PHONOLOGICAL

ACQUISITION AND IT’S

DISORDERS
Akshayaa S
I Semester M.Sc. (Speech Language Pathology)
 Phonology
⦿Phonology is the study of the sound system of the language
and is considered one of the major components of language,
along with morphology, syntax, semantics and pragmatics.
⦿The term Phonology is used to refer to the language
component that governs the manner in which speech sounds
are patterned within a language (Fey, 1992).
RELEVANCE OF UNDERSTANDING TYPICAL SPEECH SOUND
ACQUISITION FOR SLPS

An understanding of typical speech sound acquisition is akin to having solid foundations under a house. In paediatric SLP
practice, judgments about whether a child’s speech is typical occurs daily. This decision making is guided by knowledge of
research data as well as clinicians’ experience. Studies of children’s typical speech sound acquisition are the primary research
data used by SLPs to make these decisions. Seven main areas of SLP practice are informed by a comprehensive understanding
of speech sound acquisition:
1. Referral: Providing advice to parents, educators, and health professionals regarding whether a child should be referred for a
speech assessment.
2. Assessment: Deciding which assessment tools are appropriate to examine speech behaviours that are relevant for the age of
the child. For example, if the child is 1;6, an inventory of consonants, vowels, and syllable shapes should be determined. If
the child is 7;0, polysyllabic words and phonological awareness skills also should be assessed.
3. Analysis: Analyzing the speech sample in order to decide whether the child’s speech is age appropriate on a range of
measures.
4. Diagnosis: Determining whether a child has a delay or disorder and whether his or her areas of difficulty warrant speech
sound intervention.
5. Selecting intervention targets: There are two major schools of thought regarding how to use knowledge of typical
speech sound acquisition to select intervention targets. Proponents of the traditional developmental approach suggest that
intervention targets should focus on errors on the production of early developing sounds (Davis, 2005). Proponents of the
complexity approach (also called non-traditional approach and least knowledge approach) select later-developing sounds;
the aim of such an approach is to produce a systemwide change (cf. Gierut, 2007; Gierut, Morrisette, Hughes, and
Rowland, 1996).
6. Intervention: Adapting teaching and feedback to an age-appropriate level, and determining that a child has achieved his
or her goals to the expected level.
7. Dismissal/discharge: Deciding whether a child’s speech is within normal limits for his or her age (Tyler, 2005) and
whether his or her speech sound intervention should be concluded for other reasons, for example, the child has progressed
as far as he or she is going to and no longer is making progress or the child lacks motivation for continued therapy.
ACQUISITION PERIOD
 DISORDERS
Over 90% of speech-language pathologists in schools serve individuals with speech sound disorders (ASHA 2006). Early
phonological disorders are associated with subsequent reading, writing, spelling, and mathematical difficulties. Children with
phonological disorders may exhibit general academic difficulty through grade 12 (Gierut 1998).

Speech sound errors are commonly observed in typically developing young children. Children acquire simple unmarked sounds
(maximally closed and maximally open sounds such as stops, nasals, glides and vowels) before they acquire more marked sounds
requiring complex constrictions. Shriberg (1993) categorized 24 speech sounds into early, middle and late acquisition groups.
These have been confirmed in subsequent studies (Goldstein and Fabiano 2010).
Speech sound disorders is an umbrella term referring to any difficulty or combination of difficulties with perception, motor
production, or phonological representation of speech sounds and speech segments—including phonotactic rules governing
permissible speech sound sequences in a language.

Speech sound disorders can be organic or functional in nature. Organic speech sound disorders result from an underlying
motor/neurological, structural, or sensory/perceptual cause. Functional speech sound disorders are idiopathic—they have no
known cause.
English speaking children should have a complete phonemic inventory of English sounds by the age of 8. Speech errors that persist
beyond age 8 are considered residual articulation errors. These persistent articulation errors typically involve the “late 8” sounds.
Some speech sound errors can be secondary to structural or neurological problems, such as:

• developmental disorders (e.g.,autism)

• genetic syndromes (e.g., Down syndrome)

• neurological disorders (e.g., cerebral palsy)

• hearing loss (including hearing loss secondary to otitis media)

Speech sound disorders include articulation disorders (difficulty producing the motor movements of speech sounds) and
phonological disorders (difficulties acquiring the underlying linguistic representations of speech sounds).
Functional Speech Sound Disorders
Functional speech sound disorders include those related to the motor production of speech sounds and those
related to the linguistic aspects of speech production. Historically, these disorders are referred to as articulation
disorders and phonological disorders, respectively. Articulation disorders focus on errors (e.g., distortions and
substitutions) in production of individual speech sounds. Phonological disorders focus on predictable, rule-based
errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound. It is often difficult
to cleanly differentiate between articulation and phonological disorders; therefore, many researchers and
clinicians prefer to use the broader term, "speech sound disorder," when referring to speech errors of unknown
cause.
Organic Speech Sound Disorders

Organic speech sound disorders include those resulting from motor/neurological disorders (e.g., childhood apraxia
of speech and dysarthria), structural abnormalities (e.g., cleft lip/palate and other structural defects or anomalies),
and sensory/perceptual disorders (e.g., hearing impairment).
Articulation Disorders

Articulation disorders, children with speech articulation disorders have difficulties with the motor production of speech sounds.
Articulation errors can be classified as substitutions (e.g., [w] for /r/, “th” for /s/), omissions, distortions or additions.

An oral mechanism examination must be performed to identify or rule out an underlying structural (anatomical) or functional
(physiological) reason for the motor production difficulty. Articulation disorders may have an identifiable origin, such as a brain
injury or genetic syndrome, or they may be of unknown origin. Residual articulation errors result when the wrong motor program
for the production of specific speech sounds has been learned (Fey, 1992).
Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and
words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips,
jaw, tongue) needed for speech. The child knows what he or she wants to say, but the brain has difficulty coordinating the muscle
movements necessary to say those words.

Dysarthria is a motor speech disorder. The muscles of the mouth, face, and respiratory system may become weak, move slowly, or
not move at all after a stroke or other brain injury. The type and severity of dysarthria depend on which area of the nervous system
is affected. Some causes of dysarthria include stroke, head injury, cerebral palsy, and muscular dystrophy.
Oromyofunctional Disorder (OMD) causes the tongue to move forward in an exaggerated way during swallowing and/or speech.
The tongue may lie too far forward during rest or may protrude between the upper and lower teeth during speech and swallowing.
Some children with OMD produce sounds incorrectly, while in others speech may not be affected at all. OMD most often causes
sounds produced with the tongue tip to sound differently. For example, the child may say "thumb" instead of some because the
tongue tip is too far forward.

Articulation disorder is the inability to form the certain word sounds correctly past a certain age. Word sounds may be dropped,
added, distorted, or swapped. Keep in mind that some sound changes may be part of an accent, and are not speech errors. Signs of
an articulation disorder can include:

Leaving off sounds from words (example: saying "coo" instead of "school")

Adding sounds to words (example: saying "puhlay" instead of "play")

Distorting sounds in words (example: saying "thith" instead of "this")

Swapping sounds in words (example: saying "wadio" instead of "radio").

SEMANTIC ACQUISITION
AND IT’S DISORDERS
Semantics is the study of the relationship between words and how we draw meaning from those words. People can absolutely
interpret words differently and draw different meanings from them.

Semantics involves the deconstruction of words, signals, and sentence structure. It influences our reading comprehension as well
as our comprehension of other people’s words in everyday conversation. Semantics play a large part in our daily communication,
understanding, and language learning without us even realizing it.
ACQUISITION PERIOD
Semantic disorder

◦ Specific Language Impairment

◦ Semantic Pragmatic Disorder
◦ Autism Spectrum Disorder
◦ Intellectual Disability
◦ Aphasia 
◦ Alzheimer’s Disease
◦ Right Hemisphere Damage
◦ Traumatic Brain injury
◦ Parkinson’s disease
Aphasia 

Aphasia is an acquired neurogenic language disorder resulting from an injury to the brain, most typically, the left
hemisphere. Aphasia involves varying degrees of impairment in four primary areas:
◦ Spoken language expression

◦ Spoken language comprehension

◦ Written expression
◦ Reading comprehension

CHARACTERISTICS:
◦ Semantic deficits were believed to be one of the dimensions that clearly separated the symptom space of Broca’s and Wernicke’s
aphasia. These two types of aphasia are usually the consequence of a left-hemisphere lesion in right-handers (Lecours &
Lhermitte, 1979). Studies in which participants were required to explicitly judge semantic relations obtained evidence of severe
disruptions of semantic processing in Wernicke’s aphasics (Grober, Perecman, Kellar, & Brown, 1980; Whitehouse, Caramazza,
& Zurif, 1978).
◦ In contrast to the Wernicke’s aphasics, the performance of patients with Broca’s aphasia in these studies
was close to that of neurologically intact participants. This led to the claim that, in Wernicke’s aphasia, the
semantic lexicon was structurally affected, whereas in Broca’s aphasics it was largely unaffected (Grober,
Perecman, Kellar, & Brown, 1980).
◦ Milberg and colleagues concluded that the Broca’s aphasics are impaired in their automatic access to
semantic representations of words. However, the fact that the Broca’s aphasics can make semantic
judgments indicates that, although the activation level of lexical entries may be reduced, the lexical entries
are accessed and the organization of the semantic network appears to be intact.
◦ Consequently, these patients are able to use strategies in an off-line task to judge the semantic relationship
between prime–target pairs.
◦ Individuals with non-fluent aphasia have particular difficulty producing function words (e.g., determiners,
prepositions, pronouns), often rendering their expression ‘‘telegraphic’’; consisting largely of content
words without the connecting syntactic framework (Goodglass, Kaplan, & Barresi, 2001).
◦ By contrast, individuals with fluent aphasia demonstrate more difficulty with content words (e.g., nouns, verbs,
adjectives), frequently rendering their output ‘‘empty’’, or lacking in meaningful content.
◦ Individuals with fluent aphasia have more difficulty retrieving semantically specific (or ‘heavy’) verbs such as
run, than semantically general (or ‘Light’) verbs such as go (Kim, 2004), whereas individuals with agrammatism
may show the opposite pattern (Barde, Schwartz, & Boronat,2006).
◦ Errors in the use of content words, i.e. semantic paraphasia, are reported to be characteristic of Wernicke’s
aphasics.
◦ Performance of Wernicke’s aphasics on content words is affected by the frequency of the word in the vocabulary:
infrequent words take longer to retrieve and are more often inaccurately retrieved than frequent words.
Alzheimer’s Disease:
◦ Alzheimer’s Disease patients often demonstrate a progressive decline in performance on tasks that are
dependent upon semantic memory, including word finding and picture naming (Hodges & Patterson, 1995).  
CHARACTERISTICS:
◦ Semantic task impairment can occur with a sparing of other linguistic abilities, such as phonology, prosody,
and syntax, and only minor perceptual problems. some studies showed a hyper priming phenomenon (i.e., an
increased semantic priming effect), which evolves in a dynamic manner depending on the level of semantic
memory deterioration.
◦ Alzheimer’s disease patients lack the distinctive semantic attributes of concepts: there is strong evidence that
dysfunction in linguistic tasks is caused by the general cognitive impairment in AD (Feinberg and Farah,
1997).
◦ The most common and obvious language errors made by AD patients are semantic errors (Croot et al.,
2000), namely that they use superordinate category names instead of the target name (Saito and Takeda,
2001) or circumlocutory speech with progressively impaired naming (Emery, 2000).
◦ Difficulties in tasks of confrontational naming and verbal fluency (Appell et al., 1982)
◦ Difficulties in word finding are one of the earliest manifestations of language breakdown in AD. This
pattern of impairment has been implicated as the loss of semantic knowledge in AD (Hodges et al., 1992).
◦ Lexico-semantic impairments in AD have been attributed to abnormalities in intentional and automatic
access to semantic memory.
Right Hemisphere Damage:
Right hemisphere damage (RHD; also known as “right hemisphere disorder” and “right
hemisphere brain damage”) is an acquired brain injury—usually secondary to stroke or TBI—
that causes impairments in language and other cognitive domains that affect communication.
CHARACTERISTICS:
◦ RHD individuals are reported to be impaired in retrieving or using semantic information.
Such impairments affect the semantic processing of words more than their formal
dimensions (e.g., phonological, morphological), and they appear to particularly affect words
that are infrequent, abstract or non-imageable.
◦ Le Blanc and Joanette (1996) reported that RHD individuals had a specific tendency to
produce less prototypical words in an unconstrained oral naming task.
◦ In addition, studies on RHD patients have revealed their difficulties in maintaining or in imparting coherence,
as well as a deficit in their ability to access and/or report more distantly related category members.
◦ Impaired in retrieving or using semantic information.
◦ Difficulty understanding abstract language, figurative language, lexical ambiguities, or information that can
be interpreted in multiple ways.
◦ Difficulty making inferences and understanding the global meanings of discourse such as topic, gist, and big
picture.
◦ Difficulty understanding jokes, irony, and sarcasm; and
◦ Difficulty understanding others' emotions
◦ They exhibit lower performance on a comprehensive set of word retrieval tasks (Krishnan,2015)
GRAMMATICAL ACQUISITION
AND IT’S DISORDERS
Syntax is a branch of linguistics that is concerned with the study of the structure of a sentence and ordering of its
elements. The word syntax itself derives from Greek word meaning ‘together’ or ‘arrangement’. Syntax is the grammar,
structure, or order of the elements in a language statement. Syntax is deeply concerned with the relationship between the
finite and the infinite. In syntax we study how words combine to form sentences and the rules which govern the formation
of sentences. British use the term ‘grammar’ for the same level of language that is referred to as ‘syntax’ by Americans.
The main emphasis, for the moment, will be on the level of language that examines how words combine into larger units.
Three main units are the phrase, the clause and the sentence.
ACQUISITION PERIOD
Grammatical disorders

The key features observed in grammatical disorders are:

• Agrammatism.
• Paragrammatism
 Agrammatism
• According to the classical clinical description of aphasias, the sentences Broca’s aphasics
produce in spontaneous speech are characterized by their simplicity or reduced syntactic
complexity.
• These sentences are often incomplete, with functional elements (including grammatical
inflections) being omitted.
• These problems also usually occur in writing, whereas sentence comprehension is said to
be more or less unaffected.
● For example: Broca’s aphasics’ attempts to produce some simple English sentences,
● He’s going on the bus - He going bus
● When did this happen? - This happened?
● The woman is packing the case - Woman is packing the case
● During assessment linguistic judgement tasks, lexical decision experiments and reaction-time techniques are assessed to
check knowledge of grammar.
● Example: The man showed her baby the pictures
● The man showed her the baby pictures
● Sentences like these, differing with only the position of the will be presented and the patient have to match the sentence with
the appropriate picture.
 Paragrammatism

• The spontaneous speech of Wernicke’s aphasics appears to be fluent, with normal prosody and
syntactic structure.
• However, although the sentences these patients produce are quite long and complex, they are not
always syntactically well-formed and contain various kinds of errors, e.g. word exchanges and
exchanges of whole constituents as well as blends of different constituents.
• This cluster of properties is called paragrammatism
For example, a conversation between the speech and language pathologist and patient goes as follows:
Clinician: What is this? (= a lady’s shoe)
Patient: Yes, sir. Now there there I remember. I have you there what I thought was the…a lady. one.
another. with a very short. very very clever done. do that the one two. go. but there’s the liver. and
there is the new. and so on. It is a document. late
GRAMMATICAL FEATURES PERTAINING TO
DISORDERS
 Intellectual Disability

•Children with mental retardation develop syntactic skills in the same sequence as typically developing children.
However, there is probably a plateau.
•Children with mental retardation have simplified sentence structure with infrequent use of compound and complex
sentences.
•MLU is usually not more than 3 words per utterance. They use shorter and less complex sentences than their similar
aged peers.
•Acquisition of grammatical morphemes in approximately the same sequence as their typically developing (TD) peers.
However, mastering takes longer period of time.
•They may have telegraphic speech where children leave function words out of sentences and only include content
words.
•They have difficulty with receptive syntactic abilities. It is challenging for them to understand long and complex
sentences. This may be related in part to their deficits in working memory.
 Autism Spectrum Disorder

• Specific difficulty with verb endings and pronouns.

• Less complex sentences were observed. (Owens, 2004)
• Echolalia- repeating back what was said to them. They may repeat words immediately or even hours or days
after hearing them.
• Specific deficit in creating novel sentences. They may use ‘Prefabricated sentences’. (Schuler& Fletcher,2002)
 Hearing Impairment

•Pre-lingual deaf children used single word utterances predominantly.

•Stoppage of linguistic behavior after babbling i.e., hearing impaired children do not pass through
the lalling stage (as defined in Berry, 1969).
• The hearing impaired attain echolalic stage.
• Even though some deaf children of hearing parents acquire first words at the same rate as hearing
children, they typically fall progressively behind their peers in vocabulary growth (Spencer and
Ledneberg, 1997).
• Only content words are present, bound morphemes, Tense, gender markers are omitted.
 Learning Disability

•Selecting Appropriate picture to a referred complex sentence

•Difficulty in comprehension of pronouns
•Grammatically incorrect sentences while writing, mostly only content words are present in
written language.
•In written language usually Tense and gender markers are either omitted or wrong
•Cannot use appropriate Pronouns in long narratives.
REFERENCES:
●http://www.asha.org/public/speech/disorders/SpeechSoundDisorders.htm
●http://www.asha.org/public/speech/disorders/SSDcauses.htm
●Bernthal, J., Bankson, N. W., & Flipsen, P., Jr. (2017). Articulation and phonological disorders: Speech sound disorders in children. New York, NY: Pearson.
●Baker, E., & Williams, A. L. (2010). Complexity approaches to intervention. In S. F. Warren & M. E. Fey (Series Eds.). & A. L. Williams, S. McLeod, & R. J. McCauley (Volume
Eds.), Intervention for speech sound disorders in children (pp. 95–115). Baltimore, MD: Brookes.
●(Cascardo, 2010)Cascardo, D. (2010). ICD-10 implementation process: have a strategy that works. The Journal of Medical Practice Management : MPM, 25(6), 368–372.
●Ball Martin J & Perkins Michael R (2008),.Handbook of Clinical linguistics, Blackwell Publishing
●Antinucci Francesco & Parisi Domenico (1975) .Early Semantic Development in Child Language, Foundations of Language Development, 189–201. doi:10.1016/b978-0-12-443701-
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●Boelens Harrie & La Heij Wido (2017). The development of semantic blocking in children. British Journal of Developmental Psychology, 35(2), 310–315. doi:10.1111/bjdp.12178 
●Stoel-Gammon Carol (2010). Relationships between lexical and phonological development in young children*. Journal of Child Language, 38(01), 1–
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●Clark Eve V (1973). What’s In A Word? On The Child’s Acquisition Of Semantics In His First Language ,Cognitive Development and Acquisition of Language, 65–
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●Kay Debora A & Anglin Jeremy M (1982). Overextension and underextension in the child’s expressive and receptive speech. Journal of Child Language,
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●Nazzi Thierry &Josiane Bertoncini (2003).Before and after the vocabulary spurt: two modes of word acquisition? Developmental Science 6(2), pp 136–142
●John Dona Shaji (2019). Semantic Intention and Semantic Relation in Typical Malayalam Speaking Children, Language in India, ISSN 1930-2940 Vol. 19:8 .
Blackwell