Speech Sound Disorders in Children Articulation &
Phonological Disorders - 9th Edition
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3 Speech Sound Acquisition
Sharynne McLeod
Relevance of Understanding Typical Speech Sound Acquisition for
Speech-Language Pathologists
Models of Speech Acquisition
How Speech Sound Acquisition Data Are Obtained
Overall Sequence of Speech Sound Acquisition
Phase 1: Laying the Foundations for Speech
Phase 2: Transitioning From Words to Speech
Phase 3: The Growth of the Inventory
Phase 4: Mastery of Speech and Literacy
Factors Influencing Typical Acquisition of Speech
Conclusion: Understanding and Applying Typical Speech Acquisition
Questions for Chapter 3
4 Factors Related to Speech Sound Disorders
Nicholas W. Bankson, John E. Bernthal, and Peter Flipsen Jr.
Structure and Function of the Speech and Hearing Mechanism
Motor Abilities
Cognitive-Linguistic Factors
Psychosocial Factors
Conclusion
Questions for Chapter 4
5 Classification and Comorbidity in Speech Sound Disorders
Peter Flipsen Jr., John E. Bernthal, and Nicholas W. Bankson
Organically Based Speech Sound Disorders
Childhood Apraxia of Speech
Idiopathic Speech Sound Disorders
Comorbidity
Conclusion
Questions for Chapter 5
6 Assessment: Data Collection
Nicholas W. Bankson, Peter Flipsen Jr., and John E. Bernthal
Assessment Planning
Speech Sound Sampling
Screening for Speech Sound Disorders
Comprehensive Speech Sound Assessment: The Assessment Battery
Assessment in Very Young Children
Related Assessment Procedures
Conclusion
Questions for Chapter 6
7 Assessment: Decision Making
John E. Bernthal, Nicholas W. Bankson, and Peter Flipsen Jr.
Case Selection
The Nature of the Problem
Target Selection
Other Factors to Consider in Intervention Decisions
Digital/Online Phonological Analysis
Case Study: Assessment Data
Conclusion
Questions for Chapter 7
8 Using Evidence-Based Practice in Treatment
Peter Flipsen Jr., Nicholas W. Bankson, and John E. Bernthal
The Basics of Evidence-Based Practice
The Published Evidence
Clinical Evidence
Client Preferences and Values
Conclusion
Questions for Chapter 8
9 The Basics of Remediation
Nicholas W. Bankson, Peter Flipsen Jr., and John E. Bernthal
A Framework for Conducting Therapy
Additional Service Delivery Considerations
Tracking Progress in Intervention
Facilitating Generalization
Dismissal From Instruction and Maintenance
Treatment Considerations for Very Young Children
The Challenges of Working With Older Children
Conclusion
Questions for Chapter 9
10 Motor-Based Treatment Approaches
John E. Bernthal, Peter Flipsen Jr., and Nicholas W. Bankson
Approaches to Intervention
Treatment Continuum
Motor Learning Principles
Optimizing Learning: The Challenge Point Framework
Teaching Sounds/Establishment
Beyond Individual Sounds
Remediation of Vowels
The Use of Nonspeech Oral-Motor Activities
Case Study Revisited: Motor Perspective
Questions for Chapter 10
11 Linguistically Based Treatment Approaches
Peter Flipsen Jr., Nicholas W. Bankson, and John E. Bernthal
Contrast Approaches
Noncontrast Approaches
Remediation Guidelines for Linguistically Based Approaches
Case Study Revisited: Linguistic Perspective
Questions for Chapter 11
12 Treating Specific Populations: Childhood Apraxia and Older
Children
Peter Flipsen Jr., John E. Bernthal, and Nicholas W. Bankson
Childhood Apraxia of Speech
Assessment of Childhood Apraxia of Speech
Treatment for Childhood Apraxia of Speech
Treating Older Children
Specific Treatment Options for Older Children
Summary
Questions for Chapter 12
13 Phonological Awareness: Description, Assessment, and
Intervention
Brigid C. McNeill, Laura M. Justice, and Gail T. Gillon
What Is Phonological Awareness?
Phonological Awareness as Literacy Development
The Development of Phonological Awareness
Phonological Awareness Development and Reading
Phonological Awareness and Speech Sound Disorders
The Role of the Speech-Language Pathologist
Assessment
Intervention
Questions for Chapter 13
14 Language and Dialectal Variations
Brian A. Goldstein, Leah Fabiano-Smith, and Aquiles Iglesias
Dialect
Disorder Within Dialect
Characteristics of American English Dialects
Phonology in Speakers of Language Varieties Other Than English
Phonological Development in Bilingual Children
Assessment Considerations for Children From Culturally and
Linguistically Diverse Populations
Intervention for Speech Sound Disorders in Children From Culturally
and Linguistically Diverse Populations
Summary
Questions for Chapter 14
15 Accent Modification
Carol Tessel
Foreign Accent
The Role of the Speech-Language Pathologist in Accent Modification
Goals of Accent Modification
Understanding Language Interactions
Assessment
Treatment and Instruction
Evidence of Success of Accent Modification
Application to Specific Languages
Summary
Questions for Chapter 15
Appendix A: Procedures for Teaching Sounds
Appendix B: Activities for Facilitating Phonemic Awareness in School-Age
Children
References
Index
About the Faculty Materials
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About the Authors
John Bernthal, Ph.D., is an Emeritus Professor at University of Nebraska–
Lincoln. His career included positions in the public schools of Louisiana,
and at Northwestern State (Louisiana), Minnesota State University–
Mankato, University of Maryland, University of Northern Iowa, and
University of Nebraska–Lincoln. Dr. Bernthal served for 30 years as a
department chair at the latter two institutions. He has published articles,
tests, and books in the area of speech sound disorders in children. Dr.
Bernthal has received the Honors of the American Speech-Language-
Hearing Association, the Council of Academic Programs in Communication
Sciences and Disorders, and the National Student Speech-Language and
Hearing Association. He has also been named 2007 Kansas University
Distinguished Allied Health Alumnus and served as President of the
American Speech-Language-Hearing Association.
Nicholas Bankson, Ph.D., is an Emeritus Professor at James Madison
University. His career included tenured positions at the University of
Maryland, Boston University, and James Madison University. Dr. Bankson
served for 27 years as a department chair that included the latter two
institutions. He has published articles, tests, and books in the areas of
speech sound disorders in children and child language disorders. He has
received the Honors of the American Speech-Language-Hearing
Association, the Council of Academic Programs in Communication
Sciences and Disorders, and the National Student Speech-Language and
Hearing Association.
Peter Flipsen Jr., Ph.D., S-LP(C), CCC-SLP, is a Professor of Speech-
Language Pathology at Pacific University, Oregon. He previously served on
the faculty at Minnesota State University-Mankato, the University of
Tennessee, Knoxville, and Idaho State University. Using his more than 30
years of experience in the field as a clinician, teacher, and researcher, Dr.
Flipsen teaches courses in phonetics, speech sound disorders in children,
and research methods. He has published more than 30 peer-reviewed
journal articles in the field and presented his work nationally and
internationally. His research has focused on classification of speech sound
disorders, measurement of intelligibility of speech, speech and language
development in children with cochlear implants, and the treatment of
residual speech errors in older children.
About the Contributors
Leah Fabiano-Smith, Ph.D., CCC-SLP, is an Associate Professor and
Director of the Multicultural and Bilingual Certificate program at the
University of Arizona. Her research interests focus on phonological
acquisition and disorders in bilingual Spanish-English speaking children
and health disparities for the Latinx community due to misdiagnosis of
disorder.
Gail T. Gillon, Ph.D., is Director of the Child Well-Being Research
Institute at the University of Canterbury, New Zealand, and is co-director of
A Better Start National Science Challenge, a 10-year program of research
focused on ensuring all children’s learning success and well-being. She has
an extensive publication record in children’s speech-language and literacy
development.
Brian Goldstein, Ph.D., CCC-SLP, is the Chief Academic Officer and
Executive Dean of the College of Rehabilitative Sciences at the University
of St. Augustine for Health Sciences. He holds a B.A. in linguistics and
cognitive science from Brandeis University and an M.A. and Ph.D. in
speech-language pathology from Temple University. Dr. Goldstein is well-
published in the area of communication development and disorders in
Latino children. His focus is on phonological development and disorders in
monolingual Spanish-speaking and Spanish-English bilingual children. He
is a fellow of the American Speech-Language-Hearing Association (ASHA)
and received ASHA’s Certificate of Recognition for Special Contribution in
Multicultural Affairs.
Aquiles Iglesias, Ph.D., is a Professor and the founding Director of the
Speech-Language Pathology program at the University of Delaware. Dr.
Iglesias’s work focuses on language development and assessment of
bilingual (Spanish/English) children. He is the author of the
Bilingual/English Spanish Assessment (BESA), Systematic Analysis of
Language Transcripts (SALT), Quick Interactive Language Screener
(QUILS), and Quick Interactive Language Screener: English/Spanish
(QUILS: ES).
Laura Justice, Ph.D., is Distinguished Professor of Educational
Psychology at The Ohio State University. Dr. Justice is also Executive
Director of the Crane Center for Early Childhood Research and Policy, as
well as the Schoenbaum Family Center. A certified speech-language
pathologist, much of her research focuses on identifying strategies to
improve the language skills of young children, including those with
disabilities.
Raymond D. Kent, Ph.D., is Professor Emeritus of the Department of
Communication Sciences and Disorders, University of Wisconsin–Madison.
Dr. Kent’s primary research interests are 1) speech intelligibility in various
clinical populations, especially motor speech disorders in children and
adults; 2) typical and atypical development of speech in children; and 3) the
development and refinement of methods for the study of speech and its
disorders. Most recently, he collaborated on an NIH-supported project that
uses MR and CT imaging, along with acoustic analyses, to study the
anatomic development of the vocal tract in relation to its acoustic
properties. Dr. Kent has published several specialty books and is currently
working on a dictionary of communication sciences and disorders.
Sharynne McLeod, Ph.D., is a speech-language pathologist and Professor
of Speech and Language Acquisition at Charles Sturt University, Australia.
She is an elected Fellow of the American Speech-Language-Hearing
Association and life member of Speech Pathology Australia. She was
named Australia’s research field leader in audiology, speech and language
pathology (2018, 2019, 2020) and has won editors’ awards from the Journal
of Speech, Language, and Hearing: Speech (2018) and the American
Journal of Speech-Language Pathology (2019). She was an Australian
Research Council Future Fellow, previous editor-in-chief of the
International Journal of Speech-Language Pathology, and has coauthored
11 books and over 200 peer-reviewed journal articles and chapters focusing
on children’s speech acquisition, speech sound disorders, and
multilingualism.
Brigid C. McNeill, Ph.D., is a speech-language therapist and Professor and
Deputy Head of School of Teacher Education in the College of Education,
Health and Human Development at the University of Canterbury. Dr.
McNeill is an international expert on literacy development in children with
childhood apraxia of speech. Her research also focuses on developing and
evaluating methods to better prepare teachers to support children’s early
literacy development.
Carol A. Tessel, Ph.D., CCC-SLP, is an Associate Professor at Albizu
University–Miami. Dr. Tessel has been a bilingual speech-language
pathologist for 20 years, with clinical specialties in early intervention,
bilingualism, and speech sound disorders. Her research includes issues of
second language acquisition, bilingual phonology, neurophysiology of
speech perception, and pedagogy in communication sciences and disorders.
She currently teaches courses in disorders of articulation and phonology,
evaluation and treatment of culturally and linguistically diverse populations,
clinical phonetics, acoustics, and research methods in communication
sciences and disorders.
Preface
We are pleased to share with you the ninth edition of our speech sound
disorders textbook. We continue to hear that this text is regarded as a classic
resource for providing clinicians with an expansive knowledge base in the
area of speech sound disorders. The first edition was published in 1981, and
since then it has been utilized as a college textbook and resource by many
aspiring and practicing speech-language pathologists. As in previous
editions, we continue to endeavor to provide a comprehensive and timely
summary of the literature in the area of speech sound disorders. There is no
doubt that certain information and knowledge are retained over the years;
however, there also continue to be changes and developments in
contemporary clinical practice that we seek to incorporate in each new
edition, including this ninth edition. We are pleased to share with you, our
reader, what we hope will be a useful resource in your professional library.
NEW TO THIS EDITION
In this ninth edition, we have retained the general organization from the
previous edition, but we have also:
1. Added learning objectives to introduce every chapter.
2. Included brief cases in several chapters to illustrate some key points,
which we have called Clinical Vignettes.
3. Expanded our use of boxes to highlight some important concepts.
4. Reorganized much of the content in the second half of the book, with
the net result being an expansion from 12 to 15 chapters. This
reorganization included:
a. Creating separate chapters for Evidence-Based Practice (now
Chapter 8) and Remediation Basics (now Chapter 9) to allow for
a more in-depth discussion of each area.
b. Expanding our discussion of Motor-Based Approaches (now
Chapter 10) to include vowel remediation and modifications to
traditional therapy.
c. Expanding our discussion of both childhood apraxia and
treatment for older children and moved them into a separate
chapter (now Chapter 12).
d. Expanding what was previously an appendix into a now complete
chapter on accent modification (now Chapter 15).
As with previous editions, in all chapters, we and our guest authors have
attempted to synthesize the most up-to-date research and literature in the
field while maintaining our eclectic perspective relative to the nature and
treatment of speech sound disorders. In the assessment and treatment
chapters, you will continue to see some of our biases regarding clinical
management. We continue, however, to defer to clinician judgment in
deciding which assessment and treatment procedures are most useful to
them and the clients they serve.
We are indebted to several professionals who have once again
contributed their knowledge and expertise in specialized areas to this text:
Leah Fabiano-Smith, Gail Gillon, Brian Goldstein, Aquiles Iglesias, Laura
Justice, Ray Kent, Sharynne McLeod, Brigid McNeill, and Carol Tessel. We
also appreciate the contributions and suggestions from several anonymous
reviewers of the eighth edition of the text. Thanks to Melissa Bernhardt for
her assistance with reformatting and updating the reference list. Finally,
thanks also to Kelly Farquharson for once again preparing the Instructor’s
Resource Manual.
As authors, we assume all responsibility for errors, oversights, and
misconceptions that may appear in this book. Our hope is that this edition
will provide you with a comprehensive source of information on the
management of individuals with speech sound disorders and that it will be a