Phonological Disorders: A Case Study

Summary of Interpretation: Given the information provided in Interpretation A, the clinician diagnosed Kara-Lynn with a severe phonological disorder. This diagnosis was made based on evidence provided by testing results, clinician observations, and speech analyses. Kara-Lynn demonstrated phoneme collapses into /d/ in place of stops (/p/, /t/, /k/, /g/), fricatives (/s/, /z/, /θ/, /ð/), and some consonant clusters (/tr/, /gr/) across all word positions. For example, Kara-Lynn produced /diə/ for “seal,” /dædɚ/ for “treasure,” and /dədudɚ/ for “computer.” Kara-Lynn also presented with active phonological processes of final consonant deletion (/fɪ/ for “fish”), cluster reduction (/tul/ for “school”), vocalization (/ɛləkə/ for “helicopter”), and deaffrication (/ʃi/ for “cheese”). She also presented with inconsistent patterns of initial-consonant deletion (/ɑʊps/ for “house”, /ɪʒ/ for “bridge”). In most instances, Kara-Lynn presented with both final consonant deletion and another phonological process, which markedly impacted her speech intelligibility, as when she produced /lɑʊ/ for “clown,” demonstrating both final consonant deletion and cluster reduction. She also expressed a high percentage of CV (27%) and CVC (29%) syllable and word shapes, with little other variation. Analysis of Kara-Lynn’s speech sample revealed similar errors exhibited during formal assessment, including phoneme collapse into /d/, high occurrences of initial and final consonant deletion and cluster

The article’s purpose was to provide normative data for phonological development of British-English speaking children. The article focused on two aspects of speech development: the age of acquisition of sounds such a phonetic acquisition and the age in which error patterns stopped. In addition, this article discussed the effects that age, socioeconomic status and gender may have on speech sound development. The authors hypothesized that girls would display higher levels of phonological accuracy as compared to boys and that children from higher socio-economic families would have higher levels of phonological skills than children from low socio-economic families. It was also hypothesized that phonological skills should develop with age, that

The first time I realized I was different was in second grade, when I opened my mouth to answer a question and my peers giggled as I struggled to answer. I pronounced my R's like W's, which threw my whole pronunciation of the English language into a twist. My previously "adorable" lapses in speech were now affecting me negatively. I was different than the rest of my classmates; I had been born with a speech disorder.

Many people would like to make a difference, not only in their own life, but in others’ lives as well. Deepak Chopra once said, “Everyone has a purpose in life…a unique gift or special talent to give to others. And when we blend this unique talent with service to others, we experience the ecstasy and exultation of our own spirit, which is the ultimate goal of all goals.” All of us, at one point in our lives, have to make the difficult decision of the goals we want to work towards. We all have certain goals, standards, and expectations of ourselves. Not everyone will figure out what they want to be right away, and some will know from the very beginning. My plan for my life is helping others through Speech Language

A phenomenon applicable to the vast field of Speech-Language Pathology, and the foundation of research now and in the future can all be attributed to, difference versus disorder. This concept considers the complexities of those served within the profession and highlights the range of possibilities displayed from an individual, that draws a fine line between a person being labeled as having a dialectal difference or a speech and/or language disorder. A difference can be defined as an alteration in an individual’s speech and/or language that can be attributed to internal and external factors such as race, culture, and the environment in which a person lives. In contrast, a disorder is an actual disability that interferes with a person’s speech

Preschoolers with verbalization sound disorders have clinically consequential impairments in the engenderment of sound production of the ambient language. Although many of these produced sound errors resolve after several years (with or sometimes without intervention), developmental appropriate speech sound production is not always achieved. Some sound errors may continue into adulthood. Concretely, (Preston, Hull, & Edwards, 2013) intended to determine if preschool verbalization error types (e.g., atypical sound errors and distortion errors), which may reflect different levels of psycholinguistic processing, are indicative of school-age phonological awareness and verbalization sound outcomes.

Kara-lynn is a 3 year; 6 month old female presenting with a severe phonological disorder. Her results from testing indicate that her speech intelligibility is significantly reduced due to multiple phoneme collapses into /d/ of the following phonemes and consonant clusters: /p/, /g/, /k/, /s/, /z/, /θ/, /ð/, /tr/,and /gr/. In addition, the use of multiple phonological processes, including: final consonant deletion, initial consonant deletion, cluster reduction, vocalization, and deaffrication also significantly contribute to her reduced intelligibility. Her speech intelligibility in known context was calculated to be 64%, which is low for a child who is 3 years; 6 months(consider adding reference). Reduced intelligibility can impact a child’s ability to communicate wants and needs, making Kara-Lynn’s speech intelligibility an area of need.

Theories of language learning can further be broken into theories for speech-sound errors and treatment for these disorders. One of these theories is sensory-perceptual theory with sound production training. This relates to errors due caused by a breakdown in sensory and motor systems of individual sound units (Peña-Brooks & Hedge, 2015). In contrast, the phonological theory suggests errors unrelated to motor skill but, instead, to misrepresentations of phonological rules (MacReynolds, 1987). While neither approach has proven to be most effective in the generalization of correct productions of speech sounds, this paper will be using the sensory-perceptual theory of language acquisition.

The purpose of this evidence based research paper is to evaluate the efficacy of the cycles approach when compared to the traditional articulation therapy approach in the treatment of children who are highly unintelligible. The Cycles Phonological Remediation Approach (Hodson, 2011) is a treatment method for children with severe speech sound disorders. This approach targets phonological pattern errors in a sequential manner. During each cycle, one or more phonological patterns are targeted and after each cycle is complete, another cycle begins. Recycling of phonological patterns continues until the targeted patterns are generalized into the child’s conversational speech. The cycles approach is meant to mirror typical phonological development in children (Hodson, 2011).

Phonological Dyslexia is the type of dyslexia that hinders one's ability to identify basic sounds and causes them to lose phonemic awareness, or the ability to identify and manipulate individual phonemes in words (Desroches et. al, 2005). Research has also revealed a range of impairments and problems in other domains. This includes impairments in visual processing, auditory processing, working memory, oral language and motor functioning (Lum et. al, 2013).

On the articulation subtest of the DEAP X produced errors /ϴ/→ /f/, /ð/ → /d/ in all positions, as well as /k/→ /t/ and /g/→ /d/ in initial position. She also produced /ts/ → /tʃ/ in the final position of a word. X produced lateralizations of /ʃ/ and /s/ in all positions. The phonology subtest assess phonological processes in both single words and connected speech. On the phonology subtest she demonstrated fronting of /k/→ /t/ in initial position and blends. The single word-connected speech subtest indicated inconsistent errors when fronting /t/→ /k/. The scores based on the three subtests indicate the client produces distortions of /s/ and /sh/, as well as typical simplifications for /k/, /g/, /ϴ/, and /ð/

A phonological process is a typical pattern that all young children use when developing their speech. The child’s brain creates rules to simplify speech sounds and make words easier to say. As children grow older, they outgrow these patterns on their own and eventually, their speech becomes intelligible. A phonological process disorder is when a child continues to exhibit these patterns past the age expected for them to disappear. Phonological processes consist of syllable structure processes, substitution process, and assimilation processes.

Even though advanced cochlear implant (CI) and hearing aid (HA) technology is making tremendous strides in the DHH community, these hearing devices still cannot completely restore normal hearing or fully represent all aspects of normal speech sounds. Therefore, children within this population are potentially at a higher risk for speech disorders, speech delays, or language difficulties. The acquisition of phonological awareness (PA) and PA abilities is an important developmental step in speech and language. Moreover, PA skills have been shown to significantly affect early literacy abilities in normal hearing children. PA is commonly defined as the conscious ability

Clinical Implications: Minimal-contrast treatment is effective and efficient for treating children with phonological disability. Avoiding listener confusion is motivating for suppressing process use.

“Phonological disorders in children can result from physical or organic causes or may be functional in nature ("Phonological disorders in," 2013)”. Children with a phonological disorder may experience a higher risk for reading and writing disabilities. “If left unresolved, phonological disorders have long-term consequences that may interfere with an individual's future social, academic, and vocational well-being, largely resulting from persistent, reduced intelligibility of speech ("Phonological disorders in," 2013).”