Speech Sound Disorders Week Nine

Consider only

intended target consonants. Intended vowels are not considered.

Errors on postvocalic "r" (farm) are

counted

stressed and unstressed "er" are

considered vowels

Do not score target consonants in the _____________________ repetitions of a syllable. ("ba-balloon)

second or successive

Do not score target consonants in words that are partially or completely ____________________.

unintelligible

Percentage of Consonants Correct Formula

PCC = # of correct consonants / # of correct + incorrect consonants X 100

Classifications for Results of PCC

85-100% Mild

65-85% Mild/Moderate

50-65% Moderate/Severe

<50% Severe

Phonological Approaches focus on three main areas:

◦ Groups of sounds with similar patterns of errors are targeted

◦ Phonemic contrasts that were previously neutralized are established

◦ A naturalistic communicative context is emphasized

Contrast Approaches

◦ Most frequently used approaches for phonological treatment

◦ Goal is to increase effectiveness by addressing the lost phonemic contrasts in the child’s speech

◦ Approach is behavioral

◦ Three major ways used:

◦ minimal contrasts, maximal contrast, multiple contrasts

Minimal Contrasts

(aka Minimal Pair/Minimal Oppositions Method)

• Considered most appropriate for mild to moderate phonological disorder

• Phoneme contrast limited to one or just a few features (thus MINIMAL)

• Examples:

• bat-pat

vary only in voicing in the initial phoneme

• tea-key

differ in place

• toe-so

differ in manner

• Word pairs are formed that contrast the child’s error and target production and are represented easily by picture (semantically meaningful)

• 5 to 10 word pairs

• May have to select “near minimal pairs” or non words

Minimal Pairs

Words that differ by only one phoneme

Things to consider in target selection of minimal pairs

◦Relative frequency of occurrence

◦Consequence the process has on intelligibility (includes how many sounds affected)

◦Child's age and phonological development

Before starting the minimal contrast method it may be necessary to

additionally teach production of the target sound before starting. Recommended that child be stimulable and/or have 40% or more imitative production

Familiarization

"Look at this picture, this is a seal and look at this other picture this color is teal"

Auditory Discrimination

Therapist repeats the words in random order and asks the child to point to it. After SEVEN CONSECUTIVE correct responses (or 80% accuracy), the therapist can feel confident that the child auditorily differentiates between the two sounds.

Production Training:

Child instructed to be the "teacher". If child incorrectly says an intended word, creates an "aha" moment of communicative breakdown

Carryover Training:

work toward progressing with the sound in more complex speech situations, such as phrase, sentence (think hierarchy of Traditional Approach)

Multiple Contrasts

(Multiple Oppositions)

• Generally for moderate to severe phonological disorder, often with a phoneme collapse

• Target sounds are selected similar to minimal pairs, but pairs are created for all/most errors simultaneously

• Example:

child substitutes /t/ for /s/, /k/, /tʃ/ and /tr/

• Child would say “tip” for sip, kip, chip, trip

• Word pair sets are created:

• Example Set 1: tip-sip, tip-Kip, tip-chip, tip-trip

• Example Set 2: tease-sees, tease-keys, tease-cheese, tease-trees

• Example Set 3: two-Sue, two-coo, two-chew, two-true

• Four phases of treatment:

• 1. Familiarization and production of contrasts

• 2. Production of the contrasts (focused practice) + interactive play

• 3. Production of the contrasts with communicative contexts

• 4. Conversational recasts

Maximal Contrast

(Maximal Opposition)

• Best for moderate to severe phonological disorder

• Word pairs selected have multiple features that contrast between phonemes. Minimal pair words sets are used but the FEATURE contrasts are many.

• Example:

• chop-mop

vary in features of: sonorant, nasal, voice, anterior, coronal, high, strident

• chain-lane, can-fan, gear-shear, see-bee, thumb-gum

• Child’s error is not used for comparison

• Sound correctly produced by child that is maximally different from the error sound is used in comparison.

• Example:

child substitutes /t/ for /ʃ/ (says top for “shop”)

• Minimal Pair approach= top-shop, tip-ship

• Maximal Opposition approach= me-she, mack-shack, my-shy, mall-shawl

• use /m/ because in child’s repertoire and maximally opposed to /ʃ/

• Treatment same as with Minimal Pairs

The Empty Set

pairing 2 phonemes not in child’s speech in target words

◦ Example:

◦ Child produces /t/ for /ʃ/ and also does not produce /r/

◦ Clinician would contrast /ʃ/ and /r/ because they are maximally opposed and not in child’s phonetic inventory (“EMPTY SET”)

Goal Writing for Phonological Disorders

*When you are thinking about goals, you will want to think more broadly.

*Typically goals are written first to specifically try to increase intelligibility.

*The treatment approach you choose will likely drive how you write your goals.

*This is where we may include the phrase “age appropriate sounds” as a context of our goal—we may not expect certain sounds to reach mastery due to the child’s age.

*The goals will still be SMART goals, but will look a bit different from our articulation goals inmost cases.

*Goals may be written as a class of sounds, by a process, etc.

*Goals will start at the word level.

Examples of Goal Writing for Phonological Disorders

◦ Sally will correctly produce velar sounds (k, g) in all positions of words with 80% accuracy given minimal visual/verbal cues.

◦ Tatiana will demonstrate the suppression of liquid gliding by correctly producing /r, l/ in all positions of words with 80% accuracy, as measured by untrained probes.

◦ Roberto will demonstrate suppression of the process of final consonant deletion by “marking” the final consonant in 80% of words, as measured by 10 untrained CVC probe words.