I got a new student, skimmed through his articulation goals, and ran and picked him up for speech therapy. Never knowing how accurate old goals are, I asked him to tell me the story from his favorite book – Clifford. I then stood up, walked over to my desk, took a long swig of coffee, and stared at him stupefied. What on earth did he just say? Was that even English or Spanish? Take a look.
I thus began a long journey into Inconsistent Deviant Phonological Disorders (IDPD) that resulted in this:
I love the fact that he is wearing the same shirt because when I give presentations on this topic it makes me look like I am a 20 minute miracle worker. The fact is, it took me about 2 months and that just happened to be his favorite Spiderman shirt that he always wore.
Low Speech Intelligibility: AKA – Inconsistent Deviant Phonological Disorders (IDPD)
Let’s unpack this first.
- Inconsistent – Not a pattern
- Deviant – Not a phonological process that we should have ever seen
- Phonological – Rule based
- Disorder – Limiting condition
A.k.a – mushmouth
These are the children who are highly unintelligible and their productions are inconsistent. If you ask them to say WHEELBARROW you may get SNEFARROW and if you ask again get PEELJARREL. However, at the sound level they can be 100% accurate. Broomfield & Dodd (2004) found that these children can make up 9% of the students that we see.
How to Improve Severely Low Speech Intelligibility
After beating myself up a good deal for not being able to help this student and several failed attempts at articulation therapy and phonological approaches, I finally found the answer I needed: The Core Vocabulary Approach. Here is what it looks like and how I helped another student.
The Core Vocabulary Approach
- Choose 50 words that are highly important to the student and to the student’s environment. These words should be used A LOT. Here is an example of what we focused on. The student gets a say in what’s important, the teacher gets a say, and the parents get to choose some words. Notice that this is a dual language student so we chose from Spanish and English.
- Achieving consistency is paramount. Establish consistent productions at any level and build their consistency up to the word level. This means we even accept errors if the errors grow to be consistent.
- As words become clearly spoken, we move them off of the list and add some new.
- The list always stays at 50 words.
- Some teachers have created binders where the words move over to “success areas.” Some teachers have added success areas to their word-wall in the classroom.
- Stick with the list and use it to take data to see what to keep and what to has become intelligible.
Let’s take a look again.
Hopefully now you can see why traditional phonological approaches and articulation approaches failed. They weren’t addressing the underlying problem with children with severely low speech intelligibility: consistency.
Great Additional Resources to Treat Low Speech Intelligibility
Technology has traditionally been NO help to us in this area because most of the apps and programs pre-pick all the words you need based on the sounds in the word. This is of little use when results demand that you choose words from a child’s environment. The team at Little Bee Speech made a beautiful program that allows you to rapidly choose vocab from your students environment and build the lists. Not only that but you can make lists specific to students and work with them in a group. Aaahhh!
Why are we excited? They just released a Spanish version too.