Top Lang DisordersVol. 25. Nil. .1, pp- ZM-241© ZCMtS LippiiKoU Williams & Wilkins, Inc.

Assessment, Target Selection,and InterventionDynamic Interactions Within aSystemic Perspective

A. Lynn Williams, PhD

There are a number of clinical options available for speecb-langtiage patbologists to choose from toanalyze a child's pbonological system, select treatment targets, and design intervention. Frequently,eacb of tbese areas of clinical options is viewed independently of one another or approached witbinan eclectic framework. In this article, an integrated and systemic approacb is presented which as-sumes that a dynamic interaction exists among assessment, target selection, and intervention. Sys-temic Phonological Assessment of Child Speecb, tbe distance metric approach to target selection,and tbe multiple oppositions treatment approach arc described, witb examples provided for eacbcomponent. Finally, a case study is presented that examines the systemic approach of multipleoppositions relative to the approach of minimal pairs. Key words: assessmettl, tlisUtnce metric,multtplc oppositions, ph<mot<>}^icitt n'strt4Clt4rinfi, target selection

SPEECH-LANGUAGE pathologists have sev-eral clinical options from which to choose

wheti assessing a child s speech, selectingintervention targets, and designing an inter-vention progratn. These options range fromtraditional phonetic frameworks to a varietyof phonologicai/lingtiistic frameworks. It isnot uncommon, then, for speech-languagepathologisls lo complete an assessment fromone framework, choose targets on the basisof another perspective, and implement inter-vention from yet another, a third, perspec-tive. Although this mix-and-match approachoften yields positive otitcomes in remediatinga speech disorder, the question becomes, "Is itthe most efficient approach to treating speechdisorders in children?" The purpose of this ar-ticle is to present an integrated approach toassessment, target selection, and intervention

From the Department of Communicative Disorders.Fast Tennessee State University, Johnson City, Tenn.

Corresponding author A. Lynn Williams, PhD. Depart-ment of Commtinicative Disorders, PO Bttx 70643. EastTennessee State University, Johnson City, TN 37614(e-mail: willianii®etsu.edu).

that incorporates a systemic perspective itiwhich each component interacts dynamicallywith the other components. The systemic per-spective views speech disorders in childrenwithin an integrated system in which eachcomponent of clinical management informsand interacts with the others within a unifiedwhole. A systemic perspective assumes thatthe unique phonological profile of a child willinteract with the teaching input of the targetsselected and the approach used to derive thephonological restructuring that is needed toalign a child's system more with the ambientspeech community. This article will describeeach of these components of clinical manage-ment from a systemic perspective and pro-vide clinical examples. Finally, all three com-ponents will be integrated within a case studyto illustrate the dynamic interactions betweenthese components.

SYSTEMIC PHONOLOGICAL ANALYSISOF CHILD SPEECH

Given that phonological description is thefoundation on whieh treatment is based,the starting point for developing effective

231

232 TOPICS IN LANGUAGE DISORDERS/JULY-SEPTEMBER 2005

interventions and establisbing tbe conditionsfor pbonological cbange is witb a thorougband accurate analysis. Tbe Systemic Phonolog-ical Analysis of Cbild Speecb (SPACS; Williams,2001, 2003a) is a cbild-based assessmentmodel tbat maps tbe child s sound systemonto the adult system in terms of phonemecollapses. The SPACS is completed on an ex-tensive 245 single-word elicitation probe (Sys-temic Pbonological Protocol, SPP; Williams,2003a) that contains all English pbonemesa minimum of ftve titnes in each word po-sition and elicits potential minimal pairsand morphophonemic alternations. From tbisdatabase, the phonetic inventor)' and distri-butional and pbonotactic characteristics ofa cbild's sound system are first describedin terms of an independent phonologicalanalysis. Tbe relatiotial phonological analysisof SPACS involves the correspondence of achild's error productions for adult sound tar-gets, as represented by the mapping of thetwo sound systems via the phoneme collapses(cbild system mapped onto tbe adult soundsystem). The phoneme collapses provide ameans for examining the cbild s organizationof a limited sound system in accommodatingthe fiiU adult system of the ambient language,wbicb results in a one-to-many correspon-dence. The phoneme collapses can, therefore,be seen as strategies developed by tbe cbild tocompensate for a limited sound system.

Examples of word-initial and word-ftnalphoneme collapses are shown in Figures 1and 2 for "Mark," age 6 years 0 months (datataken from Grunwell, 1987).

Notice in Figure 1 the symmetry in theword-initial phoneme collapses that exist inMark's sound system to account for a lim-

ited sound system. Specifically, he produceda voiceless glide [h] for voiceless continuants[f, s, J], whereas he produced tbe voiced glide[j] for voiced continuants [I, r]. Similarly, Markcollapsed voiced noncontinuants and clusterto tbe voiced stop Id] and voiceless noncon-tinuants and cluster to tbe voiceless stop [t].In both sets of phoneme collapses, it is in-teresting to note the phonetic resemblancesbetween Mark's production and the adult tar-gets. In the first set of phoneme collapses,Mark produced a voiceless or voiced con-tinuant [h, j] for tbe collapsed target voice-less and voiced continuants. In tbe secondset of phoneme collapses, Mark again pro-duced a voiceless or voiced noncontinuant forthe collapsed target voiceless or voiced non-continuants. Tbese collapses represent mirrorrules that exist along tbe voicing and continu-ancy parameters and signify a logical and sys-tematic strategy to compensate for a limitedsound system, which reflects the "order in thedisorder" (Grunwell, 1997).

Given tbat the distribution of glides canonly occur in word-initial and word-medial po-sitions, Mark needed a different strategy to ac-commodate word-fttial continuants. Indeed,as shown in Figure 2, be did exbibit a differentset of phoneme collapses.

Notice in Figure 2 thai .Mark did notmaintain the continuant/noncontinitant dis-tinction that be had word-initially. Ratber,he combined continuants and noncontinu-ants to form a larger sound class of obstru-ents. Although not tested, it would be pre-dicted tbat word ftnal /z/ would be producedas [d] to mirror his production of final /s/ ,which was collapsed to tbe voiceless obstru-ent It]. Notice again the symmetry of tbe

voiceless/voiced continuants collapsed to |h,j] voiceless'voiced non-continuants collapsed to [t, d]

f i gure 1. Mark s woai-iiiitial phoiifnic coilapscs.

Assessment, Target Selection, and Intervention 233

voiceless obstruents collapsed to [t] voiced obstruents collapsed to [d]

Figure 2. Mark's word-final phoneme collapses.

two phoneme collapses, which reflects a log-ical accotTtmodation of a limited sound sys-tetn. Marks word-final organization is basedonly on voicele.ss or voiced obstruents. There-fore there were only two word-final phonemecollapses as compared to the four word-initial phoneme collapses chat addressed bothvoicing (voiceless/voiced) and continuancy(continuant/noncontinuant).

In contrast to this systemic descriptionof Mark s sound system using phoneme col-lapses, a phonological process analysis woulddescribe differences between his productionsand the adult targets using a finite set ofa priori lahels, or phonological processes(Williams, 1995)- Looking at Mark's word-initial sound system, a phonological processanalysis would label all of the voiceless frica-tives produced as (h] as "glottal replace-ment" and the liquids produced as [j! as an"idiosyncratic gliding process." The processanalysis would miss the symmetry betweenthese two phoneme collapses that accommo-dates the voicing distinction between con-tinuants. Three different phonological pro-cesses would be needed to describe Mark srule of noncontinuants collapsed to [t] or[d]. Specifically, a phonological process anal-ysis would lahel each sound change witha different phonological process, includingfronting," "deaffrication,' and "fronting +

cluster reduction." Agaiti, the phonologicalprocess analysis would miss the symmetryand systemic organization of Mark's soundsystem that is expressed by the two sets ofword-initial phoneme collapses (i.e., voice-less/voiced continuants and voiceless/voiced

noncontinuants) that incorporate the param-eters of voicitig and continuancy.

In sum, the phoneme collapses dia-grammed for Mark compared system-to-system (child:adult) rather than sound-to-sound (error:target) comparisons, which usedphonological processes to label each soundchange relative to the adult target. Follow-ing from the SPACS, intervention becomesa dynamic interaction between a child'soriginal phonological organization and thetreatment input that works to facilitate a newphonological reorganization. It is thereforeassumed that the unique phonological profileof a child will interact with the teachinginput of the targets selected for intervention,which is described in the next section.

DISTANCE METRIC: A SYSTEMICAPPROACH TO TARGET SELECTION

The effect of targets selected for interven-tion on phonological learning has been re-cently revisited. Typically, speech-languagepathologists have relied on phonetic factorsthat were based on developmental normsor stimulability or both. Specifically, clini-cians chose sounds that were stimulable andearly-developing. Gierut, Morrisette, Hughes,and Rowland (1996) proposed phonemic, orlinguistics-hased, criteria for selection of tar-gets. In this "nontraditional" approach to tar-get selection, it was recommended that clin-icians choose sounds that are nonstimulable,later-developing, phonetically more complex,and linguistically marked and represent least

234 TOPICS IN LANGUAGE DISORDERS^ULY-SEPTEMBER 2005

phonological knowledge. A scries of studies(Gierut, Elbert, & Dinnsen, 1987; Ciieait et al.,1996; Miccio, Elbert, & Forrest, 1999; Powell,Elbert, &. Dinnsen, 1991; Tyler & Figurski,1994) have been cited as evidence that teach-ing more complex sounds results in greateroverall change in the child's phonologicalsystetn.

This position has been recently challengedby Rvachew and Nowak (2001), whose re-sults were contrary to those reported by theprevious series of investigations, Specifically,they reported that targets that were least dif-ficult (i.e., early-developing and most knowl-edge) resulted in greater progress toward ac-quisition of sounds than did targets that weremost difficult (i.e., later-developing and leastknowledge).

Although these two positions (phoneticallyeasier targets versus phonological ly complextargets) represent opposite views, both aresimilar in that they appeal to the dichot(vmous characterization of an individual sound.That is, whether a sound is characterizedas early-developing or later-developing, stim-ulable or nonstimulable, most knowledge orleast knowledge. The point of disagreement iswhether to choose a target on the basis of easeor difficulty of production. Williams (2()0()b,2003b, 2005) recently described a third op-tion that involves a systemic approach totarget selection. This approach is based onthe function of a soitnd in the child's rulerather than the characteristics of a soundthat is independent of the child s phonolog-ical rule. The function of a sound is a con-cept which assumes that the importance oftarget sounds is broader than the character-istics of the sound itself. As indicated by thefirst two approaches, sounds can be charac-terized as early-developing or later-developingwith regard to age of acquisition accordingto a specified set of norms that are indepen-dent and autonomous with regard to a specificchild. However, the function of a sound is de-pendent on the role it plays within a partic-ular child s unique phonological system, andtherefore it will vary from child to child. C on-sequentiy, the function of a particular sound

is independent of the characteristics of thatsound.

The systemic approach to target selection isbased on a distance metric that incorporatestwo parameters: (1) maximal classificationand (2) maximal distinction. Maximal classi-fication involves selection of targets from aphoneme collapse or rule set, which repre-sent different manner classes, different placesof production, and different voicing. Selec-tion of targets that are representative of thesound classes collapsed across a phoneme col-lapse provides focused training across a ruleset. Maximal classification represents a verti-cal parameter, which involves selection fromamong the target sounds that are included ina phoneme collapse.

Maximal distinction is the selection of spe-cific target sounds that are maximally dis-tinct from the child s error in terms of place,voice, manner, and linguistic unit (singletonversus cluster). Maximal distinction repre-sents a horizontal parameter in which thecollapsed target sounds are maximally dis-tinct in relation to the individual child's error.Selection of targets that are more distinctfrom the child's error (maximal distinction)makes them more salient and therefore pre-sumably more learnable. Collectively, the twoparameters ofthe distance metric specify thattargets that represent the extremes of thechild's rule set, or phoneme collapse, are se-lected. The goal in intervention is to achievemaximum phonological reorganization withthe least amount of intervention. By select-ing targets that are more distinct from thechild s error (maximal distinction) and arerepresentative of the sound classes collapsedacross a phoneme collapse (maximal classifi-cation), the target sounds contrasted to thechild's error can be made more salient andare therefore predicted to be more learnable.For example, selection of /k. tJ, s, tr/ astargets to contrast to the child's error sub-stitute of [t] satisfies both vertical and hor-izontal parameters of maximal classificationand maximal distinction in terms of select-ing targets from different places (velar, palatal,and alveolar), manner (stop, affricate, and

Assessment, Target Selection, and Intervention 235

Table 1. Two logical options for target selec-tion for Mark

Option 1

Goal 1; h-f. s, ;(voiceless continuants

word-initially)Goal 2: d ^ g, d3 {and

possibly untested / z/)(voiced obstruents

woal-finally)

Option 2

Goal 1: j - 1, r(voiced continuants

word-initially)Goal 2: t - k, tJ, s, J"(v<}iccless obstruents

word-finally)

fricative), and linguistic units (singleton andcluster).

Returning to the phoneme collapses dia-grammed for Mark, let us examine how thedistance metric would be used to select treat-ment targets. Assuming that the phoneme col-lapses in word-initial and word-fmal positionsare functioning as mirror rules to accommo-date the parameters of voicing and contlnu-ancy, then addressing one rule in each posi-tion might be assumed to generalize to tbeother phoneme collapses. Two options arepossible, as summarized in Table 1.

Selection of eitber option in Table 1 will di-rect intervention to tbe full ninge of Mark'sphoneme collapses in botb word positions.In Option 1, Goal 1, targets represent a vari-ety of places of production (labio-dental. alve-olar, and palatal). Tbe voicing and mannercbaracteristics of the sounds in this phonemecollapse did not vary. Goal 2 of Option 1includes different places (velar, palatal, andpossibly alveoiar if /z/ is found to patternlike the voiceless phoneme collapse in word-final position), and dilferent manner classes(stop, affricate, and possibly fricative). In Op-tion 2, Goal 1, the targets include the fullspectrum of the phoneme collapse and dif-fer only witb regard to place (alveolar andpalatal). In Goal 2 of Option 2, the targets in-clude a variety of places of production (ve-lar, palatal, and alveolar) and manner classes(stop, affricate, and fricative). Regardless ofoption, tbese targets were selected on the ba-sis of tbeir ftinction witbin a pboneme col-lapse ratber than on tbeir individual character-

istics of early or later-developing phonemes,stimulable or nonstimulable, or most or leastpbonological knowledge.

To summarize, tbe systemic approacb dif-fers from both the traditional and pbonolog-ical complexity approaches to target selec-tion. Tbe latter two approaches are basedon the characteristics of the specific sounds,whicb are independent of any particularchild's phonology. Furthermore, these indi-vidual sound cbaracteristics are generic acrossall sound systems. Conversely, the systemicapproacb using the distance metric consid-ers tbat a particular sound will functiondifferently witbin different sound systems.Consequently, a given sound does not aiway.sfimctioti in the same manner, or have tbesame potential for pbonological reorganiza-tion, across all cbildren.

MULTIPLE OPPOSITIONS: A SYSTEMICAPPROACH TO PHONOLOGICALINTERVENTION

The multiple oppositions intervention ap-proach is based on the assumption that learn-ing is facilitated by tbe size and nature ofthe linguistic "chunks" tbat are presented tothe child. With multiple oppositit)ns, largertreattnent sets tbat are integrated to addressseveral error sounds simultaneously from onerule set are incorporated in treatment. This ap-proacb predicts tbat learning will be general-ized across a rule set (or pboneme collapse)and result in systemwide phonological re-organization. This intervention model is basedon holistic, systemic sound learning that in-corporates principles of distributed learning.Tbus, the multiple oppositions approach pro-vides both an integrated and distributed ap-proach to sound learning (Williams, 20()0a).

Unlike the singular contrastive approachesof minimal pairs (Weiner, 1981). maximaloppositions or treatment of tbe empt>' set(Gierut, 1992), multiple oppositions contrastsseveral error sounds within a single rule set.Therefore, not only are more sounds trained(i.e., larger treatment sets), but the inte-grated treatment sets comprise target sounds

236 TOPICS IN LANGUAGE DISORDERS ULY-SEPTEMBER 2005

from across the child's phonological rule.Focusing individual children s attention ontheir error pattern in this manner confrontsthem with the extent of phonologic changethat must be achieved while exposing themto the relatedness of all the target soundsto their error pattern. The distributed inputof the larger/integrated treatment sets there-fore enlai^es the frame of relevant learning.In tbis regard, the larger/integrated treatmentinput represents tbe gestalt" of learning thatneed.s to occur. It assumes that the whole ofthe learning task is greater than the sum ofits parts. Tbis theoretical perspective assumesthat tbe greatest amount of cbange will occurin the shortest amount of time when interven-tion is focused on disruption across a rule set.

A case study will be used to illustrate tbedifferences between the two contrastive ap-proaches of multiple oppositions and mini-mal pairs. Botb approacbes directly addressthe homonymy tbat results from a cbild s lossof adult pbonemic contrasts by confrontingthe cbild witb his or her error and the tar-get sound(s). The two approacbes differ, bow-ever, in the size and nature of their contrastivetreatment sets. As noted previously, minimalpairs involve a single contrast between thechild s error and one target sound, whereasmultiple oppositions involve several targetsounds from a rule set that are contrasted si-multaneously with the child's error.

"Jane" was a female, age 6 years 5 months, infirst grade wbo exhibited a moderate phono-

logical impairment with age-appropriate ex-pressive and receptive language skills. Shewas a participant in a comparative interven-tion study in wbicb she received treatmenton one phonological goal using multiple op-positions and on a second goal using min-imal pairs. Her word-initial and word-finalphoneme collapses based on the SPACS aresummarized in Figure 3.

Jane's SPACS was interesting in that she pri-marily exbibited developmental sound errorsof gliding, labialization, and fronting that re-sulted in small phoneme collapses of just thetarget sound and one otber phoneme. Theonly extensive phoneme collapse of obstru-ents and clusters to [gl did not have a paral-lel, or mirror, phoneme collapse to [k]. Noticein Figure 3 that Jane did not maintain a voic-ing distinction, in that both voiced and voice-less target obstnients were produced as [g].Therefore, tbis collapse appears to representa sound preference for this cbild.

From these phoneme collapses, targetswere selected for each intervention approach.Efforts were made to equate the number oftargets witbin each approach; however, therewas one less target addressed in tbe minimalpair approacb owing to tbe size and overlap-ping nature of the remaining collapses. Thetargets selected for eacb approacb are pre-sented in Table 2.

As summarized in Table 2, multiple op-positions targets included representative tar-gets from the phoneme collapse of fricatives

Word-lnitia) phoneme ci lapses

9

^ / 6 s w

y frer

Word-final phoneme collapses

e

V

^ f

Figure 3. Word-initial and word-final phoneme collapses for Jane.

Assessment, Target Selection, and Intervention 237

Table 2. Multiple oppositions and minimalpairs targets selected for Jane

Multipleoppositionstargets

Minimal pairstargets

g ^ f. e, gl. fr (word-initially)

" r (word-initially)J" (word-initially)e (worci-tinally)

and dus te r s to [g]. These targets varied interms of place of production (labiodental andlinguadental), linguistic unit (singletons andclusters), and cluster type (stop + liquid andfricative -I- liquid clusters). For the minimalpair targets, one target was selected from eachof the remaining smaller phoneme collapsesthat was not a cognate collapse. That is, / e /was selected, but not / 6 / . Although / e / wasalso a target word-initially, it was selected over/6/ word-finally because it is a more frequentlyoccurring English phoneme and would there-fore result in more meaningful contrastiveword pairs. Furthermore, / e / functioned verydifferently in word-initial and word-final posi-tions. Word-initially, / e / was part of a collapseof obstruents and clusters to [g| that differedin terms of place, voice, and manner of pro-duction. Word-finally, / e / only differed fromthe child s error substitute, [f], in terms ofplace of production.

Each set of targets was trained within tbespecified intervention approach using tbetreatment paradigm described by Williams(2003a). Specifically, eacb set of targets re-ceived a maximum of 21 treatment sessions.Treatment was initiated at an imitative leveluntil tbe training criterion of 70% accuracyacross two consecutive treatment sets wasmet and then treatment STvitched to a spon-taneous level. A generalization probe was ad-ministered three times prior to intervention toestablisb a baseline of performance and wasthen administered every tbird treatment ses-sion tbereafter. The probe included all target

sounds in 10 untrained words in tbe trained-word position and an untrained control soundfor a total of 80 probe items. If a target mettbe genemlization criterion of 90% accuracyon the untrained words, a conversational sam-ple was completed. A target was terminatedfrom treatment if it was correctly producedwith at least 50% accuracy in conversationalspeech.

Treatment consisted of five sets of con-trastive word pairs for each pbonological goal.Eacb 30-minute treatment session elicitedabout 80 to 100 responses. Tbe contrastiveword sets for each goal are presented inTable 3.

A multiple-baseline design across bebaviorswas used with counterbalancing for tbe twointervention approaches. Jane received treat-ment on multiple oppositions first, followedby minimal pair treatment. Sbe completed21 treatment sessions with each intervention

Table 3- Multiple oppositions and minimalpairs contrastive word pairs for Jane

Multipleopposit ionscontrastiveword pairs

g - f, e, fr. gl(word-initially)

goes — foes, /eoz/.froze, glows

gum - /fAm/, thumb.from, glum

gad -- fad, Thad,/frasd/, glad

gore ^ four, Thor,/fror/, /glor/

gaze ^ faze, /etz/.frays, glaze

Minimal pairscontrastiveword pairs

s - 1 (word-initially)save -self-Sue —sack ^sell -w — rwed ^one ~weedwar "~w es t '

- shaveshell"shoe- shackshell(word-initially)' redrun

— reedroar

- restf '^ e (word-fmally)whiffdeaf-roof-calf-^reef ^

— with- death-RuthKathwreath

238 TOPICS IN LANGUAGE DKSORDERS/ ULY-SEPTEMBER 2005

Table 4. Summary of Janes final and highest treatment and generalization performance

Goal

g -- f, e. fr, gl (word-initially)

s -- j" (w(jrd-initially)w - r (word-initially)f -- e (word-ftnaily)

Finaltreatment

f-90% (spon)-6-100% (spon)*fr-60% (spon)gl-90% (spon)'J"-80% (spon)r-85% (spon)e-95% (spon)

Highesttreatment

f-90% (spon)"e-100% (spon)'fr-60% (spon)

gl-100% (spon)'J-95% (spon)r-85% (spon)

e-100% (spon)

Finalgeneralization

f-100%e-40%fr-0%

gl-](H)%1-50%r-10%0-40%

Highestgeneralization

f-100%e-100%fr-20%

g!-l(K)%J--50%r-10%e-90%

Nate, spon — spontaneous level of production,*.Sound met critcTia tbr termination.

approach for a total of 42 treatment sessions,A summary of her treatment results is pro-vided in Table 4 for each treatment approachaccording to her final treatment performance,highest treatment performance, final general-ization performance, and highest generaliza-tion performance.

Of the four multiple opposition targets,three met treattnent criterion to move fromimitative to spontaneous early (within 2 to7 treatment sessions) and also met the crite-ria for termination (/f., e, g!/). Although thefourth target, /fr/, did not achieve the samelevels of treatment and generalization perfor-mance as the other three targets, qualitativeimprovement was noted in Jane's productionof [f] for target /fr/ rather than her originalproduction of |g] fbr/fr/.

Compared to the minimal pair targets, onlyone target, /e/, evidenced an early change tospontaneous production (session 3), whereasthe other two targets remained at the imita-tive level for 11 and 13 sessions. Recall that/&/ was a previously trained target with mul-tiple oppositions. None of the tbree minimalpair targets met the criteria for termination,

A SPACES was completed following eachtreatment approach. A pre- and posttreatmentcomparison of tbe targeted pboneme col-lapses is summarized in Figure 4,

As indicated by the pre-post treatmentcomparisons of the treated phoneme col-

lapses in Figure 4, significant change was ob-served following multiple oppositions treat-ment. Specifically, the pboneme collapse wasrestricted from a 1:8 collapse originally toa 1:4 collapse following treatment. Further-more, the posttreatment collapse representedmore developmental sound errors, that is, [f]was prodticed for /e, fr, er/ as comparedto Jane s atypical production of [g| for targetfricatives and clusters. Following minimal pairtreatment, no cbange was observed in twoof the three treated phoneme collapses, Tbeonly cbange that occurred was the elimina-tion of tbe collapse of/r / to [w|. Interestingly,there was no change in tbe word-final collapsealtboitgh / e / was a previously tai^eted soundfrom the larger word-initial collapse trainedwith multiple oppositions.

The two treatment approaches can also becompared with regard to broader, systemwidechange. Several aspects of global change wereexamined, including (1) the percentage ofnew or expanded sounds tbat were added toJane s inventory following each treatment ap-proacb, (2) the number of sounds that werestabilized tbllowing each treatment approach,and (3) the number of tintreated sounds thatwere added to ber inventory following eachtreatment approach,

Tbe percentage of new or expanded soundsor both represents aspects of Jane's soundsystem that are characterized by new

Assessment, Target Selection, and Intervention 239

Multiple Oppositions

(Pre-posl IreHtmenl of targeted

phoneme coiiapiies)

Prc INisl

Iword-inilial) (utirid-initial)

g

n r^ O l' / O

y » — " ' t "

Y gr er

^ Sr

18 phoneme collapse 1 4 phnnetne collapse

Minimal Pairs

(Pre-posl treatment of targeted

pboneme collapses)

I're

(\vord-miliai)

s

(uord-initial)

" < "

(word-final)

e

Post

(word-initial)

s

(word-initial)

eliminated

(uord-linall

e

Figure 4. Pretreatment-posttreatmcnt SPACS following multiple oppositions and minimal pairs treatment.

knowledge, using definitions suggested byElbert and Ciierut (19H6), eitber of a previous-ly absent word sound (i.e., inventory con-straint or Type 6) or expansion to previouslyunknown positions (i,e,, positional constraintor Type 4). Tbat is, tbe sound moved froman unknown level of knowledge (Type 6or Type 4) to a known level of knowledge(Type 3 pbonological rule or Type 1 ambientknowledge) on the knowledge continuutn.

The number of stabilized sounds does notrepresent any new knowledge or knowledgeof sounds expanded to new positions, butknown sounds that were not previously pro-duced correctly all the time (i.e., producedincorrectly at least twice, but still representknowledge of the target sound) to soundsthat were consistently produced correctly.This measure of cbange represents movementfrom 'fspe 3 to Type ! on the knowledgecontinuum.

Finally, tbe number of untreated soundsadded to tbe inventory reflects change inJane s sound system that was not directlytreated. This type of cbange would indicate

tbat a previously unknown sound (Type 6 in-ventory constraint) moved to eitber a Type 3(pbonological rule) or Type 1 (ambient).

Greater systemwide change occurred fol-lowing the multiple oppositions approachtban the minimal pair approach. Specifically,a greater percentage of new or expandedknowledge occurred following multiple op-positions (10% compared to 1%) and changesoccurred to both trained and untrained as-pects of Jane s sound system, as indicated bythe addition of/6/ to her inventory. Followingminimal pair treatment, tbe only change thatoccurred in trained sounds occurred with /r/,and no untreated sounds were added to herinventory. However, two previously knownsounds became stabilized following minimalpair treatment. It is interesting to note tbatthere were no sounds eligible to move froma known, but inconsistent, production levelto a stable level of production prior to themultiple oppositions intervention. Thus, thenew or expanded knowledge that occurredfollowing multiple oppositions treatment be-came stabilized after minimal pairs treatment.

240 TOPICS IN UNtiiiAGE DISORDERS/JULY-SEPTEMBER 2005

Table 5. Features, assumptions, and predictions of SPACS, distance metric, and multiple oppo-sitions components in a unified systemic framework

SPACS (phonologicaldescription)

Features • Child-basedapproach

• System-to-systemmapping usingphoneme collapstfs

Assumptions • Child's systemis unique, independentsound system

• Phonemecollapses represemcompensatory strategiesto acconimodatt: alimited soimd system

Predictions • Greater phonologicalrestructuring occurswhen the child s owniiniqiic system isconsidered in planningintervention

Distance metric(Target selection)

• Based on theftinctUm of a soundrather than thecharacteristicsot a sound

• Based on theextreme aspects of a ruleset that incorporates twoparameters; (1) maximalclassification and (2)maximal distinction

• The importanceof target sounds isbroader than thecharacteristics of thesound itself

• Treatment inputinteracts dynamicallywith a child s uniquephonological profile

• Targets that arc moredistinct from the child serror (maximaldistinction) and arerepresentative ofthesounds collapsed in arule set (maximalclassification) arcpredicted to be morelearnable

Multiple oppositions(Intervention)

• Larger/integnucdcontrastive word sets areused to directly confronthomonymy that existsfrom collapse of severaltarget sounds to a singleerror production

• Learning isfacilitated by the sizeand nature of thelinguistic "chunks"presented to the child intreatment

• The whole ofthe learning tasks isgreater than the sumof its parts

• Learning is a dynamicinteraction between achild's uniquephonological profileand intervention

• Phonological learningwill be facilitated andgeneralized across arule set

• Learning will result insystemwide phonologicalrestructuring

As illustrated in this case study, the dytiamic CONCLUSIONinteniction of the three components of assess-ment, target selection, and intervention re-stilted in systemwide change in a short timeperiod of only 21 treatment sessions with tbemultiple oppositions approacb.

The question of bow to optimize thephonological restructtiring of a child'ssoutid system requires consideration ofseveral issues. On a general level, teaching

Assessment, Target Selection, and Intervention 241

phonology to individual children with asound disorder requires an understandingof their unique phonological profile. Thisfirst issue involves the assumption thatdisordered speech comprises a system thatrepresents a unique phonological profile of aself-contained and independent system.

A second issue in teaching phonology to achild rec|uires manipulation of the treatmentinput that corresponds {o the child s learningneeds. Tliis issue assumes that the treatmentinput interacts dynamically with the child sunique phonological profile. Thus, target se-lection does not represent an independentstep from the phonological analysis, nor a con-sideration of factors or chanicteristics that areexternal to the child s phonological system.Rather, target selection is directly linked tothe individual child s distinctive phonologicalsy.stem, including strategics the child has de-veloped to accommodate a limited sound sys-tem and the phonetic relationship hetweenthe child's productions and the adull target.

The final issue in teaching phonology to achild requires the speech-language patholo-gist to present the treatment input in a waythat will result in the greatest amount ofchange in the least amount of time. Tliis issueassumes that phonological learning is predi-cated by the diet of linguistic chunks that arepresented to the child in intervention. Tliere-fore, the way we engineer" the information

to be learned is not only an important aspectto the teachability of a phonology, but is alsointegrally related to both the unique organiza-tion of the child s phonology and the saliencyof the targets we select to help individual chil-dren reorganize their sound systems.

Each of the aspects involved in teach-ing phonology (i.e., phonological descrip-tion, target selection, and intervention), issummarized in Table 5. The assumptionsand predictions of each of these areas aresummarized.

Alignment of phonological assessment,target selection, and intervention within aunified systemic framework provides an ap-proach to the clinical management of phono-logical impairment that is desirable over ap-proaches that are not integrated within aconsistent structure. Each component of thesystemic framework interacts with and con-tributes to the other components in a mannerthat would not be expected within either aneclectic approach or frameworks that do notconsider the systemic and interactive natureof children's sound systems, target selection,and intervention. The sy.stemic approach isone method for integrating these componentsto discover the order within the disorder"of phonological impairments. Understandingthat order provides the basis, or foundation,for creating the greatest amount of change inthe least amount of time.

REFERENCES

ElbtTt. M, & (.icriit, J. A. (1986). fhiHcttMink <,f cthii-cat /ihonotofiy: Approaches tn as.-^essini'nt mid tivat-ment. San Diego, CA: College-Hill Press.

Gierut, J. A. (1992). The conditions and course iif clini-cally induced phonological changf,>»Hmrt/ of SpeechandHearinfi Research. .J5. 1049 1063.

(iienit, J. A,, l-lbert, M.. & Dinnsen, D. A. (I9H7). Afunctional analysis of phonoloHical knowledge andgeneralization learning in misarticulating children.Joumat of Speech and Hearing Research. ,iO, 462-479.

Gierut, J. A.. Morrisette, M. L,, Hughes, M. T, & Rowland,S. (1996). Phonological treatment efficacy and devel-opmental norms. Larif>uage. Speech, and liectriii^ Ser-vices in the Schiiois. J 7. 215- 230.

(iamwell. P. (19S"'). Clinicalphonotogy (2nd cd.) Haiti-more, MD: Williams & Wilkins.

Grunwell, R (1997). Developmental phonological disabil-ity; Order in disorder. In B, W, Hodsun & M. L. Edwards(Eds.), Perspectives in uppiied phonotogy. <;aither.vbui^, MD: Aspen Publications.

Miccio. A. W., Rlbt-rt, M., & Forrest, K. (1999). Therelationship between slimulabilily and phonologicalacquisition in children with normally developingand disordered phonologies. American Journal ofSpeech-taiiguage Pathoiogy. 8. 347-363.

Powell, T W, Elbert. M., & Dinnsen, D. A. (1991). Stimula-hility- as a factor in the phonological generalization ofmisarticulating preschool children.yoi/r/jfl/ of Speechand Hearing Research. ^4. 13 IH-1328.

242 TOPICS IN LANGUAGE DISORDERS/JULY-SEPTEMBER 2005

Rvachew, S., & Nowak, M. (2001). The effect of targetselection strategy on phonological learning, ^ow^" /of Speech. Language, and Hearing Research. 44,610-623.

Tyler, A. A., & Figurski, Q. R- (1994). Phonetic inventorychanges after treating distinctions along an implica-tion hierarchy- Clinical Linguistics & Phonetics, 8.91-107.

Weiner, E (1981). Treatment of phonological disahility us-ing the method of meaningful minimal contrast: Twocase studies. Journal of Speech and Hearing Disor-ders. 4 6,97-H)i.

Williams, A. L. (199.3). Phonological rcoi^anization: Aqualitative measure of phonological impntvement.American Journal of Speech-language Pathology, 2.44-51.

Williams, A-1.. (20(M)a). Multiple oppositions: Theoreticalfoundations for an alternative contrastive interventionappniach. American Journal of S/?eech-languagePathology, % 282-288.

Williams. A. L C20(X)b) Multiple oppositions: Case stud-ies of variables in phonological intervention. Ameri-can Journal of Speech-tanguage Pathology. 9, 289-299.

Williams. A. 1., (2001) Phonological assessment of childspeech. In D. M. Ruscello (lid,). Tests and measure-ments in speech-lanUinguage pathology (pp. 31-76). Wobum, MA: Buttcrworth-Heinemann,

Williams, A. L. (2003a). Speech disorders in preschoolchildren: A resource guide. (Clifton Park, NY:Thomson Dtlmar Learning,

Williams, A. L. (2(K)3h). Target selection and treatmentoutcomes. Perspectitms on Language Learning andEducation. KXD. 12-16.

Williams, A, L. (2005). Developmental norms to distancemetrics: Past, present, and future directions for targetselection practices. In A. Kamhi & K. Pollock (Eds.),Phonological disorders in children: Clinical decisionmaking in assessment and inten<ention (pp. 101-108). Baltimore, MD: Brookes Publishii^ Co,