Multidomain Developmental Indicators in 4-to 9-Year-Old Children with Oral Motor and Speech Sound Disorders

Abstract

Introduction: Persistent speech sound disorders (SSDs) are common in childhood and affect communication, literacy, and social development. Identifying risk indicators (RIs) and predictors for atypical oral motor and speech development is crucial for early intervention. This study examined medical, developmental, oral-behavioural, and hereditary RIs in children with SSD and compared diagnostic subgroups to typically developing peers. Methods: A clinical cohort of 198 children (ages 4-9) referred for specialist assessment was compared to 77 age-matched controls. Children were classified into four subgroups: motor speech disorder, with/without oral motor developmental delay and/or language-oriented disorder (MSD+), language-oriented disorder with oral motor developmental delay, no MSD (LD + ODD), ODD-only, and LD-only. Thirty-one RIs were analyzed using the chi-square or Fisher's exact tests with Bonferroni correction. Multivariate binary backwards logistic regression identified predictors of group membership (clinical vs. control). Results: The clinical group showed 11 of 31 RIs significantly more prevalent than controls (p < 0.0016). Children with multiple diagnoses (MSD+ and LD + ODD) had the highest RI counts (12 and 11, respectively), while single-diagnosis groups showed fewer RIs (LD-only: 2; ODD-only: 6). Significant RIs included medical (adenoid surgery, pulmonary disease), oral behaviours (mouth stimuli, selective eating), and developmental indicators (abnormal or absent crawling, delayed bladder control, fine/gross motor delay, non-canonical babble, poor attention during story listening). Family history of speech/language delay and literacy difficulties was also significant. The regression model demonstrated an excellent fit (Nagelkerke R-2 = 0.69; classification accuracy = 86.8%). Strong predictors for having an oral motor and/or a speech disorder included adenoid surgery (OR = 63.49), ear tube surgery (OR = 60.53), mouth stimuli behaviours (OR = 9.77), non-canonical babble (OR = 10.45), abnormal crawling (OR = 12.20), and family history of speech/language delay (OR = 9.89). Conclusion: Children with SSD often present multiple RIs across medical, developmental, oral-behavioural, and hereditary domains, especially those with combined diagnoses. Findings highlight the need for early, multidomain assessment and suggest that RIs such as oral motor behaviours and early developmental delays may inform screening and intervention strategies, supporting clinicians in identifying children who could benefit from tailored early intervention.