Elements in phonological intervention: A comparison of three approaches using the Phonological Intervention Taxonomy

The following book chapter has been accepted for publication:
Baker, E., McCauley, R. J., Williams, A. L., & McLeod, S. (2019, in press). Elements in phonological intervention: A comparison of three approaches using the Phonological Intervention Taxonomy. In E. Babatsouli & M. J. Ball (Eds.) On under-reported monolingual child phonology. Bristol, UK: Multilingual Matters.

Here is the final summary paragraph of our chapter

In summary, in this chapter, we have outlined the value of a carefully developed system for describing interventions, such as the Phonological Intervention Taxonomy, which builds on the rich history of Ingram’s work in child phonology. We did this primarily by illustrating how explicit, detailed descriptions of intervention structure can facilitate comparisons that can help the clinician make clearer decisions about what intervention may meet a child’s needs. In addition, we have presented thoughts about how such a taxonomy might be applied with the goals of increasing accuracy in the use of interventions, the clinician’s understanding of their own readiness to learn and use an intervention, and the field’s development of more rationally based curricula for beginning clinicians. Finally, we suggest research efforts that may lead to a better understanding of how interventions work and for whom they might work best.

The Phonological Intervention Taxonomy was originally described here:
Baker, E., Williams, A. L., McLeod, S., & McCauley, R. (2018). Elements of phonological interventions for children with speech sound disorders: The development of a taxonomy. American Journal of Speech-Language Pathology, 27(3), 906-935. doi:10.1044/2018_AJSLP-17-0127. 

Intervention for children with phonological impairment: Knowledge, practices and intervention intensity in the UK

The following manuscript has just been accepted for publication.
Hegarty, N., Titterington, J., McLeod, S., Taggart, L. (2018, in press June). Intervention for children with phonological impairment: Knowledge, practices and intervention intensity in the UK. International Journal of Language and Communication Disorders.

It forms part of Natalie Hegarty's PhD (She is studying at the Ulster University and I am co-supervisor). Congratulations Natalie

Here is the abstract

Background Across the world, research has shown that intervention for children with phonological impairment can be both effective and efficient. However, research has also raised concerns about the translation of this evidence to practice, highlighting questions around clinician knowledge and understanding of approaches, and the intensity of intervention provided within real-life clinical contexts.
Aim To investigate the clinical management of phonological impairment by speech and language therapists (SLTs) in the United Kingdom (UK).
Methods & Procedures An anonymous, UK-wide, online survey was developed using Qualtrics. The target audience were UK-based SLTs who worked with children with phonological impairment. The following topics were explored: (1) SLTs’ understanding of intervention approaches, (2) SLTs’ use of intervention approaches to treat phonological impairment, (3) SLTs’ provision of intervention intensity for children with phonological impairment.
Outcomes & Results A total of 166 responses were analysed. To remediate phonological impairment, SLTs most commonly used speech discrimination (79.5%), conventional minimal pairs (77.3%), phonological awareness therapy (75.6%) and traditional articulation therapy (48.4%). Participants least frequently used the complexity approaches targeting the empty set (82.9%) and 2/3-element clusters (75%) as well as the cycles approach (75.6%). Results also showed that some SLTs were uncertain of what the empty set and 2/3-element clusters approaches entailed. In terms of intervention intensity, participants predominantly provided intervention once per week (69%) for a total of 9-12 sessions (ranging from 5-30 sessions, 71.5%) and elicited targets 10-30 times in single words per session (59.4%) in sessions lasting 21-30 minutes (41.4%).
Conclusions & Implications The most commonly used intervention approaches identified in the current survey (i.e., speech discrimination, conventional minimal pairs and phonological awareness therapy) may be used eclectically by SLTs, which could impact upon the effectiveness and efficiency of treatment for phonological impairment. The current study also highlighted that almost half of participants always/often used traditional articulation therapy to remediate phonological impairment, even though this approach has been found to be less effective for this difficulty. Additionally, it appears that the currently provided intervention intensity for phonological impairment in the UK is significantly lower than what is indicated in the literature. Therefore, a research-practice gap exists for SLTs in the UK working with children with phonological impairment.

Elements of phonological interventions for children with speech sound disorders: The development of a taxonomy

The following manuscript has been accepted for publication:
Baker, E., Williams, A. L., McLeod, S., & McCauley, R. J. (2018, in press January). Elements of phonological interventions for children with speech sound disorders: The development of a taxonomy. American Journal of Speech-Language Pathology.

This manuscript has been the result of many years of collaboration, beginning at a research retreat in San Diego in 2011. I believe the manuscript makes a really important contribution to our understanding of the elements (or ingredients) that are required for undertaking intervention for children with speech sound disorders.

Here is the abstract:

Purpose: Our aim was to develop a taxonomy of elements comprising phonological interventions for children with speech sound disorders.
Method: We conducted a content analysis of 15 empirically supported phonological interventions to identify and describe intervention elements. Measures of element concentration, flexibility, and distinctiveness were used to compare and contrast interventions.
Results: Seventy-two intervention elements were identified using a content analysis of intervention descriptions, then arranged to form the Phonological Intervention Taxonomy: a hierarchical framework comprising 4 domains, 15 categories, and 9 subcategories. Across interventions, mean element concentration (number of required or optional elements) was 45, with a range of 27 to 59 elements. Mean flexibility of interventions (percentage of elements considered optional out of all elements included in the intervention) was 44%, with a range of 29% to 62%. Distinctiveness of interventions (percentage of an intervention’s rare elements and omitted common elements out of all elements included in the intervention [both optional and required]) ranged from 0% to 30%.
Conclusions: An understanding of the elements that comprise interventions and a taxonomy that describes their structural relationships can provide insight into similarities and differences between interventions, help in the identification of elements that drive treatment effects, and facilitate faithful implementation or intervention modification. Research is needed to distil active elements, and, identify strategies that best facilitate replication and implementation.

Lynn, Rebecca and Elise analysing data to develop the taxonomy in 2011

Sharynne, Lynn, Rebecca and Elise at our research retreat in San Diego in 2011