Case Study for Multiple Oppositions

Discuss target selection in a case study example

Devon Lawrey, CCC-SLP
By Devon Lawrey, CCC-SLP
May 21, 2024
Case Study for Multiple Oppositions

4-year-old boy presenting with a moderate-severe speech sound disorder.

During the evaluation, he produced the following phonological processes: final consonant deletion, syllable deletion, voicing, deaffrication, stopping, cluster reduction, and nasal assimilation.

Additionally, he produced a phoneme collapse: [d] for /z/, /tr/, /dʒ/, /k/, /tʃ/, /sl/, /kr/.

Included in his speech sound inventory: [b, p, m, n, ŋ, w, d, t, g, h, z, s, f, ʃ]

Not included in his speech sound inventory: [k, v, dʒ, tʃ, ʒ, l, ɹ, θ, ð]

All clusters are reduced in all word positions. ** Does he meet the criteria for multiple oppositions approach? ** Yes!

  • He is within the age range
  • He is missing 9 sounds from his inventory across 4 manners, including a stop, fricatives, affricates, and liquids
  • He has a phoneme collapse to [d] as well

What targets would be the best choice? I like to break this information down into a table, see below

Phoneme Collapse:

Screenshot 2024-05-13 at 2.42.29 PM.png

Potential therapy targets:

Screenshot 2024-05-13 at 2.41.22 PM.png

I would choose /k/, /tʃ/, and /sl/ as therapy targets. /k/ differs in placement and voicing. /tʃ/ differs in manner, placement, and voicing. /sl/ differs in manner, voicing, and linguistic unit. There is not one correct answer. You could justify another target choice. This comes down to clinical judgment.

**Potential target word sets: ** Deep vs keep, cheep, sleep Dip vs Kip, chip, sip Dew vs coo, chew, slew Daze vs K’s, chaise, sleighs

Topics discussed in this article:
Speech Sound DisordersTherapy Tips

Devon Lawrey, CCC-SLP

Devon Lawrey, CCC-SLP has been practicing speech therapy throughout the state of Michigan for six years. She has her Master's Degree in Speech-Language Pathology from Western Michigan University. Her passion in life is collaborating with families to support their child's individual communication needs and improve their overall quality of life.