Although children with speech impairment are at increased risk for impaired literacy, many learn to read and spell without difficulty. Around half the children with speech impairment have delayed acquisition, making errors typical of a normally developing younger child (e.g. reducing consonant clusters so that "spoon" is pronounced as…

Background: Awareness of individual phonemes in words is a late-acquired level of phonological awareness that usually develops in the early school years. It is generally agreed to have a close relationship with early literacy development, but its role in speech change is less well understood. Speech and language therapy for children with speech…