presented by Barbara L. Davis
Children between 3-5 years of age identified with developmental speech disorders of all levels of severity are using at least single word language forms to communicate. Their language-based speech forms are likely to exhibit mild, moderate, or severe intelligibility deficits for listeners relative to their lack of achievement of chronological age expectations for speech sound productions. Their speech delay or disorder may be accompanied by other diagnoses (e.g., down syndrome, hearing loss). The clinician’s goal and target selection for planning intervention is critically based on assessment to determine each individual child’s patterns of delay or disorder in producing the speech patterns expected for his/her age. The overall goal of intervention for these pre-school children is to achieve chronologically appropriate age expectations for producing intelligible language-based communication. Goals in intervention are developed related to the intervention approach the clinician feels is most closely matched with the child’s deficits. Targets are developed based on the type of intervention approach selected. Criteria for goal and target selection will be reviewed.
Dr. Barbara Davis is the Houston Harte Centennial Professor of Communication Emerita at The University of Texas at Austin. She has also worked as an SLP in public schools, private practice, and at the Texas Department of Health. Dr. Davis has published more than 100 articles and book chapters and two books. Her research and teaching interests include acquisition of speech production skill and applications to speech disorders. She has studied typically developing infants in English and diverse language environments, as well as childhood apraxia of speech and speech patterns in young infants receiving cochlear implants and in children diagnosed with autism. Her teaching profile includes Speech Science, Phonetics, Infant-Toddler Intervention, and Developmental Speech Disorders. She has presented continuing-education workshops to SLPs nationally and internationally since 1987.
Pre-school children 3-5 years of age who are diagnosed with speech delay or disorder may show mild, moderate, or severe levels of unintelligibility to listeners relative to expectations for their chronological age. In assessing children relative to choosing goals and targets for intervention, overall goals relative to remediation, prevention, and compensation must first be considered. Relative to choosing goals and targets for direct remediation, client individual factors (e.g., 1) personal factors, 2) speech, language, and hearing factors, or 3) physical, organic, or structural factors must be considered. The status of prior or concurrent treatment must be included relative to choosing goals and targets as well.
Numerous intervention approaches have been developed for children with developmental speech disorders. In choosing goals and targets for each child, the clinician must address a variety of questions related to the intervention approaches being considered. These include issues related to appropriate target populations and assessment methods. In addition, the theoretical basis of approaches, EBP level of research available and important components based on clinician judgement regarding the basis of the child’s delay or disorder. Finally practical requirements, key components, assessment, progress monitoring of goals and targets selected, as well as accommodations of cultural and linguistic diversity are relevant to choosing goals and targets.
Types of intervention goals and targets are largely determined by the intervention approach chosen. Interventions fall into several general categories: direct speech interventions (usually directed at phonological knowledge), general interventions (usually directed at language more generally), and motor speech-based interventions (usually focused on phonetic or articulation aspects of the speech production apparatus). Exemplars of each of these intervention approaches will be evaluated relative to their approach to goal and target selection for pre-school children with developmental speech disorders.