Phonemic error Patterns in the Pediatric Population as Reported by Practicing Speech-Language Pathologists

Background: Phonemic awareness plays a vital role in speech intelligibility and literacy development in early stages of learning. Phonemic errors may occur in cases of phonemic awareness deficits, affecting communication, learning, and psychosocial interaction in pediatric patients. Segmental phonemic errors are clinically significant in the presence of speech sound disorders and may impact decoding and spelling in later stages if not addressed in a timely manner. Objective: To identify the pattern of phonemic errors in the pediatric population, as identified by practicing speech-language pathologists in clinical settings. Methods: A descriptive cross-sectional study was conducted using a non-probability purposive sampling technique among 306 speech-language pathologists working in hospitals, clinics, rehabilitation centers, and academic institutes in Lahore, Pakistan. A structured questionnaire was used to collect data, and variables included commonly observed age groups, commonly used assessment tools, types of errors, phonemes involved, factors responsible for errors, treatment modalities, duration of treatment, re-assessment, caregiver involvement, and the need for further research. Descriptive statistics were analyzed using SPSS version 25.0. Results: Most of the speech-language pathologists assessed and treated phonological/phonemic disorders in their patients. Phonemic errors were most commonly found in the 4- to 5-year-old group (72.9%). Informal methods such as speech samples (28.8%) and standardized tests like DEAP (22.5%), GFTA (21.6%), and KLPA (21.6%) were the most common methods for identifying phonemic errors. Substitution (50.0%) and omission (28.1%) errors were the most common types of phonemic errors. The phonemes most affected were /k/ (49.3%), /r/ (29.1%), and /s/ (21.6%). The most common causes of phonemic errors were hearing loss (35.6%) and phonological awareness (30.7%). The most commonly used therapy for phonemic errors was Minimal Pair Therapy (52.0%). The therapy lasted for 3 to 6 months (50.7%), and the child was reassessed every week (49.7%). Caregivers were involved in the therapy (71.9%). Further research was recommended by 65.4% of the SLPs. Conclusion: The preschool group was found to be the most common group with phonemic errors, mainly substitution and omission errors with phonemes like /k/, /r/, and /s/. The most used therapy for phonemic errors was Minimal Pair Therapy with regular progress monitoring and the involvement of the caregivers.