Residual Speech Errors: Causes, Implications, Treatment

The current issue focuses on residual speech errors (RSEs), a subtype of speech sound disorder in which errors persist past 8 to 9 years of age, often despite years of intervention. RSEs most commonly involve distortions of late-developing sounds such as /s/, /l/, or /r/. RSEs may affect up to 5% of school-aged children,[1] potentially posing a barrier to social and academic participation.

Both clinicians and researchers have called for a better understanding of RSEs, as well as more effective methods of intervention. In 2006, Gibbon and Paterson characterized RSEs as “one of the most neglected research areas in speech therapy.”[2] ^{(p. 275)} In the past 10 years, there has been a resurgence of research on the topic of RSEs, making significant steps toward addressing this area of need. The current issue presents a sampling of work approaching this problem from several angles.

In the first contribution, Flipsen discusses the etiology and prevalence of RSEs. This article introduces a distinction between residual and persistent errors that reflects different developmental paths of speech sound acquisition. Although relatively few studies illuminating this distinction exist at the present time, it promises to be a fruitful direction for follow-up research.

The next three articles discuss factors that might play a role in the origin and persistence of RSEs. Preston, Irwin, and Turcios investigate fine-grained phonetic perception in children with and without RSE. Cabbage, Farquharson, and Hogan also consider the role of phonetic perception and phonological working memory in case studies of children with RSEs with and without comorbid reading difficulties. Eaton discusses the possibility that subclinical deficits in cognitive skills such as self-monitoring could play a role in children's difficulty replacing developmental speech patterns with mature productions.

The next two articles provide new insights for intervention in RSEs. Focusing on the most common error sound in RSEs, Boyce discusses the complex nature of /r/ articulation and argues that more accurate articulatory placement cues could enhance outcomes in intervention for RSE affecting rhotic sounds. The next contribution, from Gibbon and Lee, offers an overview of a program of research using electropalatography to collect more detailed articulatory information about RSEs and provide biofeedback to remediate these errors.

A final contribution, from Hitchcock, Harel, and McAllister Byun, revisits the question of social, emotional, and/or academic impacts of RSEs. This issue is of particular interest in connection with the question of whether children with RSEs who do not show broader deficits in intelligibility or academic performance should still be considered candidates for speech-language services in the school setting. The article makes the case that social and emotional impacts are also important factors to consider when making decisions about treatment allocation.

These articles, along with similar recent research, are meaningful steps toward understanding RSEs and identifying more and better interventions. More importantly, they represent ongoing lines of investigation that will continue to explore the basis and treatment of RSEs. Writing in the current issue, Gibbon and Lee note that RSE “has in the past been a neglected research area in speech therapy” (emphasis added), with the implication that today the situation has changed in a positive direction.

• References

• 1 Shriberg LD. Five subtypes of developmental phonological disorders. Clin Commun Disord 1994; 4 (1) 38-53
• 2 Gibbon FE, Paterson L. A survey of speech and language therapists' views on electropalatography therapy outcomes in Scotland. Child Lang Teach Ther 2006; 22 (3) 275-292