Date of Award

Fall 2022

Document Type

Open Access Dissertation


Communication Sciences and Disorders

First Advisor

Suzanne M. Adlof


Speech sound disorder (SSD) puts children at risk for word reading difficulties but does not guarantee them. Research on early literacy skills in children with SSD has primarily focused on phonological awareness due to speech sound deficits associated with SSD. Researchers have begun to examine multiple factors beyond phonological awareness that may impact word reading and spelling development. Orthographic knowledge is another essential factor understudied in children with SSD. Previous research has shown that orthographic properties of words influence phonological awareness performance in skilled readers and children with reading difficulties. No known previous studies have examined whether orthography influences phonological awareness performance in children with SSD as compared to their peers with typical speech development (TSD). Additionally, oral language ability is known to impact reading outcomes, and these difficulties can co-occur with SSD increasing the risk of word reading and spelling difficulties. The current study examined orthographic knowledge, phonological awareness, and the interaction of these components in children with SSD and children with TSD while considering oral language ability.

Sixty children (TSD = 30; SSD = 30) between ages 6-8 years old completed speech, language, and literacy assessments through a virtual platform (Zoom), including a mixture of norm-referenced and experimental measures. Two experimental tasks were designed to measure orthographic knowledge: one measured children’s knowledge of phoneme-grapheme correspondence and the other measured children’s knowledge of orthographic patterns. An experimental phonological awareness task was used to determine whether the orthographic properties of words influenced children’s phonological awareness performance.

Results showed that children with SSD demonstrate less phonological awareness and orthographic knowledge compared to their peers with TSD and that oral language ability is a prominent factor in predicting these outcomes. Additionally, children with SSD had less orthographic properties of words influence their phonological awareness performance compared to children with TSD. Oral language ability was shown to only significantly impact the experimental phonological awareness performance in children with SSD, not children with TSD. These results suggest that oral language ability may be a pivotal protective factor for word reading and spelling in children with SSD. Gained phoneme-grapheme correspondence knowledge may also serve as a protective factor during word reading and spelling development for children with SSD, and possibly other disordered groups of children with oral language deficits who also have poor phonological awareness. Strengthening the co-development and interaction between the phonological and orthographic factors in these children could improve phonological awareness and word reading and spelling skills.


© 2022, Anna Marie Ehrhorn