Target Selection Considerations for Speech Sound Disorder Intervention in Schools

Abstract

Purpose Clinicians working with children who have speech sound disorders that involve multiple errors often prioritize particular errored sounds for intervention. However, this prioritization is not always an easy or clearly defined clinical decision, as there are many target selection considerations to weigh, some of which directly oppose one another. Conversely, sometimes there are multiple justified reasons to target a particular process or sound over others produced in error. Having a well-advised rationale regarding what sounds/sound classes to prioritize in treatment is a critical tenet of high-quality clinical service provision. Therefore, speech-language pathologists need to be mindful of differing rationales for prioritizing therapy targets and note that the same prioritization may not be appropriate for all children receiving therapy. Conclusions This clinical focus article provides an overview of a wide variety of pediatric target selection considerations (e.g., stimulability, complexity, frequency of occurrence, and interference with intelligibility) and offers clinicians theoretical and research-based rationales for each. Limitations and/or controversies that hamper practical clinical application of each target selection consideration are noted and described. Aspects in need of further research are highlighted. Additionally, through presentation of hypothetical case studies, the authors illustrate an individualized approach to target selection appropriate for a pediatric caseload.

Expansion Points Intervention in Young Children with Speech Sound Disorders: A Multiple Baseline Design

“…Second, a hallmark feature of EXP is to select phonemes on which the child is likely to make progress first, using stimulability, individual factors of the child's inventory, and utilization of a developmental theory to target selection. 26 Therefore, given that subsequent targets were more complex and evidenced greater impairment, it is expected that children would show more limited progress on these than on phonemes presented earlier in treatment.…”