Expansion Points Intervention in Young Children with Speech Sound Disorders: A Multiple Baseline Design

Abstract

The purpose of this investigation was to evaluate the efficacy of expansion points (EXP) intervention with a modified criterion for preschool children with speech sound disorders (SSD). Three preschool-aged children were enrolled in a single-subject multiple baseline intervention study. Intervention took place over 16 sessions. Pre- and post-intervention data are provided. Three outcome measures (generalization to probe words and gains in percent consonants correct, PCC, in words and in conversation) were evaluated to measure the effectiveness of the EXP intervention. All three of the participants demonstrated gains by the end of the intervention phase when measuring PCC in single words. Two of the three participants demonstrated gains in PCC in conversational speech. Progress on individual phonemes was variable across participants. Utilizing the EXP approach, two of the three children showed gains in all three outcome measures. One child showed variable performance in one outcome measure, improvement in one, and a decrease in one. Findings suggest that EXP should be further explored to evaluate intervention efficacy.

Keywords

speech sound disorders - preschool - expansion points intervention - single subject research design

Disclosures

Financial: No relevant financial relationships exist for either author.

Nonfinancial: No relevant nonfinancial relationships exist for either author.

Publication History

Article published online:
02 November 2021

• References

• 1 Van Riper C. Speech Correction: Principles and methods. Prentice-Hall; 1939
• 2 Van Riper C, Irwin J. Voice and articulation. Prentice-Hall; 1958
• 3 Elbert M, Giuret J. Handbook of clinical phonology. College-Hill Press; 1986
• 4 Fey ME. Articulation and phonology. Lang Speech Hear Serv 1992; 23 (03) 225-232
• 5 Kamhi AG. The Need for a broad-based model of phonological disorders. Lang Speech Hear Serv 1992; 23 (03) 261-268
• 6 Brumbaugh KM, Smit AB. Treating children ages 3-6 who have speech sound disorder: a survey. Lang Speech Hear Serv Sch 2013; 44 (03) 306-319
• 7 Smit AB, Brumbaugh KM, Weltsch B, Hilgers M. Treatment of phonological disorder: A feasibility study with focus on outcome measures. Am J Speech Lang Pathol 2018; 27 (02) 536-552
• 8 Brumbaugh KM, Smit AB. Applying the phonological intervention taxonomy to expansion points intervention. J Commun Disord 2021; 89: 106071
• 9 Rvachew S, Nowak M. The effect of target-selection strategy on phonological learning. J Speech Lang Hear Res 2001; 44 (03) 610-623
• 10 Williams AL. Target Selection and Treatment Outcomes. Perspect ASHA Spec Interest Groups 2003; 10 (01) 12
• 11 Smit AB, Hand L, Freilinger JJ, Bernthal JE, Bird A. The Iowa articulation norms project and its Nebraska replication. J Speech Hear Disord 1990; 55 (04) 779-798
• 12 Diehm E. Writing measurable and academically relevant IEP goals with 80% accuracy over three consecutive trials. Perspect ASHA Spec Interest Groups 2017; 2 (16) 34-44
• 13 Nobriga C, St Clair J. Training goal writing: A practical and systematic approach. Perspect ASHA Spec Interest Groups 2018; 3 (11) 36-47
• 14 Dunn C. A framework for generalization in disordered phonology. J Child Comm Dis 1983; 7 (01) 46-58
• 15 Hoffmann TC, Glasziou PP, Boutron I. et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ 2014; 348: g1687
• 16 Dworkin JP, Culatta RA. Oral structural and neuromuscular characteristics in children with normal and disordered articulation. J Speech Hear Disord 1985; 50 (02) 150-156
• 17 Gast DL, Ledford JR. Single case research methodology. Routledge; 2014
• 18 Kratochwill TR, Hitchcock J, Horner RH. et al. Single-case design technical documentation. 2010 http://ies.ed.gov/ncee/wwc/pdf/wwc_scd.pdf
• 19 Smit AB, Hand L. Smit-Hand Articulation and Phonology Evaluation. Eastern Psychological Services; 1992
• 20 Schane SA. Generative phonology. Englewood Cliffs, NJ: Prentice-Hall; 1973
• 21 Baker E, Williams AL, McLeod S, McCauley R. Elements of phonological interventions for children with speech sound disorders: The development of a taxonomy. Am J Speech Lang Pathol 2018; 27 (03) 906-935
• 22 Bislick LP, Weir PC, Spencer K, Kendall D, Yorkston KM. Do principles of motor learning enhance retention and transfer of speech skills? A systematic review. Aphasiology 2012; 26 (05) 709-728
• 23 CVI. 2017 Clinical observation recording system (CORS). Retrieved from http://www.cvisecurity.com/solutions/clinical-observation-recording-system/
• 24 Olive ML, Franco JH. (Effect) size matters: And so does the calculation. Behav Anal Today 2008; 9 (01) 5-10
• 25 Alresheed F, Hott BL, Bano C. Single subject research: A synthesis of analytic methods. The J Sp Ed. 2013; 2 (01) 1-18
• 26 DeVeney SL, Cabbage K, Mourey T. Target selection considerations for speech sound disorder intervention in schools. Perspect ASHA Spec Interest Groups 2020; 5 (06) 1722-1734
• 27 Elbert M, Dinnsen DA, Swartzlander P, Chin SB. Generalization to conversational speech. J Speech Hear Disord 1990; 55 (04) 694-699
• 28 Elbert M, Powell TW, Swartzlander P. Toward a technology of generalization: how many exemplars are sufficient?. J Speech Hear Res 1991; 34 (01) 81-87
• 29 Powell TW. Planning for phonological generalization. Am J Speech Lang Pathol 2018 1991; 1 (01) 21-27
• 30 Storkel HL. The complexity approach to phonological treatment: How to select treatment targets. Lang Speech Hear Serv Sch 2018; 49 (03) 463-481
• 31 Rvachew S, Bernhardt BM. Clinical implications of dynamic systems theory for phonological development. Am J Speech Lang Pathol 2018 2010; 19 (01) 34-50
• 32 Tyler AA, Edwards ML, Saxman JH. Acoustic validation of phonological knowledge and its relationship to treatment. J Speech Hear Disord 1990; 55 (02) 251-261