Goal Selection for Progressive Phonological Change

On April 28, 2022 I presented a workshop, ‘Assessment of Children with Speech Sound Disorders (SSDs): Identification of Subtypes’, at the SAC Speech-Language Pathology Conference. The conference was meant to be in-person but was switched to virtual format at the last minute and therefore some parts of my planned presentation did not go as planned, in particular, a exercise on target selection. I promised to put the speech sample and the “answer” to the activity in my blog. Notwithstanding the fact that there is no one right answer to the activity I am doing that today. I am sorry to be over two months late getting around to this but I find it hard to keep up with the blog now that I am school director. Before I proceed I will point out that I did publish another blog based on that workshop to highlight sources (specifically test tools). Also, I have written several blogs previously on target selection, at least one describing the particular rubric that I am recommending here. The proposed rubric for selecting goals is drawn from a paper published by Pamela Grunwell in 1992 in which she discusses Processes of Phonological Change in Developmental Speech Disorders. My adaptation of this process to modern phonological analysis and treatment approaches is described in detail in both books authored with Francoise Brosseau-Lapre, specifically Developmental Phonological Disorders: Foundations of Clinical Practice as well as the undergraduate textbook Introduction to Speech Sound Disorders.

Selecting Treatment Goals

The process for selecting treatment goals to effect progressive phonological change has the following steps:

1. Obtain a sample of the child’s speech and conduct a phonological analysis, preferably using a non-linear analysis, to identify strengths and needs at all levels of the phonological hierarchy, typically focusing on word shapes, syllable structure, and features.
2. Classify patterns of mismatch (error) in the child’s speech as: a. variable (mismatches are inconsistent); b. context specific (structure is correct in one context but consistently incorrect in another); or c. consistent (the structure is never produced correctly).
3. Select one treatment goal from each of these categories so that you will be targeting a STABILIZE goal to improve intelligibility quickly by reducing variability in the production of one structure; b. an EXTEND goal by extending production of a structure from one context where it is correct to another where it is not; and, an EXPAND goal by introducing a new structure that is currently absent from the child’s system.
4. The three structures can be targeted by using a vertical, cycles, or horizontal goal attack strategy. My preference is for horizontal with a cycles component. That is target 3 all at the same time for a block of predictable length (e.g., six or twelve weeks); then switch to three new targets, again chosen across the three types of goals.

Practice Activity

Step 1. A speech sample constructed for a hypothetical three-year-old children with moderate expressive language delay and mild receptive language delay. Notice that CV, CVC, CVCV, and CVCVC word shapes are present along with glides, stops, nasals, and fricatives.

dog	[dɑg]	fire	[bɑɪjə]	cheep	[dip]
dot	[dɑt]	need	[jid]	shoes	[duz]
wag	[wæg]	neat	[jit]	daddy	[dædi]
wack	[wæk]	yellow	[jɛjo]	lassy	[wæsi]
spoons	[pun]	elephant	[ɛfʌ̃]	cookie	[tʊki]
key	[di]	comb	[tom]	go	[do]
jump	[dʌp]	pants	[bæt]	carrots	[dæwət]
tea	[ti]	watch	[wɑʦ]	do	[du]
sun	[dʌn]	see	[di]	zoo	[du]
leash	[wis]	tram	[dæ̃]	mummi	[wʌmi]
run	[wʌn]	sleep	[wip]	banana	[jəjænʌ]
play	[beɪ]	tummy	[dʌmi]	big	[bɪg]
clap	[wæp]	doggy	[dɑgi]	bit	[bɪt]
swimming	[wɪmi]	tight	[dɑɪt]	kite	[dɑɪt]
giraffe	[wæf]	toys	[dɔɪz]	umbrella	[ʌbɛjʌ]
mud	[wʌd]	bucket	[bʌkɪ]	clean	[diː]

Step 2. Identify patterns belonging to the three major types. Here phonological patterns are described using familiar terminology for the most part:

VARIABLE	CONTEXT SPECIFIC	CONSISTENT
Weak syllable deletion 50%	Velars fronted in onsets	Clusters reduced
Nasals deleted from codas 30%	Stopping of fricatives in onsets	Liquid gliding
Unstable -voice in onsets 75%	Gliding of nasals in onsets	Palatal fronting

Step 3. Select one goal from each column, that is, variable pattern, context specific pattern, and consistent pattern. If I remember my statistics classes from over 30 years ago correctly, random selections would yield over (3!)x(3!)x(3!)=216 possible answers and they would all be fine but maybe we can be a bit more systematic than that. Here is my suggestion (but you can disagree with me in the comments!)

STABILIZE	EXTEND	EXPAND
Stabilize production of voiceless stops in the onset position.	Extend production of velar stops from coda to onset.	Expand the system to include /s/ clusters, starting with the coda position.

These recommended goals are not necessarily the “best” ones but they are designed to be complementary. The voiceless stops in the onset and the /s/-clusters in the coda might might support the appearance of fricatives and /s/-clusters in the onset. This is especially true if the voiceless stops are produced with proper aspiration. The work on velar consonants in the onset will permit focus on the voice/voiceless contrast as well.

A completely different set could have been chosen to centre on the gliding of nasals in the onset given the cost to intelligibility. This choice would impact the choices in the stabilize and expand categorize. You can think about this. You will need another set for your second “block” of treatment sessions in any case.

Notice that the rubric ensures that you will have a range of treatment goals that covers different levels of the phonological hierarchy and a spectrum of complexity. Importantly you will have several goals that reinforce change across the child’s phonology. The rubric works for young children or children with severe impairments and constrained phonologies. It also works for older children with less severed phonological impairments. It works for a variety of treatment approaches. It is very versatile. You can make choices and feel confident that you have a good justification for your treatment plan.

If you try it you will have questions however. Just ask me. I am happy to answer.

Posted by srvachew on July 10, 2022

https://developmentalphonologicaldisorders.wordpress.com/2022/07/10/goal-selection-for-progressive-phonological-change/