1. HISTORICAL PERSPECTIVE The Evolution of Current Practices

2. Articulation Sound-by-Sound Approach (Assessment-Target Selection-Intervention) SPEECH DISORDERS Historical Perspective: The Way We Were to Where We Are (1920’s – 1970’s)

3. Historical Perspective of Speech Disorders in Children 1960’s: Sound-by-Sound Analysis –motor problem -> intervention focused on positioning/movement of articulators –sound-by-sound approach assessment/intervention 1970’s: Pattern Analyses –relationship among errors (distinctive features, PVM) –1976: Ingram’s “Phonological Disability in Children”

4. 1970’s – 1990’s Artic-Phonology Tree Artic Phonology Ingram (1976) Phonological Processes  Linguistically based  Focus shifted from “mouth” to “mind”  Began to treat younger children who had more severe unintelligible speech  Order in the disorder  Shift in analysis (patterns) and intervention (generalization) SPEECH DISORDERS

5. Historical Perspective (continued) 1980’s: Phonological Process Analysis –“Individual Differences” –Competence + Performance = Knowledge (PPK) –PPK --> treatment implications (predictions) 1990’s: Independent “Self-Contained” Sound Systems –treatment efficacy (variations in intervention models) –unique language systems

6. 2010 MP MO MaxO ESES MPA CV PLA STIM PACT Cycles MPPA NSIT NLPA NN INTERVENTION Phonemic Approaches Phonetic Approaches PROMPT Nuffield DTTC ASSESSMENT TARGET Phonological Complexity Distance Metric (Systemic Approach) Independent + Relational Later sounds Non-stimulable Markedness Artic PPK PVM PPA Optimality Theory Constraint Based Early sounds Stimulable Maximal Distinction Maximal Classification SELECTION SPACS Differential Diagnosis of SSD (Diagnostic Subgroups) (cf Shriberg, 1994; Dodd, 1995) Relational Non-linear Linear Traditional

7. 2000 to Today Learnability theory – the structure of languages that makes them “learnable” Teachability – the structure of input that maximizes learnability Evidence-Based Practice (and Practice-Based Evidence) International Classification of Functioning, Disability, and Health (ICF-CY; World Health Organization)

8. Historical and Theoretical Perspective Links Differential Diagnosis of SSD (Shriberg, 1994; Dodd, 1995) Complexity of Theories (Assessment, Target Selection, Intervention) Linear (1920’s – 1970’s) (1970’s – 1990’s) (2011)

9. Traditional Perspective: Linear 10%5% 85%

10. 20%10% 70% Systemic Perspective: It’s About Time CHILD DISCHARGED 2-3 YEARS 2-3 YEARS REMAINING FOR INTERVENTION CHILD DISCHARGED 2-3 YEARS

11. Classification of SSD Etiological Classification vs Linguistic Profiling

12. Etiological Classification (Shriberg, 1997; 2006) SSD SubtypesPrevalenceProbable EtiologyAffected Process Speech Delay-Gen (SD-GEN) 56%Polygenic/EnvironmentalCognitive-Linguistic Speech Delay-Otitis media with effusion (SD-OME) 30%Polygenic/EnvironmentalAuditory-Perceptual Speech Delay- Developmental Psychosocial Involvement (SD-DPI) 12%Polygenic/EnvironmentalAffective- Temperamental (shy) Speech Delay-Apraxia of Speech (SD-AOS) <1%Monogenic? Oligogenic?Speech-Motor Control Speech Delay- Dysarthria (SD-DYS) <2% of SD population Monogenic? Oligogenic?Speech-Motor Control Speech Errors- Sibilants (SE-/s/) EnvironmentalPhonological Atunement Speech Errors- Rhotics (SE-/r/) EnvironmentalPhonological Atunement

13. Linguistic Profiling (Dodd, 1995; 2005) Linguistic ProfileCharacteristics Phonological Delay (gliding, fronting, stopping)Phonological rules or processes are evident and are characteristic of younger TD children Consistent Deviant Phonological Disorder (Not typical sound errers. A mix of of unusal patterns)(CONSISTANT) Presence of both unusual errors and typical errors, which signal the child has impaired understanding of the ambient phonological system Inconsistent Deviant Phonological Disorder (Word inconsistancy-say the word shoe different ways – sue,shue sew) Exhibit delayed and non-developmental error types and variability of production of single word tokens (> 40%) Articulation DisorderUnable to produce particular perceptually acceptable phones Childhood Apraxia of Speech (CAS)Deviant surface speech production patterns that may sound similar to Incon Dev Phono Dis, but difference is the proposed level of breakdown and symptomatology