COMD 352 Diagnosis: Articulation vs. Phonological Study Guide

COMD 352 Diagnosis: Articulation vs. Phonological Study Guide 25-26

I. Organizing Data

  • Phonemic inventory:

    • Definition: A list of speech sounds that the client can articulate.
    • Requirements:
    • Extensive data to ensure that all phonemes were tested in all possible configurations.
    • Organization: Can be organized in a matrix of all phones produced (correct and incorrect) or multiple matrixes representing different word positions.
    • Distribution of speech sounds:
      • Definition: A reference to where the correct and incorrect productions occurred within a word.

  • Listing of errors:

    • Analysis can utilize results from published articulation/phonology tests and/or speech samples.
    • Must include distribution of productions:
    • Word position:
      • Initial: Beginning of the word.
      • Medial: Occurs somewhere between the initial and final position of the word.
      • Final: End of the word.
    • Relation to vowel nuclei:
      • Prevocalic: Occurs before a vowel at the beginning of a word.
      • Intervocalic: Occurs between two vowels at the juncture of two syllables.
      • Postvocalic: Occurs after a vowel at the end of a word.
    • Can be analyzed for phonological and/or articulation errors.

  • Phonemic contrasts:

    • Analysis: Look for phonemic contrasts that occur and those that do not.
    • Consistent loss:
      • Definition: Substitution occurring every time in the client’s realizations (e.g., /t/ is always substituted for /k/).
    • Inconsistent realizations:
      • Definition: Substitutions/deletions that occur only in certain contexts.
    • Summarize collapses of phonemes:
    • Look for substitutions that represent more than one target phoneme for grouping (e.g., /t/ is substituted for both /k/ and /s/).

II. Determine Major Emphasis

  • Articulation:

    • Errors do not affect linguistic meaning (phonemic contrasts are intact).
    • Errors appear to be motoric in nature:
    • Errors are consistent, independent of context.
    • Generally consist of distortions rather than substitutions.

  • Phonology:

    • Errors affect linguistic meaning (phonemic contrasts).
    • Types of errors include substitutions, deletions, and/or additions.
    • Identified as more linguistic in nature.

  • Combining Both:

    • Both articulation and phonology can be relevant in assessment.

III. Conduct Analysis

  • If articulation emphasis, conduct an analysis of errors.
  • If phonological emphasis, choose type of analysis:
    • Phonological process
    • Distinctive features
    • Generative

IV. Determine Severity

  • Consider level of intelligibility:

    • Percentage of words understood:
    • Formula: (Number of words understood / Total number of words in sample) × 100.
    • Percentage of consonants correct:
    • Formula: (Number of correct consonants / Total number of consonants in a sample) × 100.
    • Not hard and fast but can use guidelines:
      • 90% + = mild
      • 66-89% = moderate
      • 55-65% = moderate-severe
      • 54% and below = severe

  • Consider developmental guidelines:

    • A six-month delay for a phoneme is considered disordered.
    • Determine which type of normative guidelines apply:
    • Sound: Age of mastery of sound.
    • Phonological Process: Age of suppression of phonological process.

  • Use of standardized score from published articulation/phonology tests.

  • Consider the amount of adverse attention the child's speech causes.

  • Speech-Language Pathologist (SLP) determines the level of severity based on experience and all factors outlined above.

  • Setting determines severity:

    • School regulations: Must have a moderate delay to qualify for therapy:
    • At least one sound in error.
    • Must be developmentally delayed (usually 1 year).
    • Must affect intelligibility or cause adverse attention toward the child’s speech.
    • Must affect school performance.
      • Note: More broadly defined than just academic progress, can include participation in cooperative groups and/or presenting in class.

V. Determine Priorities for Therapy

  • Consider what affects intelligibility the most:
    • Frequency of occurrence in language (e.g., /s/ occurs more frequently than /th/).
  • Consider what is most developmentally delayed.
  • Consider potential for generalization:
    • Impact on other sounds; number of phonemes in a sound class currently in error.
  • Consider stimulability:
    • Two schools of thought:
    • Do not target stimulable sounds first, as they may resolve on their own.
    • Target stimulable sounds first since they are easier to remediate, increasing overall intelligibility.

VI. Write Goals

  • Goals vary depending on setting:

    • Usually contain all of the following but may be configured differently:
    • Organized by a main goal with smaller steps including objectives and/or benchmarks.
    • What behavior is desired (e.g., correct production of /s/, suppression of stopping).
    • Amount of time for achievement.
    • What context (hierarchy of difficulty: initial -> final -> medial).
    • What setting.
    • How progress is measured.
    • What accuracy rate is targeted.

  • Examples:

    • Articulation Example:

    • Goal: By 10/1/21, Johnny will correctly produce /s/ and /z/ in all positions of words with 90% accuracy over two sessions in the therapy room setting as measured by SLP observation.

    • Objective/Benchmark 1: By 11/15/20, Johnny will correctly produce /s/ and /z/ in the initial position of words with 90% accuracy over two sessions in the therapy room setting as measured by SLP observation.

    • Objective/Benchmark 2: By 2/14/21, Johnny will correctly produce /s/ and /z/ in the final position of words with 90% accuracy over two sessions in the therapy room setting as measured by SLP observation.

    • Objective/Benchmark 3: By 6/4/21, Johnny will correctly produce /s/ and /z/ in the medial position of words with 70% accuracy over two sessions in the therapy room setting as measured by SLP observation.

    • Phonology Example:

    • Goal: By 10/1/21, Johnny will demonstrate suppression of the process (phonological pattern) of stopping by correctly producing /s/ and /z/ in all positions of words with 90% accuracy over two sessions in the therapy room setting as measured by SLP observation.

    • Objective/Benchmark 1: By 11/15/20, Johnny will correctly produce /s/ and /z/ in the initial position of words with 90% accuracy over two sessions in the therapy room setting as measured by SLP observation.

    • Objective/Benchmark 2: By 2/14/21, Johnny will correctly produce /s/ and /z/ in the final position of words with 90% accuracy over two sessions in the therapy room setting as measured by SLP observation.

    • Objective/Benchmark 3: By 6/4/21, Johnny will correctly produce /s/ and /z/ in the medial position of words with 70% accuracy over two sessions in the therapy room setting as measured by SLP observation.