A. Lynn Williams

Multiple Oppositions: Theoretical Foundations for an Alternative Contrastive Intervention Approach

A multiple opposition approach to phonological intervention is described as an alternative contrastive approach for the treatment of severe speech disorders in children. The development and theoretical constructs of this approach are presented within the context of a clinical case study. The multiple opposition approach is based on the premise that the systemic level of phonological organization is essential in the description and intervention of disordered sound systems. Phonological descriptions identify phoneme collapses, which are viewed as phonologic strategies developed by the child to accommodate a limited sound system relative to the full adult system of the ambient language. Intervention is then directed systemically across the child’s entire rule, or collapse, by using larger treatment sets of multiple oppositions rather than by one contrast at a time.

Early and later vocalization skills in children with and without cleft palate

OBJECTIVE The purpose of this study was to describe the early vocalization skills in children with cleft lip and palate (CLP) at 6 and 12 months of age and compare these early vocalization measures to later speech and vocabulary development at 30 months of age. METHODS The participants in the study included 13 children without cleft lip or palate (NCLP) who were typically developing and 13 children with CLP matched for age, gender and socioeconomic status. Standardized measures of cognition, language, hearing, and prelinguistic vocalization measures were administered at 6 and 12 months and speech production, and vocabulary measures were collected at 30 months of age. RESULTS Group differences were observed in both receptive and expressive language development at 12 and 30 months of age. Group differences were observed in the frequency of babbling and Mean Babbling Level at 12 months and speech sound accuracy and vocabulary production at 30 months of age. Significant correlation coefficients were observed between babbling frequency at 6 months and consonant inventory size, vocabulary at 30 months for the children with clefts and PCC-R for noncleft children. CONCLUSIONS This study documented that young children with clefts have persistent vocalization and vocabulary deficits well beyond palate closure. Measures of babbling frequency, Mean Babbling Level and consonant inventories provide clinically effective means of identifying these early deficits. Additionally, these measures may provide a tool for monitoring the effects of early intervention programs that promote facilitation of sound and vocabulary development.

Multiple Oppositions: Case Studies of Variables in Phonological Intervention

The multiple oppositions approach (Williams, 1992; 2000) was incorporated as the beginning point of intervention for 10 children who exhibited moderate-to-profound phonological impairments. Several...

A systematic perspective for assessment and intervention: A case study

A systemic perspective was employed in completing a phonological analysis and developing an intervention plan for Jarrod, a 7;0 year old child who exhibited a severe speech sound disorder characterized by inconsistency. Results of the Systemic Phonological Analysis of Child Speech (SPACS) revealed a limited sound system that was characterized by phonotactic inventory constraints, positional constraints, and sequence constraints. Mapping the child-to-adult sound systems through phoneme collapses revealed a logical and symmetrical system that maintained systematicity, yet permitted variability. Based on the organizational principles suggested by the phoneme collapses, targets were identified for intervention using the distance metric approach, which is based on the function of sounds within a given system rather than the characteristics of a given sound, and assumes that targets will interact dynamically with the childs unique sound system. Finally, a multiple oppositions treatment approach intended to facilitate learning across phoneme collapses and lead to system-wide phonological restructuring was described.

Assessment, Target Selection, and Intervention: Dynamic Interactions within a Systemic Perspective.

There are a number of clinical options available for speech–language pathologists to choose from to analyze a childs phonological system, select treatment targets, and design intervention. Frequently, each of these areas of clinical options is viewed independently of one another or approached within an eclectic framework. In this article, an integrated and systemic approach is presented which assumes that a dynamic interaction exists among assessment, target selection, and intervention. Systemic Phonological Assessment of Child Speech, the distance metric approach to target selection, and the multiple oppositions treatment approach are described, with examples provided for each component. Finally, a case study is presented that examines the systemic approach of multiple oppositions relative to the approach of minimal pairs.

Intensity in phonological intervention: Is there a prescribed amount?

Abstract Despite a number of studies that have demonstrated positive outcomes for inducing clinical change in children with speech sound disorders (SSD), there is a need to address the question of whether resources are being applied in an optimal manner. As a consequence, there has been a call to look within interventions to examine parameters that may contribute to intervention outcomes; specifically the intensity of intervention (dose, frequency, duration, and cumulative intervention intensity). In this paper, empirical evidence from three intervention studies using multiple oppositions primarily, and a second contrastive approach, minimal pairs, is reported with regard to the parameters of intervention intensity. The findings indicated that greater intensity yields greater treatment outcomes. Further, quantitative and qualitative changes in intensity occur as intervention progresses, and there were differences in intensity based on severity of the SSD. Based on these data, suggestions were made toward establishing some prescribed amounts of intensity to affect treatment outcomes for children with SSD.

Early Phonological Development: Creating an Assessment Test.

This paper describes a new protocol for assessing the phonological systems of two-year-olds with typical development and older children with delays in vocabulary acquisition. The test (Profiles of Early Expressive Phonological Skills (PEEPS), ) differs from currently available assessments in that age of acquisition, based on lexical norms from the MacArthur-Bates Communicative Developmental Inventories, served as the primary criterion for creating a word list. Phonetic and semantic properties of the words were also considered in selecting items for the test. Productions of words using the PEEPS protocol have been gathered from a group of children with typical development and another group with cleft lip and/or palate. By 24 months of age, the children with typical development produced more than 90% of the target words and the children with atypical development produced 73% of the words. Regarding administration, the time needed for administering the protocol decreased with age.

Assessment of Single-Word Production for Children under Three Years of Age: Comparison of Children with and without Cleft Palate

Background. This study reports comparative phonological assessment results for children with cleft lip and/or palate (CLP) to typically developing peers using an evaluation tool for early phonological skills. Methods. Children without clefts (NC = noncleft) and 24 children with CLP, ages of 18–36 months, were evaluated using the Profile of Early Expressive Phonological Skills (PEEPSs) [1]. Children interacted with toy manipulatives to elicit a representative sample of target English consonants and syllable structures that are typically acquired by children between 18 and 27 months of age. Results. Results revealed significant differences between the two groups with regard to measures of consonant inventory, place of articulation, manner of production, accuracy, and error patterns. Syllable structure did not indicate differences, with the exception of initial consonant clusters. Conclusions. findings provide support for PEEPS as a viable option for single-word assessment of children with CLP prior to 3 years of age.

An Australian survey of parent involvement in intervention for childhood speech sound disorders

Abstract Purpose: To investigate how speech-language pathologists (SLPs) report involving parents in intervention for phonology-based speech sound disorders (SSDs), and to describe the home practice that they recommend. Further aims were to describe the training SLPs report providing to parents, to explore SLPs’ beliefs and motivations for involving parents in intervention, and to determine whether SLPs’ characteristics are associated with their self-reported practice. Method: An online survey of 288 SLPs working with SSD in Australia was conducted. Result: The majority of SLPs (96.4%) reported involving parents in intervention, most commonly in providing home practice. On average, these tasks were recommended to be completed five times per week for 10 min. SLPs reported training parents using a range of training methods, most commonly providing opportunities for parents to observe the SLP conduct the intervention. SLPs’ place of work and years of experience were associated with how they involved and trained parents in intervention. Most (95.8%) SLPs agreed or strongly agreed that family involvement is essential for intervention to be effective. Conclusion: Parent involvement and home practice appear to be intricately linked within intervention for phonology-based SSDs in Australia. More high-quality research is needed to understand how to best involve parents within clinical practice.

Elements of Phonological Interventions for Children With Speech Sound Disorders: The Development of a Taxonomy

Purpose Our aim was to develop a taxonomy of elements comprising phonological interventions for children with speech sound disorders. Method We conducted a content analysis of 15 empirically supported phonological interventions to identify and describe intervention elements. Measures of element concentration, flexibility, and distinctiveness were used to compare and contrast interventions. Results Seventy-two intervention elements were identified using a content analysis of intervention descriptions then arranged to form the Phonological Intervention Taxonomy: a hierarchical framework comprising 4 domains, 15 categories, and 9 subcategories. Across interventions, mean element concentration (number of required or optional elements) was 45, with a range of 27 to 59 elements. Mean flexibility of interventions (percentage of elements considered optional out of all elements included in the intervention) was 44%, with a range of 29% to 62%. Distinctiveness of interventions (percentage of an interventions rare elements and omitted common elements out of all elements included in the intervention [both optional and required]) ranged from 0% to 30%. Conclusions An understanding of the elements that comprise interventions and a taxonomy that describes their structural relationships can provide insight into similarities and differences between interventions, help in the identification of elements that drive treatment effects, and facilitate faithful implementation or intervention modification. Research is needed to distil active elements and identify strategies that best facilitate replication and implementation.