Journal of Speech and Hearing Disorders, Volume 52, 393-409, November 1987
I
CLINICAL APPLICATION OF TWO PHONOLOGICALLY BASED
TREATMENT PROCEDURES
ANN A. TYLER MARY LOUISE EDWARDS JOHN H. SAXMAN
Syracuse University, Syracuse, NY
Two phonological process-based treatment procedures were applied in an ongoing clinical program. Subjects were 4 children
aged 3: i, 3:8, 4:1, and 5:1. Two subjects were assigned to a minimal pairs contrasting procedure, and 2 were assigned to a modified
cycles procedure based on results of a detailed phonological analysis. All children demonstrated marked changes in their
phonological systems as shown by the results of pretreatment and follow-up generalization probes. Correct production
generalized to sounds affected by the treatment process that were not a focus of training. Correct production of untrained sounds
lagged behind that of trained sounds for all subjects. Results support the hypothesis that articulation remediation is enhanced by
treating phonological processes as well as the notion that the acquisition of phonology is a gradual process. Both treatment
procedures used in this study were found to be effective and efficient, as evidenced by the elimination of up to three phonological
processes within 21/2 months for each subject.
Knowledge of normal phonological acquisition has
aided in developing an understanding of disordered pho-
nology. It is now well accepted that children who exhibit
multiple misarticulations generally have phonological
systems that are as regular as those of children with
normally developing speech (Edwards & Shriberg, 1983;
Ingram, 1976). Investigations of normal and disordered
phonological systems are frequently accomplished by
discovering the child's phonological processes (system-
atic sound changes affecting entire classes of sounds or
sound sequences).
The term phonological process has been adopted from
Stampe's (1969) theory of natural phonology, which has
been loosely interpreted in the description of functional
misarticulations. A phonological process accounts for the
child's systematic sound changes that result from the
common difficulty a class of sounds or sound sequences
poses for the speech capacity (Stampe, 1969). Phonolog-
ical process analysis provides a method for identifying
children's systematic speech sound error patterns. Using
any one of several published or informal procedures
(Edwards, 1983; Hodson, 1980; Ingram, 198!; Shriberg &
Kwiatkowski, 1980; Weiner, 1979), the phonological pro-
eesses that account for the child's misarticulations can be
identified. In recent years, several procedures have been
described that use the results of phonological process
analysis in remediating misartieulations of children with
functional artieulation disorders (Crary & Hunt, 1983;
Hodson & Paden, 1983; Weiner, 1981).
A treatment approach based on phonological process
analysis involves facilitating the emergence of new sound
patterns through treating phonological processes, as op-
posed to treating separate sound errors. The major as-
sumption of a phonological process-based treatment ap-
proach is that remediation is maximized through gener-
alization that oecnrs across the sounds affected by a
particular process when only a few sounds undergoing
that process are taught. It is assumed that the elimination
of a few specific sound errors produces change in the
underlying process accounting for those errors. There-
fore, other errors arising from the process may also be
eliminated without direct training (Compton, 1976). Al-
though proponents of a phonological process-based treat-
ment approach argue that it is efficient and effective, this
has yet to be established in empirical clinical studies.
Most phonological process-based approaches: to reme-
diation have been described in case studies where signif-
icant changes in individual children's phonological sys-
tems have been reported (Compton, 1975, 1976; Crary &
Hunt, 1983; Elbert, 1983; Grunwell, 1983; Hodson,
1983). Several training studies involving single-subject
designs (Elbert & McReynolds, 1985; McReynolds &
Elbert, 1981; Weiner, 1981) have also investigated the
effects of training and/or generalization from a phonolog-
ical process perspective. Elbert and McReynolds (1985)
investigated generalization across two sound classes
(stops and fricatives ) affected by the process of final
consonant deletion. They trained sounds in one class and
probed to assess generalization to the untrained class for
each of 4 subjects. Their results indicated that correct
production of the target pattern generalized only to items
of the trained class and not to the untrained class.
Weiner (1981) used a multiple baseline design in pro-
viding treatment of three target processes for 2 subjects.
One of the target processes, final consonant deletion,
affected sounds from two different classes; therefore,
training sounds for this process were selected from each
class. Generalization probes were administered to assess
the elimination of the target processes in untrained
words. Weiner's results indicated that correct production
generalized to untrained words that contained both
trained and untrained sounds, resulting in a reduction in
the frequency of process application for the probes.
McReynolds and Elbert (1981) investigated generaliza-
tion for 6 subjects who exhibited the process of cluster
reduction, although/s/and liquid clusters were not sep-
arated in their definRion of cluster reduction. Untrained
clusters were probed to assess generalization. Results
© 1987, American Speech-Language-Hearing Association 393 0022-4677/87/5204-0393501.00/0