The purpose of this study was to determine if single-word elicitation procedures used in the assessment of phonological processes would have highly similar results to those obtained through connected speech. Connected speech sampling provides a medium for natural production with coarticulatory influence, but can be time-consuming and impractical for clinicians maintaining heavy caseloads or working with highly unintelligible children. Elicitation through single words requires less time than a connected-speech sample and may be more effective with highly unintelligible children because the context is known, but it lacks the influence of surrounding words. Given the inherent differences between these two methods of elicitation, knowledge of the relative effectiveness of single-word and connected-speech sampling may become an issue for clinicians operating under severe time constraints and requiring an efficient and effective means of assessing phonological processes.

Highly unintelligible children may mistakenly be assumed to have difficulty only with the misarticulation of consonants. Expressive language concerns may be ignored while the primary focus of intervention becomes the correction of misarticulated speech. Questions have arisen regarding the possibility of both speech and expressive language difficulties contributing to unintelligibility. Shriberg and Kwiatkowski (1982) developed an ordinal means of rating severity of involvement. One of the constructs of the severity scale was intelligibility. The metric percentage consonants correct (PCC) was developed to identify severity of involvement of disorders of phonology.

Two preschool males who presented with the characteristics of developmental verbal dyspraxia were enrolled in a phonological cycles intervention approach. Initially, each child's deviant phonological processes were analyzed by the CAPD and target patterns and words selected for remediation. A continuous speech sample was obtained and analyzed to measure intelligibility by percentage and rating on a seven point scale. A time-space probe was developed based on targeted and non-targeted phonemes and administered prior to the first intetvention session. Using the selected targeted patterns and words, an individualized remediation plan was developed, and the phonological process cycling approach used. Each subject participated in 60 minutes of intervention for each targeted pattern to complete the first cycle in approximately 10 weeks. The time-space probes were administered approximately every two weeks.

Researchers have long been concerned with the effects of otitis media on speech and language acquisition because of the high correlation of a mild to moderate hearing loss during the time period that fluid (effusion) may be in the middle ear. Middle-ear effusion would prevent many of the auditory messages from accurately reaching the nervous system (Zinkus, 1986). Deprived of the ability to discern the subtle acoustic differences that provide information for phonetic contrasts, a child's speech acquisition may differ from children who do not experience such losses.

When the primary mode of communication is speech, the crucial ingredient for successful communication is intelligible speech. The speech of children with disordered phonologies is often unintelligible. Accurate and reliable measurement of speech with compromised intelligibility is essential if appropriate treatment procedures are to be chosen and implemented. The focus of this investigation was the measurement of speech intelligibility in young children. The purpose of this study was to investigate the relationship between the subjective method of trained ear estimation and the objective method of orthographic transcription when measuring the speech intelligibility of young speakers with a wide range of phonological profiency. For this study, the standard measurement of intelligibility was operationally defined as the percentage of words understood in a continuous speech sample derived from orthographic transcription of the sample. The secondary purpose was to investigate the accuracy of the speech-language pathologists' estimates as compared to the standard measure for each of the three groups: (a) the children with the most intelligibility, (b) with average intelligibility, and (c) with the least intelligibility. Data were collected from 47 children, aged 4:0 to 5:6, who comprised three groups with varying levels of intelligibility. Two groups of listeners who were unfamiliar with the speakers, but familiar with the topic, rated the children's percentage of intelligibility from continuous speech samples via orthographic transcription or trained ear estimation. The two methods of measuring speech intelligibility investigated in this study were found to correlate highly (£ = .96). However, there was a significant difference between the percentages derived from orthographic transcription and those derived from trained ear estimation for some speakers. The 1-test analyses revealed significant differences between the two measures for the two most intelligible groups, and no significant difference for the least intelligible group. It appears that the subjective method of estimating speech intelligibility with trained ears correlates with the objective method of orthographic transcription, but yields a different percentage score for some speakers.

One of the most common articulation errors made by children is on the phoneme Ir I. Treatment techniques for this sound have varied and have included the stimulus approach (Van Riper, 1972), phonetic placement techniques (Scripture, 1923), the sensory-motor approach (McDonald, 1964), the motokinesthetics approach (Young & Hawk, 1938), and sequential programming approach (Shriberg, 1975; Wood, 1988), to name a few. An integral part of many of these treatment methods is the use of the auditory stimulation. An innovative technique using a prosthetic device to facilitate the production of Ir I was used by Leonti, Blakeley, and Louis (1975), in the treatment of a 9.8 year old male. A follow-up study was conducted by Clark, Schwarz, and Blakeley, (1993) in which a prosthetic device, the R-appliance, was used to facilitate the production of Ir I at the word level. The results of the study indicated that the appliance facilitated the production of Ir I in isolation, in words, and in spontaneous speech. The present study investigated the use of the R-stick appliance as a facilitative device for the production of the Ir/ phoneme at the word level. It was hypothesized that the experimental group (R-stick) would have higher mean scores at the word level than the control group (no R-stick). This hypothesis was not supported by the data. Both groups showed significant improvements in their Ir I word productions, but no difference was shown between the two treatment approaches. There are several possible reasons for these results: (a) insufficient training with the use of the R-stick and the treatment protocol, (b) lack of probes during the course of the study, (c) length of treatment, (d) the small number of subjects participating in the study, and (e) the R-stick appliance is a clinician-manipulated tool.

One preschool male who was highly unintelligible was enrolled in two cycles of direct intervention utilizing the phonological cycling approach (Hodson & Paden, 1991). Prior to treatment in cycles 1 and 2, the Assessment of Phonological Processes-Revised (APP-R) (Hodson, 1986) was administered to the subject to assess phonological deficiencies and to determine the target phonological patterns. A continuous speech sample was collected prior to cycle 1 to rate speech intelligibility. Based on the results obtained from the APP-R, target patterns, target words, and an individualized treatment plan were developed for each cycle. For the first cycle of intervention, the subject participated in 60 minutes of direct intervention twice a week for 5 weeks, and in cycle 2, the subject participated in 60 minutes of direct intervention twice a week for 4 1/2 weeks. Each treatment session followed the procedures as outlined by Hodson and Paden (1991). Baseline measures were administered at the beginning of each session and probes were administered once a week. At the conclusion of both cycles, the APP-R was re-administered and a 100-word speech sample was collected. The results of the pre- and post-tests for cycles 1 and 2, baseline measures, weekly probes, and the intelligibility ratings were analyzed to determine the effectiveness of the phonological cycling approach in achieving a decrease in severity level of unintelligibility after two cycles. Results from the APP-R indicate that the subject's severity interval rating decreased from profound to severe. A comparison of pre- and post-intelligibility ratings showed an increase in intelligibility of 1.5 points on a 7-point rating scale. Based on the probes, generalization to nontreatment words in targeted and nontargeted patterns was noted in both cycles for some patterns. Overall, the phonological cycling approach was effective in achieving a decrease in severity level of intelligibility after two cycles of intervention for this subject.

Thesis (Ph.D.)--University of Canterbury, 2007. / Typescript (photocopy). Includes bibliographical references (leaves 243-263). Also available via the World Wide Web.

published_or_final_version / abstract / Speech and Hearing Sciences / Master / Master of Philosophy

published_or_final_version / Speech and Hearing Sciences / Master / Master of Philosophy