Purpose: Phonological production impairments are prevalent in children with developmental language disorder (DLD) and hearing impairment (HI). This study aims to quantify and compare phonological errors in Swedish-speaking children using a novel automated assessment tool and provide an automatic machine learning classification algorithm of children with DLD and HI to age-matched controls based on phonological errors. Methods: 72 Swedish-speaking children (29 with DLD, 14 with HI, and 29 typically developing) participated. Phonological production was elicited using a 72-item confrontation naming task. A novel tool was developed to calculate a composite phonological error score and specific scores for different phonological errors (deletions, insertions, substitutions, and transpositions) from written speech productions. This tool leverages the International Phonetic Alphabet (IPA) and a form of the Normalized Damerau-Levenshtein Distance for accurate error analysis. Results: The composite score successfully differentiated between children with DLD and typically developing children, highlighting its sensitivity in detecting phonological impairment. Machine learning models can accurately differentiate between children with and without language disorders. However, children with DLD and HI differed in the phonemic deletion errors, which suggests that their phonemic production is relatively similar. Conclusions: Children with DLD and HI exhibit significantly higher phonological error rates compared to typically developing peers. Children with HI and DLC are comparably impaired in phonology (as manifested by the compositive phonological score). These findings highlight the potential of machine learning for early identification and targeted intervention in language disorders, improving outcomes for affected children and demonstrated the potential of a multilingual tool for scoring phonological errors.

The authors have declared no competing interest.

This study did not receive any funding.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study had received ethical approval from the Regional Ethical Review Board in Linkoping, Sweden. There was no risk of physical harm associated with participation. The caregivers of all children received written information about the study, including that all participation was voluntary and that consent to participate could be withdrawn at any time without stating a reason. They were also given the opportunity to receive oral information and to ask any questions they had about e.g. the purpose of the study, participation, confidentiality or data handling. The caregivers were also offered to receive information about future publications that included data from their children. The children received simplified oral information prior to testing, and were given the opportunity to ask questions.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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All data produced in the present study are available upon reasonable request to the first author. The Phonological Scoring application is accessible at Open Brain AI (http://openbrainai.com) web platform developed by the second author.