Facilitating phoneme awareness development in 3- and 4-year-old children with speech impairment.

PURPOSE This study investigated the phonological awareness and early literacy development of 12 children who presented at 3 years of age with moderate or severe speech impairment. The children's response to early intervention that included specific activities to facilitate phoneme awareness and letter knowledge, in addition to improving speech intelligibility, was examined. METHOD Using a 3-year longitudinal design, the children's development in phonological awareness was monitored and compared to that of a group of 19 children without speech impairment. During the monitoring period from 3 to 5 years of age, the children with speech impairment received, on average, 25.5 intervention sessions. At 6 years of age, the children's performance on phonological awareness, reading, and spelling measures was also compared to that of the 19 children without impairment as well as to a matched control group of children with speech impairment who had not received any specific instruction in phonological awareness. RESULTS The results indicated that (a) phoneme awareness can be stimulated in children with speech impairment as young as 3 and 4 years of age, (b) facilitating phoneme awareness development can be achieved concurrently with improvement in speech intelligibility, and (c) enhancing phoneme awareness and letter knowledge during the preschool years is associated with successful early reading and spelling experiences for children with speech impairment. CLINICAL IMPLICATIONS The data provide evidence to support the clinical practice of integrating activities to develop phoneme awareness and letter knowledge into therapy for 3- and 4-year-old children with moderate or severe speech impairment.