Dynamic Assessment of Phonological Disorders
Condition: Speech Sound Disorder
MeSH terms: Articulation Disorders; Speech Sound Disorder
Study type: Interventional

Summary: 
      The goal of this clinical trial is to learn about (1) how speech skills can be measured and
      how various tests give speech therapists different types of information for children with
      speech sound disorder, and (2) whether changes occur in the amount of help children need when
      they work on easier sounds or harder sounds during treatment. The main questions this study
      aims to answer are: (1) what does one type of test (dynamic assessment) tell us about speech
      skills compared to another type of test (static assessment), and (2) does practice of easier
      or harder sounds show differences in progress. Participants will complete 16 sessions of
      speech treatment called "modified cycles treatment", and will complete several speech and
      language tests before, during, and after treatment by pointing to pictures, and saying
      sounds, words, and sentences.
    

Detailed description: 
      The Glaspey Dynamic Assessment of Phonology (GDAP) (Glaspey, 2006; Glaspey & Stoel-Gammon,
      2007) was initially developed because children with speech-sound delays make very slow
      progress in speech therapy and it is difficult to document change in short periods of time
      using traditional methods of assessment. The traditional methods rely on picture-naming tasks
      and the child is not given any assistance in speech productions. The lack of assistance often
      results in a floor effect in the documentation of change and progress. Without good
      documentation of change, speech-language pathologists are left uncertain about the efficacy
      of the treatment that they are administering. The GDAP is unique because it assesses change
      based on dynamic assessment; children are systematically given assistance in the production
      of speech sounds. When administering the GDAP, clinicians rate each sound on a 15-point
      ordinal scale that represents the number of cues and assistance that could be used to assist
      the child in sound production. Progress is documented as children need less support over time
      and their scores decrease. This study compares the GDAP with a traditional single-word
      measure. This study also has an extension to use the GDAP to select easier or harder targets
      during treatment, and monitor children's progress across measures over 8 weeks of modified
      cycles treatment. The treatment will include 16 sessions of therapy with two 50-minute
      sessions per week. The treatment approach that will be used is called "Cycles" and involves
      practicing a different speech sound each week (Rudolf & Wendt, 2014). The sounds that are
      practiced will be individualized to each child's needs, with harder sounds taught during four
      of the weeks and easier sounds taught during four of the weeks. The order will be
      counter-balanced across participants.
    

Intervention name(s): Modified Cycles
Intervention type(s): Behavioral
Allocation: Non-Randomized
Intervention model: Crossover Assignment
Intervention model description: Children will engage in 4 weeks of treatment on easier targets and 4 weeks of treatment on harder targets. The order (easier first or harder first) will be counterbalanced across participants.
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: phonology, delay, disorder, speech