Referral
Advise parents and professionals on whether a child needs a speech assessment.
Assessment
Choose appropriate tools based on the child’s age.
Analysis
Evaluate the speech sample to determine if the child’s speech is age-appropriate.
Diagnosis
Identify if the child has a delay or disorder that requires intervention.
Selecting Intervention Targets:
Traditional Approach: Focus on early developing sounds that the child is misproducing.
Complexity Approach: Target later-developing sounds to encourage broader changes in speech.
Intervention
Tailor teaching methods and feedback to the child’s age and ensure they meet their goals.
Dismissal/Discharge:
Decide if the child’s speech is normal for their age and if therapy should end due to lack of progress or motivation.
Traditional models: Behaviorist Models
Consequence can be described either as positive or negative, reinforcement or punishment
Children master speech and language acquisition more quickly than they could if they had to depend on stimulus-response mechanisms to learn each element
Speech is too complex to be described just by reinforcement
Linguistic models: Generative phonology
Theory of the sound structure of human languages developed by Noam Chomsky
Phonological rules map underlying representations onto surface pronunciations.
Phonological descriptions depend on information from other linguistic levels.
Generative phonological rules can explain substitutions, distortions, omissions, additions, metathesis, and coalescence
This has not had a broad application to the field of speech language pathology but is thought to have laid the groundwork for phonological-based clinical analysis.
Linguistic models: Natural phonology
Phonological model that has had the greatest impact on the field of speech-language pathology
Defined by Stampe: a phonological process is a “mental operation that applies in speech to substitute for a class of sounds or sound sequences presenting a common difficulty to the speech capacity of the individual, an alternative class identical but lacking the difficult property” (1979, p. 1
For example, children have the adult form of a word, such as tree /tri/; However, natural processes such as cluster reduction are applied because the child (at least temporarily) has some limitation to produce a particular sound or group of sounds.
The surface form (child’s production) would most likely be [ti]
Limitations
Whether the process labels being applied actually represent mental operations going on inside the head of the child
Does capture the pattern, hence the term phonological pattern rather than phonological process
Linguistic models: Non-linear phonology
Production of speech involves more than just production of a sequence of phonemes; it considers many elements (features, segments, syllables, feet, words, and phrases) both independently and in relation to one another:
Concept of links between the segmental and suprasegmental tiers and prosodic variables that highlight the interaction between speech sounds and other speech-language domains
The view that development is progressive or additive
Nonlinear intervention goals focus on utilizing established sounds in new syllable shapes and new sounds in established syllable shapes
Linguistic models: Optimality theory
Markedness constraints—limitations on what sounds and features can be produced
Faithfulness constraints—sounds and features that must be preserve
There are several stages of development within this model, during which the child increases their use of adultlike forms and decreases their use of constraints
Linguistic models: Sonority Theory
Quality of relative loudness within a speech sound
Sounds that are produced with more loudness are produced with a more open vocal tract, such as vowels and glides are sonorous
Sounds with more constriction of the vocal tract and less loudness are less sonorous, such as stops and fricatives
Researchers have found that children who reduced word initial consonant clusters left the most sonorous consonant and deleted the least sonorous
Implications for target selection and phonological awareness
Psycholinguistic Models
Consider the input of speech that a child hears and the output of speech that a child produces.
There have been debates as to whether the lexicon is best represented by
A single black box or lexicon, which would contain information relating to both the child’s perception and production of speech sounds
A two-lexicon model allows for the child’s perception and or production of the speech sound to differ from the adult form
Overall sequence of speech sound acquisition
Laying the foundation for speech (birth-1)
Transitioning the words to speech (1-2)
The growth of the inventory (2-5)
Mastery of speech and literacy (5+)
Anatomical structures supporting speech acquisition
Oral structure development begins in the fetus, nearing adult configuration by age 6 and completing by18
Significant growth occurs in the brain, especially in Broca’s and Wernicke’s areas, with a rate of 0.4 to 1.5 mm per year
Rapid myelination in the first year is crucial for motor movements, including speech
Anatomical functions supporting speech acquisition
Mastery of lip, jaw, and tongue movements starts in infancy and continues into adolescence
Jaw movements mature before lip movements; young children’s jaw movements are similar to adults, but lip movements vary
Tongue control for speech matures until around age 11, with significant refinement during
The newborn vocal tract is smaller and resembles a single tube for coordinating breathing, sucking, and swallowing; it develops into two tubes in adults
Stark’s Typology of Infant Phonations
Level 1: Reflexive (0–2 months)
Includes vegetative sounds, sustained crying, and quasi-resonant nuclei (low-pitched, muffled sounds).
Common vocalizations include fussing and crying.
Crying duration decreases from 90 minutes (1–3 months) to 60-65 minutes (4–9 months), then rises again to 86 minutes (10–12 months).
Stark’s Typology of Infant Phonations: Level 2 Control of Phonation (1–4 months)
Introduction of fully resonant nuclei (vowel-like sounds with wide frequency range).
Emergence of closants (consonant-like segments) and vocants (vowel-like segments).
Stark’s Typology of Infant Phonations: Level 3: Expansion (3–8 months)
Production of isolated vowels, vowel glide combinations, ingressive sounds, squeals, and marginal babbling.
Marginal babbling includes a mix of closant and vocant segments.
Stark’s Typology of Infant Phonations: Level 4: Basic Canonical Syllables (5–10 months)
Production of canonical babbling, single consonant-vowel syllables, whispered sounds, disyllables (CVCV), and CV-C combinations.
This stage is critical for transitioning to more complex vocalizations.
Non-Speechlike Vocalizations
Vegetative sounds (burps, hiccups).
Fixed vocal signals (crying, laughing, groaning).
Speechlike Vocalizations (Protophones)
Quasi-vowels (0–2 months): Vowel-like sounds without articulator shaping.
Primitive Articulation Stage (2–3 months): Vowel-like sounds shaped by articulators.
Expansion Stage (3–6 months): Marginal babbling, combining consonant-like and vowel-like sounds.
Canonical Babbling (6+ months): Well-formed syllables, e.g., [baba].
Stark’s Typology of Infant Phonations: Level 5: Advanced Forms (9–18 months)
Involves complex syllables (e.g., VC, CCV, CCVC), jargon, and diphthongs.
