Neural correlates of phonological processing in speech sound disorder: a functional magnetic resonance imaging study.

Speech sound disorders (SSD) are the largest group of communication disorders observed in children. One explanation for these disorders is that children with SSD fail to form stable phonological representations when acquiring the speech sound system of their language due to poor phonological memory (PM). The goal of this study was to examine PM in individuals with histories of SSD employing functional MR imaging (fMRI). Participants were six right-handed adolescents with a history of early childhood SSD and seven right-handed matched controls with no history of speech and language disorders. We performed an fMRI study using an overt non-word repetition (NWR). Right lateralized hypoactivation in the inferior frontal gyrus and middle temporal gyrus was observed. The former suggests a deficit in the phonological processing loop supporting PM, while the later may indicate a deficit in speech perception. Both are cognitive processes involved in speech production. Bilateral hyperactivation observed in the pre and supplementary motor cortex, inferior parietal, supramarginal gyrus and cerebellum raised the possibility of compensatory increases in cognitive effort or reliance on the other components of the articulatory rehearsal network and phonologic store. These findings may be interpreted to support the hypothesis that individuals with SSD may have a deficit in PM and to suggest the involvement of compensatory mechanisms to counteract dysfunction of the normal network.