Evaluation of a phonological therapy with treated and untreated groups of young children

The speech-language pathology management of children with developmental phonological disorders has been influenced by a paradigm shift. Traditional articulation therapy is being supplanted by linguistically based therapies, which take into account the systematic nature of phonology (Ingram, 1989a). Increasingly, therapy approaches (Fey, 1992) aim to change phonological patterns (Grunwell, 1995), but to date there have been no studies of phonological therapy with treated and untreated groups. Fourteen randomly selected children were treated with a multifaceted phonological therapy, comprising: family education, metalinguistic tasks, traditional phonetic production procedures, multiple exemplar techniques (minimal contrast and auditory bombardment activities), and homework; administered in alternating blocks and breaks, each of approximately 10 weeks duration. In a longitudinal matched group design their progress was compared with that of 8 untreated control children. Analysis of Variance of the initial and probe Severity Ratings of the phonological disabilities, 3 to 11 months apart, showed highly significant selective progress in the treated children only (F(1,20) = 21.22, p =<.01). Non-significant changes in receptive vocabulary (F< 1) pointed to the specificity of the therapy. The initial severity of the children's phonological disabilities was the only significant predictor of the duration of therapy they required, with strong (Pearson’s) correlations between initial severity and number of treatments (r (11) = ,75,p=<.01). A clinically applicable Severity Index with a high correlation (r (79) = .87, p <.01) with the Severity Ratings of experienced speech-language pathologists was developed, and an implementation procedure proposed. Reading tests of the treated children who had started school indicated that, despite successful speech outcomes, 8 out of 11 had early literacy learning difficulties. Encouraged by the efficacy of the therapy, refinement of the model, through evaluation of the relative contributions of its components, and testing the approach against other phonological therapies might prove edifying avenues of further research.