BACKGROUND: Phonological difficulties are prevalent in children with speech and/or language disorders and may hamper their later language outcomes and academic achievements. These children often form a significant proportion of speech and language therapists\' caseloads. There is a shortage of information on evidence-based interventions for improving phonological skills in children and adolescents with speech and language disorder.
OBJECTIVE: The aim of this systematic literature review and meta-analysis was to systematically examine the effects of different intervention approaches on speech production accuracy and phonological representation skills in children with speech and language disorders.
METHODS: A preregistered systematic review (International Prospective Register of Systematic Reviews ID: CRD42017076075) adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was completed. Seven electronic databases (PubMed, Web of Science, ERIC, PsychINFO, Cochrane Library, SCOPUS and Linguistics & Language Behavior Abstracts) were searched for studies related to oral language interventions with children with developmental speech and/or language disorder (mean age ranging from 3-18 years) published between January 2006 and August 2022. The included articles reported intervention studies with a group design in which speech production accuracy was the outcome measure. Studies were appraised using the Cochrane risk of bias tool, and individual effect sizes were calculated using standardised means differences when enough data was available. A meta-analysis was conducted obtaining the average standardised mean difference d. Heterogeneity, influence of possible moderator variables and publication bias were explored.
RESULTS: The 23 studies that met the inclusion criteria presented low-medium risk of bias. Nine effect sizes were obtained from seven of these studies that presented a pre-post-test with a control group design. Medium-high average effect sizes were found in phonological accuracy. Heterogeneity was found between individual effect sizes. Significant moderator variables and publication bias were not detected.
CONCLUSIONS: The results of this meta-analysis indicate positive effects on speech production accuracy. Based on this review, further improvements in the quality of reporting for intervention research are required in developing the evidence base for practice.
CONCLUSIONS: What is already known on the subject An increasing number of interventions is available for children and adolescents with developmental speech and/or language disorders. Previous reviews suggest relatively low levels of evidence of interventions having phonology as an outcome measure. What this paper adds to the existing knowledge This review and meta-analysis summarise the intervention evidence from a substantial body of group design studies, indicating positive results from a range of interventions with phonological outcomes. It highlights the need to systematically implement and replicate different intervention procedures to understand factors that will maximise positive outcomes and to grow the evidence base for best practice. What are the potential or actual clinical implications of this study? Tentative evidence is emerging for the effectiveness of various approaches in enhancing speech production accuracy skills of children and adolescents with developmental speech and/or language disorder.

The language production deficit in post-stroke agrammatic aphasia (PSA-G) tends to result from lesions to the left inferior frontal gyrus (LIFG) and is characterized by a triad of symptoms: fragmented sentences, errors in functional morphology, and a dearth of verbs. Despite decades of research, the mechanisms underlying production patterns in PSA-G have been difficult to characterize. Two major impediments to progress may have been the view that it is a purely morphosyntactic disorder and the (sometimes overzealous) application of linguistic theory without interceding psycholinguistic evidence. In this paper, empirical evidence is examined to present an integrated portrait of language production in PSA-G and to evaluate the assumption of a syntax-specific syndrome. In light of extant evidence, it is proposed that agrammatic language production results from a combination of morphosyntactic, phonomotor, and processing capacity limitations that cause a cumulative processing bottleneck at the point of articulatory planning. This proposed Synergistic Processing Bottleneck model of PSA-G presents a testable framework for future research. The paper ends with recommendations for future research on PSA-G.

BACKGROUND: Within cohorts of children with autism spectrum disorder (ASD) there is considerable variation in terms of language ability. In the past, it was believed that children with ASD either had delayed articulation and phonology skills or excelled in those areas compared to other language domains. Very little is known about speech sound ability in relation to language ability and non-verbal ability in Swedish preschool children with ASD.
OBJECTIVE: The current study aimed to describe language variation in a group of 4-6-year-old children with ASD, focusing on in-depth analyses of speech sound error patterns with and without non-phonological language disorder and concomitant non-verbal delays.
METHODS: We examined and analysed the speech sound skills (including consonant inventory, percentage of correct consonants and speech sound error patterns) in relation to receptive language skills in a sample of preschool children who had screened positive for ASD in a population-based screening at 2.5 years of age. Seventy-three children diagnosed with ASD participated and were divided into subgroups based on their receptive language (i.e., non-phonological language) and non-verbal abilities.
RESULTS: The subgroup division revealed that 29 children (40%) had language delay/disorder without concurrent non-verbal general cognitive delay (ALD), 27 children (37%) had language delay/disorder with non-verbal general cognitive delay (AGD), and 17 children (23%) had language and non-verbal abilities within the normal range (ALN). Results revealed that children with ALD and children with AGD both had atypical speech sound error patterns significantly more often than the children with ALN.
CONCLUSIONS: This study showed that many children who had screened positive for ASD before age 3 years - with or without non-verbal general cognitive delays - had deficits in language as well as in speech sound ability. However, individual differences were considerable. Our results point to speech sound error patterns as a potential clinical marker for language problems (disorder/delay) in preschool children with ASD.
CONCLUSIONS: What is already known on the subject Children with autism spectrum disorder (ASD) have deficits in social communication, restricted interests and repetitive behaviour. They show very considerable variation in both receptive and expressive language abilities. Previously, articulation and phonology were viewed as either delayed in children with ASD or superior compared with other (non-phonological) language domains. What this paper adds to existing knowledge Children with ASD and language disorders also have problems with speech sound error patterns. What are the potential or actual clinical implications of this work? About 75% of children with ASD experience language delays/disorders, as well as speech sound problems, related to speech sound error patterns. Understanding/acknowledging these phonological patterns and their implications can help in the diagnosis and intervention of speech sound disorders in children with ASD. Direct intervention targeting phonology might lead to language gains, but more research is needed.

The speech amplitude envelope carries important acoustic information required for speech intelligibility and contains sensory cues (amplitude rise times, ARTs) that play a key role in both sensory rhythm perception and neural speech encoding. Individual differences in children\'s sensitivity to ARTs have been related to the development of children\'s phonological processing skills across languages by the Temporal Sampling theory. Impaired processing of ARTs also characterises children with dyslexia. However, different ART tasks have been employed in different studies, in different languages, and at different ages. Here, we compare the sensitivity of three frequently used ART tasks (based on synthetic syllables, sine tones, and speech-shaped noise) in a longitudinal study of English-speaking children with and without dyslexia. Children\'s ability to discriminate rising frequency, duration, and intensity was also tested. ART discrimination in all 3 tasks was significantly inter-related, but different relations to phonology and literacy were found for different ART tasks at different ages. In particular, the often-used sine tone and speech-shaped noise ART tasks showed greater sensitivity in older children, while the synthetic syllable task (/ba/ rise) showed greater sensitivity in younger children. Sensitivity to rising frequency was also related to phonology and literacy across ages. The data are interpreted with respect to the Temporal Sampling theory of developmental dyslexia.

UNASSIGNED: Word-finding difficulty is prevalent but poorly understood in persons with relapsing-remitting multiple sclerosis (RRMS).
UNASSIGNED: The objective was to investigate our hypothesis that phonological processing ability is below expectations and related to word-finding difficulty in patients with RRMS.
UNASSIGNED: Data were analyzed from patients with RRMS (n = 50) on patient-reported word-finding difficulty (PR-WFD) and objective performance on Wechsler Individual Achievement Test, Fourth Edition (WIAT-4) Phonemic Proficiency (PP; analysis of phonemes within words), Word Reading (WR; proxy of premorbid literacy and verbal ability), and Sentence Repetition (SR; auditory processing of word-level information).
UNASSIGNED: Performance (mean (95% confidence interval)) was reliably lower than normative expectations for PP (-0.41 (-0.69, -0.13)) but not for WR (0.02 (-0.21, 0.25)) or SR (0.08 (-0.15, 0.31). Within-subjects performance was worse on PP than on both WR (t(49) = 4.00, p < 0.001, d = 0.47) and SR (t(49) =3.76, p < 0.001, d = 0.54). Worse PR-WFD was specifically related to lower PP (F2,47 = 6.24, p = 0.004, η2 = 0.21); worse PP performance at PR-WFD Often (n = 13; -1.16 (-1.49, -0.83)) than Sometimes (n = 17; -0.14 (-0.68, 0.41)) or Rarely (n = 20; -0.16 (-0.58, 0.27). PR-WFD was unrelated to WR or SR (ps > 0.25).
UNASSIGNED: Phonological processing was below expectations and specifically linked to word-finding difficulty in RRMS. Findings are consistent with early disease-related cortical changes within the posterior superior temporal/supramarginal region. Results inform our developing model of multiple sclerosis-related word-finding difficulty.

UNASSIGNED: Urdu is the lingua franca and national language of Pakistan, and is the 10th most-spoken language worldwide with over 230 million speakers. The Urdu phonological system has been examined over the past decades. However, the system has been evolving. This paper aimed to review the available studies investigating various aspects of the Urdu phonological system and to reveal the variations noted among these studies.
UNASSIGNED: Twenty-one studies examining the phonological system of Urdu were located. The studies were reviewed in terms of consonants, geminates, consonant clusters, vowels, diphthongs, syllable structure, phonotactic constraints, and stress.
UNASSIGNED: The findings indicated that 38 consonants, 23 vowels, and 15 diphthongs are used in contemporary Urdu. Most consonants exist as geminates word medially. There are six syllable structures. The consonant clusters are constrained to the coda position only, and short vowels cannot exist in the word-final position. Like other syllable-timed languages, stress is not prominent in Urdu.
UNASSIGNED: Based on this review, a contemporary Urdu phonemic and syllable structure inventory has been proposed. This will serve as a reference for use in further acquisition research and clinical practice.

The exploration of naming error patterns in aphasia provides insights into the cognitive processes underlying naming performance. We investigated how semantic and phonological abilities correlate and how they influence naming performance in aphasia. Data from 296 individuals with aphasia, drawn from the Moss Aphasia Psycholinguistics Project Database, were analyzed using a structural equation model. The model incorporated latent variables for semantics and phonology and manifest variables for naming accuracy and error patterns. There was a moderate positive correlation between semantics and phonology after controlling for overall aphasia severity. Both semantic and phonological abilities influenced naming accuracy. Semantic abilities negatively related to semantic, mixed, unrelated errors, and no responses. Interestingly, phonology positively affected semantic errors. Additionally, phonological abilities negatively related to each of phonological and neologism errors. These results highlight the role of semantic and phonological skills on naming performance in aphasia and reveal a relationship between these cognitive processes.

Learning to spell in an inconsistent orthographic system is a true challenge for primary school children. Previous empirical studies have highlighted three main skills involved in this learning process: phonological skills, morphological skills, and children\'s sensitivity to graphotactic regularities. However, the literature shows contradictions in the exact nature of the contribution of each skill at different stages of the learning process. So, the aim of our study was to test the contribution of this set of skills in the acquisition of lexical spelling as a function of children\'s grade level. For this purpose, we assessed these dimensions in a cross-sectional sample of 1101 French-speaking children from Grade 1 to Grade 5. The analyses were conducted using data-driven exploratory network modeling. The results showed (a) a predominant role of phonological skills at the beginning of learning, which tends to decrease with advancing schooling; (b) an increasing contribution of morphological skills from Grade 1 to Grade 5 with a drop in Grade 4, which is the only contribution that continues to increase in Grade 5; and (c) a contribution of the sensitivity to graphotactic regularities that tends to be stable until Grade 4 before decreasing in Grade 5. Our findings show the importance of all three skills in a dynamic process in learning to spell. The implications of these results are discussed in light of the integration of multiple patterns model of learning to spell.

A word often expresses many different morphological functions. Which part of a word contributes to which part of the overall meaning is not always clear, which raises the question as to how such functions are learned. While linguistic studies tacitly assume the co-occurrence of cues and outcomes to suffice in learning these functions (Baer-Henney, Kügler, & van de Vijver, 2015; Baer-Henney & van de Vijver, 2012), error-driven learning suggests that contingency rather than contiguity is crucial (Nixon, 2020; Ramscar, Yarlett, Dye, Denny, & Thorpe, 2010). In error-driven learning, cues gain association strength if they predict a certain outcome, and they lose strength if the outcome is absent. This reduction of association strength is called unlearning. So far, it is unclear if such unlearning has consequences for cue-outcome associations beyond the ones that get reduced. To test for such consequences of unlearning, we taught participants morphophonological patterns in an artificial language learning experiment. In one block, the cues to two morphological outcomes-plural and diminutive-co-occurred within the same word forms. In another block, a single cue to only one of these two outcomes was presented in a different set of word forms. We wanted to find out, if participants unlearn this cue\'s association with the outcome that is not predicted by the cue alone, and if this allows the absent cue to be associated with the absent outcome. Our results show that if unlearning was possible, participants learned that the absent cue predicts the absent outcome better than if no unlearning was possible. This effect was stronger if the unlearned cue was more salient. This shows that unlearning takes place even if no alternative cues to an absent outcome are provided, which highlights that learners take both positive and negative evidence into account-as predicted by domain general error-driven learning.

While the neural bases of the earliest stages of speech categorization have been widely explored using neural decoding methods, there is still a lack of consensus on questions as basic as how wordforms are represented and in what way this word-level representation influences downstream processing in the brain. Isolating and localizing the neural representations of wordform is challenging because spoken words activate a variety of representations (e.g., segmental, semantic, articulatory) in addition to form-based representations. We addressed these challenges through a novel integrated neural decoding and effective connectivity design using region of interest (ROI)-based, source-reconstructed magnetoencephalography/electroencephalography (MEG/EEG) data collected during a lexical decision task. To identify wordform representations, we trained classifiers on words and nonwords from different phonological neighborhoods and then tested the classifiers\' ability to discriminate between untrained target words that overlapped phonologically with the trained items. Training with word neighbors supported significantly better decoding than training with nonword neighbors in the period immediately following target presentation. Decoding regions included mostly right hemisphere regions in the posterior temporal lobe implicated in phonetic and lexical representation. Additionally, neighbors that aligned with target word beginnings (critical for word recognition) supported decoding, but equivalent phonological overlap with word codas did not, suggesting lexical mediation. Effective connectivity analyses showed a rich pattern of interaction between ROIs that support decoding based on training with lexical neighbors, especially driven by right posterior middle temporal gyrus. Collectively, these results evidence functional representation of wordforms in temporal lobes isolated from phonemic or semantic representations.