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Early Speech Sound Disorders And Risk For Literacy Difficulties

Barbara A. Lewis, PhD, CCC-SLP

February 9, 2016



Why are children with early speech sound disorders at risk for literacy difficulties? 


There are many possible explanations.  Perhaps these children have “fuzzy” phonological representations.  They sometimes have poor phonological awareness skills, poor verbal short-term memory, reduced vocabulary, and slow lexical retrieval.  They can also have a series of co-morbid conditions such as attentional problems, co-morbid language impairment.  They can have poor orthographic awareness and reduced narrative abilities.  All of these co-morbid conditions contribute to literacy skills. 

There have been two proposed explanations for the relationship of speech sound disorders to reading.  One, as previously stated, is that phonological representations may be degraded, “fuzzy,” and underspecified resulting in the loss of some phonetic features before they can be compared or repeated.  Therefore, the student has poor decoding skills.  Another possibility is that phonological representations are intact and phonetic features are correctly encoded, but short-term memory processes are limited.  The student has difficulty transferring information into working memory, which then disrupts reading comprehension. 

It is important to emphasize that not all children with SSD have reading difficulties.  One study reported that 22% of 7 to 9 year old children with SSD have reading difficulties.  Twenty-two percent is still a large number, but it is not every child with SSD.  We also know that children with SSD may have phonological deficiencies, but no reading difficulties.  Children with SSD have been shown to score more poorly on phonological awareness skills and single word reading than their typical peers.  Some researchers have suggested that it is the children who have non-developmental phonological process errors that are more likely to have decoding difficulties. 

Barbara A. Lewis, Ph.D., CCC-SLP is Professor in the Department of Psychological Sciences and an adjunct Professor in the Department of Pediatrics at Case Western Reserve University.  Her interests include the etiological bases of child language disorders with a focus on genetic, medical and neurological conditions that impact speech and language development.

barbara a lewis

Barbara A. Lewis, PhD, CCC-SLP

Barbara A. Lewis, Ph.D., CCC-SLP is Professor in the Department of Psychological Sciences and an
adjunct Professor in the Department of Pediatrics at Case Western Reserve University.  Her interests
include the etiological bases of child language disorders with a focus on genetic, medical and
neurological conditions that impact speech and language development. For the past 26 years, Dr.
Lewis has been the principal investigator on an NIH funded project investigating the genetic basis of
speech sound disorders.  She has followed children with speech sound disorders from early
childhood to adulthood and studied co-morbid disorders of language impairment, reading disorders
and ADHD.  She is also a co-investigator on a longitudinal project examining speech, language,
academic and social outcomes of children exposed to cocaine prenatally.  Dr. Lewis teaches courses
on language development, articulation and phonology disorders, language and literacy, and language

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