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The relationship between stimulability, speech perception ability, and phonological learning was examined in two descriptive studies. In Study 1, the children received 9 group treatment sessions targeting 3 phonological processes using the cycles approach. Treatment progress was not observed for sounds that were unstimulable before treatment. Given stimulability, treatment progress was greater for sounds that were well perceived before treatment in contrast with sounds that were poorly perceived before treatment. In Study 2, the cycles approach was modified so
that each child received 3 brief, individual treatment sessions followed by 6 group treatment sessions. Each individual session targeted stimulability of target sounds, using phonetic placement, and perception of target sounds, using the Speech Assessment and Interactive Learning System (SAILS).1 In Study 2, good progress was observed for most target phonemes, including those that were unstimulable or poorly perceived before treatment.
Key Words: phonology, intervention, stimulability, speech perception
Speech-language pathologists face increasing pressure to implement maximally efficient treatment programs. In the face of such pressures, clinics may initiate a variety of structural changes to service delivery models that are intended to reduce the cost of delivering a service to any given child; for example, group treatment, block treatment, and the use of parents or speech aides as service delivery agents. We have combined these approaches, and endeavor to treat our clients with developmental phonological delays in small groups on a "block" basis. Specifically, a child can expect to receive no more than one 3-month block of weekly treatment in any 6month period. A speech aide assists with materials preparation and parents assist with some aspects of treatment sessions. Although this strategy may reduce the cost of providing a service (in comparison with continuous weekly individual treatment sessions), it cannot be said to be efficient unless it is also effective. Therefore, it is necessary to demonstrate that measurable and satisfactory progress in phonological abilities can be achieved after 3 months of group treatment.
Efforts to improve or demonstrate the effectiveness of treatment have centered on variations in treatment approach. Hodson and Paden (1983) reported that clients with moderate to severe phonological delays achieve intelligible speech within 18 months when treated with the cycles approach. Although experimental data are lacking, Shriberg, Gruber, and Kwiatkowski (1994) suggested...