Find out in this Q&A with the editors of Interventions for Speech Sound Disorders in Children
A. Lynn Williams, Ph.D., is a professor and the associate director of the Center of Excellence in Early Childhood Learning and Development at East Tennessee State University. She has conducted federally funded research that has been the basis of several published articles and book chapters, and has developed an NIH-funded intervention software program.
Dr. Williams has served as associate editor of Language, Speech, and Hearing Services in Schools and is a Fellow of ASHA.
Sharynne McLeod, Ph.D., is a professor in speech and language acquisition at Charles Sturt University (CSU) in Australia. She is a Fellow of ASHA and Speech Pathology Australia and is the vice president of the International Clinical Linguistics and Phonetics Association.
Dr. McLeod is editor of the International Journal of Speech- Language Pathology.
Rebecca J. McCauley, Ph.D., is a professor in the Department of Communication Sciences at the University of Vermont. She is a board-recognized specialist in child language, and an associate editor of the American Journal of Speech-Language Pathology.
Although her primary interests lie in assessment of communication disorders in children, Dr. McCauley's growing interest in the challenges associated with developing and proving the value of interventions and in making such information widely accessible has led her to her current projects.
Q: Your new book Interventions for Speech Sound Disorders in Children introduces 23 approaches to speech sound disorders from around the world. Do those include interventions that may not be familiar to the North American practitioner?
A: Absolutely. In choosing which interventions to include, we researched the literature for approaches that have been examined and reported in the literature within the past decade. Our search included all English-speaking publications. This led to our including several promising intervention approaches that are likely unfamiliar to many speech-language pathologists (SLPs) within the U.S. Several of the approaches developed by researcher-clinicians have not been published in American Speech-Language Hearing Assocation (ASHA) journals; consequently, many SLPs in the U.S. have not likely heard about them.
The book builds on the international affiliations among ASHA, the Royal College of Speech and Language Therapists (RCSLT), the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA), and Speech Pathology Australia (SPA). This background allows us to present a "bigger picture" to SLPs and students illustrating the incredible amount of research on speech sound disorders in children being conducted around the world!
Q: SLP students can easily be daunted by the question of, Which intervention approach is the best one to use with this child? Using a sample case, can you walk us through the steps a student would take to analyze which intervention approach might be best for an individual child?
A: In the book, we suggest strategies, as well as chapters and sections, to guide students in reading the book to develop their clinical decision-making in choosing which intervention approach is best for a particular client. Students may find the following steps helpful in choosing the most appropriate intervention approach for a client:
a. First, examine your client's needs based on the assessment and analysis of the child's speech, case history, and other sources of information (e.g., experiences in school). This will include severity, overall intelligibility, age, consistency of error, and stimulability, as well as information relative to a differential diagnosis of motor speech disorders from other types of speech sound disorders.
The extent of the child's difficulties, such as whether there are co-existing language and literacy deficits, provides additional information in determining which intervention is most appropriate. The tables in chapter 1 will assist with selecting which approaches are most relevant to your client.
b. Second, examine which approaches relative to your client's needs have the strongest evidence. Then consider your clinical abilities and the support available for you to implement the approach.
c. Finally, turn evidence-based practice to practice-based evidence by examining the actual value of an intervention that you have chosen to implement. You will also want to anticipate the methods you will use to document the client's progress (e.g., probe data, standardized testing).
Q: How can practicing clinicians use the accompanying DVD clips illustrating many of the interventions to augment their current practices?
After reading the key components described for a particular intervention approach, clinicians can review the video clip to see the implementation of those key elements within a dynamic rather than static context, allowing them to see
a. the key components in action
b. how the components are integrated within the implementation of the approach
c. the sequential implementation of those components, and
d) how the child responds to the intervention activities.
Q: What have been some of the most dramatic changes in interventions in speech sound disorders since you have been in the field?
A: Certainly evidence-based practice (EBP) has had a major impact on our field. It has changed the way we structure our clinical-decision making and, in some cases, changed the approaches we've implemented with some of our clients. EBP, with the triad of factors (best available evidence, clinical expertise, and client's values), has also broadened the scope of factors we must consider in choosing the best approach for a particular client.
Q: What do you see as some of the most promising developments in the field?
A: One of the most promising developments is ASHA's adoption of the International Classification of Functioning, Disability and Health: Children and Youth (ICF-CY) (World Health Organization, 2007) as a framework for practice. Speech-language pathologists' application of this framework to their practices will broaden our perspectives in working with children and their families to consider the impact of our services on their participation and activities in their daily lives, and to provide holistic intervention incorporating personal and environmental factors.
Another particularly exciting development in the field is the increasing ease with which computer-based interventions and strategies, as well as methods of data collection, can be incorporated into the practice of even very busy and under-resourced SLPs.
As this trend continues, we foresee a transformation of clinical practice that could improve the quality of our services and of our professional work lives.
Q: Interventions for Speech Sound Disorders in Children follows the same model as Treatment of Language Disorders in Children, edited by Rebecca J. McCauley and Marc E. Fey. How can these two books be used to complement each other?
A: As many clinicians know, children with speech sound disorders often have a co-occurring language impairment. These two books complement each other by addressing these common communication impairments in children. Because both books incorporate an evidence-based practice framework and use a similar chapter template, it is easy to pull these resources off the shelf to look up specific intervention approaches that address the speech and language needs of a particular client.