Journal of Communication Disorders 49 (2014) 1–12

Contents lists available at ScienceDirect

Journal of Communication Disorders

Fricatives at 18 months as a measure for predicting vocabulary

and grammar at 24 and 30 months
Carolyn D. Sotto a,*, Erin Redle b, Dakshika Bandaranayake c,
Jean Neils-Strunjas d, Nancy A. Creaghead c
a
The University of Cincinnati, Department of Communication Sciences & Disorders, 3202 Eden Avenue #340, Cincinnati, OH 45267-0379,
United States
b
Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, United States
c
The University of Cincinnati, Cincinnati, OH, United States
d
Armstrong Atlantic State University, Savannah, GA, United States

A R T I C L E I N F O A B S T R A C T

Article history: Purpose: Language develops at variable rates in young children, yet markers for different
Received 19 June 2013 developmental trajectories, have not been identified. Production of fricatives in words
Received in revised form 24 January 2014 may be one marker because they are later developing sounds and contribute to syntactic
Accepted 9 February 2014 production. We examined whether children who produced fricatives in words by 18
Available online 22 February 2014 months had better vocabulary and grammar scores at 18, 24, and 30 months than children
who did not.
Keywords: Method: The expressive language skills of 37 toddlers who did and did not produce
Fricatives
fricatives in words by 18 months of age were compared at 18, 24 and 30 months of age.
Speech and language development
Results: Expressive vocabulary scores and the use of grammatical markers were
Vocabulary
Toddler
significantly better for children who produced fricatives by 18 months than for those
who did not. This effect was consistent across scores at 18, 24, and 30 months. The total
number of consonants and total number of fricatives produced at 18 months did not
significantly predict expressive vocabulary scores.
Conclusions: Because the children who produced fricatives by 18 months demonstrated
better expressive language skills than their peers who did not produce fricatives by 18
months, the early production of fricatives by toddlers may be a marker of a faster
expressive language developmental trajectory.
Learning outcomes: Readers will: (1) describe the relationship between early
phonological development and early expressive lexical development, (2) describe the role
of perceptual and motor development in speech sound the acquisition, and (3) describe the
potential relationship between the production of fricatives and expressive language
development.
ß 2014 Elsevier Inc. All rights reserved.

Early and accurate identification of language impairment is critical for children’s social, emotional and academic
development. There is abundant research regarding the negative effects of language impairment on literacy and school
success and the need for early intervention to assure that children are prepared for school (Aram & Nation, 1980; Brinton &
Fujiki, 2004; Catts, 1993; Catts, Fey, Zhang & Tomblin, 1999; Hall & Tomblin, 1978). Early markers that identify children who

* Corresponding author. Tel.: +1 513 558 8528.

E-mail address: sottocd@ucmail.uc.edu (C.D. Sotto).

http://dx.doi.org/10.1016/j.jcomdis.2014.02.003
0021-9924/ß 2014 Elsevier Inc. All rights reserved.
2 C.D. Sotto et al. / Journal of Communication Disorders 49 (2014) 1–12

may be at risk for a delayed or disordered trajectory of expressive language and markers that differentiate late talkers from
those who will require services for language delay are thus highly important.
The rate and pattern of speech and language development is highly variable among young children (Bernthal, Bankson,
& Flipsen, 2013; Sander, 1972; Smit, 1986). To be most useful, it is important that early markers be easily identifiable by
the various professionals who assess the development of young children. Predictors of language development that have
been identified as relevant at or before 18 months include: joint attention (Brooks & Meltzhoff, 2005; Watt, Wetherby, &
Shumway, 2006), play (Rescorla & Goossens, 1992; Watt et al., 2006; Weismer, Murray-Brance, & Miller, 1994),
comprehension (Buschmann et al., 2009; Thal, Tobias, & Morrison, 1991; Watt et al., 2006), vocabulary (Rescorla &
Schwartz, 1990; Rice & Bode, 1993; Weismer et al., 1994), word combinations (Rescorla & Schwartz, 1990), gesture
development (Thal & Tobias, 1992, 1994; Watt et al., 2006), and speech development (Kuhl et al., 2008; McCune &
Vihman, 2001; Mirak & Rescorla, 1998; Oller, Eilers, Neal, & Schwartz, 1999). Indicators of speech and language
developmental trajectories related specifically to speech include early speech perception skills (Kuhl et al., 2008), age of
onset of canonical babbling (Oller et al., 1999), number of phonemes available in the repertoire (McCune & Vihman,
2001), diversity of the consonant inventories and syllable shapes in early vocalizations (McCune & Vihman, 2001;
Rescorla & Ratner, 1996), and the relationship among these variables (Whitehurst, Smith, Fischel, Arnold, & Lonigan,
1991). Collectively, these indicators have been identified as markers to assist with the identification of children who are
at risk for expressive language delay, but many of them require extensive periods of observation or advanced training in
speech and language analysis. The identification of indicators of language development which are readily identifiable
without extensive training and/or testing could assist speech-language pathologists and other professionals in
determining the potential course of language development.
Fricatives may give us a novel framework for looking at the expressive language trajectory of an individual child.
Developmental data suggests that this class of sounds is mastered later in development (Goldman, Fristoe, & Williams, 2000;
Ingram, Christensen, Veach, & Webster, 1980; Shriberg, 1993) and this is believed to be because these sounds are
phonologically more marked, require greater perceptual skills, and greater motor coordination (Ferguson, 1978; Ingram,
1976; Kent, 1992). Current research shows that the phonological, perceptual, and motor systems interact closely to form a
foundation for early speech and language development (Kent, 2000; Kuhl, Conboy, Padden, Nelson, & Pruitt, 2005; Rescorla &
Ratner, 1996). The ability to produce a fricative in a meaningful way at an early age may represent a minimum competence
across the perceptual, motor, and linguistic systems that can positively influence the child’s further acquisition of the
linguistic system, including the lexicon and morphosyntax (Davis & MacNeilage, 1995; Gildersleeve-Neumann, Davis, &
MacNeilage, 2000; Kent, 2000; Moeller et al., 2007; Nittrouer, 2002).
Perceptual and motor maturation appear to have a role in children’s relatively late acquisition of fricatives (Faber and
Best, 1994). Children’s ability to perceive fricatives matures or modifies with age (Nittrouer, 2002; Wagner, Ernestus, &
Cutler, 2006). The reported later development of fricatives in speech production may reflect differences in the perceptual
characteristics of fricatives compared to other phonemes (Faber & Best, 1994; Kuhl, 1994, 2000, 2004; Kuhl et al., 2008;
Werker & Tees, 1984). Fricative sounds are more difficult to parse from the speech stream as they are produced at a higher
frequency with less intensity than other classes of sounds (Ferguson, 1978). Fricative production requires more precise
motor control than the early developing sound classes, stops, nasals and glides (Kent & Murray, 1982). Accurate fricative
production requires not only the precise placement of the tongue, but also an additional synchrony of all independent
articulators to produce the force and control and the degree of movement needed to generate the noisy turbulence that
characterizes fricatives (Kent, 1992). Children with more advanced motor control for word production may produce words
earlier than peers without the same level of control (Hoff & Parra, 2011).
From a linguistic viewpoint, markedness is considered a factor in the sequence of sound acquisition (Jakobson, 1968).
Fricatives are considered more complex or more marked than stops, nasals, and glides. A natural constraint against
production of fricatives, which are marked sounds, is related to their less frequent representation in languages although
fricatives are frequent in English (Ingram, 1976; Shriberg & Kwiatkowski, 1980). They also appear later in the child’s phonetic
repertoire (Barlow & Gierut, 1999; Ingram et al., 1980). Given that fricatives are more complex than other early developing
sounds (stops, nasals, glides), their acquisition indicates greater phonological knowledge. The child’s acquisition of these
more complex sounds can suggest that the child’s system is primed to acquire the more complex sound combinations
required for production of words and sentences. Accurate production of fricatives may also support the production of some
grammatical morphemes (plurals, possessives and verb forms) because they are realized by the /s/ and /z/ phonemes. Given
that standardized expressive language measures (Wiig, Secord, & Semel, 2004) require a child to produce these responses,
interpretation can be more accurate when a child’s post-vocalic phonetic inventory includes /s/ and /z/ (Brown, 1973;
Petinou, Schwartz, Gravel, & Raphael, 2001).
The relationship between early phonological development and early expressive lexical development has been described
by several researchers (Schwartz & Leonard, 1982; Stoel-Gammon, 1991, 2011). Production of a new word requires semantic
knowledge as well as an awareness of the articulatory movements required for that word’s production (Stoel-Gammon,
2011). Word learning is related to phonological development during early language acquisition; children are more likely to
attempt to imitate and spontaneously produce words containing phonemes already within their repertoire (Paul & Jennings,
1992; Stoel-Gammon, 1991; Vihman & Greenlee, 1987). Schwartz & Leonard (1982) found that word learning prior to 18
months is related to the presence or absence of the phonemes included in the words, and Stoel-Gammon (1998) found that
these general patterns of development continue beyond the early word learning period. Overall, toddlers with expressive
 C.D. Sotto et al. / Journal of Communication Disorders 49 (2014) 1–12 3

Table 1
Fricative status, mean total number of consonants and mean total number of fricatives at 18 months for 37 subjects.

Subject Fric (+/ ) Consonant repertoire Total Total Pre-vocalic Inter-vocalic Post-vocalic
consonants fricatives fricatives fricatives fricatives

1M + /p, b, t, d, k, w, j, n, s, R/ 10 2 /s, R/ – /R/

2M – 0 0 – – –
3F + /b, d, k, g, w, j, m, l, f, v, s, R/ 12 4 /f, v, s, R/ – /f/
4M + /b, d, k, g, m, h, f, s, R, ./ 10 4 /R, ./ – /f, s/
5F + /p, b, t, d, k, w, j, m, h, f, s, z, R, tR/ 14 5 /f, s, z, R, tR/ – /f, s, R/
6F + /p, t, d, m, n, h, s, R, / 9 3 /s, R, / – /s/
7M + /b, t, d, k, g, r, s, z, R, , tR/ 11 5 /s, z, , tR/ – /s, R/
8F + /p, b, t, d, g, j, m, h, s, z, R/ 11 3 /R/ – /s, z/
9F + /p, b, d, m, f, R/ 6 2 /f, R/ – /f, R/
10M + /p, t, d, j, m, n, h, f, s, R/ 10 3 /s/ – /f, s, R/
11M + /p, b, t, d, w, j, n, r, s, z, R, ð, tR/ 13 5 /s, R, ð, tR/ – /s, z, R/
12M + /p, b, t, d, w, j, n, r, s, z, R, ð, tR/ 13 5 /s, R, ð, tR/ – /s, z, R/
13F + /p, b, t, d, g, m, r, h, f, s, R, a/ 12 4 /f, s, R/ /a/ /f, s, R/
14F + /p, b, t, d, g, m, r, h, f, s, R, a/ 12 4 /f, s, R/ /a/ /f, s, R/
15F /p, b, t, d, k, m, n/ 7 0 – – –
16M + /b, t, d, k, g, j, m, l, r, f, s, z, R, ./ 14 5 /s, z, R, ./ – /f, s/
17M + /b, t, d, k, g, m, n, l, r, f, s, z, R, ./ 14 5 /f, s, z, ./ – /s, R/
18M /p, d, g, j, n/ 5 0 – – –
19F /p, b, t, d, g, n/ 6 0 – – –
20M /d/ 1 0 – – –
21F + /p, b, t, d, g, j, h, s, R, tR, ./ 11 4 /tR, ./ – /s, R/
22M /t, d, g, m, n/ 5 0 – – –
23M /b, t, d, m, n, h/ 6 0 – – –
24M /t, d, n, h/ 4 0 – – –
25F /b, d, g, m, n/ 5 0 – – –
26M /b, d, m/ 3 0 – – –
27M + /p, b, t, d, w, f, s/ 7 2 – – /f, s/
28F + /p, b, t, d, k, m, n, h, s, z, R, ./ 12 4 /R, ./ – /s, z, R/
29F + /p, b, d, k, g, w, m, f, R/ 9 2 – – /f, R/
30F + /b, t, d, w, n, h, f, s, z, R/ 10 4 /f, z, R/ – /s/
31M /b, t, d, g, w, h/ 6 0 – – –
32F + /b, t, d, k, g, l, h, s, R/ 9 2 – /R/ /s, R/
33F + /p, b, d, k, g, w, m, n, f, s/ 10 2 – – /f, s/
34M /b, t, d, w, m, n/ 6 0 – – –
35F + /p, t, d, k, n, l, s/ 7 1 /s/ – /s/
36M + /p, b, t, d, k, n, s, z/ 8 2 /s, z/ – /s, z/
37M + /p, b, d, n, f, s/ 6 2 – /s/ /f/

Fig. 1. Comparison of MBCDI: WS expressive vocabulary raw scores by fricative group and age.

language delay have been shown to exhibit smaller phonetic repertoires and less complex syllable shapes than typical peers
(Paul & Jennings, 1992; Rescorla & Ratner, 1996). Conversely, children with larger vocabularies also tend to have larger
(Stoel-Gammon & Dale, 1988, as cited in Stoel-Gammon, 2011) and more accurate phonemic repertoires (Smith, McGregor, &
Demille, 2006). Additionally, children’s phonological memory is greater for phonemes they are able to produce (Gathercole,
2006; Storkel & Morrisette, 2002), also enhancing language learning. Children who do produce fricatives during early word
learning may have the potential for greater growth in both short and long term vocabulary development.
The above evidence demonstrates a relationship between speech sound development and language development, but the
specific relationship between speech sound development and word production has been studied in regard to only a limited
number of sound classes. There may also be clinical utility in examining the relationship between specific phonemes/sound
classes in the phonetic repertoire and early expressive language skills (Smith et al., 2006). The established phonological
4 C.D. Sotto et al. / Journal of Communication Disorders 49 (2014) 1–12

system may also enhance the development of vocabulary and other language skills through clear communication exchanges
and the ability to attach referents to phonetic forms (McCune & Vihman, 2001); however, the relationship between specific
phonemes or classes of phonemes, such as fricatives, and the subsequent trajectory of expressive language is currently
unknown.
The purpose of this exploratory study was to determine if the production of fricatives in words may be a reliable indicator
of a faster rate of expressive language development. The expressive language skills of young children as measured by the
MacArthur-Bates Communicative Development Inventories: Words & Sentences (MBCDI: WS) (Fenson et al., 2000, 1993)
who did and did not produce fricatives were compared over time through multiple assessments. The research question was:
Is there a significant difference between the expressive language skills of children who do and do not produce fricatives prior to or at
18 months of age? We hypothesized that the expressive language skills of children who produced fricatives early should be
significantly more advanced than those who did not.

1. Methods

1.1. Participants

A total of 37 typically developing toddlers (17 females, 20 males) participated in the study. Children entered the study
between 9 and 12 months of age and remained until the age of 30 months. A phone screening was completed when children
were between 6 and 9 months to determine if they met the inclusion/exclusion criteria prior to enrollment. Exclusion criteria
included the presence of a communication or developmental delay, hearing loss, chronic medical condition, or primary
language other than English as reported by the parent or identified by the pediatrician. All participating children underwent
an audiological evaluation including otoscopic examination and standard behavioral audiometric testing within 3 months of
enrollment. Thirty-five of the children were of Caucasian descent and two were of Asian descent. Maternal education and
socio-economic status was not directly assessed but US Census data (United-States-Census-Bureau, 2000) were used to
determine that all children lived in ZIP codes with median household incomes above the threshold for poverty based on
family size and income (Dalaker, 2001). The number of siblings in the families ranged from zero to 3 with a mean of 2.0
children per family. Of the participants, eleven were firstborn or an only child and nineteen were the youngest member of
their family. Two sets of twins and 1 set of triplets participated in this study.

1.2. Assessment materials

Expressive vocabulary and emerging syntax were selected as the representative language measures for the age of the
children in the study (Heilmann, Weismer, & Hollar, 2005). The expressive vocabulary, sentence length and grammar of the
children were assessed using the MBCDI: WS (Fenson et al., 1993, 2007). The MBCDI: WS is a parent checklist that assesses
early language development including vocabulary and syntax in children between the ages of 16 and 30 months (Dale, 1991;
Fenson et al., 1993, 2007; Heilmann et al., 2005). The MBCDI: WS utilizes the parent’s knowledge of their children’s
communicative skills, and is a widely used tool in both the United States and other countries for studying early language
(Dale, 1991; Moeller et al., 2007; Tsao, Liu, & Kuhl, 2004). It has shown good concurrent validity with other measures of
expressive language (Heilmann et al., 2005).

1.3. Procedures

As part of a larger study, speech samples were conducted in the children’s homes during 30–60 min visits between 9 and
18 months to determine the presence of fricatives. Affricates were also noted and were included as part of the fricative
repertoire throughout the analysis. Affricates were not considered as a separate category and were included in the count of
fricatives. A speech language pathologist holding the CCC-SLP and/or a trained graduate student in speech-language
pathology observed the children in their homes. During the initial visit the primary caregiver completed a case history, which
was reviewed for changes during subsequent visits. Speech samples were audio-taped using an analog voice recorder with a
supplemental microphone while the speech-language pathologist and/or trained graduate student interacted with the child.
An interactive play format using a common set of toys and objects (e.g. pretend French fries, pretend milkshake, cell phones,
zebra, sock, shoes, toothbrush), books, and pretend play activities was designed to elicit fricatives in words. The examiner
engaged the child in play with the materials and encouraged the child to talk about them, using the names of the objects and
pictures in the book.
During spontaneous speech production, the evaluating speech-language pathologist and/or graduate student transcribed
fricative production online. Parents were asked to confirm the fricative repertoire observed by the researchers. If the parent
reported the presence of a specific fricative in the child’s repertoire and the phoneme could not be elicited during the visit,
the parent was given the option of recording the child’s speech and sending the tape to the clinician, or an additional visit was
scheduled. If a parent reported that a child produced a fricative in a word and the researchers could not confirm that fricative,
the fricative was not recorded as present in the child’s inventory. Vocalizations containing fricatives were categorized into
one of the following contexts: isolation, babble (variegated or reduplicated), or word. Utterances were classified as a word,
based on the ‘‘consistency of phonetic form, relationship of that form to an adult word, and range of contexts of use’’ (McCune
 C.D. Sotto et al. / Journal of Communication Disorders 49 (2014) 1–12 5

& Vihman, 2001, p. 674). Based on the presence (+) or absence ( ) of at least one fricative produced in any single word prior to
or at 18 months, children were classified into Fricative (+) (11 males, 14 females) and Fricative ( ) (9 males, 3 females)
groups. Additional data extracted from the 18-month speech sample included the total number of consonant phonemes
produced in words, the number of fricatives produced in words, and the position of fricative production in words (prevocalic,
intervocalic, postvocalic).
Parents were then asked to complete the MBCDI: WS during visits at 18 (M = 18.09, SD = 0.58), 24 (M = 24.4, SD = 0.50),
and 30 (M = 29.94, SD = .66) months of age. Parents completed Part I of the MBCDI: WS at the 18-month visit and both Parts I
and II at the 24 and 30 month visits. Part I measures expressive vocabulary development through parent documentation of
words the child produces via a checklist. Part II measures expressive syntactic development through a checklist of words that
include grammatical markers, a checklist of multi-word combinations, and the parent’s documentation of the child’s three
longest utterances. The investigators reviewed the written instructions for the MBCDI: WS with the parents. Parents either
completed the form during the visit or completed the form within one day of the visit and then returned it via mail.

1.4. Data analysis

The 18, 24, and 30 month MBCDI: WS scores for the following variables were independently calculated by a graduate
clinician and a speech-language pathologist. From Part I the total number of expressive vocabulary items was determined.
From Part II, M3L was calculated and the presence of plural, possessive, present progressive and past tense markers were
noted. The speech-language pathologist and graduate student then compared each of their MBCDI: WS results to ensure
scoring accuracy. Mean length of utterance (M3L) was calculated from the parental report of the 3 longest utterances. All
data were entered into a Microsoft Excel spreadsheet. Accurate data entry was checked by one of the lead investigators of the
study by comparing the scores to the data collection sheets. These scores were further entered into the MBCDI scoring
program (Marchman, 2004) for additional analysis, and all data were finally entered into the SAS program for statistical
analysis.
Normal distribution was first confirmed in the group data via Q–Q plot inspection and the Shapiro–Wilk test prior to
proceeding with group comparisons. To isolate study-specific effects, a mixed-effect model was first developed to determine
which factors significantly contributed to MCBDI: WS scores across time. This model included fricative status at 18 months
(+, ), visit time (18, 24, and 30 months), an interaction term for fricative status at 18 months and visit time (to account for
longitudinal design), the total number of consonants at 18 months, and the total number of fricatives at 18 months. This
approach was also used to determine if these same factors significantly contributed to the parent-reported M3L at 24 and 30
months. Categorization of the grammatical markers maintained the format of the parent report form with ordinal choices of
often [2], sometimes [1], not yet [0]. Data regarding specific grammatical markers at 18 and 24 months were analyzed using
the Wilcoxon 2 Sample test, and a Bonferroni correction of a/8 was applied due to the multiple comparisons. Using the
Bonferroni correction, the p value of each independent analysis was compared to a = .0063.

1.5. Reliability

Reliability for fricative status, number of different fricatives and position, and total number of consonants at 18 months,
was calculated. Fourteen (14) audio samples from the visits were independently coded for presence/absence of fricatives,
number of different fricatives, fricative position, and phonetic repertoire by a second investigator. Inter-rater reliability was
100% for fricative status and number of different fricatives, 100% for prevocalic position, 100% for intervocalic and 93% for
postvocalic positions, and 86% for total number of consonants. All 37 audio samples were re-coded by the same investigator
who originally analyzed them. Intra-rater reliability for fricative status, number of different fricatives and position, and total
number of consonants was 100%.
A second investigator counted the length of each utterance reported by the parent and calculated the M3L for 54% of the
samples (n = 20/37), which resulted in 100% inter-rater reliability. Total scores for 54% of the samples (n = 20/37) on the
MBCDI: WS at 18, 24, and 36 months were re-calculated by a second investigator, which resulted in inter-rater reliability of
95%. MBCDI: WS total scores for 40% of the samples at 18, 24, and 36 months (n = 15/37) were recalculated by the same
investigator who originally scored them, which resulted in intra-rater of 100%.

2. Results

Data regarding presence of fricatives and other consonants for the individual participants are presented in Table 1. Fig. 1
shows the MBCDI: WS mean scores of the Fricative (+) and Fricative ( ) groups at 18, 24 and 30 months. At 18 months the
Fricative (+) group had a mean raw score of 116.44 (SD = 60.34), while the Fricative ( ) group had a mean raw score of 48.17
(SD = 37.16). At 24 months the Fricative (+) group’s mean raw score was 425 (SD = 138.44), and the M3L was 6.18 (SD = 2.71),
while the Fricative ( ) group’s mean score was 214 (SD = 136.17), and the M3L was 2.18 (SD = 1.45). At 30 months, the
Fricative (+) group’s mean score was 576.68 (SD = 62.48), and the M3L was 8.76 (SD = 3.43), while the Fricative ( ) group’s
mean score was 468.96 (SD = 155.70), and the M3L was 5.15 (SD = 1.80).
The results of the mixed-effect model indicated that the main effects for fricative status (+, ), visit time, and the
interaction term were significantly related to the MBCDI: WS scores as shown in Table 2. Total number of fricatives at 18
6 C.D. Sotto et al. / Journal of Communication Disorders 49 (2014) 1–12

Table 2
Main effect results for mixed-effect model of the relationship between variables and expressive vocabulary scores on the
MBCDI: WS.

df F p

Fricative status (1, 33) 4.72 .037*

Visit number (2, 33) 279.00 <.001*
Fricative status  visit number (2, 33) 6.16 .005*
Total number of fricatives (1, 33) 0.19 .669
Total number of consonants (1, 33) .70 .409

* p < .05.

Table 3
Main effect results for mixed-effect model of the relationship between variables and M3L.

df F p

Fricative status (1, 33) 0.05 .826

Visit number (2, 33) 28.76 <.0001*
Fricative status  visit number (2, 33) .21 .652
Total number of fricatives (1, 33) 4.02 .053
Total number of consonants (1, 33) 0.12 .726

* p < .05.

Table 4
Results of the Wilcoxon 2 sample results testing the differences between the production of grammatical markers by the
Fricative (+) and Fricative ( ) groups.

Wilcoxon Za Significant (2-sided)

24 months
Plural 137 3.15 0.0017*
Possessive 167.5 2.15 0.0312
Present progressive 148.5 2.8 0.0051*
Past tense 160.5 2.38 0.0051*
30 months
Plural 148 1.58 0.1153
Possessive 118.5 2.93 0.0034*
Present progressive 114 3.12 0.0018*
Past tense 80 3.96 <.0001*
a
Z includes a continuity correction of 0.5.
* p < .05, Bonferroni adjusted.

Table 5
Percentage of Fricative (+) and Fricative ( ) producing specific grammatical markers at 18 and 24 months.

24 months 30 months

Fric ( ) Fric (+) Fric ( ) Fric (+)

Use plural
Always 8.3 60.0 60.0 84.0
Sometimes 41.7 28.0 30.0 16.0
Never 50.0 12.0 10.0 0.0
Use possessive
Always 33.3 64.0 40.0 88.0
Sometimes 25.0 28.0 50.0 12.0
Never 41.7 8.0 10.0 0.0
Use present progressive
Always 25.0 60.0 40.0 88.0
Sometimes 0.0 24.0 20.0 12.0
Never 75.0 16.0 40.0 0.0
Use regular past tense
Always 8.3 16.0 0.0 68.0
Sometimes 16.7 56.0 50.0 28.0
Never 75.0 28.0 50.0 4.0

months F(1, 33) = 19, p = .67 and total number of consonants at 18 months F(1, 33) = .70, p = .41 were not significantly related.
Because the interaction was significant, the data were split for visit time, and a stratified analysis was conducted to
determine if the difference between MBCDI: WS scores of Fricative (+) and Fricative ( ) children was significant at each age.
This post hoc testing revealed that differences between the MBCDI: WS scores of the two groups were significant at 18
months F(35) = 12.9, p = .001, 24 months F(35) = 19.02, p = .0001, and 30 months F(33) = 8.92, p = .005 with the Fricative (+)
 C.D. Sotto et al. / Journal of Communication Disorders 49 (2014) 1–12 7

Table 6
Number and percent of participants in the Fricative (+) and Fricative ( ) group by percentile ranking on the MBCDI: WS expressive language at 18 and 30
months.

18 months 18 months 30 months 30 months

Fricative (+) Fricative ( ) Fricative (+) Fricative ( )
(n = 25) (n = 12) (n = 25) (n = 12)
n (%) n (%) n (%) n (%)

91st percentile – – 6 (24%) –

81–90th percentile 2 (8%) – 1 (4%) 1 (8.3%)
71–80th percentile 4 (16%) – 2 (8%) –
61–70th percentile 4 (16%) 1 (8.3%) 2 (8%) –
51–60th percentile 7 (28%) 1 (8.3%) 4 (16%) 3 (24.9%)
41–50th percentile 2 (8%) 2 (16.6%) 4 (16%) 3 (24.9%)
31–40th percentile 2(8%) 3 (24.9%) 4 (16%) 1 (8.3%)
21–30th percentile 3 (12%) 1 (8.3%) 1 (4%) 1 (8.3%)
11–20th percentile 1 (4.0%) 1 (8.3%) 1 (4%) –
1–10th percentile – 2 (16.6%) – –
<1st percentile – 1 (8.3%) – 1 (8.3%)
Missing – – – 2 (16.6%)

group exhibiting better scores across time. Only visit time was significantly related to M3L (Table 3), indicating that M3L
increased with age regardless of fricative status.
Table 4 shows the results of the Wilcoxon 2 Sample test with Bonferroni correction examining the difference between the
production of grammatical markers for the two groups. Table 5 shows the percentage of children in each group who
produced each grammatical marker. There was a significant difference between groups at the .05 level for plural, present
progressive, and past tense suffixes at 24 months and a significant difference for possessive, present progressive, and past
tense suffixes at 30 months, with the Fricative (+) group demonstrating more use of these grammatical markers.
The distribution of MBCDI: WS scores presented a notable difference between the two groups when comparing percentile
scores for the upper and lower percentile halves (Table 6). At 18 months, the MBCDI: WS scores for 68.0% of the Fricative (+)
group (16/25) were at or above the 50th percentile but only 16.6% of the Fricative ( ) group (2/12) were at or above the 50th
percentile. In contrast, 83.7% of children in the fricative ( ) group (10/12) scored below the 50th percentile, while 32% of
children in the Fricative (+) group (8/25) scored at or below the 50th percentile. Table 6 shows the distribution of Fricative (+)
and Fricative ( ) children’s percentile scores on the WBCDI: WS presented in increments of 10.

3. Discussion

The present study was designed to determine if production of fricatives prior to or at 18 months was an observable
indicator of expressive language development at 24 and 30 months. The results showed that the expressive language raw
scores of children who produced fricatives by 18 months and children who did not produce fricatives by 18 months were
significantly different at 18, 24 and 30 months of age, with children who did produce fricatives prior to or at 18 months
exhibiting larger vocabularies and greater use of present progressive and past tense markers. Although it did not reach
statistical significance, children who produced fricatives also demonstrated a consistently higher M3L.
These findings confirmed the hypothesis that children who produced fricatives in words by 18 months of age would have
significantly better expressive language skills as measured by the MBCDI: WS at 18, 24, and 30 months than those who did
not. Although approaching significance (see Table 3), this advantage was not observed for M3L. Other factors, such as the
total number of consonants in the phonetic repertoire at 18 months and the total number of fricatives produced at 18 months
were not significantly related to expressive language.
As previously described, fricatives are phonologically more marked, require greater perceptual skills and motor
coordination, and facilitate the production of early grammatical markers. Thus, the acquisition of fricatives may be related to
language development. The findings of this research support the argument that early production of fricatives may indicate
competence across the perceptual, motor, and linguistic systems that can positively influence the child’s expressive language
development including vocabulary and morphosyntax. The findings provide insight into several possible relationships
between speech development and early expressive language development. First, these results further support the
relationship between the development of speech production and the development of vocabulary. In addition, these findings
may establish a potential relationship between speech production and children’s use of early grammatical markers. A third
interpretation relates to the interaction between adult linguistic input and the child’s developing speech. Each of these will
be discussed below.
Previous investigations have suggested that there is an interrelationship between early speech production and
vocabulary development (Paul & Jennings, 1992; Stoel-Gammon, 1991; Vihman & Greenlee, 1987). One possible explanation
is that greater semantic knowledge may enhance speech development as teaching children novel vocabulary has resulted in
the production of more phonologically sophisticated words and more diverse phonemes (Girolametto, Pearce, & Weitzman,
1997). Another more frequently suggested explanation is that children produce more words because they are capable of
8 C.D. Sotto et al. / Journal of Communication Disorders 49 (2014) 1–12

articulating a greater variety of phonemes or phoneme combinations (Schwartz & Leonard, 1982; Stoel-Gammon, 1989,
2011). Similar to these investigations, in the current study children with advanced speech development as defined by the
presence of fricatives at 18 months had larger vocabularies than children with less advanced speech development as defined
in the same way. Unique to this study, advanced speech development was defined by the class of phonemes produced
(Fricative +). A relationship between speech production and vocabulary/grammar was not noted when measured by the total
number of phonemes produced. The introduction of a new class of sounds (i.e. fricatives) increases the number of phonemes
available to the child to use in words thus potentially enabling the child to use more words. Additionally, a child’s memory
for sound sequences develops in tandem with phoneme production (Stoel-Gammon, 2011); children who produce more
complex phonemes such as fricatives may also have a better memory to store more complex phonological information
including phonemes and sequences that they can use to enhance vocabulary development and word production.
This study also revealed a relationship between fricative production at 18 months and the production of grammatical
markers. As discussed in the introduction, the production of fricatives prior to 18 months may indicate that a child’s
underlying phonological, perceptual, and motor systems are more prepared to produce these markers. The better
performance of the Fricative (+) children was observed for the production of grammatical markers at 24 months and plural,
present progressive, possessive, and past tense at 30 months. Intervention studies for speech sound disorders and for
language disorders have been completed to test various hypotheses regarding the interaction between these domains with
inconsistent results (Fey et al., 1994; Tyler, 2002; Tyler & Sandoval, 1994). The presence of fricatives in the phonological
repertoire may facilitate the emergence of identifiable syntactic markers (e.g. plurals, possessives, regular present,
auxiliaries) and conversely the knowledge of syntactic markers may encourage the use of /s/ and /z/ (Tyler, 2002). The
advantage in production of grammatical markers for the Fricative (+) children, however, was more strongly noted for
grammatical markers that do not require fricative production, including present progressive and regular past. Perhaps
children who produce fricatives prior to 18 months have greater experience with marking suffixes, and this experience
facilitates better grammatical development. The lack of a significant difference between the two groups at 30 months for
plurals may indicate the Fricative ( ) children are continuing along an appropriate developmental trajectory although
perhaps not as quickly as the children in the Fricative (+) group. Plurals are the earliest bound morphemes identified by
Brown (1973), appearing during Stage II (18–36 months). Possessives appear in Stage III (36–42 months) and the regular verb
forms appear in Stages IV and V (40–52+ months). Thus the Fricative (+) group appeared to be acquiring markers that are
typical of older children while the Fricative ( ) group did not appear to be as advanced.
An additional factor to consider in regard to the better expressive language development of the Fricative (+) children is the
potential effect of environmental responses to children’s communication attempts. Children with more precise articulation
or larger vocabularies may elicit more complex language feedback and input from environmental language models (Tamis-
LeMonda, Bornstein, & Baumwell, 2001). The caregivers of children who produced fricatives may have responded to the more
adult-like forms produced by their children with language that was richer in areas such as lexical selection and use of
syntactical structures. Although specific data were not collected regarding adult language or input style, all participants were
confirmed to be from households that were similar in location and socioeconomic status.
An ongoing clinical challenge is differentiating young children who will follow a typical but slower developmental
trajectory from children who will require intervention. Previously reported indicators of early expressive language
development, including joint attention (Brooks & Meltzhoff, 2005; Delgado et al., 2002; Watt et al., 2006), play (Rescorla &
Goossens, 1992; Watt et al., 2006; Weismer et al., 1994), comprehension (Thal & Tobias, 1992; Watt et al., 2006; Weismer
et al., 1994), vocabulary (Rescorla & Schwartz, 1990; Rice & Bode, 1993; Weismer et al., 1994), word combinations (Rescorla
& Schwartz, 1990), gesture development (Thal & Tobias, 1992, 1994; Watt et al., 2006), perception (Kuhl et al., 2005;
Whitehurst et al., 1991), gestures combined with vocalizations (Whitehurst et al., 1991), onset of canonical babbling (Oller
et al., 1999), size and diversity of phonetic repertoire (McCune & Vihman, 2001; Rescorla & Ratner, 1996), and variety of
syllable shapes in early vocalizations (McCune & Vihman, 2001; Rescorla & Ratner, 1996), should all be considered by
clinicians when assessing early speech and language. These indicators often require extensive testing of the child and require
the SLP to collect a complete speech sample or rely on parental report of speech and language skills. Parents may be better
able to remember specific sounds in words rather than more generic questions about all the different sounds produced.
Additionally, an indicator that can be easily identified by other professionals may help contribute to the early detection of
delayed speech and language trajectories, thus leading to earlier intervention. The first professional to assess the child, often
a pediatrician or nurse practitioner, may be able to identify the presence or absence of fricatives. Adding another marker to
the referral criteria for these professionals may increase their confidence in determining the need for further assessment
during the recommended 18-month developmental screening (American Academy of Pediatrics, 2006).
This study suggests that the presence of fricatives at 18 months indicates a positive trajectory for expressive language
development. Table 6 shows the distribution of percentile rankings on the MBCDI: WS at 18 and 30 months. At 30 months,
the majority of the Fricative (+) group (15/25) had expressive vocabulary scores above the 50th percentile including several
(6/25) at the 91st percentile or above. Only 40% (4/10) of the Fricative ( ) group had scores above the 50th percentile; 3 were
between the 51st and 60th percentile and 1 between the 81st and 90th percentile at 30 months. However, the utility of
fricatives as an indicator of delayed or disordered language is unknown and requires further research. In this study, the
difference between the expressive language of children who do and do not produce fricatives in words prior to or at 18
months of age was investigated up to only 30 months. Fig. 2 shows the gaps in raw scores at 18, 24, and 30 months of children
in the Fricative (+) and Fricative ( ) groups. Both groups demonstrated more of a quadratic rather than linear trend in
 C.D. Sotto et al. / Journal of Communication Disorders 49 (2014) 1–12 9

Fig. 2. MBCDI: WS raw scores by age and fricative group showing the quadratic trends in expressive vocabulary development.

vocabulary development. The gap between the two groups is largest around 24 months but begins to narrow as the children
approach 30 months. Although the difference between groups for almost all grammatical markers is still significant, overall
more children in both groups are producing grammatical markers, with no difference noted for plurals at 30 months. Whether
the differences between the two groups remain after 30 months or the differences continue to narrow is unknown. Follow-up
data collected during our longitudinal study revealed that 4 of the 12 children who did not produce fricatives were referred by
their pediatrician for further assessment of speech and language development after 24 months, were diagnosed with a speech
and language disorder, and were enrolled in therapy. Their speech and language development beyond that is unknown.
In examining an intervention program for children with expressive language delay, Buschmann et al. (2009) found that
43.5% of 24 month old children with expressive language delay no longer demonstrated a delay at approximately 3 years of
age without any type of intervention. The identification of more specific early markers to accurately differentiate the 56.5% of
children that do not catch up is needed. Given the current trend for early intervention rather than a ‘‘wait and see’’ approach
(American-Speech-Language-Hearing-Association, 2008; Olswang, Rodriguez, & Timler, 1998) the identification of
additional markers would be beneficial to ensure the best use of time and resources for children with speech and
language disorders. Additional investigation of the relationship between early development of specific speech sounds (such
as fricatives) and language delay is needed to determine if such a relationship can be predictive.

4. Limitations and further research needs

Limitations in the current study that should be considered when the results are interpreted for clinical and research
purposes include subject selection. The subject sample was comprised of primarily Caucasian children from a suburban area
of middle class socio-economic status. In order to apply these findings to a broader population, a more diverse sample is
needed. Additionally, to determine the usefulness of this observation as a component of clinical battery of measures, further
research is needed. Specifically, additional research should include children who are at higher risk for speech and language
impairment. Although this study supports the importance of fricatives as a marker of early expressive language
development, the role of perception, motor control and markedness, as well as parental responsiveness to speech that
includes fricatives in words and grammatical markers require further research.

5. Conclusion

In conclusion, the results of the current study indicated that a relationship between early fricative production and later
expressive language development as measured by the MBCDI: WS existed at 18, 24, and 30 months of age in a group of
typically developing children. Children who used at least one fricative in words by 18 months had significantly advanced
language skills compared to peers who did not use a fricative in words. However, the gap in development narrowed as the
children approached 30 months of age. Given the difficulty of assessing the speech and language development of children at
18 months, observation of the use of fricatives may prove to be an easily identifiable marker of an individual child’s
developmental trajectory for expressive language; however, until further work on prediction of language delay is completed,
clinicians should be cautious about applying these findings to practice.

Acknowledgements

This research was funded in part through a grant from the University of Cincinnati Research Council. The statistical
analyses were supported by The National Center for Research Resources and the National Center for Advancing Translational
Sciences, National Institutes of Health, through Grant 8 UL1 TR000077-04. The content is solely the responsibility of the
10 C.D. Sotto et al. / Journal of Communication Disorders 49 (2014) 1–12

authors and does not necessary represent the official views of the NIH. In addition, the authors wish to acknowledge the
thoughtful comments by Dr. Suzanne Boyce about the initial research hypothesis. We also appreciate the work of the
University of Cincinnati students who assisted with the study. Finally the authors wish to thank Pediatric Associates and Dr.
Christopher Bolling who acknowledged the need for research in this area and assisted with participant recruitment.

Conflict of interest statement

The authors received financial support in part through a grant from the University of Cincinnati Research Council. The
statistical analyses were supported by The National Center for Research Resources and the National Center for Advancing
Translational Sciences, National Institutes of Health, through Grant 8 UL1 TR000077-04. The content is solely the
responsibility of theauthors and does not necessary represent the official views of the NIH. There are no nonfinancial
relationships to disclose.

Appendix A. Continuing education questions

CEU questions

1. Fricatives are mastered later in development because these sounds

a. are phonologically more marked
b. require greater perceptual skills
c. require greater motor coordination
d. all of the above
2. Early expressive lexical development is related to early phonological development because
a. word production requires awareness of the articulatory movements as well as semantic knowledge
b. children are more likely to attempt words that include sounds that are already in the child’s repertoire
c. all of the words that young children would use contain only early developing sounds
d. Both a and b
3. The MBCDI:WS is designed to assess
a. early speech sound development
b. early language development through a parent checklist
c. early pragmatic development
d. language development for children 3–5 years through a parent checklist
4. This study found that there was a significant difference between
a. the expressive language raw scores of children who produced fricatives by 18 months and those who did not
b. the later phonological development of children who produced fricatives by 18 months and those who did not
c. the expressive language raw scores of children who had large overall phonetic repertoires and those who did not
d. the expressive language scores at 18 months and at 36 months.
5. The results of this study may be useful for
a. planning intervention for children with language delay
b. planning intervention for children with speech delay
c. early identification of children who may be at risk for later language delay
d. early identification of children who may be at risk for later pragmatic challenges

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