Speech Sound Disorders: Intervention (Articulation, Phonology & CAS)
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Start With the Error Profile
Match the approach to where the breakdown sits: motor production, phonological contrasts, motor planning, or hearing. Each profile calls for its own approach, its own targets, and its own way of measuring change. Most Category III items in this area give you a child's data and ask for the next clinical decision, so read the profile before you read the options.
| Profile in the stem | What it suggests | Approach family |
|---|---|---|
| Distortions of one or a few sounds (lateral /s/, derhotacized /r/), consistent across words | Phonetic (articulation) disorder | Motor-based: traditional articulation, speech motor chaining, biofeedback |
| Rule-governed patterns across a sound class (fronting, stopping, final consonant deletion), with loss of contrast between words | Consistent phonological disorder | Contrast approaches (minimal, maximal, multiple oppositions), cycles, Metaphon |
| The same word produced differently on repeated attempts, with no motor signs | Inconsistent phonological disorder | Core vocabulary |
| Inconsistent errors on consonants and vowels, disrupted transitions, prosody errors, groping | Childhood apraxia of speech (CAS) | Motor planning treatment with principles of motor learning: DTTC, ReST, NDP3 |
| /s/ and other high-frequency sounds missing in a child with hearing loss | Possible access problem | Verify audibility with the audiologist before drilling production |
| Glottal stops or pharyngeal fricatives for pressure consonants after cleft palate | Learned compensatory placements | Articulation therapy plus craniofacial team referral |
High-Yield: Articulation approaches teach how to make a sound. Phonological approaches teach that sounds change meaning. A child who says "tea" for "key" and "tar" for "car" but can imitate /k/ in isolation has a contrast problem, not a placement problem.
The rest of this outline 17
- Motor-Based (Articulation) Approaches
- Phonological (Contrast) Approaches
- Cycles (Hodson and Paden)
- Core Vocabulary for Inconsistent Speech
- Childhood Apraxia of Speech: Motor Planning Treatment
- Target Selection: Two Philosophies
- Goal Attack and Goal Writing
- Dosage and Intensity
- Generalization and Probes
- Measuring Progress
- Planning Decisions ETS Lists
- Multilingual Speakers and Dialects
- Hearing Loss, Cleft Palate, and Residual Errors
- What the Evidence Does Not Support
- Decision Points the Questions Test
- Common Traps
- Sources to Know
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