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Despite a number of studies that have demonstrated positive outcomes for inducing clinical change in children with speech sound disorders (SSD), there is a need to address the question of whether resources are being applied in an optimal manner. As a consequence, there has been a call to look within interventions to examine parameters that may contribute to intervention outcomes; specifically the intensity of intervention (dose, frequency, duration, and cumulative intervention intensity). In this paper, empirical evidence from three intervention studies using multiple oppositions primarily, and a second contrastive approach, minimal pairs, is reported with regard to the parameters of intervention intensity. The findings indicated that greater intensity yields greater treatment outcomes. Further, quantitative and qualitative changes in intensity occur as intervention progresses, and there were differences in intensity based on severity of the SSD. Based on these data, suggestions were made toward establishing some prescribed amounts of intensity to affect treatment outcomes for children with SSD.

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Abstract The multiple oppositions approach (Williams, 1992; 2000) was incorporated as the beginning point of intervention for 10 children who exhibited moderate-to-profound phonological impairments. Several variables that potentially affect phonological change were examined in a longitudinal case study of these children. Different models of intervention (multiple oppositions, minimal pairs, and naturalistic speech intelligibility training) were incorporated within different structures of treatment (vertical, horizontal, and cyclical) using a model of phonologic learning that was based on a developmental structuring of intervention. This nontraditional research paradigm is proposed as a possible bridge to link the science and practice of clinical research. Specifically, the clinical reality of providing intervention to children from their initial treatment to discharge provides a broader perspective of treatment efficacy while also serving as a foundation for future areas of more controlled investigations of specific variables.

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