Early Reading Achievement in Children With ...

Research

Early Reading Achievement in Children With Expressive Phonological Disorders Linda S. Larrivee University of Missouri–Columbia

Hugh W. Catts University of Kansas, Lawrence

In this study, 30 children with expressive phonological disorders and 27 children with normally developing phonological and language abilities were administered measures of expressive phonology, phonological awareness, and language ability at the end of kindergarten. A year later, children were given tests of reading achievement. Although the group with expressive phonological disorders performed significantly less well than the control group on tests of reading achievement, a great deal of within-group variability was observed. Children with expressive phonological disorders were divided into those with good and poor reading outcomes and compared on measures of expressive phonology, phonological awareness, and language ability. Children with poor reading outcomes had more severe expressive phonological disorders (as measured by a multisyllabic word and nonword

F

or the most part, written orthography represents the sounds of speech (DeFrancis, 1989). This association between printed symbols and spoken words plays an important role in early reading development (Adams, 1990). Knowing the correspondence between sounds and letters allows beginning readers the opportunity to decode many unfamiliar words and, in turn, to form lasting orthographic representations of these words in memory (Share & Stanovich, 1995). Given the relationship between printed words and the phonology of spoken language, one group of children who would seem to be at risk for problems in early reading achievement are those with expressive phonological disorders. These children show delayed development in the production of the sound system of language. As a result, they may be expected to have difficulties learning a symbol system based on speech sounds. Children with phonological disorders also are of particular interest to researchers concerned with literacy because deficits in expressive phonology could serve as an 118

repetition task; MULTI-PCC), poorer phonological awareness, and poorer language skills than did children in the good reading outcome group. Hierarchical multiple regression indicated that expressive phonology (as measured by MULTIPCC) and phonological awareness in kindergarten accounted for significant amounts of variance in first-grade reading achievement. Variability in children’s expressive phonology and phonological awareness may be a reflection of individual differences in their development of phonological representations. Clinical implications of these findings for identification and remediation of reading disabilities are discussed. Key Words: reading development, phonological disorders, language disorders, reading disabilities, phonological awareness

early indicator of a potential reading disability. Recently, investigators have examined the early reading achievement of children with expressive phonological disorders (e.g., Bishop & Adams, 1990; Bird, Bishop, & Freeman, 1995; Catts, 1993; Lewis & Freebairn, 1992). Several of these studies have shown only a limited relationship between early reading achievement and expressive phonology. Catts (1993), for example, conducted a longitudinal study of 56 kindergarten children with speech-language impairments. Forty-one of these children had phonological and/or language problems, whereas 15 had expressive phonological disorders alone. All children were administered a battery of speechlanguage tests. In first and second grades, children were given tests of reading achievement. The results indicated that, as a group, the children with phonological and/or other language impairments performed poorly in reading. On the other hand, children with phonological disorders alone generally scored within normal limits on tests of

American Journal of Speech-Language Pathology • Vol. 8 • 118–128 • May 1999 • © American Speech-Language-Hearing Association

American Journal of Speech-Language Pathology • Vol. 8 • 118–128 • May 1999 1058-0360/99/0802-0118

reading achievement. Regression analyses further indicated that the severity of children’s phonological disorders, as measured by the Goldman-Fristoe Test of Articulation (Goldman & Fristoe, 1986), was unrelated to later reading achievement. Bishop and Adams (1990) also conducted a longitudinal study of children with speech-language impairments. Children were tested for speech-language abilities at age 4 and again at age 5-1/2. Tests of reading achievement were administered when children were approximately age 8-1/2. Among the participants with speech-language impairments were 12 children with phonological disorders alone. These children’s problems at age 4 ranged from mild to moderate-severe. Despite their phonological impairments, all these children demonstrated normal reading achievement at age 8-1/2. Children with phonological and/or language impairments performed much more poorly in reading at follow-up. In addition, Bishop and Adams found that, in general, the best predictors of reading achievement at age 8-1/2 were measures of language development. A measure of phonological ability, percentage of consonants correct, accounted for a small but significant amount of variance in reading achievement over and above that accounted for by measures of language ability. The results of the above studies suggest that expressive phonological disorders alone are not closely associated with problems in early reading achievement. Rather, these studies indicate that it is primarily when phonological disorders are accompanied by language impairments that children experience reading disabilities. More recently, however, another study points to a different conclusion. In this study, Bird et al. (1995) examined 31 boys [5;0 (years; months) to 7;4] who were receiving intervention for expressive phonological disorders. One subgroup, consisting of 19 participants, had phonological disorders but no other language impairments, and another subgroup of 12 children had both phonological disorders and language impairments. Participants in each subgroup were individually matched to a control group on chronological age and nonverbal ability. Children with phonological disorders were seen for an initial assessment (Time 1) and were tested again after 7–12 months (Time 2) and 17–24 months (Time 3). At each of the testing sessions, expressive phonology and phonological awareness were assessed. At Times 2 and 3, several measures of reading and spelling abilities were administered. Results of the study showed that both subgroups of children with phonological disorders performed significantly less well than control children on reading and spelling tests at Times 2 and 3. Children with phonological disorders alone scored somewhat better in reading and spelling than the children with phonological disorders and language impairments. The authors attributed these differences, however, to the higher nonverbal abilities of the children with phonological disorders alone. The investigators also examined which factors were most closely related to reading and spelling outcomes. Children with phonological disorders were divided into those with good outcomes (N = 7) and those with poor outcomes (N = 24) at Time 3. The poor outcome group had significantly lower nonverbal abilities

and more severe expressive phonological disorders at Time 1 than did the high outcome group. Only the difference in nonverbal abilities remained at Time 2. There were no differences between the poor and good outcome groups on measures of language ability or phonological awareness at Time 1 or 2. The authors concluded that children with phonological disorders appear to be at risk for reading disabilities, regardless of accompanying language ability. Although accompanying language impairment appeared to explain the differences between good and poor readers with expressive phonological disorders in the studies of Bishop and Adams (1990) and Catts (1993), this was not the case in the Bird et al. (1995) study. If accompanying language impairment does not account for which children with phonological disorders are at risk for reading difficulties, what then explains the difference in the results of the studies? Two variables appear to be likely candidates. One is the severity of the expressive phonological disorder. Bird et al. (1995) suggested that differences in the severity of participants’ phonological disorders might have accounted for the inconsistencies in the findings of their study and that of Catts (1993). Bird et al. found that their group of poor readers had more severe expressive phonological disorders than did their group of good readers at Time 1. A second variable that may be related to early reading achievement in children with expressive phonological disorders is phonological awareness. Phonological awareness refers to one’s awareness that words are composed of phonemes and syllables (Catts, 1991; Hakes, 1982; Tunmer & Nesdale, 1985). Numerous studies have reported a strong relationship between measures of phonological awareness and reading (e.g., Bradley & Bryant, 1985; Catts, 1991, 1993; Lundberg, Olofsson, & Wall, 1980; Mann & Liberman, 1984; Torgesen, Wagner, & Rashotte, 1994). As a result, it is now frequently argued that phonological awareness plays a causal role in reading acquisition (Adams, 1990; Bradley & Bryant, 1985). Recent studies have shown that, as a group, children with expressive phonological disorders have problems in phonological awareness (Bird & Bishop, 1992; Bird et al., 1995; Dodd, 1995; Webster & Plante, 1992). Recently, Bird et al. (1995) compared the phonological awareness abilities of children with expressive phonological disorders who had good reading outcomes to those who had poor outcomes. Their results showed no significant differences between these subgroups on measures of phonological awareness. However, the sample studied in their investigation performed quite poorly on the phonological awareness measures, and only a small percentage of the children (23%) had a good outcome in reading. Perhaps in a sample of children with expressive phonological disorders who demonstrated more variability in reading outcome, phonological awareness would prove to be more closely related to early reading achievement. The present investigation was conducted to further examine the relationship between expressive phonological disorders and early reading achievement. Specifically, we sought to determine if a group of children chosen on the basis of expressive phonological disorders from the caseload of school speech-language pathologists would Larrivee & Catts: Early Reading

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have problems in early reading achievement. We also investigated whether variability in reading achievement was related to individual differences in expressive phonology as measured by two tasks. One measure was a standardized articulation test, the Arizona Articulation Proficiency Scale (Fudala & Reynolds, 1988), a test frequently used to assess expressive phonology in children. In addition, we administered a task involving the repetition of multisyllabic words and nonwords. This measure was used to capture variability in expressive phonology over and above that measured by our standardized measure. We predicted that children with expressive phonological disorders who had good outcomes in reading would perform significantly better on phonological awareness tests than those who had poor outcomes. We also expected that measures of phonological awareness would account for variance in early reading achievement over and above that explained by measures of expressive phonology. Finally, because several previous studies have found language abilities to be related to early reading achievement in children with expressive phonological disorders, we also examined these skills in relationship to early reading achievement.

Method Participants Thirty children, 8 girls and 22 boys, with expressive phonological disorders (PD group) participated in this study. At the beginning of the study, participants were between 5;8 and 7;3 with a mean age of 6;2. These children lived in five cities in Kansas and represented a range of socioeconomic and ethnic backgrounds. They met the Kansas State guidelines for phonological disorders and were on the caseload of school speech-language pathologists. The TABLE 1. Means, standard deviations, and F values for PD (N = 30) and PN (N = 27) groups in kindergarten on expressive phonology, phonological awareness, and language measures. PD

AAPS-PCC MULTI-PCC PA RECL EXPL LANG

PN

M

SD

M

SD

F

.66 .54 5.30 84.73 85.58 85.16

.17 .16 1.46 10.75 10.25 10.11

.98 .88 7.30 96.21 103.72 99.72

.03 .06 1.21 8.32 10.88 9.20

85.84* 110.57* 31.30* 19.99* 41.99* 33.17*

Note. AAPS-PCC = percentage consonant correct on the Arizona Articulation Proficiency Scale; MULTI-PCC = percentage consonant correct on multisyllabic word list; PA = phonological awareness composite score; RECL = average of PPVT-R, Token Test for Children, and TOLD:P grammatical understanding; EXPL = average of EOWPVT-R, TOLD:P grammatical completion, and TOLD:P sentence imitation; LANG = average of PPVT-R, Token Test for Children, TOLD:P sentence imitation; EOWPVT-R, TOLD:P grammatical completion, and TOLD:P grammatical understanding. *p < .01

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inclusion criteria in the Kansas state guidelines for phonological disorders at the time of the study specified that children below age 8 must have at least three separate consonants in error in both the initial and final position of words that are not consistent with normal developmental patterns (Kansas Guidelines and Severity Rating Scales for Speech and Language Impairments, 1988). At the outset of the study, the phonological disorders in these children ranged from moderate to severe, based on their score on the Arizona Articulation Proficiency Scale (AAPS). The PD group had a mean percentile score of 9.7 on the AAPS (SD = 11.6) with a range of 1 to 51. Although 5 children in the PD group had scores above the 16th percentile (i.e., one standard deviation below the mean), all had qualified for speech treatment services at the beginning of the school year, were currently receiving services, and continued to meet the state guidelines. Many children in the PD group also had semantic-syntactic language deficits in addition to expressive phonological disorders. Eighteen of these children performed one or more standard deviations below the mean on at least two of three receptive and/or expressive language measures (listed below). To better evaluate the performance of the above children on standardized and nonstandardized tests employed in this study, 27 kindergarten children, 14 girls and 13 boys, who showed normal phonological and language development were included in a phonologically normal (PN) group. Children in this group were selected from the same schools as those in the PD group. Kindergarten teachers assisted in the selection of these children using the following criteria: (a) normally developing speech and language abilities, (b) no history of hearing loss, (c) no emotional disorders, (d) no cognitive deficits, and (e) no obvious physical (e.g., cleft palate) or neurological impairment. The mean age of these children was the same as that of the PD group (6;2). The PN group had a mean percentile score of 80.5 (SD = 2.47) and a range of 39 to 100 on the AAPS. None of these children met state guidelines for a phonological impairment. The group placement of participants was confirmed by our testing. None of the participants in the normal group evidenced phonological or language disorders. Table 1 demonstrates that the children in the PN group performed significantly higher than the children in the PD group on measures of expressive phonology, phonological awareness, and receptive and expressive language.

Measures During kindergarten, participants were administered tasks measuring expressive phonological ability, phonological awareness, and language skill. In first grade, children were given several measures of reading achievement. The specific measures are listed below.

Expressive Phonology To measure expressive phonological ability, the AAPS was administered. This test provided an index of consonant production in initial and final positions of single syllable

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words. In addition, we used a multisyllabic word and nonword repetition task to capture added variability in children’s expressive phonology. Multisyllabic word repetition tasks have been used to measure variability in phonological skill over and above that measured by tasks involving single-syllable words (Catts, 1986, 1989; Lewis & Freebairn, 1992). For example, Lewis and Freebairn (1992) found that adolescents and adults with a history of preschool expressive phonological disorders showed no significant deficits on the Goldman-Fristoe Test of Articulation but differed significantly from normal controls on a multisyllabic word repetition task. For this task, children were asked to repeat ten multisyllabic true words and ten multisyllabic nonwords (Catts, 1986) (Appendix A). Participants’ production of words from both the AAPS and the multisyllabic word lists were transcribed online and were audiorecorded. To capture the most variability in phoneme production for each task, percent consonants correct (PCC; Shriberg & Kwiatkowski, 1982) was calculated for each task. With the exception that our samples were not taken from spontaneous speech, scoring procedures for PCC were consistent with rules outlined by Shriberg and Kwiatkowski (1982). An estimate of reliability was obtained by a trained observer transcribing 10% of audiotapes of AAPS and multisyllabic words and nonwords. Interrater reliability, calculated by dividing the total number of agreements by the total number of consonants counted, was 81%. Although this was somewhat low, it should be noted that the investigator was transcribing online, whereas the individual performing the reliability check was transcribing from the audiorecording.

Phonological Awareness Four phonological awareness tasks, administered individually to the children, included syllable segmentation, initial-sound oddity, blending, and initial and final sound isolation (Appendix B). These tasks are representative of the various tasks that have been administered in previous studies examining phonological awareness in kindergarten children. A description of each is presented below. Syllable Segmentation. In this task, children were asked to segment words into syllables (e.g., Liberman, Shankweiler, Fisher, & Carter, 1974; Lundberg et al., 1980). Training consisted of showing children how to tap their hands on a table to indicate the number of syllables in words. The examiner tapped out the syllables in two sets of one, two, and three syllable words. In the first set of three words, the examiner said the word and then tapped the table for each syllable. In the second set, the examiner said the word and then repeated it while tapping the number of syllables. Children were then asked to tap out the syllables in the twelve test words, which contained one, two, or three syllables. Oddity. In the oddity task, the children were asked to listen to sets of three words spoken by the examiner and to identify the one that did not start with the same sound as the others (e.g., Bradley & Bryant, 1985; Stanovich, Cunningham, & Cramer, 1984). Visual support was

provided through the use of pictures of the practice and test items. The children were instructed to listen carefully to the beginning sound of each of the words and to point to the picture whose beginning sound was different from that of the other two. Training consisted of one example completed by the examiner and three practice trials with corrective feedback. There were 16 test items. Blending. In the blending task, the children were required to identify a word spoken as separate phonemes by the examiner. Identification of the correct response was made by the children pointing to the appropriate picture in a set of three pictures. Many studies have required children to say the target word (e.g., Catts, 1993; Lundberg et al., 1980). However, picture identification was used to avoid confusion that might have resulted from children’s expressive phonological difficulties. Training consisted of three trials. A picture of each target word was presented on a sheet of paper with two foils. One foil was usually a rhyming word. The other foil was a word that started with the same sound as the target. For example, in the case of the target word “sheep,” the foils were “jeep” and “ship.” Thirteen test items were presented. Sound Isolation. In the sound isolation task, children were asked to judge if a target sound was in a stimulus word (e.g., Yopp, 1988). For example, the child was asked, “Do you hear /s/ in soup?” Training consisted of four trials, two requiring a positive response and two requiring a negative response. All errors were corrected on the training items. Following the training, the children were told that the examiner could no longer help them. Fifteen test trials were included. On 60% of the items, the correct response was “yes,” and on 40%, the correct response was “no.” All errors during practice trials were corrected. Following the practice trials, the children were told that the examiner could no longer help them. If children were unsure, they were encouraged to guess. An overall composite score for phonological awareness was obtained by converting the score on each individual measure of phonological awareness to a scale of 10 and obtaining an average of the four tasks.

Language Several standardized tests or subtests were administered to assess receptive and expressive language abilities. These measures were chosen because they are widely used, normreferenced measures of receptive or expressive semantics and morphosyntax. The Peabody Picture Vocabulary Test– Revised (PPVT-R; Dunn & Dunn, 1981) was used as a measure of receptive vocabulary. The grammatical understanding subtest of the Test of Language Development–2: Primary (TOLD:P; Newcomer & Hammill, 1988) and part V of the Token Test for Children (DiSimoni, 1978) were administered to assess receptive morphosyntactic ability. Standard scores from the latter two subtests for each child were converted to scaled scores with a mean of 100 and a standard deviation of 15. These scores were then averaged with that of the PPVT-R to derive a composite score for receptive language. To measure expressive vocabulary, the Expressive One-Word Picture Vocabulary Larrivee & Catts: Early Reading

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Test–Revised (EOWPVT-R; Gardner, 1990) was administered. The grammatical completion and sentence imitation subtests of the TOLD:P were used to assess expressive morphosyntax. Standard scores from the latter two subtests were also converted to scaled scores with a mean of 100 and a standard deviation of 15. These scores were averaged with that of the EOWPVT-R to derive a composite score for expressive language. Finally, an overall composite language score was calculated by averaging the expressive and receptive language composite scores.

Reading An important first step in learning to read is the acquisition of the ability to recognize words (Adams, 1990). This ability relies on knowledge and application of sound-letter correspondence rules, as well as memory for whole-word letter sequences. Two subtests of the Woodcock Reading Mastery Tests–Revised (Woodcock, 1987) were administered to assess word recognition. These were the Word Identification and the Word Attack subtests. On the Word Identification subtest, children were required to read real words presented in groups on stimulus cards. These words decrease in frequency of occurrence. On the Word Attack subtest, children read nonwords that can be pronounced using English sound-letter correspondence rules. A composite reading score was calculated by averaging the standard scores of the two subtests. Because our test sample had expressive phonological disorders, we used special scoring procedures for the measures of reading achievement. In scoring the responses of both groups, mispronunciations of words on the reading lists were not scored as incorrect if these mispronunciations reflected a phoneme error that the participant demonstrated on the AAPS.

Procedures All children initially were tested during two sessions in the last quarter of their kindergarten year. In the first session, the AAPS, multisyllabic word and nonword tasks, and measures of receptive and expressive language abilities were administered. In the second session, the phonological awareness measures were administered. The children were tested again during the last quarter of first grade. The two reading subtests were administered in one session. In all cases, children were tested individually.

cal ability, phonological awareness, and language ability in kindergarten. In our final analyses, hierarchical multiple regressions were conducted to examine the relative contributions of expressive phonology, phonological awareness, and language ability in kindergarten to reading achievement in first grade. An initial concern of this study was to investigate whether children with expressive phonological disorders are at risk for early reading problems. Table 2 displays the means and standard deviations for the measures of early reading achievement for the PD and PN groups. Analysis of variance (ANOVA) indicated that the PD group performed significantly less well than the PN group on the Word Identification subtest (F = 16.25, df = 1, 55, p < .001) and Word Attack subtest (F = 18.88, df = 1, 55, p < .001). Table 2 also displays the group means and standard deviations for the composite reading score. Again, ANOVA showed that the PD group had a significantly lower composite score than did the PN group (F = 31.3, df = 1, 55, p < .001). Although children in the PD group on average had a poorer reading outcome than did children in the normal group, some children in the PD group had more difficulties in reading than did others. To investigate the variables that may be related to reading outcome, children with expressive phonological disorders were divided into those with poor reading outcome and those with good outcome in first grade. For the purpose of this study, a poor outcome was defined as a composite reading score of ≤ 85 (at least 1 SD below the mean). Children with expressive phonological disorders who had a composite score of > 85 were considered to have a good outcome. Of the 30 participants in the PD group, 18 had a poor outcome and 12 had a good outcome. Table 3 shows means and standard deviations of the reading outcome subgroups on the AAPS (AAPS-PCC) and the multisyllabic word and nonword repetition (MULTI-PCC), phonological awareness (PA), and language (LANG) measures. An ANOVA indicated that subgroups differed significantly on each of these variables except AAPS-PCC. Children with a poor outcome in reading had more severe expressive phonological disorders (as measured by MULTI-PCC), poorer phonological awareness, and poorer language skills in kindergarten than those with a good outcome. TABLE 2. Means and standard deviations for PD (N = 30) and PN (N = 27) groups in first grade on reading measures. PD

Results In this study, three sets of data analyses were performed. In the first analysis, we compared children with expressive phonological disorders to children with normal phonological development to determine if the presence of expressive phonological disorders in kindergarten is associated with an increased risk for early reading disabilities. In a second set of analyses, children with phonological disorders were divided into those with good and poor reading outcomes at the end of first grade, and comparisons were made between groups on expressive phonologi122

Word Identification Word Attack Word Recognition Composite

PN

M

SD

M

SD

89.13 80.97

15.23 12.99

110.04 97.59

23.45 15.88

85.05

13.07

103.81

19.20

Note. Word Identification = Word Identification subtest of the Woodcock Reading Mastery Test–Revised; Word Attack = Word Attack subtest of the Woodcock Reading Mastery Test–Revised; Word Recognition Composite = average of Word Identification and Word Attack.


TABLE 3. Means, standard deviations, and F values for PD poor readers (N = 16) and PD good readers (N = 14) on expressive phonology, language, reading, and phonological awareness measures. PD Poor Readers

M AAPS-PCC MULTI-PCC PA LANG

PD Good Readers

SD

.62 .47 4.78 81.78

.20 .16 1.04 8.84

M

SD

F

.71 .62 6.11 89.01

.12 .13 1.48 10.40

2.26 8.35** 10.85* 4.24**

Note. AAPS-PCC = percentage consonant correct on the Arizona Articulation Proficiency Scale; MULTI-PCC = percentage consonant correct on the multisyllabic lists; PA = phonological awareness composite score; LANG = average of PPVT-R, Token Test for Children, TOLD:P sentence imitation; EOWPVT-R, TOLD:P grammatical completion, and TOLD:P grammatical understanding. *p < .01 **p < .05

Hierarchical multiple regression analyses were performed to further investigate the relationship between firstgrade reading achievement and kindergarten measures of expressive phonology, language, and phonological awareness (Table 4). These analyses allowed us to examine the combined and independent contributions of kindergarten measures in predicting variability in reading achievement. Because we were most interested in reading achievement among children in the PD group, regression analyses were TABLE 4. R 2 change in fixed-order multiple-regression analyses for first-grade early reading achievement in PD children. WI

WA

Steps in Regression

AAPS

MULTI

1. PCC 2. PA 3. LANG

.23* .16 .02

1. PA 2. PCC 3. LANG 1. LANG 2. PA 3. PCC

AAPS

MULTI

.43* .06 .02

.16** .19* .04

.32** .08 .03

.36* .03 .02

.36* .13** .02

.34* .01 .04

.34* .07 .03

.03 .34* .03

.03 .34* .14*

.20** .19** .00

.20** .19** .05

Note. WI = Word Identification subtest of the Woodcock Reading Mastery Test–Revised; WA = Word Attack subtest of the Woodcock Reading Mastery Test–Revised; PCC = percentage consonant correct of either the Arizona Articulation Proficiency Scale (AAPS) or the multisyllabic lists (MULTI) as listed at the head of the column; LANG = average of PPVT-R, Token Test for Children, TOLD:P sentence imitation; EOWPVT-R, TOLD:P grammatical completion, and TOLD:P grammatical understanding; PA = phonological awareness composite score. *p < .01 **p < .05

carried out using the data from the participants in this group. Analyses were performed separately for the Word Identification and Word Attack subtests. Measures of expressive phonology, phonological awareness (PA), and language (LANG) were entered into the regression analyses in several predetermined orders. Because we were particularly interested in the relationship between expressive phonology and reading, we examined this relationship individually for the AAPS (AAPS-PCC) and the multisyllabic word and nonword repetition tasks (MULTI-PCC). Hierarchical multiple regression analyses indicated that that the MULTI-PCC measure accounted for more variance in the reading measures than did AAPS-PCC. MULTIPCC accounted for 43% of the variance in Word Identification and 32% of the variance in Word Attack when entered as the first variable in the regression analysis. Also, MULTI-PCC, and not AAPS-PCC, accounted for significant independent variance in reading (at least in Word Identification) when it was entered after PA and LANG. The phonological awareness composite score also explained much variance in reading achievement. However, this variance was, for the most part, shared with MULTIPCC, and PA did not explain a significant amount of unique variance. Finally, although the language composite score was found to be related to Word Attack, it also did not explain significant independent variance in reading achievement.

Discussion The purpose of this study was to examine the relationship between expressive phonological disorders and early reading achievement. Initially, this relationship was investigated by comparing the first-grade word-recognition abilities of children with expressive phonological disorders (PD group) to children developing typically (PN group). Results indicated that, as a whole, the PD group scored significantly less well on tests of word recognition than did the PN group. On average, children with expressive phonological disorders scored approximately 1 SD below normal control children on measures of word recognition in first grade. These results suggest that children with expressive phonological disorders in kindergarten are at risk for reading problems measurable as early as the end of first grade. Although the children with expressive phonological disorders performed poorly as a group in first grade reading achievement, there were many individual differences. To investigate these individual differences, we examined the relationship between early reading achievement and expressive phonology, language, and phonological awareness abilities using two approaches. First, we separated children in the PD group into those with good and poor reading outcomes and compared these subgroups on expressive phonology, language, and phonological awareness abilities. Children with expressive phonological disorders with poor reading outcomes were found to have more severe expressive phonological disorders as measured by the MULTI-PCC, poorer phonological awareness, and poorer language skills than did children in the good Larrivee & Catts: Early Reading

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reading outcome group. Second, hierarchical multiple regression was used to further investigate the relationship between these variables. These analyses indicated that expressive phonology (as measured by MULTI-PCC) and phonological awareness in kindergarten accounted for significant amounts of variance in first-grade reading achievement. These results provide support for a relationship between expressive phonological ability and early reading achievement. An important finding of this study, however, was that the strength of this relationship depended on the way in which we measured expressive phonology. Hierarchical multiple regression analyses indicated that reading achievement was more highly related to expressive phonology when the latter was measured in terms of a multisyllabic word and nonword repetition task (MULTI-PCC) than when measured by the Arizona Articulation Proficiency Scales (AAPS-PCC). In addition, MULTI-PCC accounted for independent variance in reading achievement, but this was not the case for AAPS-PCC. Finally, reading outcome subgroups did not differ significantly on the AAPS-PCC but differed significantly on the MULTI-PCC. Other investigations that have used articulation tasks that employ relatively simple words like the AAPS also have frequently reported a limited relationship between expressive phonology and reading achievement. For example, Catts (1993) found that children’s expressive phonological ability, as measured in kindergarten by the Goldman-Fristoe Test of Articulation (Goldman & Fristoe, 1986), was unrelated to first- and second-grade reading achievement. Bird et al. (1995) also used a measure of articulation ability that, from its brief description, appears to measure production of primarily single-syllable words. As noted earlier, when this articulation test initially was used to measure children’s expressive phonology (M = 67 months), it differentiated subsequent reading outcome groups. However, when children were of comparable ages to those in the present study (M = 75 months), this measure did not differentiate good and poor reading outcome groups. Perhaps tests involving primarily one- and two-syllable words administered at the end of kindergarten do not show a relationship to reading achievement because by this time these tests are limited in their ability to capture subtle differences in some children’s phonological abilities. On the other hand, tasks involving phonologically complex words may be more sensitive to individual differences in phonological abilities. Lewis and Freebairn (1992) found that a multisyllabic word production task served to identify residual phonology problems in school-age, adolescent, and adult normal speakers with a history of preschool speech and language problems, whereas a standardized test involving primarily single-syllable words failed to uncover these problems. These findings suggest that multisyllabic word tasks may be particularly useful in identifying individual differences in the phonological abilities of both children and adults. Furthermore, it may be these differences that are related to early reading achievement. We will return to this issue later in the discussion. Several previous studies have suggested that children with expressive phonological disorders are most at risk for 124

reading disabilities if they have accompanying language impairments (Bishop & Adams, 1990; Catts, 1993; Lewis & Freebairn, 1992). The findings from the present study provided only limited support for this conclusion. Hierarchical multiple regression analyses indicated that our composite measure of language ability was unrelated to Word Identification and only weakly related to Word Attack. Furthermore, the relationship of language ability to Word Attack was not independent of the other variables (i.e., expressive phonology and phonological awareness). We did, however, find a small but significant difference in the language ability of children with good and poor reading outcomes. Children with poor reading outcomes performed less well on tests of language ability than did those with good outcomes. The difference between this study and those that have shown a stronger relationship between language ability and reading may, in part, be due to subject selection. Unlike some previous studies (e.g., Bishop & Adams, 1990; Catts, 1993), the participants in our investigation were chosen primarily on the basis of their expressive phonological disorders. Although many of these children had language impairments, the range of severity of these impairments may not have been as large as that of previous studies. Clearly, studies that have selected children on the basis of language impairments have shown a strong relationship between these impairments and reading disabilities (Bishop & Adams, 1990; Catts, 1993; Stark et al., 1984). Another possible factor that may have been related to our findings concerning language ability is that we examined early reading achievement in terms of word recognition rather than in terms of reading comprehension. Whereas language ability may influence word recognition, this ability is more closely related to reading comprehension (Bishop & Adams, 1990; Catts, 1993; Catts, Fey, Zhang, & Tomblin, in press). Our results also showed that phonological awareness was related to reading achievement in children with expressive phonological disorders. Children in the PD group who had good reading outcomes performed significantly better on our composite measure of phonological awareness than did those who had poor reading outcomes. Regression analyses further indicated that phonological awareness was strongly related to Word Identification (r = .60) and Word Attack (r = .58). These findings concerning phonological awareness are consistent with previous studies that have shown that phonological awareness in kindergarten children is a good predictor of reading achievement in the early school grades (e.g., Bradley & Bryant, 1985; Catts, 1991, 1993; Catts et al., in press; Lundberg et al., 1980; Mann & Liberman, 1984; Torgesen et al., 1994). Whereas phonological awareness was found to be related to early reading achievement, the variance it accounted for in reading was not independent of variance accounted for by expressive phonology when the latter was measured by MULTI-PCC. In fact, there was much overlap in the variance explained by the phonological awareness measures and the MULTI-PCC task. These measures jointly accounted for 30% of the variance on the Word Identification subtest and 25% on the Word Attack subtest. The overlap between MULTI-PCC and phonological


awareness in accounting for the variability in early reading achievement suggests that these tasks, in part, may tap a common factor. Other research suggests this factor may reflect the quality of children’s underlying phonological representations. Recently, it has been proposed that problems in phonological awareness may be due to deficiencies in the speech sound codes (e.g., underlying representations) of words in the lexicon (Elbro, 1996; Fowler, 1991). A number of recent investigations have provided some support for this link (Catts, Wilcox, WoodJackson, Larrivee, & Scott, 1997; Elbro, Nielsen, & Peterson, 1994; McBride-Chang, 1995; Snowling, Hulme, Smith, & Thomas, 1994; Swan & Goswami, 1997). In one such investigation, Swan and Goswami (1997) measured the precision of children’s underlying phonological representations by having children name pictured objects. They then compared children’s abilities to segment words that were named in a phonologically accurate manner (i.e., had accurate phonological representations) to the segmentation of words that were phonologically less accurate. They found that children performed significantly better when segmenting words with accurate phonological representations than with words with inaccurate representations. They concluded that phonological analysis skills rest, in part, on the accuracy and segmental organization of the underlying representations of the words being segmented. Some speech production tasks, such as MULTI-PCC, may measure the quality of phonological representations. To correctly repeat the stimulus words in the MULTI-PCC task, most of which are novel to young children, participants must perceive and encode the speech sound components of these words. Problems in this process can result in imprecise or incomplete phonological representations and subsequent errors in production. As an illustration of this point, Kamhi, Catts, and Mauer (1990) showed that poor readers who misproduced novel multisyllabic words often did not recognize these words correctly in subsequent testing. Misproduced words were frequently confused with words reflecting the children’s speech production errors. Furthermore, once children were trained to recognize stimulus words, they generally repeated them correctly. Perhaps some of the children with expressive phonological disorders in our study had difficulty representing the phonological structure of words in memory, and it was this difficulty that was being tapped by both the MULTIPCC and phonological awareness tasks. Although there has been much debate concerning the cause of expressive phonological disorders in children, problems in the quality of phonological representations appear to play at least some causal role in these disorders (Broen, Strange, Doyle, & Heller, 1983; Hoffman, Daniloff, Bengoa, & Schuckers, 1985; Jamieson & Rvachew, 1992; McGregor & Schwartz, 1992; Rvachew, 1994; Rvachew & Jamieson, 1989). In a series of studies, Rvachew and Jamieson investigated the relationship between speech production and perception in children with expressive phonological disorders. Rvachew and Jamieson (1989) showed that a subgroup of children with expressive phonological disorders had difficulty making phonemic distinctions related to some of their error

sounds. In follow-up investigations (Jamieson & Rvachew, 1992; Rvachew, 1994), children with expressive phonological disorders were taught to recognize distinctions between phonemes (e.g., improve their phonological representations) and were subsequently found to improve in their production of related words. These results suggest that some children with expressive phonological disorders may have problems developing phonological representations that, in turn, influence their expressive phonological abilities. Although there was overlap between children’s performance on phonological awareness measures and the MULTI-PCC task, we found that the MULTI-PCC measure, and not the phonological awareness composite score, accounted for independent variance in reading (measured by the Word Identification task) in children with expressive phonological disorders. The MULTI-PCC measure differs from the phonological awareness measures in that it has a much greater speech production component (Apthrope, 1995; Catts, 1989). Consequently, it might be argued that children with expressive phonological disorders also vary in speech output skills and it is this variability that is uniquely related to early reading achievement. Such a proposal seems unlikely, however, if by speech output we are referring to speech motor skills. Research clearly shows that even children with extreme speech motor deficits may learn to read with few problems (Stackhouse, 1982). More likely, children’s performance on the MULTI-PCC task is a reflection of more abstract phonological knowledge or abilities associated with speech production, and it is the latter that is related to reading achievement. In fact, it may be that the MULTI-PCC measure is just a more sensitive measure of variability in the quality of children’s underlying phonological representations than are measures of phonological awareness, at least within children with expressive phonological disorders. Future studies that examine these variables in combination with expressive phonological disorders could help clarify this relationship.

Clinical Implications Increasingly, researchers and practitioners have become concerned with the early identification of reading disabilities (Catts, 1991; Padget, 1988). The results of the present study suggest that problems in expressive phonology may serve as an early sign of potential reading disabilities. Expressive phonological disorders in preschool and kindergarten children are often quite observable. Speechlanguage pathologists can play a role in helping to identify children who are at risk for future reading disabilities. Some variables appear to be associated with an increased risk for failure in reading acquisition in children with expressive phonological disorders in kindergarten. The first of these variables is severity of the expressive phonological disorder. Our study indicates that severity may not be evident on a typical test for articulation that examines phonemes in noncomplex, well-known words. Tests involving more phonologically complex words may be necessary to aid in identification of less obvious but persistent expressive phonological disorders. Larrivee & Catts: Early Reading

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The second variable that increases risk for failure in reading acquisition is phonological awareness. Numerous assessment materials are currently available to measure phonological awareness (e.g., Lindamood & Lindamood, 1979; Torgesen & Bryant, 1994). Speech-language pathologists should become familiar with these materials and incorporate them into early assessments of children who exhibit speech and/or language deficits. The last variable identified in this study as increasing the risk for failure in reading acquisition in children with expressive phonological disorders is an accompanying language deficit. Although our study provides only limited support for a relationship between language deficits and reading problems, numerous other studies have shown a link between these problems (e.g., Bishop & Adams, 1990; Catts, 1993; Lewis & Freebairn, 1992; Magnusson & Naucler, 1993). Therefore, all aspects of children’s speech and/or language problems need to be considered when making decisions regarding the possibility of future reading problems. Once identified, children at risk for reading disabilities need intervention. Many children with expressive phonological disorders will receive intervention directed toward their articulation problems. Many of these interventions include sound awareness activities and other activities that may help improve children’s underlying phonological representations (see Hodson, 1994, for a review). Therefore, these types of interventions may in part reduce the risk of reading failure. It is likely, however, that children with expressive phonological disorders would benefit from further participation in intervention activities aimed at laying the groundwork for later reading acquisition. In preschool, this may involve activities to heighten phonological awareness, letter knowledge, and literacy experience. Programs are available to guide speech-language pathologists in developing clinical materials (e.g., Adams, Foorman, Lundberg, & Beeler, 1998; Catts & Vartiainen, 1993; Notari-Syverson, O’Connor, & Vadasy, 1998). For older children with expressive phonological disorders, intervention should target explicit phonological awareness training and development of sound-letter correspondence skills. Programs for development of these early literacy skills are also available (e.g., Lindamood & Lindamood, 1998; O’Connor, Notari-Syverson, & Vadasy, 1998). Because many children with expressive phonological disorders have other accompanying language problems, these problems also will need to be addressed to reduce the likelihood of problems with reading decoding and comprehension (Fey, Catts, & Larrivee, 1995).

Acknowledgments We are grateful to C. Melanie Schuele and Judith Goodman for their helpful comments on a previous draft of this paper. We appreciate the assistance of Alan J. Larrivee with graphics for the stimuli. Finally, we wish to acknowledge the generous help of speech-language pathologists and teachers of the Lawrence, Topeka, and Baldwin, Kansas Public Schools for their assistance in identifying participants and to the children and parents for participating in this project.

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Newcomer, P. L., & Hammill, D. D. (1988). Test of Language Development–2: Primary. Austin, TX: Pro-Ed. Notari-Syverson, A., O’Connor, R. E., & Vadasy, P. F. (1998). Ladders to literacy: A preschool activity book. Baltimore: Paul H. Brookes. O’Connor, R. E., Notari-Syverson, A., & Vadasy, P. F. (1998). Ladders to literacy: A kindergarten activity book. Baltimore: Paul H. Brookes. Padget, Y. (1988). Speech- and language-impaired three- and four-year-olds: A five year follow-up study. In R. Masland & M. Masland (Eds.), Preschool prevention of reading failure. Parkton, MD: York. Rvachew, S. (1994). Speech perception training can facilitate sound production learning. Journal of Speech and Hearing Research, 37, 347–357. Rvachew, S., & Jamieson, D. G. (1989). Perception of voiceless fricatives by children with a functional articulation disorder. Journal of Speech and Hearing Disorders, 54, 193–208. Share, D. L., & Stanovich, K. E. (1995). Cognitive processes in early reading development: Accommodating individual differences into a model of acquisition. Issues in Education, 1, 1–57. Shriberg, L. D., & Kwiatkowski, J. (1982). Phonological disorders III: A procedure for assessing severity of involvement. Journal of Speech and Hearing Disorders, 47, 256–270. Snowling, M. J., Hulme, C., Smith, A., & Thomas, J. (1994). The effects of phonetic similarity and list length on children’s sound categorization performance. Journal of Experimental Child Psychology, 58, 160–180. Stackhouse, J. (1982). An investigation of reading and spelling performance in speech disordered children. British Journal of Disorder of Communication, 17, 53–60. Stanovich, K. E., Cunningham, A., & Cramer, B. (1984). Assessing phonological awareness in kindergarten children: Issues of task comparability. Journal of Experimental Child Psychology, 38, 175–190. Stark, R. E., Bernstein, L., Condino, R., Bender, M., Tallal, P., & Catts, H. (1984). Four-year follow-up study of language impaired children. Annals of Dyslexia, 34, 49–68. Swan, D., & Goswami, U. (1997). Phonological awareness deficits in developmental dyslexia and the phonological representations hypothesis. Journal of Experimental Child Psychology, 66, 18–41. Torgesen, J. K., & Bryant, P. (1994). Test of Phonological Awareness. Austin, TX: Pro-Ed. Torgesen, J. K., Wagner, R. K., & Rashotte, C. A. (1994). Longitudinal studies of phonological processing and reading. Journal of Learning Disabilities, 27, 276–286. Tunmer, W. E., & Nesdale, A. R. (1985). Phonemic segmentation skill and beginning reading. Journal of Educational Psychology, 77, 417–427. Webster, P. E., & Plante, A. S. (1992). Effects of phonological impairment on word, syllable, and phoneme segmentation and reading. Language, Speech, and Hearing Services in Schools, 23, 176–182. Woodcock, R. W. (1987). Woodcock Reading Mastery Tests– Revised. Circle Pines, MN: American Guidance Service. Yopp, H. K. (1988). The validity and reliability of phonemic awareness tests. Reading Research Quarterly, 23, 159–177. Received October 10, 1998 Accepted January 5, 1999 Contact author: Linda S. Larrivee, University of Missouri– Columbia, Department of Communication Science and Disorders, 303 Lewis Hall, Columbia, MO 65211. Email: [email protected]. Larrivee & Catts: Early Reading

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Appendix A Multisyllabic Words and Nonwords Multisyllabic Words animal hospital spaghetti kindergarten thermometer probably aluminum specific vegetables colorado

Nonwords /sœpEkEl/ /fEdISEs/ /gEdœkIk/ /dEsIbEs/ /tSEfAstItS/ /SEbœfEdi/ /mœnEmEn/ /sEkIsIp/ /fœTEsIs/ /trIbEbli/

Appendix B Phonological Awareness Tasks Syllable Segmentation

Blending

Test items:

Test items:

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

apple (2) house (1) daffodil (3) bubble (2) secret (2) shoe (1) valentine (3) computer (3) happy (2) lollipop (3) cheese (1) boat (1)

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Oddity

Sound Isolation

Test items: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.

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net cheese tag gate fan chain gas nine bone sock duck fish cake jeep hat bed

fish (fan, dish, fish) cheese (cheese, check, knees) ship (chip, ship, shell) thumb (thumb, sun, thief) mouse (mouse, house, mouth) face (feet, vase, face) fan (van, fan, face) sun (sub, gun, sun) jet (jet, net, jam) night (light, night, nine) kite (kite, bike, coat) coat (cap, coat, boat) pot (pig, knot, pot)

nose mop ten sun thumb cheese fish mouse boot thumb sheep van pot jug nine book

pig moon cup soap five ship gum nut shell thief dog foot pig fan house pin

Test items: 1. Do you hear /n/ in nose 2. Do you hear /m/ in dime 3. Do you hear /t/ in rake 4. Do you hear /k/ in cat 5. Do you hear /s/ in zoo 6. Do you hear /f/ in knife 7. Do you hear /s/ in soup 8. Do you hear /t/ in tail 9. Do you hear /k/ in gate 10. Do you hear /f/ in thin 11. Do you hear /s/ in bus 12. Do you hear /f/ in fork 13. Do you hear /tS/ in fish 14. Do you hear /k/ in sack 15. Do you hear /m/ in rain


(yes) (yes) yes (yes) yes (yes) (yes) (yes) yes yes (yes) (yes) yes (yes) yes

no no (no) no (no) no no no (no) (no) no no (no) no (no)