Phonological Delays: Therapy Tips & Intervention Strategies

Ok here it is..what you have all been waiting for…the fourth and final installment in my Phonological Delays mini series! Today I am going to talk about what treatment method I use, how I set up my sessions, how I do homework, how I keep data, and give you some general tips. I hope this helps some of you out. However if you haven’t yet, I recommend you check out the first three parts to this series:

Part One: Phonological Delays: Don’t Treat Them Like Articulation! 
Part Two: Resources & Products I Recommend if You Treat Phonological Delays
Part Three: Phonological Delays: Treatment Methods

Phonological Intervention Method(s) I Use & Why

In my LAST POST I gave a quick review on the most common phonological approaches to intervention. I mentioned there that I primarily use the Cycles Approach developed my Barbara Williams Hodson along with minimal pairs. Why? Well when I started working with preschoolers I realized I needed to go back and review phonology and treatment methods. I asked questions on SpeakingOfSpeech.com and a fellow SLP Dawn was a huge advocate of the Cycles approach. She had FREE outlines on how to implement the methods as well. She was kind enough to send me her documents (you can now download them on her site HERE) and as she suggested I also ordered Barbara Hodson’s Book (LINK). After doing some additional research, I started using the Cycles approach and it worked!

However…some kids were still having some difficulties with fronting/backing once we had done a couple cycles and with those children, I sometimes use minimal pairs within my cycles. I have personally found this method of combining the two methods beneficial for some children with certain error patterns.

How I Set Up My Sessions

Currently, I am not working in the schools as I stay home with my babies and just work with a few private clients 1:1. However, I worked in the schools for several years (both full time and then part time) before resigning all together to stay home, so I will share how I set up my group sessions in the schools as I know the majority of the SLPs reading this work in schools.

THEMES: I plan therapy around themes, usually one theme per month. Some themes I have used in the past:

• September: Fall & Getting to Know You
• October: Halloween & Fall
• November: Thanksgiving and Fall
• December: Christmas & Hanukah
• January: Winter
• February: Winter & Valentines Day
• March: St. Patricks Day and Spring
• April: Spring and Easter
• May/June: Summer

How I Take Data

Because I use Cycles, I do not take data in the way I would for standard articulation therapy. I am not looking for the % correct, because that is not how cycles works. What I do, is keep track of how many CORRECT productions I get from a child per session. I also keep track of my cycles on my CYCLES DATA SHEET so I stay organized.

Then, every few weeks I do a quick speech sample and I probe. I then take data on % correct in conversation and in elicited words (usually just 10) to see how the child is generalizing.

That’s it

General Therapy Tips

• Try to keep your groups SMALL. I know, I know…easier said than done. With preschoolers, I keep my groups at 2, with 3 only when absolutely I have no other choice. I also group my phonological kids together whenever I can (again….easier said then done, I know, but your kids will make better progress so see what you can do).
• My goal is to get 75-150 CORRECT productions per child per each 30 minute session. And this is very doable for groups of 2-3 in preschool and is even possible for larger groups of older children. This is, of course, after the child is stimulable for the sound.
• TRY to get the kids to practice at home. I know it can be hard. But it will be worth it. HOWEVER do not send home homework unless the child can produce the sound with little to no cuing, and be sure to give the parents any cues you can. More about homework below.

How I Do Homework

Once I have worked with the child and he/she is able to produce the new sound/sound pattern with little to no cuing needed from me, I start to send home homework. Over the years I have done homework in a few different ways, but the bottom line is that I want the child to say their words 100-150 times everyday. Which, only take a few minutes. Sometimes I send home cards with games they can play, sometimes I send home a cut-and-paste worksheet for them to do (usually from THIS book). I also have had the child see how many words they can say correctly in 2 minutes and then record that number on a sheet and bring it to me and we have a little competition. This is great for 4.5 years and older usually.

I think that is it! I find that it often takes 1 to 1.5 years to get a moderately delayed child dismissed, then add/subtract for severity. Some kids are faster, some are slower. There are many factors that contribute to the timeframe like parent involvement, homework completion, the type of processes used (velars can be hard ones to treat), how many children in a group, child’s motivation and temperament, etc.

Hope you all have enjoyed this series! Please let know what you think.