Thursday, July 10, 2014

Articulation Therapy Approaches

Articulation Therapy Approaches

Articulation is the technical term for how people pronounce words. Many children and adults have no difficulty pronouncing words according to their accent. Sometimes though, children may have difficulty developing appropriate articulation, some adults may have difficulties remaining from childhood, and other adults may lose their articulation abilities thanks to a stroke, traumatic brain injury, or other medical difficulty. Speech therapy focusing on articulation is one way of addressing these difficulties. 

There are a wide range of techniques that are used by Speech Language Pathologists all over the world, however I wanted to review some of the most popular here. Traditional Articulation Therapy using minimal pairs, the Cycles Approach, and the Whole Language Approach are very different, however they contain some similar principles and all focus on treating articulation. 

Traditional Articulation Therapy
According to Van Riper (a very famous researcher) in 1978, "The hallmark of traditional therapy lies in its sequence of activities for: (1) identifying the standard sound, (2) discriminating it from its error through scanning and comparing, (3) varying and correcting the various productions until it is produced correctly, and finally, (4) strengthening and stabilizing it in all contexts and speaking situations." 

Essentially Traditional Therapy has the child identify the sound, identify the sound from the error sound (for example if they say /sh/ for /s/ the clinician would have them listen to various words and tell her/him which started with the correct /s/ sound) , correct their production through various exercises, and then expand those exercises. 

During traditional therapy, minimal pairs- pairs of words like "sheep" and "seep" or "ship" and "sip"- are often utilized to work on identifying the sound and distinguish the sound from error. Many believe that a child may be hearing a word incorrectly leading to incorrect pronunciation, so traditional therapy focuses on correcting that understanding. Typically in traditional therapy you might start with the single sound, then a syllable, then words and words in pairs, then phrases, sentences, and finally conversation.

For more information about Traditional Articulation Therapy visit

Cycles Approach
Formally known as the Cycles Phonological Pattern Approach (CPPA) was created by a researcher named Hodson to help extremely unintelligible children. It is based on the theory that children gradually learn phonological (sound) patterns as they learn to speak. For example, first children may learn early syllable structures like /baba/, then they will learn back sounds like /k/ and /g/, then /s/, etc.  Some children may have difficulty learning those patterns so they either don't develop the pattern at all or they develop different patterns (for example saying /th/ instead of /s/). The Cycles Approach uses groups of "cycles" of patterns to teach children new patterns of speech depending on their need.

An example Cycles Approach may look something like this
  • Week 1- work on pronouncing multiple syllables (for children who only use one syllable). For example, getting a child to say "i-un" for "Chicken" is an improvement upon just "un"
  • Week 2- work on producing final consonants. The final consonants would depend on the child, but for example, if a child does not produce final /d/ or final /t/ ("da" instead of "dad" or "pa" instead of "pat") those may be the targeted sounds.
  • Week 3- work on producing /s/ clusters (such as /sp/, /sl/, /st/, etc.). 
One hour of therapy time would be spent on each week's lesson and then the entire cycle would be repeated. Typically, children require 2-4 cycles to master those goals and then the cycles would move toward more difficult goals, eliminating goals mastered, and repeating goals they continue to have difficulty with.

For more information about the Cycles Phonological Pattern Approach visit
Whole Language Approach
Many children experience both articulation difficulties and language difficulties. The Whole Language Approach attempts to address articulation through language-based activities. For example, while reading a book, the clinician may emphasize certain shttps://www.blogger.com/blogger.g?blogID=3577234683978949925#editor/target=post;postID=723103093311687439;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=0;src=postnameounds while reading. The clinician may then have the child retell the story and incorporate cues, minimal pairs, or multiple repetitions to assist the child articulate correctly in a more naturalistic language setting.

For more information about the Whole Language Approach visit
Conclusion
The American Speech Language Hearing Association (ASHA) does not recommend one approach over another as each client is different, however they do emphasize that articulation therapy is effective.  There are multiple additional approaches to therapy and combinations of therapy approaches which can assist those who have articulation difficulties. At Jessica Washer Speech Therapy, we strive to utilize Evidence Based Practice- a combination of research, clinical judgement, and client values- when treating clients for the most effective therapy possible.  Our hope is that every client is able to be dismissed from therapy having met their goals and achieving their best speech and language abilities.

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