Articulation and Phonology Disorders 37For the teacher, one remarkable aspect of China’s communication disorder was that her
mother completely understood her jumbled sounds. Once during a parent– teacher conference,
China uttered what appeared to be several related sentences that were completely unintelligible to
the teacher. When she stopped, her mother matter-of-factly said that she was talking about their
family’s purchase of a pug puppy. China was describing the pug’s unfortunate appearance and say-
ing that they had named it Rosie. Apparently, the mother was able to decipher China’s language
and had learned her phonological rules.
China was scheduled for a comprehensive articulation and phonological pro cesses assess-
ment. The speech- language pathologist had three goals. First, she wanted to describe China’s
articulatory and phonological development. The type, form, and consistency of the errors need-
ed to be discovered, in addition to describing their distinctive features. Second, the clinician
wanted to decide whether China’s speech deviated significantly from that of other children of
her age and the effects the disorder had on her functional communication. How consistent were
the speech articulation and phonological errors, and what effect did they have on intelligibil-
ity? Third, the speech- language pathologist wanted to determine the type of therapy necessary
for China’s disorder and to make judgments about the improvement expected with and without
therapy.
Phonological testing involved several related but in de pen dent subtests. First, a commercially
available articulation test was used to inventory China’s functional articulation. It identified the
phonemes produced incorrectly and the positions of the errors— that is, whether they occurred
in the initial, medial, and final positions of words. In addition, China’s par tic u lar errors were
indicated. For each speech sound error discovered on the test, the clinician determined whether
it was a distortion, omission, substitution, or addition. The test also had a section to identify the
phonological pro cess used by China.
Once the direct phonological testing was completed, the clinician analyzed the features of
China’s immature and incorrect speech sound production and compared them with the adult,
mature phonological system. This was quickly and accurately done by a commercial computer
program. One feature of China’s immature phonological system was the substitution of voiceless
features by using /t/ and /k/. She would say “Kindy teet ta pug” for “Cindy sees the pug.” A sig-
nificant deterrent to speech intelligibility was China’s final consonant deletions— the reduction of
consonant-vowel-consonant syllables to consonant- vowel structures— that were apparent in most
of the speech sample. For example, China typically said “cu” for “cup,” “tu” for “tub,” and “hou” for
“house.” She also engaged in cluster reduction, in which a consonant cluster is reduced to a single
consonant, such as when she said “krirrel” for “squirrel.”
Because China’s speech disorder was predominantly phonological, the clinician also tested
her to determine her overall functional language abilities. She knew that children with significant
phonological disorders often also have related language disorders. The test results showed China
to have delayed acquisition of receptive vocabulary and grammar, as well as expressive grammati-
cal impairments.
China received daily therapy for the phonology and related language disorders. The goal of
therapy was to help her acquire adult- based phonology and consequently improve her speech
intelligibility. One successful method was contrast therapy. China was shown pictures of word