The impact of selecting different contrasts in phonological therapy

Abstract

Previous research indicates that the extent of progress made by children with phonological disorders depends upon the nature of the word pairs contrasted in therapy. For example, phonemes that differ maximally in terms of place, manner, voicing and sound class (e.g., fan -man) in comparison to therapy where the word pairs presented differ minimally (e.g., fan -van). To investigate the implications of target selection within a typical clinical context (as opposed to a rigorous research setting) eight speech-language pathologists implemented intervention with appropriate children from their caseloads. Nineteen children each received 6 hours of therapy over one school term. They were randomly allocated to two groups. One group (of nine children) received intervention based on a traditional minimal pair approach, targeting homonymy as well as distinctive feature contrast. The other group (ten children) received intervention targeting contrasts differing across a range of distinctive features. Children made considerable progress in therapy in terms of speech accuracy and number of error patterns suppressed. However, there was no difference between the progress of the two groups. Followup assessment of 14 of the 19 children indicated maintenance of progress by both groups. Reasons for the lack of difference between the groups in the current study are considered and clinical implications are drawn.

Intervention for children with phonological impairment: Knowledge, practices and intervention intensity in the UK

“…The difficulty identifying the three complexity approaches and the multiple oppositions approach may have resulted from: the relative ‘newness’ of these approaches; SLTs’ tendency to continue to implement practices they have always used (Joffe and Pring ); a lack of awareness about the approaches; the similarity between the labels of multiple oppositions and maximal oppositions leading to confusion between the two; a lack of confidence and clinical experience in the use of these approaches; and the controversy about the effectiveness of the complexity approach within clinical contexts (particularly for children under 4 years of age, which Tom was not) (Dodd et al . , Rvachew and Nowak ).…”

“…Although the evidence base for choosing complex intervention targets could be argued to be inconsistent (Dodd et al . , Rvachew and Nowak , Topbaş and Ünal ), the possibility of a more effective and time‐efficient phonological intervention provides both ethical and financial motivations to investigate its potential further. While many previous studies throughout the world have considered SLTs’ current practices with SSD (Brumbaugh and Smit , McLeod and Baker , To et al .…”

Cluster-Randomized Controlled Trial Evaluating the Effectiveness of Computer-Assisted Intervention Delivered by Educators for Children With Speech Sound Disorders

“…Given that their pre-assessment occurred in Stage 2 (6 to 8 weeks before starting intervention), that intervention was 9 weeks in duration, and that the post-assessment occurred one week later, this degree of improvement occurred over approximately 16 weeks. In a study comparing the effect of minimal versus non-minimal contrast intervention delivered weekly by SLPs in 30minute sessions for 12 weeks, Dodd et al (2008) reported that their preschoolers increase in PCC (using the same assessment task as the current study) was over 16%. This degree of improvement was commensurate with other studies of phonological intervention (e.g., Crosbie, Holm, & Dodd, 2005).…”

“…This creates a challenge-conducting experimental research within the confines of a budget, with a feasible session dose, duration, and frequency for a period of time sufficient to demonstrate a clinically significant effect. Across a selection of peer reviewed published intervention studies involving children with SSD using pre-determine time periods and a robust RCT design, positive effects have been reported for 30-minute sessions scheduled three times weekly over 8 weeks (i.e., 24 sessions) (Allen, 2013), 12 weekly 30minute sessions (Dodd et al, 2008), and 16 twice weekly 1 hour sessions over 8 weeks (Ruscello et al, 1993). Together, these studies suggest that twice weekly 60 minute sessions (or four 30 minute sessions each week) over approximately 8 to 12 weeks may be sufficient to demonstrate an effect in a research context.…”

Randomized controlled trial comparing Parent Led Therapist Supervised Articulation Therapy (PLAT) with routine intervention for children with speech disorders associated with cleft palate

“…Results determined the sample size of 20 for each group. Previous research has found that children with non-cleft speech sound disorders demonstrated a mean increase of 16 percentage points following 6 hours of therapy (Dodd et al 2008) and 6 percentage points following 9 weeks of therapy (McLeod et al 2017). Scherer et al (2008) reported an increase of 10 percentage points in PCC in her intervention study with children with cleft palate.…”