Articulation

Question

Answer

The first thing to do for a 4 year old who only has one phoneme and some vowels is to be sure that hearing is within normal limits at all frequencies, not just a few frequencies. I couldn't tell from the question whether receptive language was within normal limits, but that will have an impact on your intervention program. Additionally, you need to know whether you are dealing with some type of motor speech deficit or not. A thorough oral peripheral examination should be completed if you haven't already done so. Finding out what the communication demands at home are will also help you decide where to begin. Does the family speak for him or do they encourage him to attempt to say words? You may find that teaching the family how to help him speak at home will dramatically improve his abilities.

The next thing I suggest is to find out if this is a production or perception issue. Can the child identify error sounds when you say them such as ''This is a dut'' instead of ''duck''? If he knows that you said ''duck'' incorrectly you may be dealing with a production issue. If he doesn't know that ''dut'' is an incorrect pronunciation, you may well be dealing with more of a perceptual issue. If a this is an issue of production, you can begin by teaching correct placement of the articulators. If this is an issue of perception, you will need to spend time training the child to ''hear'' the sounds. In either case, you want to increase intelligibility and effectiveness of communication as soon
as possible. Teaching functional words from the child's environment to address needs and wants will be important.

There are several approaches that could be used with this child. Looking at your assessment information to find error patterns should be helpful in deciding where to begin. The assessment tools that you used may have approaches to intervention that go along with them. Another idea is to begin with a continuant sound such as /s/ in order to use a clearly different sound than he already produces, since the child has one stop consonant along with some vowels. The nice thing about /s/ is that intelligibility improves greatly when a child can produce it. You can combine the sounds he is able to produce with new sounds to form functional words and phrases.

One more thought is to use some type of augmentative systems to give the child more immediate access to communication. Sometimes an intermediate system that assists in communicating needs and wants as well as facilitating communicative interaction improves verbal production more rapidly. It may also relieve some of the stress from the child when he is able to communicate more clearly in some form.

Stephanie Martin

Stephanie Tarrant Martin, PhD (Audiologist and Speech/Language Pathologist) is a professor in the Communication Disorders and Special Education Department at Minot State University (MSU) in Minot, North Dakota. Dr. Martin currently teaches graduate courses and supervises clinical practicum for graduate students at MSU. She is also the Project Director for First Sounds of North Dakota which is a federally funded project designed to place equipment and train personnel in every hospital in North Dakota in order to create a universal newborn hearing screening program throughout the state.