Early Development and Disorders in Speech/Language – EDDiS

The Group conducts research on early development of speech, language and communication in children with congenital or early adverse conditions such as cleft palate (CP±L), hearing loss (HL), neurodevelopmental disorder, and extreme prematurity, as well as methods for screening and assessment of babbling and early speech/expressive language.

Foto: Shutterstock

Project overview

Development of babbling, speech and language is studied in around 100 children with congenital or early adverse conditions such as cleft palate (CL±L), hearing loss (HL), neurological developmental disorder (ND) or extreme prematurity as well as around 70 children with typical development in separate projects. The development of methods for the assessment of babbling and early speech/expressive language as well as the evaluation of early intervention are included.

The project EDDiS started several years ago to increase knowledge about why not all children operated for cleft palate develop speech difficulties. Previous projects (see page Speech Outcome in Cleft Palate) have shown that the surgical protocol does not seem to have a decisive effect.

In the first project (Early development of speech and hearing, TUTH), it was investigated whether hearing loss related to secretory otitis media (OME), which is common in cleft palate, led to problems with babbling, speech and language development and whether children with similar hearing loss without cleft palate had the same problems. The group has developed methods for observation of babbling and consonant production, studies of the measure Canonical Babbling Ratio, and evaluated babbling screening in the sub-project Jollerkoll.


Among the most common early signs of developmental disorders in children is when their speech, language or communication do not develop as expected. Babbling is an important precursor to speech, both in typically developing children and in children with different kinds of disabilities. Deficits in babbling may predict later speech and language difficulties. The overall objectives of the project are to:

  • evaluate effect of intervention for parents of young children with a late babbling start or a small expressive vocabulary
  • develop and validation of methods for screening and assessment and babbling and early speech production
  • examine auditory, speech, language and communication skills longitudinally from 0-3 years of age in children with known adverse conditions in childhood such as hearing loss, cleft palate, neurodevelopmental disabilities, and extreme prematurity.
  • test if children without known adverse conditions, who later show developmental delay including language and communication deficits, can be identified early by evaluating a method of babbling screening.


Grants from the Swedish government under the ALF agreement
Foundation Frimurare Barnhuset, Stockholm
Aina Börjesons Research Foundation
The Hearing Research Fund
The Sunnerdahl Foundation for Disability
Tysta skolan Foundation
The Margit Wibel Foundation
Queen Silvia's Jubilee Fund
Linnea & Josef Carlsson Foundation
Sävstaholm Foundation

The included projects are described on the respective researcher's profile page.


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Marion Lieberman

Karolinska Institutet
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Anette Lohmander

Karolinska Institutet

Ulrika Marklund

Linköpings universitet

Carmela Miniscalco

Göteborgs universitet
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Anna Nyman

Karolinska Institutet & Habilitering och Hälsa, Region Stockholm
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Anna Persson

Karolinska Institutet & Karolinska Universitetssjukhuset

Ellinor Strandberg

Karolinska Universitetssjukhuset

Satu Turunen-Taheri

Karolinska Institutet & Karolinska Universitetssjukhuset

Lisa Westfors

Habilitering & Hälsa, Region Stockholm

Doctoral Theses

Anna Nyman, PhD, KI, 2022: Babbling, speech and language in children with neurological disabilities – development, validity of measures and effect of intervention.

Marion Lieberman, PhD, KI, 2021: Delayed babbling at 10 months: observation, etection, and a two-year follow-up

Anna Persson, PhD, KI, 2020: Swedish children with moderate hearing loss - on the importance of monitoring auditory and early speech development the first three years.

Theses for Master of Science in Speech Language Pathology (30 ECTS)

Ellinor Strandberg, MSc, KI, 2021: Babbling and early speech in extremely premature infants at 12 months corrected age

Liisi Raud Westberg, MSc, KI, 2014: Speech in 3-years-old children with unilateral cleft lip and palate: Impact of method for palatal repair and early intervention

Selected publications


Nyman A, Strömbergsson S, Lohmander A. Canonical babbling ratio – concurrent and predictive evaluation of the 0.15 criterion. Journal of Communication Disorders, 2021;94:106-164.

Willadsen E, Persson C, Patrick K, Lohmander A, Oller DK. Assessment of prelinguistic vocalizations: a comparison of reliability in naturalistic listening in real time and phonetic transcriptionClinical Linguistics Phonetics, 2020;34(7):593-616.

Lohmander A, Holm K, Eriksson E, Lieberman M. Observation method identifies that a lack of canonical babbling can indicate future speech and language problemsActa Paediactrica, 2017;106(6):935-943.  

Lieberman M, Lohmander A. Observation is a valid way of assessing common variables in typical babbling and identifies infants who need further supportActa Paediatrica, 2014;103:1251–1257.

Cleft Palate

Lohmander A, Raud Westberg L, Olsson S, Tengroth B, Flynn T. Canonical babbling and early consonant development related to hearing in children with otitis media with effusion with or without cleft palateCleft Palate-Craniofac J. 2021;58:894-905.  

Raud Westberg L, Höglund Santamarta L, Karlsson J, Nyberg J, Neovius E, Lohmander A. Longitudinal speech outcome in young children born with unilateral cleft lip and palate treated with one- or two-stage palatal repair and the impact of early interventionLogopedics Phoniatrics Vocology, 2019;44:58-66.

Klintö K, Salameh E-K, Olsson M, Flynn T, Svensson H, Lohmander A. Phonology in Swedish-speaking 3-year-olds born with cleft lip and palate and the relationship with consonant production at 18 monthsInt J Language Communication Disorders, 2014;49:240-254.  

Lohmander A, Olsson M, Flynn T. Early Consonant Production in Swedish Infants with and without Unilateral Cleft Lip and Palate and Two-stage Palatal Repair. Cleft Palate-Craniofac J, 2011;48:271-285.

Hearing impairment

Persson A, Flynn T, Miniscalco C, Lohmander A. Impact of auditory variables on consonant production in babbling and early speech in children with moderate hearing loss – a longitudinal study. Clin Ling Phon. 2022;36:833-848.

Persson A, Marklund U, Lohmander A, Flynn T. Expressive vocabulary development in children with moderate hearing loss – the impact of auditory variables and early consonant production. Clin Ling Phon. 2022;36:547-564.

Tengroth B, Lohmander A, Hederstierna C. Hearing thresholds concurrent with OME in young children with and without cleft palate. Cleft Palate Craniofac J.2020;57:616-623.  

Löfkvist U, Bäckström K, Dahlby M, Gunnarsson S, Persson M, Lohmander A. Babbling and consonant production children with hearing impairment who use hearing aids or cochlear implants – a pilot study. Logopedics, Phoniatrics, Vocology, 2020;45:172-180.

Delayed babbling development

Lieberman M, Sand A, Lohmander A, Miniscalco C. Asking parents about babbling at 10 months produced valid answers but did not predict language screening result 2 years later. Acta Ped, 2022;00:1–7.  

Lieberman M, Lohmander A, Gustavsson L. Parents’ contingent responses in communication with 10-month-old infants with typical or late babblingClinical Linguistics Phonetics, 2019;33:1050-1062.

Neurodevelopmental disorders

Nyman A, Strömbergsson S, Lindström K, Lohmander A, Miniscalco C. Speech and language development in 5-year-olds with neurodevelopmental disabilities and the association between early and later consonant production.  Developmental Neurorehab. 2021;24:408-417.

Nyman A, Lohmander A. Babbling in children with neurodevelopmental disability and a simplified way of measuring canonical babbling ratioClincal Linguistics Phonetics, 2018;32:114-127.

Extremely Premature

Strandberg E, Lieberman M, Lohmander A. Babbling in extremely premature infants at 12 months corrected age. Clin Ling Phon. Publ Online 2023.

Content reviewer:
Åsa Catapano