Assessment of Speech Sound Disorders

Sharynne McLeod, Ph.D
Dr. McLeod provides numerous resources on her web site from her research at Charles Sturt University in Australia. In particular, it is recommended that SLPs access her questionnaires for the child and his/her family, friends and teachers (Speech Participation and Activity Assessment - Children (SPAA-C) at: http://athene.riv.csu.edu.au/~smcleod/SPAAC2.pdf.


Dr. McLeod and her colleague, Dr. Hand, have also generously offered their in-depth clusters probe (1991) here. This probe samples all initial and final English clusters at least two times. A transcription form and photographs are included for administration.


Additionally, Dr. McLeod recently made her phenomenal multilingual resources available online. Interested professionals may access the overview (http://www.csu.edu.au/research/multilingual-speech) and information about the phonologies of 40 languages (http://www.csu.edu.au/research/multilingual-speech/languages). Moreover, Drs. McLeod, Harrison and McCormack (2012) have shared their tool, Intelligibility in Context Scale (ICS). This allows SLPs to consider the ratings of parents, immediate family, extended family, friends, teachers and unfamiliar listeners in describing a child’s overall intelligibility. The ICS is available for download in English as well as 33 other languages.


Differential Diagnosis (Hammer & Stoeckel, 2006)
This chart provides an excellent overview of key factors to consider for differential diagnosis of phonological disorder, dysarthria and childhood apraxia of speech. SLPs and parents may also benefit from this resource on precisely identifying a child’s speech sound disorder.

In 2014, ASHA introduced its Practice Portal, an online resource created “to assist audiologists and speech-language pathologists in their day-to-day practices by making it easier to find the best available evidence and expertise in patient care, identify resources that have been vetted for relevance and credibility, and increase practice efficiency.” This includes numerous clinical topics, such as autism spectrum disorder, fluency, spoken language disorders and speech sound disorders. These topics were developed by the leading experts in speech sound disorders. SLPs are encouraged to consult the following portals regarding articulation and phonology, childhood apraxia of speech, and bilingual service delivery.

Carol Stoel-Gammon has written extensively about how to support speech sound development for children with Down syndrome. SLPs may learn more about factors that affect phonological acquisition for this population here.


Clinically Useful Words (Multisyllabic Words)
James (2009) shared her list and pictures of ten useful multisyllabic words. SLPs may utilize this task for the purposes of differential diagnosis or for progress monitoring throughout treatment.


Connected Speech Sample Resources
Johnson, Weston and Bain (2004) described procedures for assessing a child’s intelligibility in conversation. They delineated objects to incorporate during play that elicit a range of both singletons and clusters. Please see the paper for a list of the suggested items. Additionally, Flipsen (2006) compared procedures for calculating a child’s intelligibility in conversation. Interested readers can access his article here: http://www.waisman.wisc.edu/phonology/pubs/PUB29.pdf.

Intervention for Speech Sound Disorders

The Phonetics Flash Animation Project
This University of Iowa site features animation of how to produce target English, Spanish and German sounds. Many children have benefited from this because it makes the process of producing each sound more clear.


Enhancing Stimulability
Dr. Adele Miccio and Dr. Mary Elbert developed a stimulability program that was featured in their 1996 paper Enhancing Stimulability: A Treatment Program. The purpose is to support stimulability, not acquisition (Miccio & Williams, 2010 in Williams, McLeod & McCauley's Interventions for Speech Sound Disorders in Children). To support stimulability for young children, they created a character and associated hand motion for each sound. The character pictures are available for SLPs to download. Please note that these are not to be used for commercial purposes. For further information about this approach, please see the Miccio & Elbert article.


Modeling with Books
Many SLPs use and recommend books that feature multiple models of a target sound. Both teachers and parents can utilize this naturalistic intervention to immerse students in a target sound. Researchers have theorized that some children need more relevant models of a sound to acquire it. Here are two links to lists of books featuring target sounds:
Book List One
Book List Two


Speech Language Therapy, Caroline Bowen, Ph.D
Please visit this page for pictures and homework sheets for three-element clusters and some complex two-element clusters. Also, this page provides an excellent comparison of articulation disorders vs. phonological disorders (phonetic vs. phonemic). This page features Dr. Bowen's "fixed-up-one" routines. Families and teachers can model how to "fix" speech sound errors as part of home practice. Lastly, consult this page for information about lisp patterns or scroll down on this page for Dr. Bowen's "treasure trick" for /r/.


Nonword Characters
Research has suggested that nonwords lead to equivalent or greater changes than real words (e.g., Gierut, Morrisette & Ziemer - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3281489/). Many children exhibit “frozen forms” for target sounds or sequences and nonwords (which they have never said before) may allow them to break this pattern. Ideally, nonwords should retain a sense of meaning so that practice is meaningful. They may refer to characters or places. Monsters are often ideal for this purpose. SLPs can access line-drawn monsters for eliciting nonwords relevant to a child’s singleton or cluster targets here: Art is Fun.


Judith Kuster's Site
Dr. Judith Kuster's excellent site that features countless links to online resources in the fields of speech-language pathology and education. Phonological and articulation resources appear scrolling down to about 1/3 of the home page.


Longman Dictionary Online
The Longman Dictionary website offers child-friendly definitions of thousands of words. For example, it indicates that "thrilling" means "interesting and exciting."


Sliding Into Sounds
This colorful resource demonstrates consonants sliding into vowels as a method for teaching children to blend sounds together. It may be modified to teach clusters as well, such as F sliding into L and then into vowels.

Researchers and Innovators in Speech Sound Disorders

Claudia Dunaway, M.A., CCC_SLP
Ms. Dunaway is the former Lead SLP of San Diego Unified School District. She spearheaded many innovative projects in the district and created the Speech Improvement Class model. You can access her 2004 Articulation Differences and Disorders Manual here.


Jessica Barlow, Ph.D, Professor and Director, Phonological Typologies Laboratory, San Diego State University
Dr. Barlow is a Professor in the School of Speech, Language, and Hearing Sciences at San Diego State University. She has a PhD in Linguistics from Indiana University. She conducts research in the areas of phonology, first- and second-language phonological acquisition, bilingual phonology, and phonological disorders.


Indiana University's Learnability Lab
This site offers information and links about Indiana University's Learnability Lab. A substantial portion of the research on the complexity approach has been conducted by the dedicated researchers in this facility. Here is a link to Dr. Judith Gierut's 2007 article on phonological complexity: http://www.iub.edu/~sndlrng/papers/Gierut07.pdf


Holly L. Storkel, Ph.D, Professor and Director, Word and Sound Learning Lab, University of Kansas
Word and Sound Learning Lab at the University of Kansas
Dr. Storkel is an Associate Professor of the Department of Speech-Language-Hearing: Sciences and Disorders at the University of Kansas, Lawrence. She is also the director of the Word and Sound Learning Lab, which has been continuously funded by the National Institutes of Health since 2001. Dr. Storkel’s research focuses on how typically developing children and children with language impairments learn and represent words and sounds in memory by examining the acquisition, organization, and processing of words and nonwords.

Evidence-Based Practice in Speech/Language Pathology Resources

The Informed SLP: Monthly research summaries from Meredith P. Harold, PhD, CCC-SLP
Dr. Harold offers a free, entertaining, and informative research newsletter for busy SLPs. The site's mission is to "connect scientists and clinicians." Each month, she reviews articles from major research journals and offers guidance on how to apply best practices in the clinical setting. Please sign up to receive a monthly newsletter and to access archives.


Speech and language therapy interventions for children with primary speech and language delay or disorder (Review)
Law, Garrett & Nye (2010) have conducted meta-analyses of phonological and language treatment studies. The complete 2010 review is available for download here. The data suggested that there is no significant difference in outcomes between children who received individual or group treatment. Furthermore, the results indicate that parents and teachers can be just as effective in supporting language development as speech-language pathologists. This information may empower families and teachers to take on a greater role in promoting communication skills.


Speech Bite
This website assigns levels of evidence to research studies. ASHA (2004) stipulated levels of evidence in systematic research. The table below summarizes the various levels.


Ia Well-designed meta-analysis of >1 randomized controlled trial


Ib Well-designed randomized controlled study


IIa Well-designed controlled study without randomization


IIb Well-designed quasi-experimental study


III Well-designed nonexperimental studies, i.e., correlational and case studies


IV Expert committee report, consensus conference, clinical experience of respected authorities


SLPs can access this resource to determine if a particular study meets the criteria of a well-designed study. Few studies in this field meet the rigorous criteria of a randomized controlled study, the gold standard of research. Moreover, many papers which feature case studies provide limited evidence of the efficacy of the approach due to methodological constraints.


ASHA's Overview on Speech Sound Disorders
Families and educators may benefit from this brief resource from ASHA.


Evidence-Based Practice (EBP) Briefs
EBP briefs are available on this site to enable SLPs to access the systematic research that provides external evidence.

Preschool Speech/Language Resources

The Hanen Centre
The Hanen Centre is a non-profit organization based in Canada. Their mission is to support the language development of preschoolers through collaboration with families, teachers and other caregivers. Hanen offers several opportunities for SLPs to become certified to teach courses for families and teachers. Furthermore, Tamara Stein, Hanen Certified Speech-Language Pathologist, has developed a new column called the "Book Nook", which features ideas for supporting language and literacy development through rich children’s literature.


California State Preschool Learning Foundations
In 2008, the State of California established Preschool Learning Foundations for social-emotional development, language and literacy, English language development and mathematics. These standards serve as the basis for all of San Diego Unified’s preschool speech and language goals. Interested readers are also directed to the parent-friendly overview of the Preschool Learning Foundations in English and versions translated into Chinese, Hmong, Korean, Tagalog, Vietnamese and Spanish.

Professional Organizations and General Guidelines

American Speech Language Hearing Association


ASHA’s Guidelines on the Roles and Responsibilities of the School-Based Speech-Language Pathologists
ASHA recently revised its guidelines for school-based SLPs because of the dramatic changes in SLP practice. One point emphasizes that "implementing these roles and responsibilities requires realignment of workload priorities, reasonable workloads, professional preparation and lifelong learning."


California Speech Language Hearing Association


California License Renewal Requirements


Childhood Apraxia of Speech Association of North America
The Childhood Apraxia of Speech Association of North America (CASANA) offers helpful resources for both families and professionals.