Is Speech Perception the Missing Piece in Children’s Speech Disorders?
When children struggle with speech, parents, teachers, and health professionals often focus on the most apparent issue—production. Yet L. Nijland’s (2009) study highlights how difficulties with speech perception may underlie or exacerbate the outward deficits we hear. For many families, this can feel both hopeful (because there is a place to intervene) and frustrating (understanding that therapy might need to address perception beyond the obvious production errors). This emotional complexity underscores why identifying what is truly happening—on both the production and perception fronts—is essential for each child’s success.
What Was the Aim of Nijland’s 2009 Study?
To understand whether perception problems are directly linked to different types of speech output disorders, Nijland’s study compared children with childhood apraxia of speech (CAS), children with phonological disorder (PD), and those with a mixture of both. This non-randomised, observational design allowed for investigating which level of perception (lower-order or higher-order) aligned with each category of speech production difficulty.
• Lower-order perception typically relates to processes like identifying basic acoustic differences (for instance, discerning subtle differences in vowel length).
• Higher-order perception encompasses more complex linguistic tasks such as word rhyming, categorising sounds meaningfully, or understanding how certain phonemes function within a language’s rules.
By examining performance in tasks such as non-word auditory discrimination, word rhyming, and categorical classification, the study set out to determine whether distinct patterns of perception difficulties map onto particular speech production disorders.
How Did Perception Relate to Production in This Study?
Nijland’s findings offered a compelling link: children with CAS struggled with both lower-order and higher-order perception tasks, whereas children whose difficulties lay primarily in the phonological domain (PD) evidenced challenges predominantly in higher-order perception. Therefore, a child who cannot reliably produce accurate speech motor plans (as seen in CAS) might also face difficulties with fine-grained auditory discrimination. Over time, these lower-order perceptual deficits could affect their ability to develop higher-order (phonological) awareness. In contrast, children with PD may have relatively intact lower-order discrimination yet demonstrate challenges when it comes to more complex linguistic tasks like syllable pattern recognition.
Below is a simplified depiction of how these groups typically performed:
| Disorder Type | Lower-order (e.g., basic discrimination) | Higher-order (e.g., rhyming, classification) |
|---|---|---|
| Childhood Apraxia (CAS) | Often impaired | Often impaired |
| Phonological Disorder (PD) | Often intact | Often impaired |
| Mixed Presentation | Variable | Variable |
Crucially, the study highlighted that there are correlations between the severity of production errors and the level of perceptual impairments. Children with more pronounced lower-order production difficulties often exhibited more pervasive deficits across perceptual tasks.
Why Does This Matter for Paediatric Speech Pathology in 2025?
From a clinical standpoint in Australia, these findings encourage speech pathologists to undertake robust perceptual assessments alongside evaluations of articulation, motor planning, and phonological rules. At Speech Clinic, we increasingly integrate telehealth tools that help measure a child’s perceptual capacities—for instance, using games or structured listening activities. Given that many families rely on mobile and remote services, it has never been more crucial to tailor our diagnostic and intervention strategies to include perceptual tasks. This holistic approach benefits parents and carers who might otherwise be left wondering why improvements in speech clarity can be slow or unpredictable—when, in reality, unresolved perception issues may be limiting their child’s progress.
How Can These Findings Benefit Parents, Carers, and Other Health Professionals?
• Early Intervention: Evaluating perceptual skills provides a roadmap for picking tailored therapy goals right from the onset.
• Collaborative Treatment: Occupational therapists, audiologists, and psychologists may all contribute to a cohesive plan addressing both production and perception deficits.
• Family Empowerment: Parents and carers can gain insight into how perceptual tasks (e.g., listening games, rhyme recognition) are just as critical as practising pronunciation drills.
• Preventing Long-term Difficulties: Since lower-order perception underpins more advanced language skills, timely support can help ensure a child’s literacy and linguistic development remain on track.
What Are Potential Gaps and Next Steps in the Research?
While Nijland’s study delivers essential insights, future research may extend to larger cohorts or explore developmental trajectories over several years. For speech pathologists working with multilingual populations, the question remains as to whether the link between production and perception might vary across languages with different phonetic and phonological structures. Understanding these nuances could help refine intervention strategies further, ensuring a culturally and linguistically responsive approach.
Key Clinical Takeaways for 2025
The evidence confirms that speech perception should not be overlooked when treating speech output disorders. For a child with CAS, strategies that target nuanced auditory discrimination might be just as essential as motor planning exercises. For children with PD, tasks that cultivate phonological awareness may carry weight equal to articulation practice. Ultimately, equipping families and interdisciplinary teams with an understanding of this perceptual-production connection sets the stage for more efficient and effective treatment outcomes.
If you or your child need support or have questions, please contact us at Speech Clinic.
How can I tell if my child has a perception issue or a production issue?
A comprehensive evaluation by a qualified speech pathologist is essential, usually involving observations, speech samples, and standardised or informal perceptual tasks. Identifying whether issues stem from auditory discrimination or motor planning (or both) can guide the most appropriate therapy.
Could improving my child’s listening skills help their talking?
Absolutely. If a child struggles to perceive certain sounds accurately, they may produce them incorrectly. Targeted listening tasks and games can complement speech exercises, boosting overall communication progress.
Are perceptual problems more common in children with childhood apraxia of speech than in phonological disorder?
In Nijland’s study, children with CAS showed both lower- and higher-order perceptual challenges, whereas children with PD had higher-order perceptual difficulty but tended to pass basic discrimination tasks. This distinction can shape therapy goals.
What should parents and carers do at home to support perception skills?
Engage children in playful activities involving rhyme recognition, sound matching, and repetitive exposure to novel or complex words. Although not a substitute for formal therapy, these activities can reinforce the skills targeted during speech pathology sessions.
Does telehealth work well for assessing and treating speech perception difficulties?
Yes. Paediatric telehealth can be highly effective for many families. Digital tools allow for focused listening activities, immediate feedback, and ongoing monitoring, making it easier for families to receive advanced clinical interventions in the comfort of their home.
