Interventions for Speech Sound Disorders in Children

A. Lynn Williams, Sharynne McLeod, Rebecca J. McCauley, Alan Kamhi, Rebecca J. McCauley, A. Lynn Williams, Sharynne McLeod, Rebecca J. McCauley

• Publisher: Brookes Publishing
• Year: 2020
• ISBN:
  9781681253596
• Edition: 2
• Topic: Education
• Subtopic: Inclusive Education

An essential building block of every speech-language pathologist's professional preparation, the second edition of this bestselling textbook is a comprehensive critical analysis of 21 interventions for highly prevalent speech sound disorders (SSD) in children. Bringing together a powerhouse team of international experts, this new edition has been revised and enhanced with current research, new interventions, more guidance on selecting interventions, and updated video clips that show the approaches in action. For each intervention, readers will get a clear explanation of its robust evidence base, plus thorough guidance on implementing the approach, monitoring progress, and using the intervention with children from culturally and linguistically diverse backgrounds.

A key graduate-level text and an important professional resource for practicing SLPs, early interventionists, and special educators, this book will help readers choose and use the best interventions for children with phonological or motor-based speech disorders.

WHAT'S NEW:

• 18 high-quality video clips that offer a vivid inside look at intervention techniques in action
• Expanded information on choosing interventions and implementing them with fidelity
• New featured interventions, including Dynamic Temporal and Tactile Cueing, speech motor programming intervention, articulation interventions, and biofeedback approaches
• Up-to-date research on SSD and interventions, including Levels of Evidence tables that help readers evaluate the evidence base for each intervention
• In-depth discussion of how the interventions relate to the World Health Organization's framework of enhancing participation
• New learning activities that help readers apply their understanding of each intervention

Learn more about the new edition

This title is part of the Brookes Communication and Language Intervention Series.

1

Introduction

A. Lynn Williams, Sharynne McLeod, and Rebecca J. McCauley

Speech sound disorders (SSD) in children are a widespread, high-prevalence disability (Eadie et al., 2015; Law, Boyle, Harris, Harkness, & Nye, 2000; McLeod, Harrison, McAllister, & McCormack, 2013) that comprises 40% to 70% of the caseload of speech-language pathologists (SLPs) who work in pediatric settings (Furlong, Serry, Erickson, & Morris, 2018; Joffe & Pring, 2008; McLeod & Baker, 2014). SSD are diverse and vary in both severity and type and often co-occur with other disabilities, such as language and literacy impairments. Following is a comprehensive definition of SSD that is used throughout this book:

Children with speech sound disorders can have any combination of difficulties with perception, articulation/motor production, and/or phonological representation of speech segments (consonants and vowels), phonotactics (syllable and word shapes), and prosody (lexical and grammatical tones, rhythm, stress, and intonation) that may impact speech intelligibility and acceptability . . . speech sound disorders is used as an umbrella term for the full range of speech sound difficulties of both known (e.g., Down syndrome, cleft lip and palate) and presently unknown origin. (International Expert Panel on Multilingual Children’s Speech, 2012, p. 1, emphasis added)

This definition of SSD aligns closely with definitions of SSD from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) and the International Classification of Diseases, 11th Revision (ICD-11; World Health Organization [WHO], 2018) except that, in this book, we also include children with known causes for their SSD (e.g., cerebral palsy). A number of the authors have used the following classification from McLeod and Baker (2017) to describe the breadth of SSDs: phonology (phonological impairment and inconsistent speech disorder) and motor speech (articulation impairment, childhood apraxia of speech, and childhood dysarthria).

The breadth and complexity of SSD present a considerable challenge for SLPs to differentially diagnose the type of SSD and determine the most appropriate intervention approach for a given child, especially when there are a number of published approaches from which to select. Similar to the first edition, this book uses a prescribed template to describe a number of intervention approaches that were developed for the range of SSD that SLPs may encounter in their practice. This template facilitates critical comparisons across interventions in terms of client populations and key elements as well as levels of evidence. As in the first edition, this organization may be useful for different groups of readers who will likely read the book with different goals in mind. In particular, we expect this book will be of interest to four different groups: 1) students of speech-language pathology; 2) clinical practitioners who work with children with SSD; 3) faculty and clinical educators who teach students about SSD in children; and 4) parents of children with SSD. The chapter begins with a description of the purpose of the book followed by an overview of the template and organization of each intervention chapter, with recommended sections for different readers. Next, a structural framework for intervention is described to aid in the understanding of the components of each intervention. Finally, the chapter ends with a list of references for several core components that are foundational to working with children with SSD.

THE PURPOSE OF THIS BOOK

Clinical decision making is defined as choosing among available alternatives and involves collection, interpretation, and evaluation of data in order to make an evidence-based decision (Tiffen, Corbridge, & Slimmer, 2014). A growing body of literature demonstrates that explicit training in clinical decision-making skills is required for novice clinicians (Dudding & Pfeiffer, 2018; Finn, 2011; Furlong, et al., 2018; Ginsberg, Friberg, & Visconti, 2016; Hill, Davidson, & Theodoros, 2012). This is a critically important skill for students and practitioners to develop in making evidence-based clinical decisions in selecting intervention approaches, especially when there are a number of published approaches from which to select. Baker and McLeod (2011) identified 42 different intervention approaches for children with SSD. While there is empirical evidence that most studied interventions are effective, no single approach has proven to be the most effective. This adds to the overwhelming nature of the decision that both novice and experienced clinicians face in determining which approach to select from an array of approaches. The variety poses a challenge for SLPs: knowing which approaches best suit the children with SSD on their caseloads and understanding how to implement the approaches with fidelity. Further, different approaches may be better suited to specific degrees and types of impairments (see Table 1.1) or at different points within the continuum of intervention for a given child (Baker, McCauley, Williams, & McLeod, 2020). So, the question is, How do clinicians determine which intervention approach is the best one to use with their client? That is where this book comes in.

Table 1.1. Breadth of speech sound disorders included in this book
Primary populations	Children with: Articulation delay/disorder Phonological delay/disorder Inconsistent speech disorder Speech impairment Phonological/morphological disorder Phonological/language disorder Phonological/phonological awareness/literacy impairment Repaired cleft lip and palate Childhood apraxia of speech Motor speech disorders, including childhood apraxia of speech and developmental dysarthria
Secondary populations	Children with: Craniofacial anomalies Hearing loss Sensorimotor impairments Cerebral palsy Tongue thrust Intellectual impairment, including children with Down syndrome Congenital conditions associated with developmental dysarthria, such as conditions affecting the cranial nerves, and early onset muscular dystrophy

A primary purpose of this book is to describe and critically analyze a range of intervention approaches used for children with SSD. A second, equally important, or even more important, purpose is to help readers learn skills that will enable them to examine and critically evaluate these and other approaches for themselves. Thus, in response to the previous question, our goal with this book is to provide SLPs with sufficient information about each intervention approach so that they can align the clinical characteristics of their client’s SSD to the intervention approach that best addresses those needs. Furthermore, we do not believe that a single intervention approach will be the sole intervention for any child with SSD. As readers will learn through reading about the various approaches in this book, several interventions are designed as transitional methods to help children progress from emerging sound systems to elaborating their sound systems.

Both of these purposes provide compelling rationales for a book because of the complexity of SSD and because children with SSD comprise a heterogeneous population. SSD are diverse, varying in both severity and type (articulatio...