448087

2012
CLT28310.1177/0265659012448087Child Language Teaching and TherapyGillam and Ford

Article

Child Language Teaching and Therapy

28(3) 297­–308
Dynamic assessment of © The Author(s) 2012
Reprints and permission: sagepub.
phonological awareness for children co.uk/journalsPermissions.nav
DOI: 10.1177/0265659012448087
with speech sound disorders clt.sagepub.com

Sandra Laing Gillam and Mikenzi Bentley Ford

Utah State University, USA

Abstract
The current study was designed to examine the relationships between performance on a
nonverbal phoneme deletion task administered in a dynamic assessment format with performance
on measures of phoneme deletion, word-level reading, and speech sound production that
required verbal responses for school-age children with speech sound disorders (SSDs). The study
adds to existing literature by administering the nonverbal task to children with SSDs, and by
incorporating the use of an error-specific prompting system in a dynamic assessment format to
inform instructional decisions. Ten school-age children with various degrees of speech sound
disorders participated in the study. Speech production, phonological awareness, and word-
level reading skills were examined. Performance on measures of verbal and nonverbal phoneme
deletion were significantly correlated; however, the measure of nonverbal phoneme deletion
was not related to performance on measures of speech sound production. Both measures were
related to word-level reading.

Keywords
phonemic awareness, speech sound disorders, assessment, word reading

I Introduction
A number of linguistic abilities underlie proficient reading and writing skills, including phonologi-
cal awareness. Phonological awareness refers to the awareness of the sound structure of spoken
language (Gillon, 2000; Schuele and Boudreau, 2008; Stackhouse and Wells, 1997) and is highly
linked to reading proficiency (Catts and Kamhi, 1999). It has been suggested that difficulties in
the use of previously stored phonological information or ‘representations’ may be the basis of
problems that some children have in learning to read and spell (Carroll and Snowling, 2004). There

Corresponding author:
Sandra Laing Gillam, Language and Literacy Clinic, 2610 Old Main Hill, Logan, UT 84322, USA
Email: sandi.gillam@usu.edu
298 Child Language Teaching and Therapy 28(3)

are a number of tasks that are used to assess underlying phonological representations, most of
which require verbal output on the part of the child.
Typical tasks used to measure phonological awareness include sound categorization or allitera-
tion (e.g. cat begins with the same sound as which of the following words: leg, cup, man); blend-
ing (m + a + n = man) and phoneme elision or deletion (cold – [k] = old). Research suggests that
the ability to perform various phonological awareness tasks emerges at different points in time,
progressing from the awareness of larger to smaller sound units (McNeill and Hesketch, 2010;
Schuele and Boudreau, 2008). It is generally accepted that children are able to match similar
sounds in words (sound categorization/alliteration) before they are able to segment words into
their respective sounds (segmentation). The phoneme awareness tasks that have been shown to be
most closely related to the development of early reading and spelling are those that require manip-
ulation of phonemes such as blending, segmentation and deletion tasks (Perfetti et al., 1987;
Rosner and Simon, 1971; Schuele and Boudreau, 2008).
There are a number of standardized assessments that are available to assess phoneme blending,
segmentation and deletion, including the Test of Preschool Early Literacy (TOPEL; Lonigan et al.,
2007). The TOPEL was designed for children between the ages of 3 and 5;11 and includes subtests
that measure print knowledge, vocabulary and phonological awareness. Phonological awareness is
measured through elision and blending tasks. The Comprehensive Test of Phonological Processing
(CTOPP; Wagner et al., 1999) is a similar measure designed for clients between the ages of 4 and
24 and includes composite scores for estimating skill in phonological awareness (categorization,
blending, deletion/elision), phonological memory and rapid naming. The Preschool and Primary
Inventory of Phonological Awareness (PIPA; Dodd et al., 2000) is a phonological awareness meas-
ure appropriate for children between the ages of 3 and 7 and includes subtests for measuring syl-
lable and phoneme segmentation, rhyme, alliteration, phoneme isolation and letter knowledge. A
comprehensive measure of phonological skills is the Phonological Assessment Battery (PhAB;
Frederickson et al., 1997), designed for children between the ages of 6 to 15; however, it does not
include subtests for measuring blending, segmentation or elision/deletion.
Many of the subtests on available phonological awareness measures require that children
respond verbally by producing a ‘free-response’ to a stimulus item. For example, on the CTOPP
children are asked, ‘What is cold without /k/’ to elicit the response old. Scoring involves making a
judgment as to whether a response is correct or incorrect. In the previous example, old is the correct
response and any other response as incorrect. The sound segmentation subtest of the PIPA requires
children to repeat words, inserting a clear pause between each phoneme. However, when a child’s
speech contains errors – as is the case when children present with speech sound disorders (SSDs)
– scoring may be less than straightforward. There are no guidelines in any of the manuals reported
here to inform scoring or interpretation under these conditions.
Approximately 10% of preschool and school-age children demonstrate some form of speech
sound disorder in the USA (National Institute on Deafness and Other Communication Disorders,
2007), and more than 92% of speech language pathologists (SLPs) will serve a child with SSD at
some point in time (Shewan, 1988). There is mounting research evidence that children with SSDs
are at increased risk for demonstrating difficulty acquiring phoneme awareness and in learning to
read (Anthony et al., 2011; Bird et al., 1995; Snowling et al., 2000). Therefore, measurement of
phoneme awareness, or underlying phonological representations, for children with SSDs is a very
important part of the assessment battery.
An alternative method to measuring phonemic awareness when children demonstrate a SSD is
to use a receptive or nonverbal task that does not require a verbal response (Larrivee and Catts,
1999; Rvachew, 2007; Sutherland and Gillon, 2005). This was the approach taken by Rvachew
Gillam and Ford 299

(2007), who examined the relationships between phonological processing and reading skill for
children with and without SSDs. Her findings revealed that phonological processing skill –; meas-
ured using nonverbal phonological awareness tasks from the Phonological Awareness Test (PAT;
Robertson and Salter, 1995) – and not speech production was related to later reading ability.
Nonverbal measures of phonemic awareness may provide better information regarding underlying
phonemic knowledge or phonological representations than measures that require a verbal response
for children with SSDs.
Recently, Claessen et al. (2010) designed a task to measure underlying phonological represen-
tations that does not require verbal output. Researchers administered the task to 69 typically
developing Year 2 (ages 7–8) children in Australia. Their tool, the Silent Deletion of Phonemes
(SDOP), consists of 35 items administered on a laptop computer and asks children to delete and
manipulate sounds silently or ‘internally’. Research suggests that tasks that require silent manipu-
lation of sounds allow for more accurate measurement of a child’s stored phonological representa-
tions than those that require verbal output. The SDOP task is administered in two separate
sessions. The first session is conducted to ensure comprehension for the pictures used as stimuli,
and the second session consists of the actual administration of the SDOP. This procedure is under-
taken to increase the likelihood that children will use their own ‘internal phonological representa-
tions’ to respond to the SDOP task than those spoken by the examiner and to reduce demands on
working memory. The stimulus is presented, ‘Black without /l/ is ____,’ and children are asked to
select from an array of four pictures to indicate the picture that represents the new word after dele-
tion (e.g. back). The SDOP reports acceptable internal consistency (Cronbach’s alpha = .85) and
high correlations with word and passage level reading (r = .62). Concurrent validity was meas-
ured by correlating children’s SDOP scores with a standard measure of phonological awareness;
the Sutherland Phonological Awareness Test: Revised (SPAT-R; Neilson, 2003) and was moderate
(r = .63). The SDOP is an acceptable measure of phonological awareness that does not require a
verbal response for use with children who demonstrate SSDs.
Recently, a receptive phoneme deletion task was developed that extends the work of Claessen
et al. (2010) to older children and is administered in a dynamic assessment format (Gillam et al.,
2011). The most familiar approach to dynamic assessment is the ‘test, teach, retest’ paradigm that
involves using actual child responses to inform instruction (Laing and Kamhi, 2003). A child’s
responsiveness to instruction during dynamic assessment is often a better way to diagnose prob-
lems in learning than performance on static assessments (Gutierrez-Clellen and Pena, 2001).
Dynamic assessment of phonological awareness has been shown to be a better predictor of reading
performance than static measures for children with and without speech and language impairments
(Gillam et al., 2011; Laing and Espeland, 2004; Laing and Kamhi, 1998; Spector, 1992).
Like the SDOP, the dynamic assessment of phoneme deletion is nonverbal and requires children
to silently manipulate sounds in words in increasingly complex syllable contexts. Internal reliabil-
ity for the dynamic assessment of the phoneme deletion task was assessed using Cronbach’s alpha
and is: = .88. Concurrent validity was assessed against a standard measure of phoneme deletion
(CTOPP) and is large (r = .84). The measure is unique because it incorporates a prompting system
based on the errors children make on the task. The number of errors made on the task provides
insight as to the quality of underlying phonological representations. Analysis of the types of errors
informs remediation.
The current study (Gillam et al., 2011) was designed to examine the relationships between
performance on the nonverbal phoneme deletion task administered in a dynamic assessment for-
mat with performance on a measure of phoneme deletion requiring a spoken response rather than
with performance on measures of phoneme deletion with a spoken response, word-level reading,
300 Child Language Teaching and Therapy 28(3)

and speech sound production for school-age children with SSDs. The study adds to existing litera-
ture by administering the nonverbal task to children with SSDs, and by incorporating the use of an
error-specific prompting system in a dynamic assessment format to inform instructional
decisions.
The following questions were asked:

1. To what extent does the nonverbal phoneme deletion task administered in a dynamic
assessment format correlate with performance on a verbal measure of phoneme deletion
(CTOPP, elision)?
2. To what extent do the phoneme deletion tasks (verbal and nonverbal) correlate with
performance on a measure of word-level reading (Woodcock Reading Mastery Test-
Revised, WRMT; word identification subtest) for children with SSDs?
3. To what extent do the deletion tasks (verbal and nonverbal) correlate with performance on
measures of speech production for children with SSDs (GFTA, PCC)?

II Methods
1 Participants
Participants were recruited from the city school district in Logan, Utah. Educators were asked to
refer children to the study who were being served by SLPs for primary speech impairment, who
had no identified developmental delays, and who were monolingual English speakers. Parents who
contacted the research team were invited to speak to research staff to decide whether they would
be interested in having their child participate in the study. Parents were interviewed and students
were consented and screened for participation in the study. Children who demonstrated a speech
sound disorder (SSD) without associated cognitive or motor/physical impairments (complex com-
munication needs) and were currently receiving services in the public schools for SSD were eligi-
ble for participation in the study. Children were excluded from participation in the study if their
nonverbal reasoning ability fell below 1 standard deviation (SD) of the mean on the Test of
Nonverbal Intelligence: 3 (TONI-3: Brown et al., 1998). Ten children between the ages of 5;0 and
10;9 (5 male; 5 female) participated in the study.

2  General procedures
Data collection took place at the Utah State University Speech and Hearing Center. Each child was
seen individually for testing. The examiners were trained research assistants under the supervision
of a certified speech language pathologist. Children were given breaks after each assessment to
play in a clinic playroom and have snacks under supervision of research assistants and, in some
cases, parents. Participants were given the Goldman Fristoe Test of Articulation (GFTA; Goldman-
Fristoe, 2000), the word identification subtest of the Woodcock Reading Mastery Test: Revised
(WRMT-R; Woodcock, 1987), the phoneme deletion subtest of the Comprehensive Test of
Phonological Processing (CTOPP; Wagner et al., 1999) and a nonverbal measure of phoneme dele-
tion administered in a dynamic assessment format (Gillam et al., 2011). Participants were also
given the Test of Nonverbal Intelligence: 3 (TONI-3; Brown et al., 1998).

a  Speech production tasks:   The GFTA was administered by three research assistants and was
recorded with a digital recorder. As one research assistant administered the assessment using the
standardized administration guidelines, recording the individual sound responses onto the GFTA
Gillam and Ford 301

protocol, the other research assistant recorded the whole-word verbal responses using broad IPA
transcription. A third research assistant observed the session from an observation room, transcribed
the students’ whole-word responses and scored the protocols after listening to the audio file. The
research assistants met and reviewed the digital recording, the whole-word transcriptions, and the
individual sound transcriptions. Scoring discrepancies were resolved by a trained research assis-
tant, who was also a certified SLP. Scoring reliability for the GFTA was 100%.
The whole-word response data obtained from administration of the GFTA was used to calculate
percent consonants correct (PCC; Shriberg and Kwiatkowski, 1982). Percent consonants correct
was calculated by adding the total number of consonants produced correctly for the whole-word
transcriptions elicited from the GFTA, dividing by the total number of intended consonants and
multiplying by 100. A trained research assistant calculated PCC. A second trained research assis-
tant calculated PCC independently and compared scores to those of the first research assistant.
Reliability of scoring was 100% for PCC. While we recognize that single-word samples are not
optimal for the calculation of PCC, we used it here as a gross measure of ‘intelligibility’.

b  Phonemic awareness tasks:  The CTOPP elision subtest was administered to all children by the
first author and contains 20-items arranged in increasing syllable complexity. CTOPP items are
presented verbally to children and require verbal responses. For example, children are asked to
delete monosyllabic words from multisyllabic words (e.g. popcorn without ‘corn’ = pop), and to
delete initial and final phonemes from words as in ‘bold’ without /b/ = ‘old’ or ‘mike’ without /k/ =
‘my’. The items become increasingly more difficult requiring medial phoneme deletion (e.g. tiger
without /g/) or cluster deletion in initial (e.g. strain without /r/), medial (e.g. winter without /t/) and
final word positions (e.g. silk without /l/). Evaluators are instructed in the manual to provide verbal
feedback on response accuracy for all 6 of the practice items and the first 5 of 20 test items, for a
total possible of 11 prompts. The test is discontinued after children miss 3 test items in a row.
The nonverbal phoneme deletion task resembles the CTOPP elision task but includes 21 pictur-
able items representing various syllable shapes requiring deletion of initial and final consonant
singletons and clusters. Children are asked to indicate their response choice by pointing to one of
a series of pictures. First, the examiner ensures that the child knows what the response choices are
by naming them and asking for a pointing response. For example, the examiner says, ‘This is ice’
(pointing to the picture of ice), ‘This is dice’ (pointing to the picture of dice) and, ‘This is under’
(pointing to the picture of ‘under’). Now you show me ‘ice’. After the comprehension check, the
stimulus item is shown to the child (e.g. This is mice) and a verbal query is given, ‘Can you show
me ‘mice without /m/?’ The child is expected to point to the picture representing ice.
The nonverbal task incorporates a systematic, dynamic scoring system based on the use of cor-
rective feedback (Spector, 1992; Yopp, 1988). Scores reflect the number of prompts that a child
requires to be successful and ranges from 1 (answered after no prompting) to 5 (answered after
maximal prompting) for a total possible score ranging from 21 (perfect score) to 105 (worst pos-
sible score). Thus, a score of 1 on the CTOPP, a verbal measure of phoneme deletion, and a score
of 1 on the nonverbal phoneme deletion task both represent the same level of performance. In
both cases, scores reflect the fact that students were able to answer the question accurately with-
out prompting. The prompted scoring system used on the nonverbal phoneme deletion task is
indicative of the level of prompting required by the child to be successful (fewer prompts indicate
higher skill) and provides the examiner with insight as to why the child responded incorrectly.
This information is used to provide specific feedback to the child so that a correct answer is more
likely on successive trials. The foils, prompts and scoring associated with the dynamic system are
as follows:
302 Child Language Teaching and Therapy 28(3)

• Foil type 1, Same: No, (stimulus; goat) without (sound; /t/) isn’t (same; goat). Goat and goat
are the same word. Listen (goat–goat). I want you to tell me which picture is (stimulus;
goat) without (sound; /t/).
• Foil type 2, Similar: No, (stimulus; goat) without (sound; /g/) isn’t (similar; coat). Goat and
coat end with the same sound. Listen (goat /ttttt/), (coat /ttttt/) [examiner highlights the part
of the similar word that is the same as in the stimulus word]. I want you to tell me which
picture is (stimulus; goat) without (sound; /t/).
• Foil type 3, Dissimilar: No, (stimulus; goat) without (sound; /t/) isn’t (dissimilar; bow).
Goat and bow have the same middle sound. Listen (goat /o/), (bow /o/) [examiner highlights
the part of the dissimilar word that is the same as in the stimulus word]. I want you to tell
me which picture is (stimulus; goat) without (sound; /t/).
• Score of 1: No prompt given.
• Score of 2: 1 prompt given.
• Score of 3: 2 prompts given.
• Score of 4: 3 prompts given.
• Score of 5: 4 prompts given.

Sample items from the phoneme deletion task are shown in Appendix 1.

c  Word-level reading:  The word-level reading measure was the WRMT-R word identification
subtest. The subtest contains 106 words arranged from simple (e.g. is, you, and) to complex (e.g.
cygnet, taupe, dossier) presented on easel pages. There are 9 words on each easel page. Children
are asked to read each word until they are unable to read 6 consecutive words on a single easel
page. The standardized manual does not include any information stating that credit may be given
for systematic speech sound errors children may produce. Therefore, incorrect productions were
judged as incorrect as per the manual. A raw score is calculated which may be converted to a stand-
ard score. In the current study, we calculated raw scores for the word-identification measure for
comparison with the other raw score data of interest. Descriptive data for individual participants on
measures of phoneme deletion, word-level reading and speech sound production are shown in
Table 1.

d  Non-verbal measure:  The TONI is a nonverbal, norm-referenced measure of intelligence, apti-

tude, abstract reasoning, and problem solving. Children are asked to point, nod or gesture to indi-
cate their response choices. The assessment contains 50 items arranged in order from least to most
difficult. A raw score is calculated which may be converted to a standard score for interpretation.

III Results
Table 2 contains Spearman’s rho Correlation Coefficients calculated to answer the questions posed
in the study. The first asked whether the nonverbal phoneme deletion task administered in a
dynamic assessment format correlated with performance on a verbal measure of phoneme deletion
(CTOPP, elision). There was a moderate significant correlation between the scores on the verbal
(CTOPP) and nonverbal phoneme deletion tasks (r = .64, p < .05) suggesting that they measured a
similar construct (e.g. phoneme deletion).
The second research question examined the relationship between the verbal and nonverbal pho-
neme deletion tasks and the measure of word-level reading (WRMT-R; word identification). There
was a highly significant correlation between the verbal measure of phoneme deletion and the
Gillam and Ford 303

Table 1  Descriptives

Participant Chronological Gender PCC GFTA WRMT CTOPP Nonverbal

age (year;month) deletion
 1 5;0 M 81 26 0 0 64
 2 5;3 F 59 46 4 0 44
 3 5;4 M 83 26 0 2 27
 4 6;6 M 61 42 7 0 41
 5 6;8 F 92 11 38 11 38
 6 7;6 F 93 9 44 4 31
 7 7;7 F 88 12 36 6 24
 8 8;0 F 99 2 40 7 31
 9 8;2 M 94 7 67 12 21
10 10;9 M 90 15 63 14 23
Notes: PCC = Percent Consonants Correct; GFTA = Goldman Fristoe Test of Articulation; WRMT-R = Woodcock
Reading Mastery Test-R, raw score, Word Identification subtest, raw score; Deletion = nonverbal phoneme deletion
task, raw score (total possible = 21–105); CTOPP = Comprehensive Test of Phonological Processing elision task, raw
score (total possible = 0–20).

Table 2  Spearman’s rho correlation coefficients

Age PCC GFTA WRMT Deletion CTOPP

Age – .75* –.70* .92** –.83** .89**
PCC – –.99** .78** –.58 .77**
GFTA – –.73* .53 –.71*
WRMT – –.61* .83**
Deletion – –.78**
CTOPP –

Notes: * p < .05; ** p < .01; PCC = Percent Consonants Correct; GFTA = Goldman Fristoe Test of Articulation;
WRMT-R = Woodcock Reading Mastery Test-R, Word Identification subtest; Deletion = nonverbal phoneme deletion
task; CTOPP = Comprehensive Test of Phonological Processing elision task. Higher raw scores on the GFTA indicate
a greater number of errors. Higher scores on the deletion task indicate a greater number of errors requiring additional
prompts. Thus, lower scores on the GFTA and the deletion task indicate better performance.

measure of word-level reading (r = .91, p < .01) and a moderate, significant correlation between
scores on the nonverbal measure of phoneme deletion and the measure of word-level reading (r =
.69, p < .05).
The third research question asked whether performance on the verbal and nonverbal phoneme
deletion tasks correlated with performance on measures of speech production (GFTA, PCC).
Measures of speech production (PCC, GFTA) were highly and significantly correlated with the
verbal measure of phoneme deletion (PCC: r = .79, p < .05; GFTA: r = .71, p < .05) but not with
the nonverbal measure of phoneme deletion (PCC: r = .48; GFTA: r = .52).

IV  Discussion and summary

Our findings suggest that both measures of phoneme deletion (verbal, nonverbal) assessed a simi-
lar construct and correlated with a measure of word-level reading. The verbal elision task (CTOPP)
304 Child Language Teaching and Therapy 28(3)

and the measure of word-level reading were highly correlated. The correlation (r = .83) was slightly
higher than correlations between the phonological awareness composite and WRMT-R composite
scores reported in the CTOPP manual for kindergarten (r = .71) and first grade children (r = .80).
Interestingly, the partial correlation controlling for age between CTOPP scores on the elision task
and the WRMT-R word identification task (r = .65) more closely resembled the correlation between
the nonverbal phoneme deletion task and the WRMT-R word identification measure (r = .61) for
the current study and in Claessen et al. (2010), which better reflects the nature of the relationship
between phoneme awareness and reading.
Speech production ability was highly correlated with performance on the verbal phoneme dele-
tion task and not to performance on the nonverbal task. This suggests that the verbal phoneme
deletion task was also measuring aspects of speech production that presented a potential confound
to the measurement of phonological awareness. For example, on the CTOPP, a child was asked,
‘Say popcorn. Now say popcorn without saying corn.’ His response to the question was, ‘bop’. A
different child responded to this prompt saying, ‘bo’ substituting the intitial /p/ and leaving off the
final sound. These responses illustrate the difficulty in scoring whether or not a child was able to
carry out the deletion task, and this has important implications for the measurement of phoneme
deletion skills in children for whom speech output is compromised. SSDs may place children at
risk for reading difficulties including problems acquiring phonological awareness knowledge
(Anthony et al., 2011), but that relationship is not a causal one. Therefore, SLPs must exercise cau-
tion when interpreting phonemic awareness results that require verbal output when children pre-
sent with SSDs.
A separate issue has to do with the level of success young children may have in completing
deletion or elision tasks, and how reflective their performance is of their underlying ability in pho-
nological awareness. It may seem intuitive that children would perform better in the nonverbal
dynamic assessment format than the verbal one because it incorporated the use of error-specific
prompting. However, the CTOPP incorporates 6 practice items and verbal feedback for errors that
occur on the practice items and the first 5 test items. It might be argued that if a child does not have
an accurate internal phonological representation for the word in question and the ability to carry
out the deletion task, no amount of prompting would result in a correct response. In other words, if
a child is unable to ‘profit from a model’ then it is unlikely that the underlying skill or representa-
tion is readily available to the child for use in completing the task. This is the premise for the use
of dynamic assessment. Data in Table 1 illustrates this notion. Notice that participants 3, 7, 9 and
10 scored nearly perfect scores on the nonverbal task, indicating that they did not require excessive
prompting to be successful. Younger participants 3 and 7 demonstrated significantly lower scores
on the CTOPP than the nonverbal task, which required them to perform essentially the same skill
using verbal output. The participants did not receive significantly ‘more’ prompting on the nonver-
bal task (score of 24 reflects 3 total prompts; score of 27 reflects 6 total prompts) than they received
on the verbal task (11 prompts possible). However, children did receive ‘error-specific’ prompting.
For example, children sometimes chose the foil that was the ‘same’ as the stimulus item, indicating
that they either did not understand the nature of the task, or that they were not able to perform the
phoneme manipulation to access the accurate underlying representation. The prompt given when
children made this error was specific to the error; ‘Goat and goat’ are the same word. Listen (goat–
goat). I want you to tell me which picture is (stimulus; goat) without (sound; /t/). In this way,
children were given clear, consistent, and specific feedback relative to their own responses.
Participants 1, 2, and 4 received scores of 0 on the CTOPP and scores ranging from 41–64 on
the nonverbal phoneme deletion task. Participant 1 required an average of 3 prompts, while partici-
pants 2 and 3 required an average of 2 prompts for every item in order to provide the accurate
Gillam and Ford 305

response. This suggests that even with significant prompting, some children may not have
possessed an appropriate underlying representation and/or ability to delete the segments to allow
them to be accurate in responding to the task and continued to make the same errors repeatedly.
Participant 9 was accurate 100% of the time on the nonverbal task, requiring no prompting, and
performed well on the CTOPP. Interestingly, participant 9’s only errors on the CTOPP involved
cluster elision (e.g. flame–lame). Examination of participant 9’s GFTA showed consistent produc-
tion errors on clusters. Performance on the nonverbal task for this participant suggested that the
underlying phonological knowledge relative to cluster elision was present, even though perfor-
mance on the verbal phonological awareness task did not reflect this knowledge.
The pattern of responses on the dynamic nonverbal task may be useful prescriptively to assist
clinicians in making decisions about what feedback children need to be accurate. For example,
participants selected the ‘similar’ foil more often than the other foil types. Similar foils rhymed or
contained similar initial or final clusters as the stimulus item. Prompting for this error involved
bringing attention to the part of the foil that was similar to the part of the stimulus that may have
caused the error. For example, the examiner might say, ‘Goat and coat end with the same sound.
Listen (goat /ttttt/), (coat /ttttt/). I want you to tell me which picture is (stimulus; goat) without
(sound; /t/).’ Prescriptive information gained through analysis of a child’s response choices may be
used to inform instruction through the use of specific feedback.

V  Clinical implications
Measurement of phoneme awareness for children with SSDs is an important yet difficult task for
SLPs because verbal responses may be difficult to transcribe, score and interpret. Similarly,
research suggests that silent phoneme manipulation, or ‘receptive’ tasks, are more appropriate for
assessing underlying phonological representations and phoneme awareness skills for children
with SSDs (Sutherland and Gillon, 2005). Traditional, standardized, norm-referenced measures
of phonological awareness do not always contain receptive items relative to blending, segmenta-
tion and elision of phonemes, nor do they offer suggestions for scoring verbal responses that
contain substitution, deletion or distortion errors. A similar problem may exist when examining
responses from children who are learning English as a second language, for children who do not
use standard pronunciation patterns, or when pronunciation differs from the expectations of the
examiner. Assessment of underlying phonological representation, and phonological and phone-
mic awareness is important for children who have SSDs (Blischak, 1994; Peeters et al., 2008;
Sandberg, 2001) because they are at higher risk for reading problems than children with typical
speech development. The nonverbal dynamic assessment of phoneme deletion may be a useful
alternative to assessments that require verbal responses and are administered in a static fashion
because it offers insight into the reasons children make errors on the task. The task is available for
use by clinicians, does not have to be administered on a computer, and may be readily adapted and
used in teaching as well as in assessment of phonological awareness. The error-specific prompt-
ing system that accompanies the dynamic assessment of phoneme deletion may provide clinicians
with important prescriptive information related to phonological processing for use in ongoing
intervention.

Acknowledgements
The authors would like to thank Chalese Buttars, Michelle Merrill, Meredith McBride and Rebecca Pitchforth
for their assistance with this project. We would also like to extend thanks to the Undergraduate Research
Program and specifically to Joyce Kinkead for supporting student research and research mentoring at Utah
306 Child Language Teaching and Therapy 28(3)

State University. This work was supported in part by a grant to the authors from the University Research and
Creative Opportunities (URCO) fund to support undergraduate research at Utah State University.

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Appendix 1 Nonverbal, phoneme deletion task

Stimulus Foils: Record the order of response choices for later analysis Total score
Initial sound: 1–5
  Foil type Target Similar Same Dissimilar  
Mice (m) ice dice mice eye  
  Foil type Similar Same Dissimilar Target  
Cup (c) cap cup under up  
  Foil type Similar Target Dissimilar Same  
Tape (t) cape ape eight tape  
  Foil type Same Similar Target Dissimilar  
Gate (g) gate wait eight ape  
  Foil type Dissimilar Target Same Similar  
Deer (d) eat ear deer tear  
Final sound:
  Foil type Dissimilar Same Similar Target  
Pine (n) wipe pine vine pie  
  Foil type Similar Dissimilar Target Same  
Boat (t) goat cap bow boat  
  Foil type Target Similar Same Dissimilar  

(Continued)
308 Child Language Teaching and Therapy 28(3)

Appendix 1 (Continued)
Stimulus Foils: Record the order of response choices for later analysis Total score
  Foil type Target Simliar Same Dissimilar
Goat (t) go coat goat bow  
  Foil type Same Target Similar Dissimilar  
Bone (n) bone bow phone bowl  
  Foil type Dissimilar Same Similar Target  
Bike (k) pie bike hike bye  
Initial cluster (2nd element):  
  Foil type Similar Same Dissimilar Target  
Glue (l) shoe Glue Boot goo  
  Foil type Similar Dissimilar Same Target  
Blow (l) Blue bone blow bow  
  Foil type Target Same Similar Dissimilar  
Skip (k) sip skip skate sit  
  Foil type Dissimilar Target Same Similar  
Grass (r) gate gas grass green  
  Foil type Dissimilar Similar Same Target  
Plants (l) axe ants plants pants  
  Foil type Similar Dissimilar Same Target  
Please (l) play pink please peas  
Initial cluster (1st element):  
  Foil type Target Dissimilar Similar Same  
Snap (s) nap no snow snap  
  Foil type Target Same Similar Dissimilar  
Stop (s) top Stop steak hop  
  Foil type Target Same Similar Dissimilar  
Skis (s) keys skis skate please  
Final cluster (2nd element):  
  Foil type Same Dissimilar Target Similar  
Belt (t) belt yell bell melt  
Final cluster (1st element):  
  Foil type Similar Same Target Dissimilar  
Fast (s) last fast fat foot  

Source: Gillam et al., 2011

Notes: Dynamic scoring: Each prompt corresponds to a potential error and is ‘foil specific’. If children point to the
correct picture after hearing the first prompt ‘Mice without /m/ is ______ (ice)’ no further prompts are required and
the score is 1. If children make an incorrect choice, provide an associated prompt according to foil type as follows:
•  Foil type same: No, (stimulus: mice) without (sound: /m/) isn’t (same: mice). Mice and mice are the same word. Listen
(mice–mice). I want you to tell me which picture is (stimulus: mice) without (sound: /m/).
•  Foil type similar: No, (stimulus: mice) without (sound: /m/) isn’t (similar: dice). Mice and dice end with the same sound.
Listen (mice /sssss/), (dice /ssss/) [examiner highlights the part of the similar word that is the same as in the stimulus
word]. I want you to tell me which picture is (stimulus: mice) without (sound: /m/).
•  Foil type dissimilar: No, (stimulus: mice) without (sound: /m/) isn’t (dissimilar: eye). Mice and eye have the same
middle sound. Listen (mice /i/), (eye /i/) [examiner highlights the part of the dissimilar word that is the same as in the
stimulus word]. I want you to tell me which picture is (stimulus: mice) without (sound: /m/).
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