The MOST Frequently Asked Question - What does a phonological therapy session look like?
Rvachew and others (2004) listed the following elements which, when added to traditional articulation therapy, resulted in greater progress than "therapy" alone:
- Traditional therapy activities
- Perceptual training
- Training in letter identification
- Training in sound-symbol relationships
- Onset identification
Based on these elements and having selected targets of which the child has little or no productive knowledge, this is what a typical 30 minute session looks like. Typically, I have seen children individually or in groups (1- 3) once per week.
Phoneme Inventory: 5 minutes or less
One child in the group gets to hold the "magic wand" and point to graphemes representing the consonants of English, while that child and the others in the group say the sounds chorally, usually with a model from the SLP. There may be an occasional pause for coaching a particular child on a particular phoneme, but that is very brief. This teaches stimulability and letter-sound correspondence, and provides the motor response that young children need.
Say-It-And-Move-It: 5-8 minutes
This is a phonologic awareness activity based on Road to the Code (Blachman et al., 2000) in which the child(ren) and SLP each have markers to move to mark each sound of each word in a contrast pair. For example, if the contrast pair were shock/rock, the child(ren) and SLP would slide two markers - [ʃ] [a] [k] for "shock", and [r] [a] [k] for "rock." To heighten the contrast between the two words in the pair, I use markers all of one color for the first word, then trading out the first marker for one of a different color to represent, in this case, [r]. A quick demonstration of what it looks like can be found here. This activity teaches phonologic awareness and provides meaning-based production of maximal contrast pairs.
Maximal opposition pairs and sets used meaningfully in a familiar context (games): 10 minutes
In this segment of the session, we play games such as Concentration or Bingo using maximal contrast pairs previous practiced in the phonologic awareness activity. I try to structure the game so that the child is doing most of the talking, e.g., the child is the Bingo "Caller," or he or she directs (using a set phrase) which card to choose next. I also build in carrier phrases for all players to use at each turn which contain the target phonemes. This optimizes the number of responses by the child in each session.
Target sounds in high frequency words used in sentences: 5-10 minutes
Since a phonologic disorder is truly a language disorder in which the child has not learned the system of sound organization, the child may also manifest other language errors. In this activity, we use high frequency words containing the target phonemes in patterned sentences containing common syntax forms (She likes to ----, Look at her ----, Yesterday he----) that the child may need to learn or practice. This provides meaningful use of target phonemes in words the child uses frequently outside of the therapy setting.
References
Blachman BA, Ball EW, Black R, Tangel DM. Road to the Code: A Phonological Awareness Program for Young Children. Baltimore, MD: Paul H. Brookes Publishing Company; 2000.
Rvachew S, Nowak M, Cloutier G. Effect of phonemic perception training on the speech production and phonological awareness skills of children with expressive phonological delay. Am J Speech Lang Pathol. 2004;13(3):250-263.