Intervention for co-occurring speech and language difficulties: Addressing the relationship between the two domains

Abstract

Although many children are referred with difficulties in both their speech and their language, the literature offers relatively little guidance on their therapy. Should clinicians treat these difficulties independently? Or should treatment depend on the potential impact of one domain on the other? This study aimed to investigate the relationship between speech and morphosyntax in treatment for a 5-year-old boy, B, with speech and language difficulties. Therapy targeted the production of regular past tenses and plurals. B had the necessary phonology for the former but not the latter. Therapy therefore directly targeted production of the past tense but targeted plurals by treating the production of the necessary phonology. After therapy, B successfully produced regular past tenses for both treated and untreated verbs. Irregular verbs did not improve. Treatment for production of word-final /s/ was successful and generalized to untreated words but not to the production of /s/ in initial or medial positions. Plurals formed by adding /s/ but not those by adding /z/ benefited. Similar treatment for production of word-final /z/ was also successful and appeared to generalize to words with /z/ in initial and medial positions. However, although plurals were now marked, they were usually realized as [dz]. The results of this single-case study demonstrate that intervention for children with speech and language impairments should take account of the aspects of speech and morphology that are impaired, and the ways these may impact on each other.