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.