Degree of understanding of oral speech (according to DeRenzi and Faglioni, 1978 in Bolceková et al. ).
27 pre-school (26 native Czech-speaking and 1 native Russian-speaking) children (age 4; 6–7; 9 and gender 18 m; 9 f); 17 children with speech and language disorders from speech and language kindergarten (SLK) and 10 children with typical language development (TLD) from a kindergarten of common type, received two tests of language comprehension, the Token Test (TT) and the subtest from the Heidelberg Language Development Test (H-S-E-T) called The Sentence Comprehension Test (SCT). The results of the TT (success rate of children with TLD was 77%; children from SLK scored 70%) surpassed the results of the SCT (children with TLD 59%; children from SLK 44%) in both groups. The most severe deficiencies have been observed in children with SLI and a boy with severe bilateral sensorineural hearing loss. The observed differences between the means in both groups (TLD, N = 10; SLD, N = 17) were not statistically significant, using Student’s t-test (TT, p = 0.28; SCT, p = 0.11). There were not statistically significant differences between the means in children from three compared groups (TLD, N = 10; SLI, N = 8; articulation disorders, N = 6), using the ANOVA (TT, p = 0.60; SCT, p = 0.23).
- specific language impairment
- language disorders
This paper focuses on understanding sentences communicated via oral speech in pre‐school children. As reported by Smolík and Seidlová‐Málková , only grammatical knowledge can help a child in recognizing different meanings of phrases, such as
2. Basic terminology
The concept of
Developmental language disorders include
Speech sound disorders include problems with articulation—
3. Research objectives
The author of the contribution collected the research data during June 2016. In children of the selected research sample, the research goals were set as follows:
Investigate understanding of oral speech by two methods.
Evaluate the results of understanding oral speech.
Compare the success of children in understanding oral speech in terms of the type of kindergarten.
4. Research methods
Regarding the research methods of data collection, the oral speech understanding component was examined using the Token Test (TT)  and the Sentence Comprehension Subtest from the Heidelberg Language Development Test . In all participating participants, with the consent of children’s legal representatives, the examinations using the Token Test and Sentence Comprehension Subtest were recorded on a video camera. The video was taken with the intent to evaluate the children’s reactions as precisely as possible. In all 27 children from the research sample, their oral speech understanding was examined by the author of this article. At the conclusion of the entire examination, the examiner briefly assessed the children’s work: “You see, well you made it.”
4.1. Token Test
Token Test (TT) assesses understanding of orally communicated sentences. It is a widely used diagnostic method utilized in the field of children’s language, in neuropsychology and cognitive investigations in general . According to Ref. , all versions of the Token Test are based on the original work by Ennio De Renzi and Luigi Amadeus Vignola (1962 in Bolceková et al. ). For children, there is a Token Test for Children‐Second Edition TTFC‐2 (McGhee et al., 2007 in Paul and Norbury ). In our research, we used a shortened version of TT with 36 items divided into six parts. For examinations, we needed 20 tokens, varying in size (large and small), shape (round and square), and color (blue, green, yellow, white, and red). The proband’s task was to handle the tokens according to instructions of the examiner. Demands on verbal working memory gradually increase in the first five parts, e.g., “
4.2. Sentence Comprehension Test
Twenty‐seven children received a subtest from the Heidelberg Language Development Test H‐S‐E‐T (Heidelberg speech evolution test, henceforth H-S-E-T)  called the Sentence Comprehension Test (SCT). The Heidelberg Language Development Test was originally created to the German language and was adapted from German to Slovak language by Mikulajová , translated to the Czech language by Smékalová . The test is not standardized for the Czech language, and the orientation standards taken from Slovakia are applied. We do not have many options in the Czech Republic to diagnose language development in childhood, and the area of understanding the syntactic structures can be diagnosed by the Sentence Comprehension Subtest by a speech‐language pathologist. H‐S‐E‐T is intended for children from 4 to 9 years of age; it has 13 subtests and assesses the level of language skills. Individual subtests of the H‐S‐E‐T, for example, focus on sentence comprehension, the ability to form plurals and singulars, on repeating phrases, the ability to form derived words, ability to form sentences, and other language areas. Subtest Sentence Comprehension Test (SCT) contains 10 instructions of varying grammar complexity; the task of a child is to handle objects according to instructions spoken by the examiner. Examples of instructions (for 5‐year‐old and older children) are the following sentences: “
5. Research sample
The research sample consisted of 27 children ranging in age from 4 years and 6 months to 7 years and 9 months. These children were from the pre‐school section of two kindergartens in the Czech Republic. Ten children (37% of the monitored sample) attended a kindergarten of common type—this group included children (labeled P1‐P10) with typical language development. Seventeen children (P11‐P27), which means 63% of the monitored sample, attended a speech and language kindergarten due to communication difficulties. As shown in Figure 1, we worked with 14 boys and 3 girls in the speech and language kindergarten and with four boys and six girls in the kindergarten of common type.
We selected our specific participants in order to point out at difficulties in oral speech comprehension in children with speech‐language disorders, especially with developmental language disorders. Their difficulties in sentence comprehension are not visible “at a glance.“
Regarding the 17 children from the speech and language kindergarten, school attendance in eight of them (47%) was postponed by 1 year. The situation was different in children from the kindergarten of common type; none of the 10 examined children had deferred school attendance. The youngest child was participant P6 from the kindergarten of common type, aged 4 years and 6 months. The oldest child from the kindergarten of common type (P3) was aged 6 years and 9 months. At the time of examination, the oldest participant (P14)—a boy from the speech and language kindergarten—was aged 7 years and 9 months. The youngest participant (P25) from the speech and language kindergarten was aged 5 years and 9 months.
We were interested in the sample composition
The success results of the children in the Token Test are shown in Figure 3. These results are expressed by the number of points—the absolute rate of successful responses. The risk of moderately severe comprehension disorder (17–24 achieved points of a total of 36 points) was observed in seven participants (P13, P14, P15, P17, P19, P20 and P27) from the speech and language kindergarten (Tables 1 and 2). In participants P13, P19, P20 and P27, the deficits were associated with SLI diagnosis. Participants P14, P15 and P17 attended the speech and language kindergarten due to impaired articulation and phonological disorder. The risk of very severe comprehension disorder (0–8 achieved points of a total of 36 points) was found in one boy (P23) with severe bilateral sensorineural hearing impairment compensated by hearing aids. The two youngest participants (P6, 4 years and 6 months, and P8, 5 years and 4 months) achieved 19 and 22 points; these results, however, were predicted because of their age. A positive development of language functions was indicated in both of these boys, and it could be assumed that their oral speech comprehension would continue to develop positively.
|Number of points||Degree of understanding of oral speech|
|0–8||Very severe disorder|
|Participant||Number of correct responses (n)||Relative number (in %)|
The most difficult instruction of the Token Test was the 29th where the least number of children was able to follow it (
Figure 4 and Table 3 show that the most pronounced difficulties with sentence comprehension (H‐S‐E‐T) occurred in participants P13, P14, P17, P20, P23, and P25. Participants P19, P21, and P27 gave only four correct responses out of 10. Instruction processing was very difficult in participants with SLI (P13, P19, P20, P21 and P27) and also in participants P14 and P17 who struggled with impaired articulation and phonological disorder. We observed serious problems in the area of comprehension in P23, the boy with severe bilateral sensorineural hearing impairment compensated by hearing aids, and P25, the boy with dysarthria pursuant to spinal muscular atrophy with respiratory deficiency, type II SMA. Considerable difficulties were associated with the implementation of instructions containing time sequences expressed by prepositions
|Participant||Number of correct responses (n)||Relative number (in %)|
In the monitored groups, we noted differences in the results of the Token Test and Sentence Comprehension Test, in favor of children from the kindergarten of common type. Figure 5 shows that children with typical speech development from the kindergarten of common type achieved an average success of 77% in the Token Test and 59% in the Sentence.
Comprehension Test: children from the speech and language kindergarten achieved an average success of 70% in the Token Test and 44% in the Sentence Comprehension Test. Figure 5 shows that children with TLD were more successful in the Token Test by 7% and by 15% in the Sentence Comprehension Test than children from SLK.
The results obtained with children with typical language development are within what should be expected due to their age, due to their intact language development in pragmatics, semantics, syntax, phonology as so as intact development in cognitive area.
The difference in achievements on the part of the children was wider in the Sentence Comprehension Subtest. This subtest was more difficult for both groups. In the Token Test, the resulting differences may appear to be small. However, it is necessary to consider differences in the age composition of the groups. The average age of children from the speech and language kindergarten was 6 years and 5 months, while the children from the kindergarten of common type were younger by 11 months–their age was 5 years and 6 months on average. It is, therefore, important to note that even a small difference between the results in favor of children from the kindergarten of common type had its predicative value. The weaker results of children from the speech and language kindergarten (Table 4) can be justified by shortcomings in the development of reception, language processing and expression. Higher error rate was observed in children with developmental language disorders (SLI) and associated deficits in cognitive abilities (P13, P19, P20 and P27). In one boy (P23), the difficulties in understanding were the consequence of severe hearing impairment. We believe that participants P14 and P17—enrolled in the speech and language kindergarten due to impaired articulation—should be differentially diagnosed in order to examine the level of sentence comprehension and other areas of communication skills since their difficulties in understanding could be primarily based on SLI. The boy with dysarthria based on spinal muscular atrophy (P25) had severe issues with the Sentence Comprehension Test.
The most severe deficiencies in oral speech comprehension have been observed in children with SLI and in a boy with severe bilateral sensorineural hearing loss. Deficits appeared in the understanding of six to nine‐word instructions in the Token Test and in the Sentence Comprehension Test.
7.1. Statistical analysis of the results
The average score in the Token Test and in the Sentence Comprehension Test in children from kindergarten of common‐type and children from speech and language kindergarten was compared using Student’s
As can be seen in Table 5, there are not statistically significant differences between the mean results in the Token Test of children with TLD from kindergarten of common type and in children with speech‐language disorders in speech and language kindergarten (calculated value of significance
|Participant||Gender||Age (years; months)||Diagnosis||Token Test||Sentence Comprehension Test|
Group 1: kindergarten of common‐type (KCT)
Group 2: speech and language kindergarten (SLK)
There are not statistically significant differences between the mean results of the Sentence Comprehension Test of children with TLD from kindergarten of common type and in children with speech‐language disorders in speech and language kindergarten (calculated value of significance
The average mean in the Token Test and in the Sentence Comprehension Test in three compared groups (TLD,
There are not statistically significant differences between the mean results in the Token Test in children from three compared groups (TLD, SLI, and AD) (calculated value of significance
|Cell No.||Group; LS means (DATA)|
Effective hypothesis decomposition
As can be seen in Table 7, there are not statistically significant differences between the mean results in the Sentence Comprehension Test in children from three compared groups (TLD, SLI, and AD) (calculated value of significance
|Cell No.||Group; LS means (DATA)|
Effective hypothesis decomposition
Although differences in the Sentence Comprehension Test are not statistically significant, we believe that when the sample is enlarged, the differences could already be significant.
7.2. Possibilities of further research
School work implies good understanding of the spoken language, as well as reading and writing. Speech comprehension is considered a significant predictor of successful reading, writing, and school work as such. In relation to understanding sentences, Paul and Norbury  state that it is necessary to realize that the syntax used in school texts is more complex than the syntax used in oral speech. Souto et al.  found out: although novel verb studies show a clear connection between how children with SLI hear new verbs and how they use them, we do not yet have evidence that this connection is tied to a poor understanding of the input sentences that house the verbs. In this study, we found poor understanding on the children’s part, but no signs that this limited understanding was the actual source of auxiliary inconsistency.
We, therefore, conclude that the gaps in speech comprehension in children with developmental language disorders make their education even more challenging and that it is necessary to reveal these problems as soon as possible and work diligently on the development of speech comprehension. We suggest observing changes in the behavioral area; we have seen, for example, a change in pragmatics, specifics in eye contact, increased psychomotor restlessness, or questions posed by children after they were told the instructions (“
The paper is dedicated to the following project: “