Articulation and Phonological Awareness
This spring (the infamous COVID-19 pandemic of 2020), I took advantage of the ASHA's learning pass. I had the pleasure of watching "Early, Persistent, and Remediated Speech Sound Disorders: There Is More to the Story" presented by Kelly Farquharson, PhD, CCC-SLP and I learned a lot about articulation and phonological awareness!
If you have the time and/or budge, I highly suggest it! I learned a lot and it validates what I have been feeling for a LONG TIME.
Speech and language development are connected. USUALLY, there is no such thing "just an articulation kid." These cases are more complicated than they appear!
Quick Review
For parents and new Speech-Language Pathologists, I want to review some of the terms here, so we are all on the same page.
- Speech sound disorders (SSD) are disorders that affect sound production of speech (how clearly and precisely a person is able to say sounds of a language).
- Phonological disorders affect how a child represents sounds/patterns of sounds of his/her language in the brain.
- Phonological awareness is the ability to manipulate sounds of a language such as rhyming and/or counting syllables.
Articulation and Phonological Awareness: What I Have Learned
I am not going to re-hash the entire presentation or the cited articles (yes, I read those too). You should read them for yourself!
However, there were some takeaways about articulation and phonological awareness that I believe are crucial to articulation therapy and we should all start implementing them today! That is what I am here to help you with now.
My Clinical Takeaways:
Children with speech sound disorders and/or phonological disorders are at risk for reading difficulties due to deficits in phonological awareness.
To be honest, this is a bit of the “chicken or the egg” for me. Does a child have weak phonological awareness skills due to a speech sound disorder or did the speech sound disorder cause weak phonological awareness skills? The answer probably doesn’t affect treatment implications (this will be coming up in a bit).
Now, the presentation has some awesome data on how typical/atypical errors, number of errors, etc… may affect a child’s risk of developing reading difficulties. It has a lot more than that too.
Again, please watch it! It is a great CEU course.
Clinical Implications
Now, on to the good stuff!
The clinical implications of this presentation are HUGE for me! It has changed how I’ve conducted therapy.
First off, I now screen for phonological skill development for all my clients, even the “R kids.” I don’t have any specific screening that I use but there are a lot out there if you need something.
If a child is having difficulty in any area, I then add that to each therapy session immediately. The chart below was presented in the presentation and it reports that the following skills to be ranked from easiest to hardest.
I start with the easiest and move up through the skills.
- Rhyming (easiest)
- Sentence segmentation
- Syllable segmenting & blending
- Identification of first/last sound
- Manipulation of sounds (hardest)
Even if a child can complete each of the above-mentioned tasks, I still use a phonological approach in therapy now. With this new approach, clients are more aware of the sounds they are working on and it helps with generalization!
At the beginning of each session I typical present a “slide” with the targeted sound.
Each slide has the client:
- Trace the letter of their targeted sound
- Identify which pictures have the target sound
- Rhyme words with the target sound
- Review what each muscle/structure must do to make a correct sound
- Complete a quick "warm-up" for the initial, medial, final position
This approach creates
- Self-awareness
- Meaningful practice
- Focused attention to goals
- Awareness of sound production at the conversational level
Materials
Per usual, I haven’t found many materials, especially telepractice materials, that accomplish all these goals. So, I decided to make some.
I worked hard (and I am I very proud) on some PowerPoint slides that challenge a client to identity the first sounds of words. It is a bit interactive and manages to keep the attention of little ones!
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