Phonological Delays: Don’t Treat Them Like Articulation!

Welcome to my short series on treating phonological delays. These posts are being written for my fellow SLPs. However if you are a parent of a child with a phonological delay you might be interested in this information, even though some of it will be in “SLP Speak.” Feel free to ask any questions in the comments section, I am happy to answer them! 

Recently I posted about my confusion when my fellow SLPs ask for “activities” for treating articulation and phonological delays. I *think* rather than “activities” you all are trying to find treatment menthols and intervention strategies…am I right? In my recent reader survey this was a common request as was more information on how to treat phonological delays. I just happen to have a lot of experience in this area working with preschoolers so I decided to do a short series on phonological delays.  I’ll tell you why it is SO IMPORTANT to NOT treat phonological delays as if they are articulation delays and  I’ll go into more detail a about how I generally treat phonological delays. Welcome to part one! Let’s get started.

Activities vs. Intervention

Before I begin, a quick note on these terms and why I use them differently (and why you should too). In terms of articulation and phonology, the most important thing is the type of intervention/treatment method you use paired with a LOT LOT LOT LOT LOT LOT LOT of drill/repetition. I’ll talk more later on what is  A LOT. What is not as important is the “activity” you pair with it. What I call an activity is the thing you do that makes the drill and repetition less boring. Ha. What I mean is, the game or craft you are using as a positive reinforcer for all the work the child is doing. The activity IS important, believe me, but not as important as the treatment method you are using.

When we are talking about language intervention however, the activity often can also double as the intervention (but not always). For example, you might be playing WH Bingo with your group to target WH questions in two of the children (so the activity also happens to be targeting your goal for those two students) but then the Bingo game may be used as the activity/reinforcer for your two children working on the /r/ sound. Make sense?

I feel that it is important to use these terms differently when we are talking about articulation and phonology (and voice and stuttering also) because the intervention really should be (whenever possible) a researched proven method for treating that specific area. On that topic, let’s review the difference between articulation and phonology.

Phonological vs. Articulation Delays

Ok ok ok….if you are reading this most likely you are an SLP, an SLP assistant, or a grad student. I could assume that you know the difference between these two types of delays but for right now, I will assume you don’t. Why? Because I got through entire graduate level courses on this stuff (with a 3.8 GPA) and still was a little sketchy on this stuff. So I am going to give the easiest explanation I can (which will also help the parents and other professionals that are reading this).

Articulation refers to the actual physical ability to produce the different speech sounds in a language. It takes years and years for children to fully develop their articulation skills, some all the way to age 8 to master them all. Others will master most sounds much earlier (my own daughter, under age 4, is currently producing all speech sounds accurately in at least one (if not all three) positions of words except the “th” sound. She doesn’t always produce the /l/ and the /r/ accurately but she does in some positions. For example she says her /r/ blends beautifully and /r/ at the end of words perfectly but some /r/ in the beginning of words is still a /w/.)

Phonology is a totally different area of study. Phonology is the study of how speech sounds are organized in a language. For the sake of this post, let’s make this is a simple as possible. In children, as they are learning to talk, they simplify adult speech because they are still learning. They are not born being able to produce all speech sounds and all patterns, so they simplify it. Researchers out there wanted to figure out how this all works and found that there are many different patterns of simplification that kids use and we call these patterns phonological processes. These patterns (most of them) are *normal* and we expect children to use at least some of them as they develop their speech. There are some patterns that can stick around for years, while others generally disappear around or before the third birthday. The problem arrises when children are still using too many simplification patterns (processes) for their age. When this happens, their speech is generally VERY hard to understand.

In fact, there are some children who, for whatever reason, are not producing an entire class of sounds in their speech, which also makes them very hard to understand. For the purpose of this article, I am not going to go into too much more detail about classes of sounds but if you are an SLP you should know what I am talking about (hint: voice, place, manner).

Lastly, another thing to keep in mind: Preschoolers tend to have phonological delays and NOT articulation delays. Kindergarteners that are hard to understand more than likely would have phonological delays but as you get older the delays tend to be articulation (note I said “tend to be” and not “always.”)

For more detailed information on phonological delays go HERE and for articulation delays go HERE.

Why You Should NEVER Use the *Traditional* Articulation Approach to Treat Phonological Delays

Let’s start with a little analogy. Let’s say you want to print some pictures out (I know, crazy concept right?) and you decide to use Costco because they have the best prices. You go online and you are given the choice between the traditional uploader and the multiple uploader. You choose the traditional uploader and begin uploading your pictures One. At. A Time. You have 150 pictures you want to print out. And they are huge files. This is going to take forever!

And then you realize maybe you should use the other uploader system that makes the file size a little smaller and it allows you to upload multiple pictures at one time. BOOM! You have gotten all your pictures online in 1/5 of the time!

Treating phonological delays as if they are articulation delays is like uploading one giant file at a time to Costco. IT WILL TAKE FOREVER. You need to use the multiple uploader. You get more bang for your buck. There are different phonological approaches to treatment that are like your multiple uploader. And I use these methods to treat my preschoolers with phonological delays.

Ok, So How Do We Treat Phonological Delays Then?

I mentioned that there are many different approaches to treating phonological delays. I am going to cover a couple of them (the methods I use) and why in my next post. Then in another post I will go over how I set up my group speech sessions when I work in the schools to give you an idea on how I use activities and treatment methods together to treat a variety of goals within one session.

Questions? Comments? I’d LOVE to hear them!

Check out the other parts to this series by going HERE.

 

Disclaimer: This post may contain affiliate links.

About Katie

Katie is a licensed, credentialed and certified pediatric speech-language pathologist and mom to three (5, 3 and 9 months). Her passion about educating, inspiring and empowering parents of children with all abilities led her to start her blog Playing With Words 365 where she shares information about speech and language development, therapy ideas and tips, intervention strategies and a little about her family life too. Katie has been working in the field of speech pathology for 9 years and is certified in The Hanen Centre’s It Takes Two to Talk ® and Target Word ® programs and holds a certificate in Applied Behavior Analysis (ABA). In addition to blogging and being a mommy, Katie works part time in her small private practice in the San Francisco Bay Area. You can follow her on Facebook, Pinterest and Twitter.

Comments

  1. This is SO helpful! Thank you!

  2. I’m SO looking forward to this series! I have a few kids w/ phonological disorders this year & really need to adjust my methods for these kiddos!
    Carrie Manchester recently posted..Book of the Week: Where’s Spot?My Profile

  3. I am very much looking forward to this series and brushing up on my phonology skills. Thank you!

  4. Thank you so much for this. They skimmed over phonology in grad school.
    Andrea M recently posted..Crazy for cupcakesMy Profile

    • Andrea I had an entire class on this in grad school but all we did was read research. As a class…we BEGGED our teacher to actually SHOW us how to do therapy for phonology and she gave us a whole 20 minute example. Reading research and DOING are VERY different things. And then when you get in the “real world” it is so different too. I hope this little series helps a bit! :)

  5. thank you for share your knowledge. I work as an English as Additional Language Co-ordinator with 2 – 5 years old children. I use a lot of your activities in our small group time. And we already have noticed a significant improvement in their language and speech. Some of the non-English speaking children are not able to produce sounds /r/, /sh/, /ch/, /ʒ/, /ts/; these are very important in their mother tongue. I’m looking forward to this series. thank you again :)

    • Hi judita! So happy to hear my site is helping you and the children you work with. Depending on what language these children speak, the sounds you listed may develop earlier or later (or not at all) than in English. I worked with children who had Spanish or French as a first language and their song system develops differently than in English, which makes treating them a little tricky ;) Good luck!

  6. I seem to feel like children with phonological delays are the ones who can typically produce the sound correctly, but for whatever reason, they don’t use it in their speech, while the articulation kids can’t produce the sound and need lots of placement cueing. Is this what you find? Do some phonological kids also have sounds they can’t “make” versus they can make it, but don’t use it correctly. Does that make sense?

    • Danielle interesting…with /s/ blends yes they can produce them (usually but not always) but with fronting, I always have had to teach the /k/ and /g/. I also usually have to teach the /f/ if they are not using it. Also some kids totally are not producing an entire class of sounds, but usually I don’t have to teach all the sounds, just some and the rest follow. So I’d say in my personal experience I still have to teach placement for many kids.

  7. Stephanie says:

    I am really looking forward to this post! As a recently certified SLP, I have a HUGE interest in phological delays/intervention. I work in an outpatient setting that uses the team approach, so I share a caseload with 3 other therapists. We tend to stick with the traditional approach and it frustrates me because I feel like we are doing a disservice to our phonology kids! I am looking forward to sharing this info with my co-workers, who are not as interested in this topic as I am!

    • Stephanie you absolutely are doing a disservice if you are treating phonological kids like articulation kids. There are MOUNDS of research on this! (I had to read it all in grad school….very morning but there is some good stuff in there!). I hope my posts will enlighten all the SLPs out there still using traditional articulation approaches for phonology!

  8. Great post! I always enjoy reading your posts. :) I had an undergrad prof who was ADAMANT about the differences between artic and phonology which was great to have the processes and therapy techniques drilled into my skull, but alas, after having 3 kids and staying at home for a few years, my memory has waned a bit. ;) I’ve got quite a few phonological process kiddos this year (and I’m strictly elementary – no pre-k) so this series will be quite helpful…thanks in advance for the refresher!

    • Stefani yes…having kids seriously drains you of brain cells so I understand ;) And as much as it was drilled in that arctic and phonology were different and re read ALL THE RESEARCH the actual implementation of the methods were not taught well (to me). I am really passionate about teaching fellow SLPs (mostly new ones) how to actually DO THERAPY because it was one thing I feel that lacked in my program.

      And yes you totally can have phonological kiddos at the elementary level. I think we had less of them in my past positions because we mostly caught them in preschool.

  9. So, now, we are patiently waiting on your info! I would love to see what you do!

  10. Wonderful information! Thank you for clarifying what I seem to always have to keep reminding myself.

  11. Hi Katie! Thank you so much, your blog is so helpful! I am an SLP & work with 3-6 year olds in an early childhood school. I am finding lots of kids who are fronters are continuing to stick that /t/ sound in target words. For example, ctar for car & otff for off. I am hoping your series addresses this!

    • Hi Elizabeth! Oh yes, this is one of the most common thing I see with my preschoolers too. I’m glad you commented..you are reminding me that I need to include more specific information on how I teach the sounds/words. I’ll be sure to include some tips in my next posts! I’m working on them now but have a full week so not sure if the next one will post this week or next. :)

  12. Hi Katie,
    Where can I find the follow up to this post? I’m working on this with my kiddo in therapy!

  13. Katie, I can’t wait to read all your notes. I was trained as a Human Communication Therapist in Mexico 14 years ago. I’m trying to get into SLP in Canada but I need to go back to grad school. Different language, different times. I’m upgrading some undergrad courses for now but I’m sure your posts will help me in the future! Thanks!

  14. Any follow up posts. :)
    ?

  15. Hi, I’m wondering if you can provide a link to the next part of this series? Having a hard time finding it…Thanks for all of the great info on your blog! :0)

  16. I’m grateful I stumbled upon this web site my son is in Headstart and Just turned 4 in October. I decided against preschool as I knew he had some sort of speech complications and thought he could use the extra year of school. Twice a week he has speech therapy and I’ve seen him Vastly Improve. Somehow, I have a lot of parents who are down on me because they think I did something wrong to make him have his speech problem (like I didn’t pay enough attention to him, or work with him). I’ve always worked with my son, I HATE that people treat him as though hes dumb because he has a speech problem. He is 4, but he knows all his colors, shapes can count to 15, 18 on a good day, Knows his abc’s, can write his name, knows his left and right. Obviously, He’s not stupid. Atticus (my son) use to skip the middle of the word, now he skips the ends. When hes lazy he will skip the first syllable, second or third. I would like to see something about Syllable skipping, as I’ve looked a lot online and have found nothing really. I look forward to reading more articles you write as well and using any activities you have! Thanks.

  17. Hi! My little girl was just seen by a speech therapist for the first time. The therapist suspected tongue thrust, and gave us some swallowing and tongue position exercises, but it doesn’t seem right to me. My little girl doesn’t mouth breathe, or swallow incorrectly. Her resting tongue position seems normal. What she does is pronounce her /l/, /s/, /th/, and sometimes /t/ and /d/ sounds interdentally. They SOUND correct, with a little slushiness on the /s/, but you see her tongue coming out of her mouth all of the time. Other than the /s/, every sound sounds right. She just turned six. Have you heard of this? Any thoughts or advice on some resources for me? Thank you so much.

    • Hi Maggie, Some children who produce sounds interdentally have tongue thrusts, and some do not so it is hard to say what is going on. If you do not feel comfortable with the SLPs thoughts, I encourage you to get a second opinion. Good luck!

  18. I am a grad student in my first year of clinic, and was given a child with severe phono disorder. In researching techniques, I stumbled upon your blog. Thank you so much for these posts! They are so helpful!

Speak Your Mind

*

CommentLuv badge