Pediatric+Speech+Sound+Disorders+-+Phonology

=Pediatric Speech Sound Disorders: = =//Phonology// =

=What is a phonology disorder? =
 *  A phonological disorder is an impaired comprehension of the sound system of a language, and the rules that govern the sound combinations. There is a failure to use the accurate speech sounds that are appropriate for the child's age level. There is an observed relationship between early phonological disorders and subsequent reading, writing, spelling, and mathematical abilities. (ASHA 2)
 * "A speech sound disorder occurs when mistakes continue past a certain age. Every sound has a different range of ages when the child should make the sound correctly. Speech sound disorders include problems with articulation (making sounds) and phonological processes (sound patterns)."
 * A phonological disorder affects a speaker's production and/or mental representation of speech sounds of the target language. Specifically, a phonological disorder may reflect an inability to articulate speech sounds, with the communication difficulty involving a motoric component. (Gierut, 1998)

**Sources:**  =How is a pediatric phonology disorder diagnosed? =
 * ASHA 1: "Speech Sound Disorders" //Articulation and Phonology//. ASHA. 20011. http://www.asha.org/public/speech/disorders/SpeechSoundDisorders.htm
 * ASHA 2: "Incidence and Prevalence of Communication Disorders and Hearing Loss in Children - 2008 Edition" //Speech Disorders//. ASHA. 20011.[]
 * Gierut, J. A. (1998, February). Treatment Efficacy: Functional Phonological Disorders in Children [Electronic version]. //Journal of Speech, Language and Hearing Research//, //41//, 585-600.
 * A speech-language pathologist (SLP), is the professional that evaluates the child with speech and language difficulties. The SLP listens to the child and may use a formal test to record sound errors. Most often phonological disorders are sucessfully treated through therapy and the more mild forms dissappear on their own.

[[image:topas.jpg width="204" height="252"]]

 * Authors: Phyllis Newcomer Edna Barenbaum
 * Publishers: PRO-ED
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Age Range: 3-9 Years
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Administration Time: 15-30 Minutes
 * <span style="font-family: Tahoma,Geneva,sans-serif;">**Description:** Comprises four sub-tests (Rhyming, Incomplete Words, Sound Sequencing, and Sound Deletion) that measure three areas of phonological awareness: sound comparison, phoneme blending, and phoneme segmentation. (ASHA 3)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">The kit includes: Examiner's Manual, 25 Examiner Record Booklets, Block Kit, Block Kit Instructional Manual, and an Audio Cassette, all in a sturdy storage box.
 * ===<span style="font-family: Tahoma,Geneva,sans-serif;">Price: $127.00 ===

<span style="color: #0000ff; font-family: Tahoma,Geneva,sans-serif;">[[image:BBTOP.jpg]]

 * <span style="font-family: Tahoma,Geneva,sans-serif;">Authors: Nicholas W. Bankson and John E. Bernthal
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Publishers: PRO-ED
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Age Range: 3-9 Years
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Administration Time:15-20 Minutes
 * <span style="font-family: Tahoma,Geneva,sans-serif;">**Description:** Assesses a child's articulation and phonology. Yields scores through word inventory, consonant inventory, and phonological process inventory. Manual provides training and practice exercises for phonological process scoring. (ASHA 4)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Designed for preschool and school-age children, the BBTOP includes a colorful Picture Book containing 80 pictures, one for each test item, and an easel on which to place the book.
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Complete BBTOP Kit includes Manual, Picture Book, 25 Record Forms, and an easel, all in a carrying case.
 * ===<span style="font-family: Tahoma,Geneva,sans-serif;">Price: $195.00 ===

<span style="font-family: Tahoma,Geneva,sans-serif;">**Sources:**


 * <span style="font-family: Tahoma,Geneva,sans-serif;">ASHA 1: "Speech Sound Disoders" //Articulation and Phonology//. ASHA. 20011. http://www.asha.org/public/speech/disorders/SpeechSoundDisorders.htm
 * ASHA 3: "Test of Phonological Awareness Skills" //Assessment Instruments//.ASHA. 2011. http://www.asha.org/SLP/assessment/Test-of-Phonological-Awareness-Skills-%28TOPAS%29.htm
 * <span style="font-family: Tahoma,Geneva,sans-serif;">ASHA 4: "Bankson Bernthal Test of Phonology" //Assessment Instruments//. ASHA. 2011. []
 * <span style="font-family: Tahoma,Geneva,sans-serif;">PRO-ED WEBSITE 1: (TOPAS): [] w/pic
 * <span style="font-family: Tahoma,Geneva,sans-serif;">PRO-ED WEBSITE 2: (BBTOP) [] w/pic

=<span style="color: #f72652; font-family: Tahoma,Geneva,sans-serif;">What theoretical approaches guide treatment of a pediatric phonological disorder? = <span style="font-family: Tahoma,Geneva,sans-serif;">**Sources:**
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Distinctive Feature Theory
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Natural Phonology
 * <span style="font-family: Tahoma,Geneva,sans-serif;">"**Distinctive features** are the smallest indivisible sound properties that establish phonemes. An inventory of distinctive sound features would demonstrate similarities and dissimilarities between phonemes. These similarites and differences are marked by the presence of certain properties in some phonemes and the absence of these properties in others." (Example: /k/ and /g/ are identified by the use of voice. /k/ and /g/ are both consonantal sounds, neither are vocalic or nasal. However, /k/ is not voiced and /g/ is voiced.) (Waengler, 64)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">**Distinctive Feature Theory** is used to identify the properties of certain sounds that distinguish them from other sounds. "Distinctive feature analysis contrasted the features of the target sound to the substitution, resulting in a list of distinctive features that differentiated between the two. This analysis could show whether (1) error and target sounds shared common features and (2) specific error patterns existed." (Waengler, 65)
 * **Traditonal approach** to sound teaching considers both the perception and production of speech sounds and introduces linguistic complexity with successive improvements in sound learning. Treatment typically starts with what has been called ear training or auditory bombardment, then progresses to sound production, at first in isolation then words, phrases, etc. This approach is considered a sensory-motor method of sound teaching. (Gierut, 1998)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Baumen-Waengler, Jacqueline. (2008). Articulatory and Phonological Impairments: A Clinical Focus. Boston, MA: Pearson Education, Inc.
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Gierut, J. A. (1998, February). Treatment Efficacy: Functional Phonological Disorders in Children [Electronic version]. //Journal of Speech, Language and Hearing Research//

=<span style="color: #b724b4; font-family: Tahoma,Geneva,sans-serif;">What are the general goals of treatment and expected outcomes? =
 * <span style="color: #201818; font-family: Tahoma,Geneva,sans-serif;">Phonological process treatment may involve teaching the rules of speech to individuals to help them say words correctly. (ASHA 1)
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif;"> No matter what combination of difficulties a child with a developmental phonological disorder has, appropriate speech-language pathology treatment is usually successful in eliminating or at the very least, reducing the problem. Children with phonological impairments do not necessarily go on to experience literacy problems, but children who still have phonological disability in the form of speech errors (especially those at the severe end of the scale) when they start school, are very much at risk for difficulties learning to read and spell. This is one reason for wanting to treat them early, at three or four years of age. (Bowen, C)
 * <span style="color: #000000; font-family: Tahoma,Geneva,sans-serif;">In a traditional approach a child listens to and may judge the accuracy of a target sound in attempt to improve speech sound awareness and the self-monitoring of speech. Treatment then progresses to sound production, with the child producing the target sounds in units increasing linguistic complexity (i.e. sound in isolation, then words, phrases, sentences, and finally conversational speech. Initially, the target sound may be introduced in a word-initial position, follwed by word-final position and then word-medial position. (Gierut, 1998)

<span style="font-family: Tahoma,Geneva,sans-serif;">** Sources: **


 * <span style="font-family: Tahoma,Geneva,sans-serif;">ASHA 1: "Speech Sound Disoders" //Articulation and Phonology//. ASHA. 20011. http://www.asha.org/public/speech/disorders/SpeechSoundDisorders.htm
 * BOWEN, C. (1999) Multiple exemplar training in Phonological therapy: [] on (April 9, 2011)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Gierut, J. A. (1998, February). Treatment Efficacy: Functional Phonological Disorders in Children [Electronic version]. //Journal of Speech, Language and Hearing Research//, //41//, 585-600.

=<span style="color: #40d46a; font-family: Tahoma,Geneva,sans-serif;">Treatment Goals: =
 * Treatment goal: The client will communicate effectively, at a developmentally appropriate level.


 * **A behavioral objective for a traditional approach:**
 * Using a mirror, the client will produce /t ʃ  / when shown a picture of items where /t  ʃ  / is in initial position, 16 out of 20 times, with 80% accuracy.

=<span style="color: #0985ec; font-family: Tahoma,Geneva,sans-serif;">What kinds of techniques/activities might be observed in a typical treatment session? =

<span style="font-family: Tahoma,Geneva,sans-serif;">**1. Minimal Pair Contrast Therapy-** The therapeutic use of pairs of words that differ by one phoneme only. These minimal pairs are used to establish contrasts not present in the child's phonological system. (Bauman-Waengler, Jacqueline pp 313)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">In essence **m****inimal pair contrast therapy** treatment teaches featural contrasts through the use of pairs of words that differ by a single phoneme. The featural differences between the phonemes are the focus of treatment. The premise is that,once a featural difference is introduced, that same difference will be applied by a child to other relevant phonemic pairs. For example, the phonemes /k/–/t/ differ in terms of place, dorsal versus coronal. If the place distinction is learned in treatment of /k/–/t/ pairs, this same dorsal coronal contrast should be carried over to other dorsal-coronal pairs such as / /–/d/ and /ŋ/– /n/. The clinical advantage then is that generalization to untreated phonemes is expected to occur. Minimal pair treatment can be set up in a variety of ways that affect the extent of generalization for children with phonological delays. (Barlow/Gierut)

<span style="display: block; font-family: Tahoma,Geneva,sans-serif; text-align: left;">**2.** **Phonological Cycles Approach-** This approach uses three key elements which include auditory bombardment of phonological targets at the beginning and end of sessions, use of minimal pairs to teach production and "cycling" of the phonological targets. (Mighigan Speech Language Guidlines, pp A-9) <span style="font-family: Tahoma,Geneva,sans-serif;">** 3. Focused Auditory Input Therapy -** Intended for very young children who are unwilling or unable to produce targets when we first see them. In this case no production is demanded but the clinician designs the environment to provide for lots of opportunity for the child to hear the target sound or pattern. (Bowen, C.)


 * <span style="color: #f464ce; font-family: Tahoma,Geneva,sans-serif;">Activity Example: **<span style="color: #f464ce; font-family: Tahoma,Geneva,sans-serif;"> Phonological Bingo

<span style="font-family: Tahoma,Geneva,sans-serif;">[[image:Bingo.jpg]]
<span style="font-family: Tahoma,Geneva,sans-serif;">Students play exciting variations like Five in a Row, Blackout, and Four Corners while honing skills in:
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Sound Awareness
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Rhyming
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Segmentation
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Blending (PRO-ED WEBSITE 3)

<span style="font-family: Tahoma,Geneva,sans-serif;">**Sources:**
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Bauman-Waengler Jaqueline (2008) Treatment of Phonemic errors. Stephan D. Dragin (Ed), Articulatory and Phonological Impairments: A clinical Focus (pp 313)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Barlow A. Jessica Ph.D. & Gierut A. Judith Ph.D. (2002) Pair Approaches to Phonological Remediation. Seminars in Speech and Language, 23 (1). Retrieved from []
 * <span style="font-family: Tahoma,Geneva,sans-serif;">BOWEN, C. (1999) Multiple exemplar training in Phonological therapy: [] on (April 9, 2011)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Michigan Speech Guidelines. //Articulation/Phonology// June 20 2006. []
 * PRO-ED WEBSITE 3: (BINGO) [] w/pic

<span style="color: #f9c32f; font-family: Tahoma,Geneva,sans-serif;">What did I observe during my field observations of treatment for a pediatric phonology disorder?
<span style="font-family: Tahoma,Geneva,sans-serif;">** Ashley's Response: **
 * <span style="font-family: Tahoma,Geneva,sans-serif;">At the Kindergarten grade level in a public school setting, I observed a 5 year old being evaluated for her 3 year IEP, using "The Test of Phonological Awareness" by Carolyn Robertson. The test was divided into six different sections including blending, substitution, isolation, segmentation, rhyming and graphemes.
 * __<span style="font-family: Tahoma,Geneva,sans-serif;">Examples __<span style="font-family: Tahoma,Geneva,sans-serif;">:
 * <span style="font-family: Tahoma,Geneva,sans-serif;">The clinician presented the client with three different colored blocks, representing three different speech sounds. The clinician created the word FUN with the blocks and asked the client to change the word from FUN to RUN.
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Using a flipbook with letters of the alphabet, the client was asked to make the sounds of each letter, including both sounds for vowels.
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Using a flipbook the client was asked to produce various speech sounds including "eh" "ch" "oa" "str" "ou" and "oi".
 * <span style="font-family: Tahoma,Geneva,sans-serif;">The clinician broke down a word by each speech sound, leaving a pause inbetween. The client was then asked to repeat the word without any pauses. (Ex: S-l-ip-er)


 * Sandra's Response:**
 * During an observation in a pre-school classroom, I observed an SLP "playing" a Blending Bingo game. She allowed two other students to participate with the client and herself. The client sat on the side of the clincian. To begin the game, the SLP went over each picture on the board and had the students repeat it individually. Words in this game included: fox, map, door, milk, silk, house, mouse - mostly minimal pairs. The SLP would say the word, breaking up the onset and rime. She would raise her left hand while saying the onset, then the right hand for the rime. When she placed both hands together, the children would say the word, blending the onset and rime. They would place a marker on the word. Once a child achieved Bingo, she asked her client to say the words to her. The client seemed to enjoy the game and the fact that other children in her class were participating with her.


 * Brittany's Response:**
 * During my field observations, I observed an SLP rendering services to an 8 year old boy. One of the materials that the clinician used were pictures. Three pictures were shown on a card and the clinician would say the words aloud for the client. The client was then asked which words out of the three rhymed. This was a sound discrimination task to strengthen the client's ability to differientiate between phonemes. The next step of this task was for the client to be able to tell which words began with the same sound. The clinician would read aloud the words and ask the client which words began with the same sound. The last step of the task involved the placement of the sounds. The clinician would read the words aloud and ask the client whether a certain sound was at the beginning, middle, or end of the word.

=** Video: **= <span style="font-family: Tahoma,Geneva,sans-serif;">media type="youtube" key="L1b13ICJipw" height="390" width="640" <span style="font-family: Tahoma,Geneva,sans-serif; line-height: 0px; overflow: hidden;">"Weak Syllable Deletion" Speechpathstudent. 23 April 2009. []

=<span style="color: #cc249f; font-family: Tahoma,Geneva,sans-serif;">**Works Cited:** =
 * <span style="font-family: Tahoma,Geneva,sans-serif;">ASHA 1: "Speech Sound Disoders" //Articulation and Phonology//. ASHA. 20011. http://www.asha.org/public/speech/disorders/SpeechSoundDisorders.htm
 * <span style="font-family: Tahoma,Geneva,sans-serif;">ASHA 2: "Incidence and Prevalence of Communication Disorders and Hearing Loss in Children - 2008 Edition" //Speech Disorders//. ASHA. 20011.[]
 * ASHA 3: "Test of Phonological Awareness Skills" //Assessment Instruments//.ASHA. 2011. http://www.asha.org/SLP/assessment/Test-of-Phonological-Awareness-Skills-%28TOPAS%29.htm
 * <span style="font-family: Tahoma,Geneva,sans-serif;">ASHA 4: "Bankson Bernthal Test of Phonology" //Assessment Instruments//. ASHA. 2011. []
 * <span style="font-family: Tahoma,Geneva,sans-serif;">PRO-ED WEBSITE 1: (TOPAS): [] (picture)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">PRO-ED WEBSITE 2: (BBTOP) [] (picture)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">PRO-ED WEBSITE 3: (BINGO) [] (picture)
 * <span style="font-family: Tahoma,Geneva,sans-serif;">MINIMAL PAIR APPROACHES BARLOW/GIERUT: []
 * <span style="font-family: Tahoma,Geneva,sans-serif;">BOWEN, C. Multiple exemplar training in Phonological therapy. 1999. []
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Barlow A. Jessica Ph.D. & Gierut A. Judith Ph.D. (2002) Pair Approaches to Phonological Remediation. Seminars in Speech and Language, 23 (1). Retrieved from []
 * <span style="font-family: Tahoma,Geneva,sans-serif;">Michigan Speech Guidelines. //Articulation/Phonology// June 20 2006. []
 * <span style="font-family: Tahoma,Geneva,sans-serif;">"Weak Syllable Deletion" Speechpathstudent. 23 April 2009. []