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.”)
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.