Screening for speech sound disorders: The impact of the elicitation method on assessment time and diagnostic accuracy

Background: Speech screenings are used in preschools for the early identification of speech sound disorders (SSD) as children with persisting SSD are placed at risk socially, and academically. Screening materials should enable time-efficient assessment and a high level of diagnostic accuracy. Both factors can be influenced by the method used to elicit productions, i.e., imitation vs. spontaneous naming. It is unclear to what extent the elicitation method impacts children’s productions. Some studies found no significant differences whereas other studies showed that imitation yielded more consonants correct than spontaneous naming. Thus, the elicitation method might influence the assessment scores and thereby the diagnostic accuracy of a given screening assessment. The aim of the present study was to examine whether the elicitation method influences 1) the assessment time, 2) children’s speech scores, and 3) the diagnostic accuracy of a screening material used for the identification of SSD in Denmark.
Method: Twentynine Danish-speaking children aged 2;10-3;4 years were assessed with Udtale af sproglyde (eng. Pronounciation of speech sounds). The screening was carried out using imitation and spontaneous naming. The assessment time and scores from the different elicitation methods were compared. Also, the diagnostic accuracy was calculated based on the scores of the two screening methods. A validated phonology test was used as the reference standard.
Results: Results showed that imitation took less time (2 min.) than spontaneous productions (6 min.) and lead to more initial consonants correct and higher speech scores. The diagnostic accuracy of the screening was low when imitation was used. Sensitivity improved through spontaneous naming.
Conclusions: The present study indicated that imitation was more time efficient. However, the study also indicated that imitation may overestimate children’s productions and thereby affect the diagnostic accuracy of screening assessments used for the identification of SSD.