Speech sound disorder (SSD) is one of the most common communication disorders in children, which must be diagnosed and treated in childhood to prevent its negative psychological, occupational, and social consequences in adulthood. The use of serious games is one technology that could help treat SSD. This study aims to design and evaluate the usability of a digital game for 3-6-year-old children. This developmental study was carried out in three main stages: determining information requirements, designing and developing a digital game, and evaluating the usability of the designed game. In the first stage, the consonants, syllables, words, and sentences that should be used in the game were determined through focus group sessions and a questionnaire completed by 30 speech-language pathologists (SLPs) in two Delphi rounds. In the designing and developing stage, the game design document was first written, and then sketches and wireframes were drawn based on this document. Then, the game was developed in the second phase using Java programming language. In the third stage, the usability of the designed game was evaluated by six experts and 22 SLPs using Nielsen\'s usability heuristics and the Post-Study System Usability Questionnaire (PSSUQ), respectively. Also, the usability of the game was evaluated by ten children. To determine the information requirements, SLPs confirmed 23 consonants, 138 syllables, 564 words, and 69 sentences to teach children the game. According to Nielsen\'s usability heuristics, the designed game had 23 unique usability problems with a mean severity of 2.29. \"User control and freedom,\" with five usability problems, was the most frequently identified problem, and \"error prevention,\" with a mean severity of 3.83, was the most severe problem. The results of the SLPs\' evaluation also showed that the \"interface quality\" of the designed game obtained the highest score, with a mean score of 6.25 out of 7. Also, 100% of children stated that the game was designed beautifully, and 90% of children also liked the game. A serious game designed for children with SSDs achieved satisfactory results in usability evaluation. Therefore, this smartphone-based game can be easily used among these children to provide fun therapy sessions under the supervision of parents.

BACKGROUND: Identification of auditory processing disorders is achieved using questionnaires along with linguistic, non-linguistic, and auditory processing tests. Notably, the questionnaires \"Children\'s Auditory Performance Scale\" (CHAPS) and \"Auditory Processing Domain Questionnaire\" (APDQ) are widely recognized and used. The current study investigated the psychometric properties of the CHAPS and APDQ in Greek Cypriot children.
METHODS: The CHAPS and APDQ questionnaires were completed by parents of 40 Greek Cypriot children, 16 typically developing (TD) children, and 24 children with a history of Speech Sound Disorders (SSDs).
RESULTS: There were significant differences between the two groups on both questionnaires. Cronbach\'s alpha was calculated at α = 0.922 for the CHAPS total score and α = 0.926 for the APDQ total score. The Receiver Operating Curve (ROC) analysis provided a cut-off point equal to -0.30 (AUC 0.849, p < 0.001) for CHAPS and a cut-off point equal to 90.00 (AUC 0.820, p < 0.001) for APDQ. Significant positive Spearman ρ correlations were observed between the CHAPS and APDQ (ρ = 0.639, p = 0.001).
CONCLUSIONS: The CHAPS and APDQ can identify distinct auditory processing characteristics between in children with SSDs and TD children.

This special issue of Clinical Linguistics and Phonetics presents a selection of papers, four in total, from the first thematic workshop entitled \"Phonetic/phonological aspects of typical and atypical speech development with emphasis on Greek\" which took place during the 25th International Symposium on Theoretical and Applied Linguistics held at Aristotle University in Thessaloniki in May 2022. It also includes one additional contribution within the thematic scope of the volume that was submitted to the journal independently of the workshop. Papers examine data from different clinical populations, including a clinical case study, as well as data or theoretical background from typical groups. They address aspects of speech production in childhood, adolescence and early adulthood. They thus reflect the aim of the workshop which was to provide a forum to researchers for the exchange of findings covering different populations (typical and clinical), age groups, genders, and various aspects of production. The ultimate goal was the formation of a working group that would bring together researchers with a special interest in phonetics and phonology, explore factors that influence speech acquisition and development in typical and atypical populations, convene and discuss present and future directions in speech acquisition and development with emphasis on the Greek language.

The alveolar lateral is phonetically and phonologically complex. Previous studies have shown that /l/ is one of the last segments to be acquired by typically developing Portuguese children. However, little is known about how Portuguese children with atypical development acquire /l/. In this paper, we investigate the acquisition of /l/ by Portuguese children with protracted phonological development (DLD; SSD). We explore the effect of syllable structure and segmental properties in the acquisition of /l/ and describe mismatches used for target /l/, thus contributing empirical evidence to the ongoing discussion on differential diagnoses for children with primary phonological disorders. Our results show that the lateral is more problematic in SSD than in DLD, with the manner of articulation being more problematic than its place. A syllable-segment interface effect was attested. Mismatches showed a preference for [w, ɾ, ø]. The results are discussed considering their implications for clinical practice and the role of target phonetic and phonological properties in the /l/ acquisition path.

BACKGROUND: Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents\' role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders.
OBJECTIVE: This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention.
METHODS: A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants\' speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants).
RESULTS: The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received.
CONCLUSIONS: The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve.
UNASSIGNED: DERR1-10.2196/54426.

Problem: Phonetic transcription is crucial in diagnosing speech sound disorders (SSDs) but is susceptible to transcriber experience and perceptual bias. Current forced alignment (FA) tools, which annotate audio files to determine spoken content and its placement, often require manual transcription, limiting their effectiveness. Method: We introduce a novel, text-independent forced alignment model that autonomously recognises individual phonemes and their boundaries, addressing these limitations. Our approach leverages an advanced, pre-trained wav2vec 2.0 model to segment speech into tokens and recognise them automatically. To accurately identify phoneme boundaries, we utilise an unsupervised segmentation tool, UnsupSeg. Labelling of segments employs nearest-neighbour classification with wav2vec 2.0 labels, before connectionist temporal classification (CTC) collapse, determining class labels based on maximum overlap. Additional post-processing, including overfitting cleaning and voice activity detection, is implemented to enhance segmentation. Results: We benchmarked our model against existing methods using the TIMIT dataset for normal speakers and, for the first time, evaluated its performance on the TORGO dataset containing SSD speakers. Our model demonstrated competitive performance, achieving a harmonic mean score of 76.88% on TIMIT and 70.31% on TORGO. Implications: This research presents a significant advancement in the assessment and diagnosis of SSDs, offering a more objective and less biased approach than traditional methods. Our model\'s effectiveness, particularly with SSD speakers, opens new avenues for research and clinical application in speech pathology.

OBJECTIVE: Children with specific language impairment (SLI) might present with speech sound disorder (SSD) and phonological awareness (PA) deficits which put them at risk of potential reading problems. This work aimed to organize an intervention program in Arabic for phonological training and to assess the effect of PA training versus the phonological therapy (PT) for children with SLI and SSD.
METHODS: The study was carried out on 60 children with comorbid SLI and SSD, aged 5-7 years. Children were equally divided into two groups; each group received language therapy combined with (PT or PA training). Measures of language development, phonological output, and PA were taken before therapy and at 4 month post-therapy for all children.
RESULTS: The two therapy groups made nearly the same amount of progress in the development of language and phonological production, with no significant differences regarding language age and percent of consonants correct (PCC). The PA training group progressed more on the PA skills than children who received PT over the same time.
CONCLUSIONS: PA training could facilitate the development of phonological skills by targeting the child\'s awareness of phonemes and improving the production of sound patterns.

This paper describes the latest development in the classification stage of our Speech Sound Disorder (SSD) Screening algorithm and presents the results achieved by using two classifier models: the Classification and Regression Tree (CART)-based model versus the Single Decision Hyperplane-based Linear Support Vector Machine (SVM) model. For every single speech sound in medial position, 10 features extracted from the audio samples along with an 11th feature representing the validation of the (mis)pronunciation by the Speech Language Pathologist (SLP) were fed into the 2 classifiers to compare and discuss their performance. The accuracy achieved by the two classifiers on a data test size of 30% of the analyzed samples was 98.2% for the Linear SVM classifier, and 100% for the Decision Tree classifier, which are optimal results that encourage our quest for a sound rationale.

There is a growing body of literature on phonological development in Greek-speaking children, either typically developing (TD) or with speech sound disorders (SSD). In this paper, a cross-sectional longitudinal approach was used to investigate the development of speech output processing skills in TD Greek-speaking preschool-aged children. Moreover, a group of Greek-speaking children with SSD were assessed to identify potential loci of impairment in atypical development. The developmental study involved two groups: group 1 (n = 16) aged 3;0-3;5 years and group 2 (n = 22) aged 4;6-5;0 years, assessed at three assessment points six months apart. Children with SSD (n = 15) aged 5;6-6;0 years were assessed to be compared with performance of group 2 TD children (at the third assessment point). Assessment tasks included (a) a picture naming task, (b) a task of real word repetition and (c) a task of nonword repetition. A strong time effect was found in both groups of TD children in the development of speech output processing abilities. Performance accuracy was higher on tasks including real words than nonwords; children performed more accurately on repetition rather than spontaneous naming of real words; repetition accuracy on 2-3 syllables items was significantly better than on 4-5 syllables items. Children with SSD were outperformed by TD children of the same age in all assessment tasks; lexicality and word length effect were found in the clinical group. Findings from the present study may be used as a starting point to diagnose children with speech production difficulties in Greece.

Speech is a powerful, natural mode of communication that facilitates effective interactions in human societies. However, when fluency or flow of speech is affected or interrupted, it leads to speech impairment. There are several types of speech impairment depending on the speech pattern and range from mild to severe. Childhood apraxia of speech (CAS) is the most common speech disorder in children, with 1 out of 12 children diagnosed globally. Significant advancements in speech assessment tools have been reported to assist speech-language pathologists diagnosis speech impairment. In recent years, speech assessment tools have also gained popularity among pediatricians and teachers who work with preschoolers. Automatic speech tools can be more accurate for detecting speech sound disorders (SSD) than human-based speech assessment methods. This systematic literature review covers 88 studies, including more than 500 children, infants, toddlers, and a few adolescents, (both male and female) (age = 0-17) representing speech impairment from more than 10 countries. It discusses the state-of-the-art speech assessment methods, including tools, techniques, and protocols for speech-impaired children. Additionally, this review summarizes notable outcomes in detecting speech impairments using said assessment methods and discusses various limitations such as universality, reliability, and validity. Finally, we consider the challenges and future directions for speech impairment assessment tool research.