Treatment of severe articulatory impairment in a three year old child:  A treatment efficacy study

By E.A. Strand


This paper reports data regarding the efficacy of a treatment approach based on integral stimulation, for a young child with a severe speech disorder. Baseline and probe data were collected over a period of 17 months.  The paper includes a rationale for the treatment approach based on several principles of motor learning; a brief discussion of what evidence led to the decision that motor planning/programming impairment contributed to the child’s speech disorder; a description of how treatment was implemented; and a summary of the data showing her improvement in speech performance. The treatment data illustrate that the child exhibited rapid change following the implementation of treatment for some items more than others. The degree of performance change was greater than that for control probes, and improvement was maintained for most but not all utterances. Discussion focuses on: 1) explanations for her slow improvement, and changes that were implemented in therapy to facilitate more rapid improvement.2) why the child had more difficulty with retention of performance for some utterances; and 3) how incorporating the principles of motor learning may facilitate the treatment of severe developmental speech disorders which are accompanied by motor impairment.