How to Use Complexity Approach in Your Speech Sessions

Take the complexity out of the complexity approach! Step-by-step directions will make it simple as can be.

Devon Lawrey, CCC-SLP
By Devon Lawrey, CCC-SLP
July 18, 2023
How to Use Complexity Approach in Your Speech Sessions

The complexity approach can seem intimidating to initiate, but it can help children improve their overall intelligibility more efficiently.

**What is the Complexity Approach? **

Focus on later-developing sounds and clusters to create “system-wide” change. It can improve intelligibility faster. Children will acquire earlier developing sounds as well as later developing sounds. There are two phases of production training: imitation and spontaneous. It’s best for children aged 3-6 years old with phonological disorders who have a persistent temperament.

**How to Choose Targets: **

You will choose 2 or 3 cluster targets depending on the data you gather from your phonological analysis. The child must have the second and third phonemes in their phonemic inventory (it must occur twice on a probe or assessment) to use three-element clusters. If they don’t, then choose two-element clusters as targets. Check out all the clusters and their sonority level in our treatment library.

For the example below, let’s say the child has /s/, /p/, and /l/ at least two times in their inventory, so you choose to target /spl/ blends.

**What Your Sessions Might Look Like: **

First Session: Complete a phonological analysis by checking all single phonemes and clusters at the word level. You choose to target /spl/ based on the analysis.

Next Sessions: You will target /spl/ blends in the next sessions. The child will imitate your model for seven sessions or until the child produces targets with 75% accuracy for two consecutive sessions. You will provide lots of cueing and feedback as needed. Focus on word-level productions at this time.

After seven sessions or 75% accuracy: You will recheck single phonemes and clusters using a single-word probe.

Next phase: You will now focus on the spontaneous phase of the approach. The child will produce targets spontaneously with 90% accuracy across three consecutive sessions or a total of 12 sessions. You can include activities beyond word level in naturalistic play.

Here are a few ideas for naturalistic play: Use playdoh to make playdoh balls and “splat” it. Use bath toys and “splash” them in a bucket of water. Use play food or play doh and chop it while practicing the target “split”.

Monitor for Generalization: Check singletons and onset clusters immediately following treatment, at two weeks and two months using single-word measures.

One important consideration is the child’s temperament and persistence with difficult tasks. This approach is challenging, and it can be too frustrating for some children.

Topics discussed in this article:
Therapy TipsSpeech Sound Disorders

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.