Polysyllabic Word Productions as a Screening Tool for Speech Sound Disorders in Native Nepali-Speaking Children: A Pilot Study

Abstract

Aims and Objectives: Speech sound disorders (SSD) affect children’s communication, learning, and social participation, yet culturally adapted screeners are scarce in Nepal. Polysyllabic words (≥3 syllables) place higher demands on speech planning and phonotactics, making them useful for detecting SSD. This study aimed to develop and pilot a brief Nepali polysyllable screener for three to five years, preschool children.
Methods: A cross-sectional, known-groups validation design was employed. Twenty native Nepali-speaking children out of whom 10 were SSD and 10 were typically developing (TD) were matched for age and sex. They were assessed using a 10-item picturable polysyllable word list. Responses were audio-recorded, scored dichotomously, and analyzed for group differences, internal consistency, and diagnostic accuracy.
Results: TD children obtained significantly higher scores (mean score=9.1) than SSD peers (mean scoe = 5.2), with a large effect size (Cohen’s d = 3.5). Item-level analyses showed adequate discrimination (corrected item–total correlations 0.41–0.74). Internal consistency was good (KR-20 = 0.82). Receiver operating characteristic (ROC) analysis demonstrated excellent diagnostic accuracy (AUC = 0.94, 95% CI 0.83–1.00). An optimal cutoff of ≤7 yielded sensitivity of 0.90 and specificity of 0.95.
Conclusion: The Nepali 10-item polysyllable screener reliably distinguished SSD from TD speech in preschool children. Although limited by small sample size, findings highlight its potential as a clinically valid, rapid triage tool for early identification of SSD in Nepalese schools and clinics.