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Need for phonological awareness training to treat expressive phonological impairments

Barbara Hodson, Ph.D,CCC-SLP

April 14, 2003



Is phonological awareness the sole intervention to master at the base of phonological disorders?


A growing body of evidence indicates that young children with Expressive Phonological Impairments (EPI) commonly experience poor phonological awareness skills (Larivee & Catts, 1999; Webster & Plante, 1992). Moreover, many go on to experience difficulties in reading and spelling (Bird, Bishop, & Freeman, 1995; Clarke-Klein & Hodson, 1995) even after intelligibility issues have been resolved.

Phonological Awareness (PA), which refers to an individual's ability to reflect on and manipulate the sound structure of a language independent of meaning (Stackhouse, Wells, Pascoe, & Rees, 2002), correlates highly with reading success (Stanovich, 2000). As well, results from a number of treatment studies (e.g., Blachman, Ball, Black, & Tangle, 1994; Hatcher, Hulme, & Ellis, 1994) indicate that PA skills can be enhanced by direct, systematic instruction.

Gillon (2000) provided phonological awareness treatment to 23 children with EPI (between the ages of 5 and 7 years) and found that these children made significantly greater gains both on phonological awareness tasks and also on phonological production measures than 23 children in a "traditional intervention" control group after approximately 20 hours of phonological awareness treatment.

In a follow-up study approximately 11 months after the treatment study ended, Gillon (2002) reevaluated 20 of the PA treatment children and compared their performances with 20 children in the traditional treatment group. Results indicated that children who received the structured phonological intervention sustained their growth in phoneme awareness and word recognition, whereas children in the traditional group evidenced minimal improvement in phoneme awareness and most continued to be poor readers.

Stackhouse et al. (2002) cautioned, however, that children with the most severe problems might not benefit from general phonological awareness instruction alone. They noted that "articulatory skill" is needed for "rehearsing" words for phonological awareness tasks and for spelling.

Regarding your question about using phonological awareness intervention alone for children with phonological disorders, severity must be a consideration. Highly unintelligible children with extensive omissions and a limited repertoire of consonants typically need direct phonological intervention that will help them learn to produce consonants and phonological patterns (Hodson & Paden, 1991).

PA intervention may suffice for children who no longer evidence phonological deviations in their productions. Nonetheless, other aspects (e.g., fluency, comprehension) usually need to be considered as well, and, of course, PA intervention needs to be "linked" to literacy (Hatcher et al., 1994). Clearly, each child's strengths and weaknesses, as well as any special needs, must be evaluated and reviewed when making decisions to determine optimal intervention goals.

Bird, J., Bishop, D., & Freeman, M. (1995). Phonological awareness and literacy development in children with
expressive phonological impairments. Journal of Speech and Hearing Research, 38, 446-462.

Blachman, B., Ball, E., Black, R., & Tangle, D. (1994). Kindergarten teachers develop phonemic awareness in
low-income, inner-city classrooms. Does it make a difference? Reading and Writing: An Interdisciplinary Journal, 6, 1-18.

Clarke-Klein, S., & Hodson, B. (1995). A phonologically based analysis of misspellings by third graders with disordered-phonology histories. Journal of Speech and Hearing Research, 38, 839-849.

Gillon, G. (2000). The efficacy of phonological awareness intervention for children with spoken language impairment. Language, Speech, and Hearing Services in Schools, 31, 126-141.

Gillon, G. (2002). Follow-up study investigating the benefits of phonological awareness intervention for children with spoken language impairment. International Journal of Language and Communication Disorders, 37, 381-400.

Hatcher, P., Hulme, C., & Ellis, A. (1994). Ameliorating early reading failure by integrating the teaching of reading and phonological skills: The phonological linkage hypothesis. Child Development, 65, 41-57.

Hodson, B., & Paden, E. (1991). Targeting intelligible speech: A phonological approach to remediation. Austin, TX: ProEd.

Larivee, L., & Catts, H. (1999). Early reading achievement in children with expressive phonological disorders. American Journal of Speech-Language Pathology, 8, 118-128.

Stackhouse, J., Wells, B., Pascoe, M., & Rees, R. (2002). From phonological therapy to phonological awareness. Seminars in Speech and Language, 23, 27-42.

Stanovich, K. (2000). Progress in understanding reading. New York: Guilford Press.

Webster, P., & Plante, E. (1992). Effects of phonological impairment on word, syllable, and phoneme segmentation and reading. Language, Speech, and Hearing Services in Schools, 23, 176-182.


Barbara W. Hodson, PhD, CCC-SLP, currently is a Professor and Coordinator of the Doctoral Program at Wichita State University. Her publications include Targeting Intelligible Speech (co-author with Elaine Paden), Perspectives in Applied Phonology (co-editor with Mary Louise Edwards), and From Phonology to Metaphonology, a theme issue edited for Topics in Language Disorders. In addition, she developed English and Spanish phonological assessment instruments and computer software for phonological analysis. Hodson, who is a Fellow of the California and American Speech-Language-Hearing Associations, received the State Clinical Achievement Award for California in 1987 and for Kansas in 1992. Her primary professional interests include developing more effective and more efficient evaluation and treatment procedures for highly unintelligible children.

barbara hodson

Barbara Hodson, Ph.D,CCC-SLP

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