological processes. Most people are familiar with the more common patterns, such as gliding where /w/ is used in place of /r/ and /l/. A child may say, “Wook at the siwy wabbit” for “Look at the silly rabbit.” Other common patterns include cluster reduction (adjacent consonants are simplified to the initial consonant in a cluster) such as “tain” for “train” or “pant” for “plant,” weak syllable deletion (the unstressed syllable in a word is omitted), such as “ephant” for “elephant” and “bufy” for “butterfly,” and reduplication (the stressed syllable in a word is repeated in place of the weak syllable), such as “baba” for “bottle” and “wawa” for “water.”
A phonological process disorder is a type of speech sound disorder. It is typically diagnosed when a child continues to employ phonological processes or simplification patterns longer than is developmentally appropriate or when the child displays patterns that do not follow the typical developmental path. Some patterns, such as initial consonant deletion, where the first sound of a word is omitted (e.g., “at” for “cat” or “ook” for “book”), can greatly impact a child’s ability to be understood, as can the child’s use of multiple patterns at the same time. Research in phonological development provides information on what phonological processes are usually employed and when typically developing children abandon the various simplification patterns for more adult-like speech. These developmental norms help speech-language pathologists determine the need for and timing of treatment. Children who enter school with a phonological process disorder often experience a delay in the development of early reading skills. Which of these children will go on to a later diagnosis of dyslexia is not so straightforward. What we do know is that a child with a phonological disorder runs a greater risk of displaying reading difficulty at age 8 than those children who do not. More importantly, children diagnosed with a phonological process disorder in addition to a language disorder, difficulty with attention, memory, and/or processing speed, and those with a family history of reading impairment display the greatest risk for significant reading difficulties by the end of second grade. The bottom line for me, as an SLP, is that early intervention of speech sound disorders is critical to provide the best scaffolding for reading acquisition, especially if a child presents with any additional risk factors for dyslexia. While researchers have worked hard over the past 25 years to identify reliable predictors of dyslexia, they have yet to determine a single cause. This is likely due to the fact that dyslexia is a complex neurobiological disorder. A quick search on the incidence of dyslexia will yield estimates ranging from 5% to an incredible 20% of the population. With this many school-aged children being diagnosed, research into the identification of pre-cursors is critical - and thankfully, ongoing. One more important note, a phonological process disorder is NOT the same as phonological processing or phonological awareness skills, which are critical for reading acquisition. The neurobiological underpinnings may be responsible for the development of each, however, one does not equal the other. For more information on speech sound disorders, please visit the American Speech-Language-Hearing Association: https://www.asha.org/.../clin.../articulation-and-phonology/ Click here for a great developmental chart and descriptive information on phonological processes: https://littlebeespeech.com/.../phonological_processes.pdf