Therapy approaches for speech sound disorders

Who it’s for How it works Therapy intensity Research & resources

Minimal Children with Contrasts a known and unknown sound Typical dosage is two – RCTs: Dodd et al. (2009)
Pairs mild-moderate, differing by one distinctive feature (e.g., 30–45-minute sessions per and Ruscello et al. (1993)
consistent phonological coat vs. goat). week with a goal of 100+ trials
errors per session, but frequency – More info: Storkel (2022)
Intervention includes familiarization, varies.
– Therapy resources: Minimal
perception training, imitation, and
Pairs Handbook, SCIP
independent production in drill–play
activities.

Maximal Children with A complexity approach similar to minimal (Similar to minimal pairs) – More info: Storkel (2022)
Oppositions consistent phonological pairs, except the known and unknown
errors who are missing – Therapy resources: SCIP
sounds differ by multiple distinctive
6+ phonemes in their features (e.g. meet vs. feet; /m/ and /f/
speech sound inventory differ in place, manner, and voicing).

Contrasting two unknown, maximally

opposed sounds is called Treatment of
the Empty Set (see a description here).

Multiple Children with Contrasts the known sound with 2–4 High frequency (3 – RCT: Allen (2013)
Oppositions moderate-severe, unknown sounds (e.g. tie vs. hi, pie, and sessions/week) with 50+ trials
consistent phonological try). per session for 10 weeks to – TISLP reviews on multiple
errors, with a collapse maximize outcomes. oppositions here and here
to one phoneme Intervention includes familiarization,
– More info: Storkel (2022)
imitation, independent production in
play/drill-play, and conversation. – Therapy resources: SCIP

This free download accompanies The Informed SLP’s research review “Everything you want to know about treatment approaches
for speech sound disorders.” This supplemental document and the review are free to read and share.
Therapy approaches for speech sound disorders
Who it’s for How it works Therapy intensity Research & resources

Cycles Children with multiple A highly specified approach, with set rules 60 minutes/weekly divided – Description: Prezas &
phonological errors for target selection and ordering. Therapy among 1–3 sessions. One Hodson (2016)
who are highly follows a set routine (including auditory cycle lasts for 5–16 weeks.
unintelligible. bombardment, multiple production Complete 3–4 cycles (or 30–40 – Review: Hassink & Wendt
activities, stimulability probes, and a hours of therapy) to maximize (2010)
May be a good choice phonological awareness activity), results.
– Therapy resource: Cycles
for kids with cognitive addressing one error pattern at a time
Handbook
delays or those who get in a cyclical fashion with the goal of
frustrated by slow improving overall intelligibility.
progress.

Core Children with Choose a pool of 70 target words in Typically, two 30-minute – Description: Dodd et al.
Vocabulary inconsistent collaboration with the child, parents, and sessions per week for 8 weeks, (2006)
phonological errors teachers. Target 10 words every session, but 1 or 3 sessions a week may
focusing on consistency of the child’s also be effective.
best production (using drill-based
activities), rather than perfect production.
Remove target words from the pool when
the child can produce them consistently.

Complexity Young children (ages Target selection principle prioritizing (Varies) – Ask TISLP: “Complexity
Approach 3–6) with phonological later-developing sounds and clusters to approach for speech sound
disorders create broad changes in the child’s disorders”
speech sound system.
– Tutorial: Storkel (2018)
Underlies other phonological approaches
– Resources: SLPath.com
(e.g. Maximal Oppositions).

This free download accompanies The Informed SLP’s research review “Everything you want to know about treatment approaches
for speech sound disorders.” This supplemental document and the review are free to read and share.
Therapy approaches for speech sound disorders
Who it’s for How it works Therapy intensity Research & resources

Stimulability Young children (2–4) Therapy focuses on stimulability and
Approach who aren’t yet increasing the child’s phonetic
stimulable for many inventory by reviewing sound character
consonant sounds cards and corresponding hand motions
(e.g., Coughing Cow, where you place your
hand on your throat) and completing
turn-taking play activities.
45–50-minute sessions once or – Description: Miccio & Elbert
twice a week for no longer than (1996)
12 weeks.
– Miccio’s Sound character
cards

Traditional Children with Follows a developmental progression, (Varies) – Elicitation strategies:

Articulation articulation (but not tackling one sound at a time through a Secord et al. and Caroline
phonological) errors. production hierarchy (isolation, syllables, Bowen
Approach
words, phrases, sentences, conversation)
– Apps: SATPAC, staRT
until mastery.

Naturalistic Young children with Add speech recasting to natural play (Varies) – TISLP Reviews on EMT+PE:
Approaches co-occurring speech & activities (naturalistic recasting), or add here and here
language disorders phonological emphasis to Enhanced
who are unlikely to Milieu Teaching (EMT+PE) – More info: Kaiser et al.
participate in drill or (2017)
drill/play-based therapy

Meta- Children at-risk for or Target children’s explicit awareness of (Varies) – Description: Metaphon
phonological diagnosed with literacy sounds’ distinctive features, and/or
– TISLP Review: LiPS
disorders working on letter-sound knowledge and Is a supplement, not a
Approaches
phonemic awareness. replacement, for direct work
– Free phonological
on speech in most cases.
Specific approaches include Metaphon, awareness resources
Integrated Phonological Awareness
Intervention, and LiPS.

This free download accompanies The Informed SLP’s research review “Everything you want to know about treatment approaches
for speech sound disorders.” This supplemental document and the review are free to read and share.