Question
I am currently working in the schools with a three year old child. The child transferred to the schools from a birth to three program. He is highly unintelligible. His previous SLP worked with him using the traditional approach. Goals included production
Answer
I would definitely move to a phonological approach for this child. That approach is designed for children who are highly unintelligible, and there is evidence that it is more effective and efficient for young children. One advantage is the opportunity to change patterns of error rather than one sound at a time, which can encourage faster change in the child's phonological system. Of course, the first step would be a phonological analysis using the Bankson Bernthal Test of Phonology, the Hodson Assessment of Phonological Patterns, the Khan Lewis Phonological Analysis, another commercial product, or your own analysis. Then you could consider using Hodson's cycles approach.
The following references give information about these approaches as well as the rationale for using a phonological approach. You can also find more information in the presentations here on SpeechPathology.com, including a presentation by Barbara Hodson
This book describes Hodson's approach to treatment of children with phonological disorders.
Klein, E.S. (1996). Phonological/traditional approaches to articulation therapy: A retrospective group comparison. LSHSS, 27, 314-323.
This journal article describes the evidence related to implementation of a phonological approach versus a traditional approach.
Nancy Creaghead is a speech-language pathologist and professor at the University of Cincinnati, where she teaches in the area of language disorders in preschool and school-age children.
Nancy Creaghead, Ph.D
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