Analysing the spontaneous speech of children with Foetal Alcohol Spectrum Disorder (FASD)
Foetal Alcohol Spectrum Disorder (FASD) is a global problem that affects various communities. FASD denotes a pattern of abnormalities intermittently seen in children born to women who consume huge quantities of alcohol during pregnancy (Church & Kaltenbach, 1997). Church and Kaltenbach (1997) suggest that FAS may be one of the primary causes of hearing, speech and other language problems in children. The two main approaches used to determine the effects of FASD on language are standardised language test (using a statistical approach to test some or all four domains of language, namely, phonology, syntax, morphology and semantics) applied to close-ended questionnaire answers and, to some extent, narrative analysis (in the course of which researchers use wordless picture books to analyse narratives in order to determine the social-communicative characteristics of individuals with FASD). Although the use of standardized measures of language might be helpful to determine problematic areas in relation to the different language domains (Wyper & Rasmussen, 2011), they do not show the difficulty with social-communicative functions which these children might be facing (Coggins, Friet, & Morgan, 1998). On the other hand, while narrative analysis addresses an important level of language (discourse level), it does not foreground the inherently interactive nature of language use and the problems that may be associated with communicative interactions. These shortcomings, in turn, suggest possible limitations in the interventions intended to address the language needs of children with FASD. There is, therefore, a need for complementary approaches that offer a more rounded picture of language impairment in children with FASD. In this study, three approaches are used in identifying features of the speech of children with FASD against the backdrop of comparisons with features in the speech of normally developing children. Firstly, conversational analysis (applied to spontaneous, open-ended speech) is introduced as a means to determine the more social-interactive aspects of speech impairment in children with FASD. Secondly, measures of linguistic aspects of speech (the mean length of utterance, Index of Productive Syntax and the number of different word roots) designed specifically for spontaneous speech are employed (they are applied to the same spontaneous data as the conversational analysis data). Thirdly, the more traditional standardized language test measures applied to non-spontaneous speech are used (covering the four domains of syntax, phonology, semantics, and pragmatics). The study’s objectives are to (1) compare patterns in the interactive speech of FASD children and normally developing children; (2) explore the relationship between FASD children and normally developing children in relation to both spontaneous speech measures and standardized measures of language; and (3) compare the impact of the primary caregiver's level of education on testing through spontaneous measures versus standardised measures. Using data from 14 children in the Bellville suburb of Cape Town, South Africa, the study finds that, on the conversational analysis measures, children with FASD, in contrast to normally developing children, tend to obey fewer rules of turn-taking, to overlap less, to engage less in self-repair and to struggle with management and maintenance of topics. The study also finds that children whose scores on the standardized language tests (with non-spontaneous data) suggest they have no language difficulty, especially in terms of phonology, obtained scores in measures of spontaneous speech that indicated language difficulty. The study also found that the socio-economic status of caregivers was a credible explanation for certain features in the speech of children with FASD is very similar to features in the speech of normally developing children. This finding highlights the role of family setting in mitigating the effects of FASD.