The clinical practice of speech and language therapists with children with phonologically based speech sound disorders

Abstract

Children with speech sound disorders (SSD) represent a large number of speech and language therapists’ caseloads. The intervention with children who have SSD can involve different therapy approaches, and these may be articulatory or phonologically based. Some international studies reveal a widespread application of articulatory based approaches in children with different SSD. In Portugal no survey has been previously conducted about speech and language therapists (SLTs) practices when working with children with SSD, so it is still unknown how SLTs treat children with SSD. This study aims to explore the use of different intervention approaches of SLTs in Portugal, and to describe the approaches most frequently used in treating children who have phonologically based SSD. Data collection was conducted through a questionnaire available on the web platform Advanced Communication and Swallowing Assessment (ACSA; http://acsa.web.ua.pt ), and data analysis was based on 88 responses, corresponding to 5% of the total Portuguese SLTs population. Results showed that the intervention approaches most used with children who have SSD are phonological awareness (97% of the participants), auditory discrimination (92%), meaningful minimal contrast therapy (75%) and parent-based work (58%). The great majority of SLTs combined several approaches in their intervention. There was also a high percentage of SLTs that used articulation based approaches, namely articulation work (31%) in cases of phonologically based disorders. Most (63%) SLTs used weekly interventions over a period of more than six months (51%). The data presented here agrees with the results obtained in South African, UK and USA studies in terms of the approaches most frequently used in intervention with children who have phonologically based SSD. Regarding the frequency and duration of intervention, there is a discrepancy between the results obtained and what is commonly used across research. The characteristics described by the Portuguese SLTs for establishing the differential diagnosis of SSD do not always reflect the evidence available in recent literature. The findings presented in this article revealed the intervention approaches that SLTs currently use to treat children with phonologically based SSD and the theoretical foundations that guide their clinical practice. This allows the reader to compare clinical practice of SLTs across countries and research studies.