Treating phonological processing disorders is a key piece of what you do as a pediatric SLP. It’s important to understand how phonological processing disorders differ from other speech sound disorders, how to get caregivers on board, and how to choose the best treatment approaches to help your clients. You CAN help children develop more intelligible speech and set them up on a path for successful communication all of their lives!

Understanding Phonological Processing Disorders

Before you begin to educate caregivers about phonological processing disorders (PPDs), it’s important to ensure you have a solid understanding of this type of speech sound disorder. 

What is a Phonological Processing Disorder?

A phonological processing disorder is a type of speech sound disorder where a child has difficulty organizing their speech sounds into a system of sound patterns (aka phonology!). 

Examples of PPDs:

• Final consonant deletion
• Backing
• Syllable reduction

*Read about other phonological processes too! 

Diagnosis of PPD

Children are typically diagnosed with phonological processing disorders during early preschool years, between the ages of 3 and 5. Before a diagnosis of PPD is made, children should be able to produce many speech sounds independently. 

Recent research from McLeod and Crowe (2018) found that the majority of children have acquired most consonants by the age of 5.

Certain factors can increase a child’s likelihood for a PPD:

• Family history of speech and language disorders
• Hearing loss
• Frequent ear infections
• Orofacial myofunctional disorders

When initially meeting with caregivers, ask questions about these factors to develop a greater sense of understanding about the child.

Key Differences between PPD and Other Speech Sound Disorders

Phonological processing disorders are different from other common speech sound disorders like articulation and childhood apraxia of speech. PPDs indicate an issue with the language rules that govern the sound system.  

Children with articulation errors have trouble physically producing specific speech sounds such as /r/, /th/, or /k/, but there is no pattern to the sounds that they are misarticulating.

Childhood Apraxia of Speech is a motor planning disorder that results in difficulty coordinating movements needed for speech. There is also no pattern to the sounds impacted with children diagnosed with this speech sound disorder.

Impact on Speech Intelligibility

Phonological processing disorders can have a significant impact on a child’s speech intelligibility. Many times, even caregivers of a child with a PPD have difficulty understanding what their child says. 

When entire classes of sounds are missing or incorrect, this can negatively affect a child’s self-confidence in expressing their thoughts and needs to others. 

Treating Phonological Processing Disorders Early On

Working to improve young children’s phonological abilities is so important!

Early Intervention

Early intervention is key when working with children with phonological processing disorders. Therapy is not a quick fix, but the outcome is so much better when addressed early on!

Treatment requires commitment, consistency, and time, and you should be honest with caregivers about this upfront.

Get Caregivers On Board

Caregiver buy-in is vital when working with a child with a phonological processing disorder. If you don’t have their support, carryover of skills will likely be slow. 

Ensure parents understand the ins and outs of phonological processing disorders by providing education and communicating regularly.

Make it easy on yourself by using done-for-you resources. These comprehensive Parent Education Handouts provide caregivers with basic information about PPD, practical tips for motivating their child, and speech homework ideas.

Therapy for Phonological Processing Disorders

Once you’ve gotten caregivers fully on board with the treatment needed for phonological processing disorders, it’s time to ensure you’re ready for therapy sessions!

Confidently select therapy targets using these data-driven treatment approaches:

• Cycles Approach
• Minimal Pairs Approach
• Play-Based Treatment

Cycles Approach

The cycles approach is a great choice for children with highly unintelligible speech. It was designed by Barbara Hodson to help children presenting with multiple phonological processes make faster progress in speech therapy. 

The cycles approach targets each phonological process a child uses for a short amount of time before cycling through other phonological processes. Cycles may range in time from 2 to 16 weeks. 

Therapy is continued until each phonological process is eliminated from a child’s conversational speech. 

Important consideration: Only work on phonological processes that a child is stimulable for!

Minimal Pairs Approach

The minimal pairs approach is a common choice when working with children with PPD. With this approach, you choose different word pairs to help a child learn to differentiate sounds between words while learning correct phonological rules. 

A minimal pair is a set of words that are different by only one sound or feature. These pairs help children create sounds they don’t currently use or reduce phonological processes found in their speech.

Examples: 

• “Me” and “we”
• “Bat” and “bad”
• “Dough” and “go”

The minimal pairs approach is best used for mild to moderate disorders. 

Play-Based Treatment

Play-based treatment approaches are often the best with young children. Although you may feel like you can’t get as many repetitions as you can with other approaches, be confident that choosing targeted play-based activities often increases a child’s generalization of skills later on! 

Use these S-Blend Cluster Reduction activities to teach s-blends and reduce cluster reduction errors through engaging activities. 

This Final Consonant Deletion PPD resource helps children learn to add final consonants to words while playing fun games about… 

For children experiencing difficulties substituting front sounds for back sounds, use this Fronting Phonological Processes Resource! It aims to correct fronting errors by focusing on k, g, and h sounds in play. 

Finally, address letter sounds /f/ and /v/ in this F/V Phonological Processes Playtime Packet. This set includes 42 play-based activities and many concrete examples and is perfect for in-person or virtual therapy!

Using premade resources helps save you time and ensures that your phonological therapy sessions are effective– even while you’re deep into having fun with your students!

Phonological Processing Disorders require thoughtful and systematic intervention approaches, but it doesn’t have to be challenging or stressful for you! Using data-driven methods like Cycles and Minimal Pairs approaches plus fun, play-based activities can significantly improve children’s speech outcomes. Early intervention and consistent practice from caregivers are key to helping children develop intelligible speech. Remember, you are exactly the SLP your PPD clients and families need to make amazing improvements!

You may also be interested in reading:

3 Ways to Empower Caregivers in Speech Therapy

MUST-KNOW Information about Phonemic Awareness and Speech Sound Disorders  

Why is Early Intervention Important?