Beyond Sounds: Decoding Speech Errors and Phonological Awareness in Preschoolers

The purpose of this clinical focus article is to describe the phonological awareness (PA) skills of children with speech sound disorders (SSD) and the relationships between types of speech errors and strengths and weaknesses in PA. Through three case studies, we demonstrate the heterogeneous speech and preliteracy skills of preschoolers with SSD. Children who produce more atypical and omission errors are more likely to present with PA deficits. However, some children who produce mostly substitution errors nonetheless present with weaknesses in PA, as do many children with resolved speech production difficulties. The high prevalence of PA difficulties in children with SSD, or in children who presented with SSD at a younger age, provides an important opportunity for speech-language pathologists to assess preliteracy skills and provide targeted intervention for phonological processing needs to facilitate later literacy acquisition. Guidelines for assessing preschoolers with SSD are provided.