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Waisman Center at University of Wisconsin-Madison Speech Report Jordyn Bickham

Name:XX Grade: Preschool Age: 4 years; 1 month Reason for Referral and Background Information A 4 year 1-month old male, a monolingual English speaker, was referred to the Waisman Center at the University of Wisconsin-Madison due to parent’s concerns regarding a possible speech delay. Clinical Observations The clinician initiated a casual conversation with the child, asking him open ended questions. These questions focused on topics that interested the child, making the flow of conversation more probable. The clinician reiterated phrases stated by the child for clarity. The child demonstrated satisfactory pragmatic skills such as turn taking and answering questions when asked. The child also displayed some audible breathing and nasality. This interaction was recorded by the clinician for future reference. Formal Evaluations Photo Articulation Test – Third Edition (PAT-3) The PAT-3 (photo articulation test) was utilized during formal evaluation. This test provides opportunities for the child to produce speech sounds that focus on the beginning, middle, and end consonants as well as the vowel sounds in select words. If the consonant or vowel was produced correctly, a plus sign (+) would be marked in the box. If the child produced a differing sound from the expected target, a negative sign (-) would be marked in the box. The nine target words included dog, cat, cake, vacuum, house, spoon, zipper, scissors, and teeth. The child exhibited phonological processes including stopping, fronting, consonant cluster reduction, devoicing, and final consonant deletion for target consonants. The first of these, stopping, typically suppressed between ages 3-5, was characterized by d/z (e.g., dipper/zipper), d/s (e.g., sciddors/scissors), and b/v (bacuum/vacuum). Fronting, suppressed between ages 3;6 (may persist to 5), was represented by t/k (e.g., tat/cat). Consonant cluster reduction, suppressed between ages 4-5 (may persist to age 8-9), was present when producing p/sp (e.g., poon/spoon). Devoicing, suppressed at age 6, was present when the child produced t/d (e.g., tog/dog). Lastly, final consonant deletion, suppressed at age 3, was present in ca/cake. Phonological processes for non-target consonants and vowels included affrication ch/t (e.g., cheeth/teeth), typically suppressed at age 3, and vowelization a/r (e.g., zippa/zipper),typically supporessed at age 4. According to the age ranges of suppression for each phonological process, final consonant deletion, stopping, vowelization, and affrication were produced atypically. Fronting, devoicing, and consonant cluster reduction have a wider age range of suppression and suggest that these errors may be developmental. If fronting, devoicing, and consonant cluster reduction persist past their suppressed age, further measures for therapy should be taken.

Informal Evaluations Speech Sample The clinician elicited the speech sample and asked the child directed questions about his home life producing spontaneous speech. This was transcribed in IPA format. The purpose of this speech sample was to examine the child’s phonological processes and intelligibility. Intelligibility was calculated by determining the number of intelligible words divided by the total number of words produced. The child received a score of 89%. Typically developing peers usually score near 100% in this category. To further assess his phonological processes, percent of consonants correct (PCC), was calculated. This was collected by tallying the number of correct consonants and dividing that by the total number of attempted consonants. He received a score of 77%. This suggests that he produced fewer correct consonants than would be expected according to his age and gender. The phonological processes present in this speech sample included fronting (e.g.,tat/cat), labialization (e.g., per/her), denasalization (e.g., do/no), consonant cluster reduction (e.g., pitty/pretty), consonant cluster substitution (e.g., tose/close), vowelization (e.g., sisto/sister), final consonant deletion (e.g., don/don’t), affrication (e.g., ju/you), gliding (e.g., yike/like), backing (shink/think), and stopping (e.g., dump/jump). Fronting is suppressed by age 3;6 (may persist to 5), labialization by age 6, consonant cluster reduction between ages 4-5 (may persists to 8-9), vowelization by age 4, consonant cluster substitution by age 9, final consonant deletion by age 3, affrication by age 3, gliding by age 6, denasalization by age 2, stopping between ages 3-5, and devoicing by age 6. These parameters suggest that final consonant deletion, lateralization, vowelization, denasalization, stopping, and affrication do not appear to be developmental and is not typical for a child this age. The presence of labialization, consonant cluster substitution, fronting, consonant cluster reduction and gliding may be developmental considering the ages are above the child’s current age. Clinical Impressions The child demonstrated typical and atypical phonological processes compared to his peers. This suggests that he has a phonological delay. Atypical processes include final consonant deletion, lateralization, vowelization, denasalization, stopping, and affrication. Typical processes include fronting, consonant cluster substitution, labialization, consonant cluster reduction, and gliding. The child revealed several differences within the two tests. In the PAT-3, the child was prompted to say nine different words with specific targets. In the speech sample, the child was able to talk about topics of interest, therefore, making him more comfortable. This exposed several more phonological processes than did the PAT-3. The child’s phonological ability is delayed. His intelligibility is lower than average for his age range as is his PCC. He will benefit from speech therapy. Recommendations To address the child’s articulation and phonological concerns, he will be enrolled into speech therapy. There, he will work with a small group of peers who are focusing on the same phonological processes. The clinician will have the children work on correct tongue placement of the /k/ sound. Once improvement is marked, long term recurrence of fronting will be reduced. The clinician will then work one-on-one with the child, making him aware of correct and incorrect sounds. The clinician and child will work together to accurately produce the /r/ sound in final position. The clinician will strive for 6 correct final position /r/ sounds out of every 10

opportunities given. This will assist in reducing the frequency of vowelization. Treatment will occur twice weekly in 30 minute sessions. These steps will make the child more intelligible and improve his phonological skills....