Articulation Disorders (Speech Sound Disorders)

- Executive Summary

 1.  How to identify speech sound disorders from organic causes of impaired speech production:

     a. History taking: to exclude delayed developmental milestones, sensori-neural hearing loss, cleft palate, and dysarthria. (strong recommendation)

     b. Thorough    general    and    otolaryngological examination. (strong recommendation)

2.  Speech  sound  assessment: formal language and articulation tests to assess language and phonology, followed by:

     a. Phonetic  transcription  for  the  phonological errors and any special context where they occur. (strong recommendation)

     b. Identify error pattern: omission, substitution, or distortion. (strong recommendation)

     c.  Stimulability. (strong recommendation)

     d. Intelligibility. (strong recommendation)

3.  Treatment options:

     a. Contextual   therapy:   this   approach   utilizes that speech sounds are produced in syllable- based contexts in connected speech and some phonemic/phonetic   contexts    can   facilitate correct production of a particular sound. (conditional recommendation)

     b. Contrast therapy: minimal opposition, maximal opposition, or multiple opposition therapy. (strong recommendation)

     c.  Cycle approach: the child is provided with a practice on a given target for a predetermined period, before moving to another target for a predetermined period, and then cycles again. (strong recommendation)

     d. Metaphone therapy: bringing about phonological change through increasing the metalinguistic awareness. (conditional recommendation)

     e. Naturalistic intelligibility intervention: naturalistic intervention refers to the notion that phonological disorders should be corrected in communication situations that resemble everyday life. (strong recommendation)