Developmental phonological disorders
Developmental Phonological Disorders (synonyms)are a group of language disorders that affect children’s ability to develop easily understood speech by the time they are four years old, and, in some cases, their ability to learn to read and spell.

Phonological disorders involve a difficulty in learning and organising all the sounds needed for clear speech, reading and spelling. They are disorders that tend to run in families. Developmental phonological disorders may occur in conjunction with other communication disorders such as stuttering, specific language impairment (SLI), or developmental articulatory dyspraxia.

Phonological therapy
In a linguistic, or phonological approach to the treatment of developmental phonological disorders (Bowen & Cupples, 1999a, 1999b), children are helped to discover the linguistic rules that underlie the sound-patterns of spoken language. Therapy targets are selected only after detailed phonological analysis (Edwards, 1994; Grunwell, 1997;Stoel-Gammon, 1988).

Phonological analysis reveals the individual sounds (the exemplars) that can be targeted in therapy in order to facilitate system-wide generalisation (within a sound class, or to another sound position, or to a particular sound position). For example:

GENERALISATION WITHIN A SOUND CLASS:
targeting a fricative consonant (e.g., /f/) may facilitate generalisation to other fricatives (e.g., /s/, /z/, /v/, etc).

GENERALISATION TO ANOTHER SOUND POSITION: targeting initial (SIWI) 'sh' in therapy may facilitate the use of 'sh' in other positions in words (SIWW, SFWF) - these abbreviations are explained in the footnote.

GENERALISATION TO A PARTICULAR SOUND POSITION: teaching one or two final consonants may facilitate the emergence of all final consonants.

Phonological therapy techniques
Three techniques that can be used in such linguistically based therapies are:

1. minimal contrast therapy (minimal pair therapy)

2. auditory bombardment (focused auditory input)

3. auditory input therapy

In terms of the first two techniques, in PACT Therapy (Bowen & Cupples, 1999a, 1999b) minimal contrast activities (or 'minimal pair contrast therapy' (Bernthal & Bankson, 1998)) and auditory bombardment frequently overlap. This is why they are referred to collectively as multiple exemplar training (Bowen, 1998).

The third technique, auditory input therapy is the creation of two British Speech and Language Therapists, Lesley Flynn (deceased) and Gwen Lancaster, and is described in detail in their "Children's Phonology Sourcebook" (Flynn & Lancaster, 1996).

All three techniques can be implemented easily, not only by clinicians, but also by parents in the course of enjoyable child-parent communicative interactions. Such 'interactions' might include story reading, reciting nursery rhymes, enjoying rhyming humour, experimenting with cloze (sentence completion) tasks, and numerous games.

Minimal contrast therapy
There are many minimal contrast activities to choose from. Mostly they involve simple card games with minimal meaningful contrasts (MMC’s) pictured on playing cards, or on pictures pasted into children’s speech books ('homework books').

Sometimes maximal feature contrast are used in therapy, though it must be noted that in the research that validated PACT-Therapy (Bowen, 1996) minimal contrasts were employed. Examples of training sets, always consisting of pictures, and usually accompanied by the written word are listed below.

1. "Point to the one I say": in which the child points to pictures of the words, spoken in random order (e.g., glow, black, low, steam, back, team, glow), or rhyming order (e.g., low, glow, back, black, team, steam), by the therapist or parent.

2. "Put the rhyming words with these words": in which the therapist or parent sets out three to nine cards (e.g., pat, peel, pill, pull) and the child places rhyming cards beside them (fat, feel, fill, full).

3. "Say the word that rhymes with the one I say": in which the therapist or parent says words containing the target phoneme, and the child says the rhyming non-target word (e.g., the adult says, "fill" and the child says "pill").

4. "Give me the word that rhymes with the one I say": in which the adult says the non-target word, and the child selects the rhyming word containing the target sound (e.g., the adult says, "pill" and the child selects "fill").

5. "Tell me the one to give you": in which the child says the word, and the adult responds to the word actually said. So, for example, if the child attempted to say "fill", but produced it as "pill", the adult would give him or her "pill", causing them to experience a communication failure. This game is based on the homophony confrontation tasks described by Weiner (1981). The aim is for the children to realise the failure to communicate their message, and attempt to revise their production. In PACT-Therapy (Bowen & Cupples, 1999 in press) this is the only minimal contrast activity that is not included in homework. It requires a 'light' touch, and humour that the child finds funny and did not go on for too long. Games involving homophony confrontation are not played in therapy sessions when siblings are present, because of the possibility of their giving rise to teasing.

6. "You be the teacher, and tell me if I say these words the right way or the wrong way": in which the adult says the words in rhyming or random order, and the child judges whether the words have been produced correctly or not.

7. "Silly Sentences": in which the child judges whether a sentence is a "silly one" (e.g., the adult might say "We flew to Melbourne in a pane (plane)" and the child judges the sentence a "silly one").

8. "Silly Dinners": is a variation of "Silly Sentences". The adult says what they want for dinner, and the child judges whether it is a "silly dinner" or not (e.g., "For my dinner I will have 20 hot ships (chips) and two delicious shops (chops)".

9. "Shake-ups and Match-ups" a game in which the child is presented first with four picture cards representing minimal meaningful contrasts (MMC’s) such as: car/calf; tie/tight. The word-pairs are repeated to the child several times, and then the picture cards are put into a container and "shaken up". The child is then asked to take the cards out of the container, and arrange them on the table "the same as they were before" (i.e., in pairs).

10. "Find the two-step words": in which the child sorts the words with consonant clusters SIWI from minimally contrasting words with singleton consonants SIWI (e.g., top/stop).

11. "Walk when you hear the two-steps": in which the child "walks" with their fingers when they hear a consonant cluster syllable initial word initial (SIWI) as opposed to a singleton consonant SIWI.

In each activity the therapist or parent helps the child perform the task, gradually phasing out the help until the child is performing their part independently. The purpose of the tasks is explained (by the clinician) to the caregivers and the children themselves, as a good way of listening to, and "thinking about", the way words sound. Parents are instructed to encourage the children to "think the words in your mind" while performing sorting tasks.

Including graphemes (printed words) means that sometimes the children sort pictures visually as well as, or possibly instead of, auditorily. If they do, it is encouraged, and viewed as an additional way for children to find systematic patterns and correspondence between linguistic levels. Minimal contrast activities typically provide a natural lead-in to a brief "input" of auditory bombardment, and the boundaries between where minimal contrast activities finish, and auditory bombardment activities take over, are sometimes blurred. Minimal contrast training sets sometimes double as auditory bombardment list words.

Auditory bombardment (focused auditory input)
Auditory Bombardment (or focused auditory input) activities also take a variety of forms. In the PACT-Therapy approach, auditory bombardment  is included using lists of words with the same initial consonant (Hodson & Paden, 1991), word lists exemplifying minimal meaningful contrasts (Monahan, 1986), and word lists exemplifying maximal feature contrasts (Gierut, 1992).

Auditory bombardment is explained to parents and children as a good way of listening to sounds in words. During therapy sessions, the auditory bombardment words are read to the child one to three separate times during the session. The lists comprise 10 to 15 different words (all familiar, or all unfamiliar, or a combination of the two) with a common phonetic feature (e.g., all starting with /s/; or all ending with a particular consonant class, for example the nasals /m/, /n/ and /õ /; or a list of minimal meaningful contrasts. Here is an examples of an auditory bombardment list for nasals consonants (m, n, and ng) Syllable Final Word Final Position (SFWF):

pin-ping thin-thing win-wing Kim-king rim-ring dim-ding ping-ping-ping ding-ding-ding boing-boing-boing-boing-boing

The rationale for using unfamiliar words is based on the observation that new lexical (and grammatical) learning in normal development appears to promote changes in the child’s phonological system (Shriberg & Kwiatkowski, 1980), and is hence a potential trigger for phonological innovation. Funny or made up words (e.g., kerpow), and contrasts (e.g., zowie-kerpowie) and onomatopoeic words (e.g., ding dong) are used for their perceptual saliency for the children, and because clinical experience has shown that most children and parents find them fun.

When auditory bombardment is included in the homework, parents are asked to present it twice in each homework session. All that is involved is for the adult to read the word list to the child while s/he listens quietly. Parents are encouraged to say the rhyming words "rhythmically" in pairs, so that they form couplets (or triplets if there are three words, e.g., Sue/shoe/chew; sip/ship/chip; sore/shore/chore). When tape recordings of therapy sessions are taken home, they always include auditory bombardment.

Auditory input therapy
Auditory input therapy (Lancaster & Pope, 1989; Flynn & Lancaster, 1996) has the advantage of being able to be implemented with very young children, with the active participation of caregivers. It incorporates minimal meaningful contrast therapy and metalinguistic activities. In essence, the approach involves setting up interesting and attractive games and tasks during which the child is exposed to multiple 'repetitions' of particular sound targets, spoken by the adult, with no requirement for them to practice saying words or sounds.

References
Bernthal, J.E., & Bankson, N.W. (1998). Articulation and phonological disorders.(4th ed.) Boston: Allyn and Bacon.

Bowen, C. (1996). Evaluation of a phonological therapy with treated and untreated groups of young children. Unpublished doctoral dissertation. Macquarie University.

Bowen, C. (1998). Developmental phonological disorders: A practical guide for families and teachers. Melbourne: The Australian Council for Educational Research Ltd.

Bowen, C. & Cupples, L. (1998). A tested phonological therapy in practice. Child Language Teaching and Therapy. 14, 1, 29-50.

Bowen, C. & Cupples, L. (1999a). Clinical Forum: Parents and children together (PACT): A collaborative approach to phonological therapy. International Journal of language and Communication Disorders.

Bowen, C. & Cupples, L. (1999b). Clinical Forum: PACT: A phonological therapy in depth. International Journal of language and Communication Disorders.

Edwards, M.L. (1994). Phonological process analysis. In Williams, E.J. and Langsam, J., editors. Children’s phonology disorders: Pathways and patterns. Rockville, MD: American Speech-Language-Hearing Association.

Flynn, L., & Lancaster, G. (1996). Children’s Phonology Sourcebook. Oxford: Winslow Press.

Gierut, J. (1992). The conditions and course of induced phonological change. Journal of Speech and Hearing Research, 35, 1049-1063.

Grunwell, P. (1997). Natural phonology. In M. Ball & R. Kent (Eds.), The new phonologies: Developments in clinical linguistics. San Deigo: Singular Publishing Group, Inc.

Hodson, B., & Paden, E. (1991). Targeting intelligible speech: A phonological approach to remediation. (2nd ed.). Texas: Pro-Ed.

Lancaster, G. & Pope, L. (1989). Working with children’s phonology. Oxon: Winslow Press.

Monahan, D. (1986). Remediation of common phonological processes. Four case studies. Language Speech and Hearing Services in Schools, 17, 187-198.

Shriberg, L.D., & Kwiatkowski, J. (1980). Natural Process Analysis New York: Academic Press.

Stoel-Gammon, C. (1988). Evaluation of phonological skills in pre-school children. New York: Thieme Medical Publishers.

Vihman, M.M. (1996). Phonological development: The origins of child language. Oxford: Blackwell Publishers Ltd.

Weiner, F. (1981). Treatment of phonological disability using the method of meaningful contrast: Two case studies. Journal of Speech and Hearing Disorders, 46, 97-103.

Explanation of SIWI, SFWF, SIWW, SFWF
In the branch of Clinical Linguistics called clinical phonology, the abbreviations SIWI, SFWF, SIWW, and SFWW are used to describe where sounds occur in spoken words. 

SIWI is "syllable initial word initial position". 
In the word "ball", /b/ is SIWI. 

SFWF is "syllable final word final position". 
In the word "rub" /b/ is SFWF. 

SIWW is "syllable initial within word position". 
In the word "abundant" /b/ is SIWW. 

The terms are used to denote how the words are pronounced by an individual, not the way you spell them, or the way they "should" be pronounced. 

So, for example, when you break a word like "innocent" into syllables with regard to how you might spell it you get inn-o-cent. 

But when most speakers of English SAY the word it becomes (roughly!) ih-nu-sent or ih-no-sent so that the /n/ is SIWW (not SFWW as it would be if you said in-uh-sent or in-oh-sent).

Page updated 13 May 2009

http://www.speech-language-therapy.com/audbom.html