Research Methods - Final Research Paper 7

A SURVEY OF SPEECH-LANGUAGE PATHOLOGISTS APPROACHES TO ASSESSMENT AND INTERVENTION:
INFLUENCES OF SEVERITY OF CHILDRENS SPEECH SOUND DISORDERS
Natalie Brickner, Maria Moritz, Lauren Normoyle, and Erin Rutkowsky

University of Wisconsin Whitewater
Summer 2015
Research Methods in Communication Disorders

Dr. Giuliana Miolo
A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

Influences of Severity of Childrens Speech Sound Disorders
Brickner, Moritz, Normoyle, Rutkowsky
Introduction
The caseloads of speech-language pathologists (SLPs) consist of high numbers of clients with speech sound
disorders (SSD). In fact, it has been suggested that as much as 75% of the children on the SLPs caseload have SSDs
(Brumbaugh & Smit, 2013). Therefore, it is critical for SLPs to understand what qualifies as a SSD and how to assess and
treat disorders of varying severity. According to the American Speech-Language Hearing Association (2015), the general
category of SSDs encompasses a combination of difficulties with perception, motor production, and/or the phonological
representations of speech sounds and speech segments. Two examples of SSDs in young children are articulation and
phonological disorders. Because severe SSDs (S-SSD) can lead to further difficulties with literacy, social interaction, selfesteem, and building meaningful relationships, early assessment and intervention are critical (Brumbaugh & Smit, 2013).
Early assessment and intervention for young children with SSDs may also reduce the number of school-aged children on
SLPs caseloads. However, differentiating between articulation and phonological disorders and identifying appropriate
assessments and interventions can be difficult because a true dichotomy between these disorders does not exist (BaumanWaengler, 2012).
Historically, children with reduced intelligibility have been diagnosed with an articulation disorder regardless of
severity and have been treated using a traditional articulation approach to intervention (Baker, 2006). Current textbooks
and other resources describe articulation disorders as difficulties with the motor production part of speech which affects a
persons ability to produce certain speech sounds (Bauman-Waengler, 2012). In general, to assess a child with a SSD, SLPs
collect a speech sample. Traditionally, these samples have been analyzed by examining the individual phoneme errors
produced (Baker, 2006). In addition to using informal assessments, formal assessments, such as the Goldman-Fristoe Test of
Articulation 2 (GFTA-2), are used to determine the severity of the SSD compared to the childs typically developing peers
(Brooks & Hedge, 2007). Following assessment, SLPs have traditionally treated children diagnosed with a SSD by using an
articulation approach which addresses each speech sound individually using a hierarchy from isolation to connected
speech. The speech sounds are chosen based on the order of typical developmental acquisition, stimulability, and their
effects on intelligibility (Brumbaugh & Smit, 2013). However, according to Kamhi (2006), the traditional articulation therapy
approach will be less effective than the phonological therapy approach when the child with a SSD is exhibiting a
phonological based disorder (as cited in Brumbaugh & Smit, 2013).
Diagnosis, assessment, and intervention for children with SSDs began to evolve as a result of Ingrams (1976)
publication of Phonological Disability in Children (Baker, 2006). Rather than focusing on problems with individual speech
sounds, Ingram (1976) suggested that children may have problems organizing and using phonemes to signal meaning in
linguistic contexts (Baker, 2006). This difficulty with organization and comprehension of the sound system associated with
language differentiates phonological disorders from traditional articulation disorders (Bauman-Waengler, 2012). To assess a
phonological disorder, SLPs still collect a speech sample, but the analysis varies from the traditional articulation approach.
Instead of examining the individual phoneme errors, SLPs look for patterns of errors, known as phonological processes,
including multiple phonemes (Baker, 2006). In addition to this informal assessment, SLPs use formal assessments, such as
the Hodson Assessment of Phonological Patterns 3 (HAPP-3), to determine the severity of the SSD compared to the childs
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typically developing peers (Brooks & Hedge, 2007). Following assessment, SLPs must identify the most effective and
efficient approach to intervention. By remediating phonological processes using a phonological approach to intervention,
the child should be able to generalize the correct pattern to many of the associated phonemes (Baker, 2006). While the
traditional articulation approach to intervention can be used for children with S-SSDs, it is more efficient to use a
phonological approach addressing multiple phonemes simultaneously. Baker (2006) suggested that children treated using
the phonological approach had improved intelligibility in less than two years, while treating the same child with a
traditional articulation approach could take up to six years to obtain similar results. Despite the decreased time in
intervention required before dismissal, SLPs are still reluctant to embrace phonological intervention.
Research shows that even though an abundance of phonological methods have been published, the majority of
clinicians do not implement phonological approaches. Hodson (1992) found that less than 10% of SLPs were using
phonological approaches with their clients, and Klein (1996) suggested this may be due to the time needed to learn how to
effectively use the phonological approach and the lack of efficacy studies available. For example, Lousada et al. (2012)
evaluated the efficacy of an articulation approach compared to a phonological approach to intervention for young children
with phonological disorders. The participants were randomly assigned to either an articulation approach or a phonological
approach and researchers collected pre- and post-intervention measures related to percent consonants correct (PCC) and
the childrens use of phonological processes. The researchers concluded that although the articulation and phonological
approaches were both effective, the phonological intervention was more efficient (Lousada et al., 2012). Even so, further
research is necessary to support the efficacy of the phonological approach.
Regardless of the available research, phonological interventions for severely unintelligible children are still not
consistently implemented. Brumbaugh & Smit (2013) distributed a national survey asking SLPs about their service delivery
and intervention approaches for young children with SSDs, and they found that SLPs were still more likely to use the
traditional articulation approach rather than a phonological intervention. However, certain phonological approaches were
being used one third of the time. Their rationale for less frequent use of phonological intervention was confusion related to
methodology and uncertainty about the appropriate technique to use for each client (Brumbaugh & Smit, 2013). Skahan,
Watson, and Lof (2007) found the majority of SLPs learned information about SSDs and how to provide services to children
with SSDs through graduate courses, workshops, and undergraduate courses instead of through evidence-based practice
or research articles (p. 251).
Research Questions and Hypotheses

Does the severity of the childs SSD influence SLPs assessment protocols and approaches to intervention? There
does not appear to be a consensus in the assessment protocols and approaches to intervention with children with SSDs.
Evidence supporting assessment protocols and approaches to intervention for articulation and phonological disorders are
available as well as preliminary conditions for which approach would be most appropriate. Based on these findings, we
predicted that more SLPs would use a traditional articulation assessment protocol and a traditional articulation approach to
intervention than a phonological assessment protocol and a phonological approach to intervention regardless of the
severity of the childs SSD.
Do SLPs who graduated after 1990 use a different assessment protocols and approaches to intervention for children
with SSDs of varying severity? The available research suggested that despite the emergence of a phonological approach to
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assessment and intervention in the 1970s, phonological approaches to assessment and phonological intervention may not
be used by SLPs if it was not introduced during their academic careers. Based on these findings, we predicted that SLPs who
earned their degrees after 1990 would be more likely to use different assessment protocols and approaches to intervention
depending on the severity of the SSD.
Method
Participants
The participants were 294 SLPs from the school districts within each of the twelve Cooperative Education Service
Agencies (CESAs) in Wisconsin. Participants reported on their educational background [i.e., graduate institution (see
Appendix D; Table 1 & Appendix D; Figure 1), year of graduate degree completion (see Appendix D; Figure 2)] and their
professional background [i.e., regional CESA representation (see Appendix D; Table 2), number of years of professional
experience (see Appendix D; Table 3), age ranges of students with whom they had experience (see Appendix D; Table 4),
status of Certification of Clinical Competence (see Appendix D; Table 5)].
Participant Recruitment
Participants were recruited via: (1) a monthly electronic newsletter sent to members of the Wisconsin SpeechLanguage Pathology and Audiology Association (WSHA) and (2) an email message sent to any SLP whose email address was
published on a Wisconsin school district website. A web link to the survey was included in the electronic newsletter and in
the email message. The electronic newsletter was sent to 700 members of WSHA, and the email message was sent to 647
SLPs from the Wisconsin school districts. Due to the two methods of recruitment, it is not possible to determine the
response rate because participants could have received the survey link through both the WSHA newsletter and the
Wisconsin school district email messages.
Materials
The survey was designed using Qualtrics, a private research software company which allows the user to generate a
survey that may be distributed electronically through email. The Institutional Review Board (IRB) at the University of
Wisconsin-Whitewater approved the survey and research project.
The survey consisted of twelve questions (see Appendix A). Eight questions requested information about the
participants educational background and professional experience. Of those eight questions, four questions were closed
response (i.e., participants had to select the boxes beside the responses that applied), and the remaining four questions
were open response (i.e., participants could include their own text responses in the space provided). Four questions
addressed the participants assessment protocols and approaches to intervention with children with SSDs. The participants
were presented with two scenarios:
1.
A 4K teacher tells you that a student in her class, Matt, is highly unintelligible. She also notices that he tends to
leave sounds off at the end of words. He is becoming very frustrated because others do not understand him.
2.
A 4K teacher tells you that a student in her class, Sally, is having trouble pronouncing certain sounds. However, for
the most part, the teacher can understand what Sally is trying to say.
Scenario one described Matt, a 4K student with a severe SSD (S-SSD), while scenario two described Sally, a 4K student
with a mild SSD (M-SSD). Following each scenario, the participants were presented with two open ended questions:
1.
Assuming [Matt/Sally] requires a full assessment, what would you include in your assessment protocol?
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2.

Assuming [Matt/Sally] is eligible for services, what type of intervention approach would you use?
The participants were given unlimited space to respond to each question.
Procedures
We created an email template which included a brief explanation of the purpose of the study, instructions to
complete the survey, the web link to the survey, and researcher/faculty supervisor contact information for receiving study
results (see Appendix B). A mass email was sent using the Wisconsin school district email addresses, and a modified version
of the email template was sent to a representative from WSHA to be included in the monthly electronic newsletter (see
Appendix C). We maintained records of the contact information for the SLPs who requested to receive the final results for
the study; however, that contact information was in no way connected to the data collected.
The survey link remained active for approximately ten days. After closing the survey, we downloaded the data and
reviewed the information about the participants educational background and professional experience. Because we were
interested in answering questions related to the participants year of graduate degree completion and their responses to
the assessment and intervention questions presented with each scenario, that data was coded to be analyzed using SPSS
statistical analysis software. The responses for each question were coded by two of the researchers using consensus coding.
Coding Assessment Protocols. We reviewed the responses to the open-ended questions for assessment following
each scenario and recorded the names and frequency of the formal articulation and phonological assessment tools being
administered (e.g., GFTA-2, HAPP-3, CAAP-2). Based on the assessment protocol, we coded the overall approach to
assessment as a(n): articulation approach, phonological approach, combination approach, assessment using the CAAP
(which could be either an articulation and/or a phonology assessment depending on how the assessment was analyzed), or
not available if the assessment protocol could not be coded in one of these four categories. In addition to reviewing the
formal articulation and phonological assessment tools, we also recorded the names and frequency of informal assessment
tools (e.g., speech/language sample, parent/teacher interview) and other formal assessment tools (e.g., PLS-5, CELF-5
Preschool) used.
After coding the formal assessment tools for articulation and phonology, we excluded the responses that could not
be clearly categorized as articulation, phonology, or combination approaches to assessment from further analysis.
Therefore, those participants who reported that they would use the CAAP-2 (n=12, M- SSD; n=14, S-SSD) but did not specify
whether they used the articulation component and/or the phonological component) were excluded from the data set. As a
result, the percentage totals reported for the approaches to assessment do not sum to 100.
Coding Intervention Approaches. We reviewed the responses to the open-ended question for intervention
following each scenario and listed all the types of intervention programs reported by the participants. We coded each of
these programs as a(n): articulation approach, phonological approach, combination approach, depends on assessment
results, or not available if the approach to intervention could not be coded in one of these four categories (e.g., service
delivery model, minutes/week, pull-out/push-in therapy, individual/group therapy). For example, participants who reported
using a traditional approach to therapy would be coded as an articulation approach; participants who reported using a
Cycles approach would be coded as a phonological approach; and participants who reported using both a traditional
articulation approach and a Cycles approach would be coded as a combination approach. Participants were coded as
depends on assessment results if they reported that their choice of intervention would depend on the results of the
4

assessment. Each participant, regardless of the number of different therapy programs reported, was assigned only one
code.
Coding Participants Year of Graduate Degree Completion. The participants were coded as: graduating before 1990
(pre-1990), graduating after 1990 (post-1990), or not available if they answered the question incorrectly (i.e., provided
information other than their graduation year).
Results
Effects of Severity on Assessment Protocol
Percentages were calculated using only those participants whose responses were coded as a(n): articulation
approach, phonology approach, or combination approach.
Articulation. 66.7% of the participants included a formal test of articulation in their assessment protocol for the
child with M-SSD and 24.2% included one for the child with S-SSD (see Appendix D; Figure 3). The most commonly reported
formal assessment coded as an articulation approach was the GFTA-2 (see Appendix D; Table 6). 59.5% included it in their
protocol for the child with M-SSD and 39.9% included it in their protocol for the child with S-SSD.
Phonology. 2.7% of the participants included a formal test of phonology in their assessment protocol for the child
with M-SSD and 28.4% of participants included one for the child with S-SSD (see Appendix D; Figure 3). The two mostcommonly reported formal assessments of phonology were the HAPP-3 and the KLPA-2 (see Appendix D; Table 6). 11.4% of
the participants included the HAPP-3 in their assessment protocol for the child with M-SSD and 35.5% included it for the
child with S-SSD. 5.3% of the participants included the KLPA-2 in their assessment protocol for the child with M-SSD and
14.7% included it for the child with S-SSD.
Combination. 23.5% included a combination of formal tests of articulation and phonology in their assessment
protocol for the child with M-SSD and 40.3% included a combination for the child with S-SSD (see Appendix D; Figure 3).
Chi-Squared Test of Independence. The results of a chi-square test of independence revealed a significant
difference between the percentage of participants selecting formal tests of articulation vs. tests of phonology based on the
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severity of the SSD, (4, N=238) = 45.569, p < 0.001.

Informal Assessments. The three most commonly reported informal assessments included in the protocols for both
children were a(n): speech/language sample, parent/teacher interview, and observation (see Appendix D; Table 7).
Other Formal Assessments. The two most-commonly reported formal assessment tools measuring areas other than
articulation or phonology were the PLS and the CELF-5 Preschool (see Appendix D; Table 8). 10.6% included the PLS in their
assessment protocol for the child with M-SSD and 18.3% included the PLS for the child with S-SSD; and 6.1% included the
CELF-5 Preschool for the child with M-SSD and 9.2% included the CELF-5 Preschool for the child with S-SSD.
Effects of Severity on Intervention Approach

Articulation. 47.4% of the participants reported using a traditional articulation approach to intervention with the
child with M-SSD and 4.8% reported using it with the child with S-SSD (see Appendix D; Figure 4). 60.9% of the participants
reported using the Traditional Van Riper Approach with the child with M-SSD and 21.8% reported using it with the child
with S-SSD (see Appendix D; Table 9).
Phonological. 3.8% of the participants reported using a phonological approach to intervention with the child with
M-SSD and 51.3% reported using it with the child with S-SSD (see Appendix D; Figure 4). 7.5% of the participants used a
5

Hodson Cycles Approach to Phonological Remediation with the child with M-SSD and 38.7% used a Hodson Cycles Approach
to Phonological Remediation with the child with S-SSD (see Appendix D; Table 9).
Combination Approach. 1.5% of the participants reported using a combination of traditional articulation and
phonological approaches to intervention with the child with M-SSD and 11.1% reported using one with the child with S-SSD
(see Appendix D; Figure 4).
Depends on Assessment Results. 19.2% of the participants reported their approach to intervention would depend
on the assessment results for the child with M-SSD and 15.9% reported their approach to intervention would depend on
the assessment results for the child with S-SSD (see Appendix D; Figure 4).
Chi-Squared Test of Independence. The results of a chi-square test of independence revealed a significant
difference between the percentage of participants selecting articulation approaches to intervention vs. phonological
2
approaches to intervention based on the severity of the SSD, (9, N=183) = 25.687, p = 0.002.
Other Types of Intervention Approaches. The three most commonly reported other types of intervention
approaches were a(n): literacy intervention, oral motor intervention, and a phonological awareness intervention (see
Appendix D; Table 9).
Effects of Year of Graduate Degree Completion

Of the 294 participants, 27.2% earned their graduate degree between 1960 and 1990 (pre-1990), 67.3% earned
their graduate degree between 1990 and the present (post-1990), and 5.4% did not provide the year they earned their
graduate degree (see Appendix D; Figure 2). To evaluate the effect of graduation period (pre- vs. post-1990) on the
participants choice of assessment tools and intervention for both children, chi-square tests of independence were used.
These analyses revealed no significant differences between the period of graduation and choice of assessment tools for the
2
child with M-SSD, (3, N=242) = 0.633, p = 0.889, or the child with S-SSD, (3, N=253) = 6.405, p = 0.093, or between the
2
period of graduation and intervention approaches for the child with M-SSD, (3, N=187) = 4.779, p = 0.189 or the child
2
with S-SSD, (3, N=221) = 5.544, p = 0.136.
Discussion
One purpose of this survey was to determine if the severity of the childs SSD influenced the participants
assessment protocol or approach to intervention. We predicted that more SLPs would use a traditional articulation
assessment protocol and a traditional articulation approach to intervention than a phonological assessment protocol and a
phonological approach to intervention regardless of the severity of the childs SSD. For the child with M-SSD, 66.7% of
participants included formal articulation tests and 2.7% included formal phonology tests in their assessment protocol; and
47.4% of participants used a traditional articulation intervention approach and 3.8% used a phonological intervention
approach. In contrast, for the child with S-SSD, 24.2% of participants included formal articulation tests and 28.6% included
formal phonology tests in their protocol; and 4.8% of participants used a traditional articulation intervention approach and
51.3% used a phonological intervention approach.
When selecting an assessment protocol and intervention approach for the child with M-SSD, participants favored
an articulation assessment protocol and intervention approach, which was consistent with our initial prediction. In contrast,
when selecting an assessment protocol for the child with S-SSD, 68.9% (i.e., the sum of phonological approach and
combination approach to assessment) of participants included a phonological assessment tool in their assessment protocol;
6

and when selecting an intervention approach for the child with S-SSD, 62.4% (i.e., the sum of phonological approach and
combination approach to intervention) of participants included a phonological intervention approach, which was not
consistent with our initial prediction. The responses provided for assessment and intervention for the child with S-SSD
suggested that SLPs practices are influenced by the severity of the childs SSD, and there is an increased acceptance for
phonology.
The other purpose of this survey was to investigate if there was a difference between the year the participants
earned their graduate degree and their assessment protocol and intervention approach with the children. We predicted
that SLPs who earned their degrees after 1990 would be more likely to use different assessment protocols and intervention
approaches depending on the severity of the SSD. Our survey data suggested that the year the participants earned their
graduate degree did not influence their approaches to assessment and intervention, which was not consistent with our
initial prediction. Graduate coursework changes from year to year, so it is valuable to know the year SLPs earned their
graduate degree. Our findings indicated that the graduation year, and the associated coursework, did not influence the
SLPs decision to include phonological or articulation approaches to assessment or intervention.
Research Implications
Although we did not find a significant difference between approaches to assessment or intervention depending on
the year the participants earned their graduate degree, there is other data that could infer how the participants decided to
use a traditional articulation approach or phonological approach to assessment and intervention for the child with a SSD.
Additionally, further research could ask SLPs why they adopted their preferred approaches to assessment and intervention
for the child with a SSD (e.g., coursework, continuing education, clinical experience, etc.).
Limitations
Only SLPs who were members of WSHA and/or who currently work in a Wisconsin school district received the
survey, therefore the ability to generalize the results of this study to the practices of SLPs outside of Wisconsin may be
limited.
The use of open-ended questions presented two limitations. First, these types of questions required researchers to
interpret all of the participants responses to create a code for data analysis. Though the researchers took every precaution
to use consistent coding while avoiding researcher bias, subjective judgments were made during the interpretation process.
Also, it appeared that some of the participants misunderstood what the intervention question was asking. The researchers
intended for the participant to respond with their specific approaches to intervention for the child with a M-SSD and a SSSD. However, some of the responses provided were related to the service delivery model and could not be used to draw
conclusions regarding approaches to intervention (i.e., they had to be coded as not available).
Acknowledgements
We would like to acknowledge the Wisconsin Speech-Language Pathology and Audiology Association for
distributing our survey, the speech-language pathologists who took the time to complete it, and our faculty supervisor, Dr.
Giuliana Miolo, for her guidance. We are grateful for their contributions to our study and to the field of speech-language
pathology.

References
American Speech-Language Hearing Association. (2015). Clinical topics: SSDs articulation and
phonology. Retrieved from http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935321&section=Overview
Baker, E. (2006). Management of speech impairments in children: The journey so far and the road ahead. Advances in
Speech-Language Pathology, 8(3), 156-163. doi: 10.1080/14417040600701951
th
Bauman-Waengler, J. (2012). Articulation and phonological impairments: A clinical focus (4 ed.). Saddle River, NJ: Pearson
Education, Inc.
Brooks, A., & Hedge, M.N. (2007). Assessment and treatment of articulation and phonological disorders in children. Austin,
TX: Pro-Ed.
Brumbaugh, K.M., & Smit, A.B. (2013). Treating children ages 3-6 who have SSD: A survey. Language,
Speech, and Hearing Services in Schools, 44, 306-319. doi: 10.1044/0161-1461(2013/12-0029)
Hodson, B. (1992). CLINICAL FORUM: Phonological assessment and treatment applied phonology: Constructs,
contributions, and issues. Language, Speech, and Hearing Services in Schools, 23, 247-253.
Klein, E. (1996). Phonological/traditional approaches to articulation therapy: A retrospective group comparison. Language,
Speech, and Hearing Services in Schools, 27, 314-322.
Lousada, M., Jesus, L.M.T., Capelas, S., Margaca, C., Simoes, D., Valente, A., Hall, A., & Joffe, V.L. (2012). Phonological and
articulation treatment approaches in Portuguese children with speech and language impairments: A randomized
controlled intervention study. International Journal of Language & Communication Disorders, 48(2), 172-187. doi:
10.1111/j.1460-6984.2012.00191.x
Skahan, S.M., & Lof, G.L. (2007). Speech-language pathologists assessment practices for children with suspected speech
sound disorders: Results of a national survey. American Journal of Speech-Language Pathology, 16, 246259.

Appendix A
Survey

Appendix B
Email Template
Dear future colleague,
We are graduate students completing our Master's degree in speech-language pathology at the University of Wisconsin Whitewater. As part of our program, we are conducting a research study to learn more about SLPs' approaches to the
assessment and intervention of children with speech sound disorders. We are contacting you, as a practicing SLP, to find
out if you would be willing to participate in our study by completing a brief survey. We would greatly appreciate your
participation, but it is completely voluntary.
By clicking the link below, you will be directed to a 10-question survey which will take approximately 5 to 10 minutes to
complete.
http://uwwhitewater.co1.qualtrics.com/SE/?SID=SV_3WTp9XeOt8wqnv7
We know how busy you are, so we greatly appreciate your support. If you would like to receive the results of our research,
or if you have any questions about this survey, please contact Erin Rutkowsky (RutkowskE07@uww.edu) or our faculty
supervisor, Dr. Giuliana Miolo (miolog@uww.edu).
Thank you for your time,
Natalie Brickner
Maria Moritz
Lauren Normoyle
Erin Rutkowsky
Giuliana Miolo
This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to
whom they are addressed. If you have received this email in error please notify the system manager. This message contains
confidential information and is intended only for the individual named. If you are not the named addressee you should not
disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail
by mistake and delete this e-mail from your system. If you are not the intended recipient you are notified that disclosing,
copying, distributing or taking any action in reliance on the contents of this information is strictly prohibited.
10

Appendix C
Modified Version of Email Template Used in WSHA Electronic Newsletter
We are graduate students completing our Master's degree in speech-language pathology at the University of Wisconsin Whitewater. As part of our program, we are conducting a research study to learn more about SLPs' approaches to the
assessment and intervention of children with speech sound disorders. By clicking the link provided, you will be directed to a
10-question survey which will take approximately 5 to 10 minutes to complete. We would greatly appreciate your
participation, but it is completely voluntary.
http://uwwhitewater.co1.qualtrics.com/SE/?SID=SV_3WTp9XeOt8wqnv7
We know how busy you are, so we greatly appreciate your support. If you would like to receive the results of our research,
or if you have any questions about this survey, please contact Erin Rutkowsky (RutkowskE07@uww.edu) or our faculty
supervisor, Dr. Giuliana Miolo (miolog@uww.edu).
Thank you for your time,
Natalie Brickner
Maria Moritz
Lauren Normoyle
Erin Rutkowsky
11

Appendix D
Tables and Figures
Table 1: Participants Graduate Institutions by Region
Graduate Institutions by Region
Percent
Participants
Graduate Institutions by Region
Percent
Participants
West
2.0%
Northeast
1.7%
Colorado State University
0.3%
Long Island University
0.3%
Eastern Washington University
0.3%
State Un of New York College at Buffalo
0.3%
Idaho State University
0.3%
Towson University
0.3%
San Francisco State University
0.3%
University of Maine at Orono
0.3%
University of Northern Colorado
0.3%
University of Vermont
0.3%
University of Wyoming
0.3%
South
1.7%
Midwest
9.5%
Arkansas State University
0.3%
Bowling Green State University
0.3%
South Florida University
0.3%
Central Michigan University
0.3%
Texas Tech Uni Health Science Center
0.3%
Illinois State University
0.3%
Texas University at Austin
0.3%
Indiana University
0.3%
Western Carolina University
0.3%
Iowa State University
0.3%
Wisconsin
85.1%
Minnesota State University
0.3%
Marquette University
6.1%
Minot State University
0.3%
University of Wisconsin - Eau Claire
14.2%
Northwestern University
0.3%
University of Wisconsin - Madison
12.2%
St. Ambrose University
0.3%
University of Wisconsin - Milwaukee
8.8%
Truman State University
0.7%
University of Wisconsin - Oshkosh
1.7%
University of Illinois
0.3%
University of Wisconsin - River Falls
3.7%
University of Minnesota - Duluth
3.4%
University of Wisconsin - Steven's Point
22.0%
University of Northern Iowa
1.4%
University of Wisconsin - Whitewater
15.9%
Western Michigan University
0.7%
Viterbo University
0.3%
**n = 288; six participants did not provide a graduate institution
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Table 2: Participants Regional CESA Representation
Regional CESA Representation
Percent Participants
North (CESA 5, 9, 12)
17.1%
East (CESA 1, 7, 8)
19.7%
West (CESA 4, 10, 11)
16.9%
Central (CESA 2, 3, 6)
40.7%
Other
5.6%
Table 3: Participants Number of Years of Professional Experience

Years of Professional
Experience
Percent
Participants
0-4
19.2%
5-9
15.5%
10 - 14
15.1%
15 - 19
16.2%
20 - 24
11.7%
25 - 29
6.9%
30 - 34
11.0%
35 +
4.5%
Table 4: Age Ranges of Students with Whom Participants Have Had Experience
Age Ranges of Students
Number of Participants
Early Childhood (3-6 years)
236
Elementary School (6-10 years)
250
Middle School (10-14 years)
164
High School (14-21 years)
114
Table 5: Participants Status of Certification of Clinical Competence (CCC-SLP)

Status of Certification of
Clinical Competence (CCC)
Percent
Participants
Currently Holds
85.6%
Does Not Hold
9.9%
Expired
4.6%
13

Table 6: Participants Responses to Assessment Question: Formal Assessments for Articulation and Phonology
Mild Scenario
(n = 264)
Frequency Percent
Participants Responses to Assessment Question:

Formal Assessments of Articulation and Phonology
Articulation
Arizona Articulation Proficiency Scale 2 (AAPS-2)
Goldman Fristoe Test of Articulation 2 (GFTA-2)
Photo Articulation Test 3 (PAT-3)
8
157
20
3.0%
59.5%
7.6%
3.0%
Structured Photographic Articulation Test II (SPAT-D II)

Phonology
ALPHA Test of Phonology

Assessment of Phonological Processes Revised (APP-R)
Bankson-Bernthal Test of Phonology (BBTOP)
Hodson Assessment of Phonological Patterns 3 (HAPP-3)
0
0
1
30
Hodson Computerized Analysis of Phonological Patterns (HCAPP)

Khan-Lewis Phonological Analysis 2 (KLPA-2)
Both Articulation and Phonology
2
14
0.4%
11.4%
0.8%
5.3%
Clinical Assessment of Articulation and Phonology 2 (CAAP-2)
12
4.5%
0.0%
0.0%
Severe Scenario
(n = 273)
Frequency Percent
4
109
12
8
1
2
1
97
1.5%
39.9%
4.4%
2.9%
0.4%
0.7%
6
40
0.4%
35.5%
2.2%
14.7%
14
5.1%
Table 7: Participants Responses to Assessment Question: Informal Assessments

Informal Assessments
Case History
Parent/Teacher Interview
Observation
Hearing Screening
Oral Mechanism Examination
Speech/Language Sample
Speech/Language Screener
Speech Sound Inventory
Teacher Articulation Checklist
Stimulability
Mild Scenario
(n = 264)
Frequency Percent
7.2%
19
45.5%
120
39.0%
103
14.0%
37
37
201
2
0
0
11
14.0%
76.1%
0.8%
0.0%
0.0%
4.2%
Severe Scenario
(n = 273)
Frequency Percent
9.9%
27
44.3%
121
44.3%
121
17.9%
49
39
220
6
1
1
4
14.3%
80.6%
2.2%
0.4%
0.4%
1.5%
14

Table 8: Participants Responses to Assessment Question: Formal Assessments (Other Areas)
M-SSD
(n = 264)
Number Percent
S-SSD
(n = 273)
Number Percent
0.4%
0.0%
0.0%
0.7%
1
5
0.4%
1.9%
3
8
1.1%
2.9%
0.4%
0.4%
Developmental Assessment of Young Children 2 (DAYC-2)

Developmental Profile 3 (DP-3)
Fluency and Voice
Fluency/Voice Test
Language
Comprehensive Assessment of Spoken Language (CASL)
1
4
0.4%
1.5%
2
4
0.7%
1.5%
1.1%
1.8%
0.4%
0.7%
Clinical Evaluation of Language Fundamentals 5 Preschool (CELF-5 Preschool)

Expressive One-Word Picture Vocabulary Test 4 (EOWPVT-4)
Expressive Vocabulary Test 2 (EVT-2)
Formal Receptive Vocabulary Test
Preschool Language Scale 4 (PLS-4) or Preschool Language Scale 5 (PLS-5)
Peabody Picture Vocabulary Test 4 (PPVT-4)
16
7
5
0
28
11
6.1%
2.7%
1.9%
0.0%
10.6%
4.2%
25
7
9
1
50
16
9.2%
2.6%
3.3%
0.4%
18.3%
5.9%
Preschool Syntax Assessment

Receptive and Expressive Language Test
Receptive and Expressive Vocabulary Test
Receptive Vocabulary Test
Receptive One-Word Picture Vocabulary Test 4 (ROWPVT-4)
Structured Photographic Expressive Language Test 4 (SPELT-4)
0
9
1
1
5
3
0.0%
3.4%
0.4%
0.4%
1.9%
1.1%
1
15
4
1
6
5
0.4%
5.5%
1.5%
0.4%
2.2%
1.8%
Syntax Test
Test of Early Language Development 3 (TELD-3)
Test of Language Development 4 (TOLD-4)
Writing/Spelling Work from Classroom
Learning Achievement
Assessing Pupils Progress (APP)
1
1
2
1
0.4%
0.4%
0.8%
0.4%
0
2
2
0
0.0%
0.7%
0.7%
0.0%
0.0%
0.4%
Learning Accomplishment Profile 3 (LAP-3)

Literacy and Phonological Awareness
Assessment of Literacy and Language (ALL)
Phonological Awareness Literacy Screener (PALS)
School Readiness and Basic Concepts
Boehm Test of Basic Concepts 3 (Boehm-3)
0.4%
0.4%
0
0
0.0%
0.0%
1
1
0.4%
0.4%
0.8%
0.7%
Bracken School Readiness Assessment 3

Portage Guide
Wiig Assessment of Basic Concepts (WABC)
0.4%
0.8%
0.4%
0.4%
1.1%
0.0%

Formal Assessments (Other Areas)
Apraxia
Apraxia Test
Kaufman Speech Praxis Test (KSPT) or Kaufman Assessment Battery for Children
(KABC)
Auditory Discrimination and Phonological Processing
Auditory Discrimination Test (ADT)
Phonological Processing
Cognitive Development
Battelle Developmental Inventory - 2 (BDI-2)
2
1
3
0
15

Table 9: Participants Responses to Intervention Question
Participants Responses to Intervention Question
Articulation
Five Minute Kid Articulation Approach
Lindamood Phoneme Sequencing Program for Reading, Spelling,
and Speech (LiPS-4)
M-SSD
S-SSD
(n = 266)
(n = 271)
Number Percent Number Percent
15
1
Traditional Van Riper Articulation Approach
162
Phonology
Hodson Cycles Approach to Phonological Remediation
Minimal Pairs Contrast Therapy
20
3
Modified Hodson Cycles Approach to Phonological Remediation

Phonologically Impaired Classroom
Unspecified Phonological Approach
Other Approaches
Language Intervention
Literacy Intervention
2
0
17
Oral Motor Intervention

Phonological Awareness Intervention
Sign Language/Voice Output Device
Social/Pragmatic Intervention
Syntax Intervention
3
4
0
1
0
0
2
5.6%
0.4%
6
0
2.2%
0.0%
60.9%
59
21.8%
7.5%
105
7
38.7%
1.1%
0.8%
0.0%
6.4%
0.0%
0.8%
1.1%
1.5%
0.0%
0.4%
0.0%
3
1
104
2
8
9
6
2
2
1
2.6%
1.1%
0.4%
38.4%
0.7%
2.9%
3.3%
2.2%
0.7%
0.7%
0.4%
16

Figure 1: Participants Graduate Institutions in Wisconsin
1%
7%
Marquette University
19%
University of Wisconsin - Eau Claire
17%
University of Wisconsin - Madison

University of Wisconsin - Milwaukee
University of Wisconsin - Oshkosh
14%
26%
University of Wisconsin - River Falls

University of Wisconsin - Steven's Point
University of Wisconsin - Whitewater
10%
4%
Viterbo University
2%
17

Figure 2: Participants Year of Graduate Degree Completion
6%
27%
1960 - 1990
1990 - present
Not Available
67%
18

Figure 3: Percentage of Participants Using Articulation vs. Phonology vs. Combination Formal Assessment Tools for Mild and
Severe SSDs
100.0%
80.0%
23.5%
40.3%
Percentage of Participants
2.7%
60.0%
Combination
Phonology
40.0%
28.6%
Articulation
66.7%
20.0%
24.2%
0.0%
Mild
Severe
Severity of Speech Sound Disorder
19

Figure 4: Percentage of Participants Using Articulation vs. Phonology vs. Combination Approaches to Intervention for Mild
and Severe SSDs
100%
80%
Percentage of Participants
15.9%
60%
19.2%
11.1%
1.5%
3.8%
Depends on Assessment
Results
Combination
Phonology
40%
51.3%
Articulation
47.4%
20%
4.8%
0%
Mild
Severe
Severity of Speech Sound Disorder
20

Research Methods - Final Research Paper 7

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A SURVEY OF SPEECH-LANGUAGE PATHOLOGISTS APPROACHES TO ASSESSMENT AND INTERVENTION:

INFLUENCES OF SEVERITY OF CHILDRENS SPEECH SOUND DISORDERS

Natalie Brickner, Maria Moritz, Lauren Normoyle, and Erin Rutkowsky

Research Methods in Communication Disorders

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

Research Questions and Hypotheses

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

The participants were given unlimited space to respond to each question.

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

severity of the SSD, (4, N=238) = 45.569, p < 0.001.

Effects of Severity on Intervention Approach

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

Effects of Year of Graduate Degree Completion

with S-SSD, (3, N=221) = 5.544, p = 0.136.

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

Graduate Institutions by Region

Colorado State University

Long Island University

Eastern Washington University

State Un of New York College at Buffalo

Idaho State University

San Francisco State University

University of Maine at Orono

University of Northern Colorado

Arkansas State University

Bowling Green State University

South Florida University

Central Michigan University

Texas Tech Uni Health Science Center

Illinois State University

Texas University at Austin

Western Carolina University

Iowa State University

Minnesota State University

Minot State University

University of Wisconsin - Eau Claire

University of Wisconsin - Madison

St. Ambrose University

University of Wisconsin - Milwaukee

Truman State University

University of Wisconsin - Oshkosh

University of Wisconsin - River Falls

University of Minnesota - Duluth

University of Wisconsin - Steven's Point

University of Northern Iowa

University of Wisconsin - Whitewater

Western Michigan University

**n = 288; six participants did not provide a graduate institution

A Survey of Speech-Language Pathologists Approaches to Assessment and Intervention:

North (CESA 5, 9, 12)

West (CESA 4, 10, 11)

Table 3: Participants Number of Years of Professional Experience

Early Childhood (3-6 years)

Elementary School (6-10 years)

Middle School (10-14 years)