The Case Against the Autonomy of Phonological Disorders in Children

Abstract

Sometimes clinical research is more like detective work than pure science. There are scattered and misleading clues, some clear facts, and contradictions to be sifted through before strong claims can be made. Because the facts available are typically lacking, working theories must be constructed to clarify old information, to generate new hypotheses, and to guide further investigation. Less like the tough minded Sherlock Holmes, the investigator fumbles along like the dauntless Lieutenant Columbo. The clinical case having to do with the possible relationships between children's phonological and language disorders is one for which super-sleuthing is required. The facts are shaky and maddeningly complex. In his influential book on articulation disorders, Winitz (1969) reviewed existing research on the topic dating back to 1931. All of the investigators whose papers were examined in one way or another sought to determine whether phonological deficits were associated or correlated with aspects of language development and general intellectual fuctioning. Findings were equivocal: "For some of the studies a substantial relation between articulation and certain language measures especially at the young age levels was demonstrated, and for other studies no relation or only a low relation was found." Although some progress has been made since the Winitz review, our current understandings are hardly more advanced. In this article I present my own sleuthing on the topic. Basing my views on the selective rather than exhaustive use of published and unpublished material, my purpose is to clarify existing information and to suggest some novel hypotheses worthy of further testing. In the process, a case is made against viewing children's phonological disorders as autonomous from language disorders. Evidence is adduced to suggest that they do not constitute separate clinical entities as historically assumed. Phonological disorders and language disorders stem from the same underlying causes. The paper centers around two key points. The first is that researchers have conducted very narrowly defined studies over the last 20 years, and this orientation has obscured the general nature of phonological disorders. Greene (1964), noting the diagnostic confusion arising from "incompleteness of diagnostic investigations," adds, "In children who are speaking but very imperfectly they [speech pathologists] often diagnose articulatory disorders instead of the underlying language disorders." Accordingly, in this presentation, papers offering a broader view of phonological and language disorders are examined. Excluded from consideration are studies dealing solely with aspects of phonological behavior.