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J Dev Behav Pediatr. 2007 Dec;28(6):438-47.

Relationship between speech-sound disorders and early literacy skills in preschool-age children: impact of comorbid language impairment.

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  • 1Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.



Disorders of articulation or speech-sound disorders (SSD) are common in early childhood. Children with these disorders may be at risk for reading difficulties because they may have poor auditory, phonologic, and verbal memory skills.


We sought to characterize the reading and writing readiness of preschool children with SSD and identify factors associated with preliteracy skills. Subjects were 125 children aged 3 to 6 years with moderate to severe SSD; 53% had comorbid language impairment (LI). Reading readiness was measured with the Test of Early Reading Ability-2 (TERA) and writing skills with the Test of Early Written Language-2 (TEWL), which assessed print concept knowledge. Linear regression was used to examine the association between SSD severity and TERA and TEWL scores and analysis of variance to examine the effect of comorbid LI. Performance on a battery of speech and language tests was reduced by way of factor analysis to composites for articulation, narrative, grammar, and word knowledge skills.


Early reading and writing scores were significantly lower for children with comorbid LI but were not related to SSD severity once language status was taken into account. Composites for grammar and word knowledge were related to performance on the TERA and TEWL, even after adjusting for Performance IQ. Below average language skills in preschool place a child at risk for deficits in preliteracy skills, which may have implications for the later development of reading disability.


Preschool children with SSD and LI may benefit from instruction in preliteracy skills in addition to language therapy.

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