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Abstract
The purpose of this study was to investigate phonological processing in children and adolescents with congenital motor speech impairments. Thirty-two participants with cerebral palsy and no intelligible speech who used augmentative and alternative communication (AAC user group) and 32 students with impaired but intelligible speech (speech-impaired group), aged 7.5 to 17.5, as well as reading-level-matched controls (younger children with normal speech and no physical disabilities) were assessed on a protocol of phonological processing in three areas: retrieval of whole-word phonology, phoneme awareness, and phonological recoding. Phoneme awareness and phonological recoding were assessed from beginning to advanced levels. Reading assessment included two nonspeech measures of word reading. Between-group comparisons indicated that, compared to reading-level-matched controls, both the AAC user and the speech-impaired group scored significantly lower in all areas of phonological processing. Relative strengths and weaknesses in phonological processing were identified. For example, although AAC users and students with impaired but intelligible speech showed relatively good competence in using sound-letter correspondences to recognize unknown printed strings, they showed low skill in using sound-letter correspondences to spell, even though in speaking children these two skills are comparable. The results are discussed in terms of their implications for understanding and addressing the literacy learning needs of students with congenital motor speech impairments.