Why you Need FEWER Words & MORE Trials for Phonological Therapy

April 18, 2021

Flashback to a couple of years ago... I had several phono kids on my caseload who weren't making a ton of progress.

After reevaluating my therapy and diving into some research, I realized I wasn't actually following the guidelines of the treatment approach I was using. For example, I knew the gist of minimal pairs therapy but I didn't fully understand the treatment approach and how to appropriately implement it.
More often than not, I'd grab a deck of /k/ sound webber articulation cards for my kiddo who was fronting.

Needless to say, that is NOT the way we should be doing phonological therapy.

If this sounds like you, don't worry, most of us have been there. The important part is that you are doing your part by researching topics like this and hopefully this blog post can help you break that habit.

Tell me more...

Here is what is usually happening when you are using a ton of different words with your phono kids -> You are getting a lot of trials in during your therapy session, awesome right?!? (nope). This is a NO because... the trials you are getting are not ACCURATE trials.

We all hear that "100 trials" goal per session. Well, those 100 trials won't be very helpful if they are not accurate. In order to help our students learn these rules of our phonological system, they need a lot of accurate practice.

When we are using 20 different words in a session, this hinders our client's ability to get accurate trials because we are constantly switching up a few things...

- We are constantly changing up the context that the target pattern is found in. This increases the student's cognitive load. Not to mention, some of the words in articulation decks should never be used for a child who is fronting... e.g., "cat".

- We are also introducing so many words that the student might not even be familiar with. I mean have you seen some of the words in those articulation decks? Even I don't know what some of those words mean!
This increases the cognitive load because the child is also thinking about and learning the meaning of the word at the same time they are trying to change their entire phonological system! That would be hard work for anyone.

Instead, we should...

So, using just a handful (3-6 depending on your client and the treatment approach you are using) of words can help your student get more accurate trials. And, myth buster: using only a few words will NOT hinder generalization. Research has shown that children will generalize to non-targeted words when only a few words are targeted at the word level each session.
Pretty amazing, right?

https://pubs.asha.org/doi/full/10.1044/2017_LSHSS-17-0080

Using just a handful of words will also help with carryover. From my experience, my students' families are much more likely to practice at home when there are only 4 homework words and they remain the same for weeks on end - rather than sending home 10+ different words each week.

Application:

Just because we can't grab articulation decks 2 minutes before our client shows up anymore doesn't mean we have to spend hours planning for our sessions. In fact, it is quite the opposite.

The majority of the work is up front when you are carefully assessing your client and choosing the appropriate target words. Once you have the target words you can create images to go along with these words. Laminate the images for durability and keep them in your student's file. You can also send a copy home with the client.
Now, every time your student arrives at your door you are ready to go! Choose a couple of quick reinforcers or fast turn taking games (card games, board games, games with a lot of pieces like honey bee tree or pop the pig) and drill those target words throughout the entire session.

You can also get a bit more creative and embed the target word into the fun activity. For example, you can have a picture of a boy who you name "Pat" and a picture of a suitcase. Grab some mini objects and let your child tell you which ones they want to "pack" for vacation. The ones that they don't want to bring on vacation, they can give to "Pat". In fact, you can grab a freebie of this idea HERE.

Love hands-on therapy? Grab some mini objects that are already sorted into minimal pairs for you!