Traditional Therapy or Phonological Approach

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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

Useful references would include the following:

• Bernthal, J., & Bankson, N., (2004) Articulation and Phonological Disorders. (5th Edition) Boston: Allyn & Bacon.
  
  This book provides an overview of the phonological approach as well as explanation of several methods for implementing it.
  
  
• Hodson, B. (2007) Evaluating & Enhancing Children's Phonological Systems. Greenville, SC: Thinking Publications.
  
  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.