Consequently, the lack of implementation of this evidence-based approach is a cause System-wide change is the primary goal within theĬomplexity approach ( Gierut, 1998, 2001). Thus, a child should require less time in phonological treatment, leading to earlierĭismissal from an SLP's caseload. Overall intelligibility, rather than only improving a single or few treatment targets. When system-wide change occurs, a child improves Of his or her native language with the treatment target serving merely as a trigger With system-wide change, the child learns something more global about the sound system To the treatment target (e.g., fricative /θ/) accurately in untreated words. Liquid /l/) accurately in untreated words, and produces untreated sounds unrelated In untreated words, produces untreated sounds related to the treatment target (e.g., Specifically, the child produces the treatment target (e.g., liquid /r/) accurately System-wide change has been definedĪs multiple forms of generalization ( Gierut, 1998, 2001). To close the gap with typically developing peers. To produce system-wide change in a child's speech so that acquisition is accelerated Goal of clinical treatment for children like this who have multiple sound errors is On an articulation test (e.g., Goldman-Fristoe Test of Articulation) and at leastįive to seven target English sounds excluded from their phonemic inventories.

In research studies, the complexity approach has typically been tested with 3- toĦ-year-old children with very low scores (i.e., below the fifth or sixth percentile) Opposition, empty set see Barlow & Gierut, 2002, for a summary). Resources can be used to learn about additional methods consistent with the complexityĪpproach, such as complexity-based minimal pair treatment variants (e.g., maximal Resources to speed the planning process in selecting complex treatment targets. Pays off in greater gains during treatment and (b) provide coaching and implementation On the complexity approach to show that the initial investment in phonological analysis The goals of this tutorial are to (a) review the evidence This clinical tutorial will focus on one aspect of the complexity approach: selectingĬomplex treatment targets. With high caseloads, but with appropriate support, the planning process can be streamlined. In addition, the complexity approach requires a detailedĪnalysis of phonology to guide treatment planning, which may seem challenging to clinicians In fact, Brumbaugh and Smit showed that 70% of SLPs were not familiar with With other approaches? It is likely that clinicians lack familiarity with the complexityĪpproach. Why is there a lack of implementation of the complexity approach compared Research studies investigating the complexity approach than almost all other approachesĬombined” ( Kamhi, 2006, p. Given that the evidence base for the complexity approach is quite strong with “more In contrast, only 8% of SLPs sometimes, often, or always used a complexityĪpproach in treatment of children with phonological disorders.

That over 50% of SLPs sometimes, often, or always used a traditional, phonologicalĪwareness, minimal pairs, or cycles approach in treatment of children with phonologicalĭisorders. Specifically, Brumbaugh and Smit's survey showed However, a recent survey by Brumbaugh and Smit (2013) suggests that speech-language pathologists (SLPs) are not equally familiar with allĮvidence-based treatment alternatives. There are a number of evidence-based treatmentsįor children with phonological disorders (see Baker & McLeod, 2011, for a review). Children with functional phonological disordersĮxhibit delays in sound production in the absence of any obvious motoric, structural, Although thereĪre a variety of speech sound disorders, this article will focus on children withįunctional phonological disorders. Language, often requiring clinical treatment to normalize their speech. Children with speech sound disorders have trouble learning the sounds of their native

Sonority plateaus