Individual Differences and Successful Intervention: Child Language Disorders

1
Individual Differences and Successful
Intervention Child Language Disorders

• PRESENTERS
• Amy L. Weiss, University of Rhode Island
• Bonnie Brinton, Brigham Young University
• Martin Fujiki, Brigham Young University
• Lynne Hewitt, Bowling Green State University
• Linda Larrivee, Worcester State College
• Judith Vander Woude, Calvin College
• MODERATOR
• Rhea Paul, Yale University
• 2008 ASHA CONVENTION

2
What Do We Mean By Focusing on Individual
Differences?

• What are the personal factors that a particular
  client brings to the clinic setting that may
  account for the variability in successful
  therapeutic outcomes across clients?

3
Each presenter will (more or less) address the
following questions

• What are the individual differences that have
  been considered most essential in the
  intervention literature for this communication
  disorder area?
• How successful have researchers been in their
  linkages between individual differences and
  therapy success?
• What practical message(s) to clinicians can be
  gleaned from what we know about individual
  differences?
• What clinically-relevant information re
  individual differences is left to be determined?

4
Amy L. WeissUniversity of Rhode
IslandTreating Children With Speech Sound
Disorders
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Some Sources of Individual Differences

• Do all children develop their phonological
  systems in the same way, at the same pace?
• Inter-child variability
• General developmental trends
• Variability in acquisition rates
• Intra-child variability
• Immaturity of speech motor control system
• Inconsistent application of phonological rules
  (immaturity of linguistic system)

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Speech Sound Disorders (SSD) Not a Trivial
Problem

• A prevalence of 3.8 in six year olds (Shriberg,
  Tomblin, McSweeny, 1999).
• Higher prevalence in males than females (4.5 v.
  3.1, ibid).
• Law et al., 2000 median prevalence estimate
  between 8-9 for children ages 5-8 years.
• ASHA 2008 Schools Survey
• SLPs regularly working with children with SSDs
• 93.2 in preschoolers
• 96.7 in elementary schools
• 86.9 in junior/senior high schools

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If We Assume
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What Does the Literature Say About What Works?

• Gieruts (1998) review
• SLPs select target sounds absent from childs
  repertoire
• Sound targets were later-developing, not
  stimulable, phonetically complex
• Drill-play treatment mode
• Perceptual production training
• Use of microcomputer software programs
• Weston Bain (2003)
• Studies have shown different therapy approaches
  work but EBP-wise, data arent powerful enough to
  dictate best practices.

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What Guides Our Choices From Among Therapy
Approaches?

• Do we know why a particular child has a speech
  sound disorder?
• Are there multiple explanations?
• Personal features
• Etiology (Shriberg Kwiatkowski, 1982)
• Cognitive-Linguistic, Speech and Hearing
  Mechanism, Social/Emotional/Behavioral causal
  correlates
• Beyond Etiology
• Motivation
• Attitude
• Genetic Predisposition?
• Articulation or Phonology?
• Other Linguistic Deficits?

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Capability-Focus (Kwiatkowski Shriberg, 1993)

• Capability
• Linguistic variables, risk factors affecting
  success

• Focus
• Motivational events and effort displayed by the
  client

Stimulability and Self-monitoring
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Other Client Variables

• Matches between the clients phonological
  repertoire and
• Selection of Therapy Targets
• Phonological Knowledge (Gierut colleagues)
• Most Knowledge v. Least Knowledge (Rvachew
  colleagues)
• Stimulability (Miccio colleagues)
• Taking responsibility for sound change
• Issues of personality/temperament
• Conclusions
• As Powell stated, there is no one size fits all
  approach for selecting therapy for speech sound
  disorders.

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REFERENCES

• Gierut, J. (1998). Treatment efficacy functional
  phonological disorders in children. Journal of
  Speech, Language, and Hearing Disorders, 41,
  S85-100.
• Kwiatkowski, J., Shriberg, L. (1993). Speech
  normalization in developmental phonological
  disorders A retrospective study of
  capability-focus theory. Language, Speech and
  Hearing Services in Schools, 24, 10-18.
• Law, J., et al. (2000). Prevalence and natural
  history of primary speech and language delay
  findings from a systematic review of the
  literature. International Journal of Language
  Communication Disorders,35, 165-188.
• Powell, T. (2008). The use of nonspeech and motor
  treatments for developmental speech sound
  production disorders. Language, Speech and
  Hearing Services in Schools, 39, 374-379.
• Rvachew, S., Nowak, M. (2001). The effect of
  target selection strategy on phonological
  learning. Journal of Speech, Language, and
  Hearing Research, 44, 610-623.
• Shriberg, L., Kwiatkowski, J. (1982).
  Phonological disorders I A diagnostic
  classification system. Journal of Speech and
  Hearing Disorders, 47, 226-241.
• Weston, A., Bain, B. (2003, November). Current
  v. evidence-based practice in phonological
  intervention A dilemma. Poster session presented
  to the annual convention of the American
  Speech-Language-Hearing Association, Chicago.