CHANGES IN PHONOLOGICAL SYSTEM AFTER TREATMENT OF PHONOLOGICAL DISORDERS

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CHANGES IN PHONOLOGICAL SYSTEM AFTER TREATMENT OF
PHONOLOGICAL DISORDERS

• Márcia Keske-Soares
• Marizete Ilha Ceron
• Karina Carlesso Pagliarin
• FEDERAL UNIVERSITY OF SANTA MARIA - BRAZIL

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INTRODUCTION

• There are many choices of therapeutic models to
  treat children with phonological disorders.
• However, before beginning a phonological therapy
  the clinician must know how the speech sounds
  organize themselves and work within the language.

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INTRODUCTION

• In the evaluation of children you may take into
  consideration the phonemes present in the
  phonetic inventory and the phonological system
  and from these data, analyze the distinctive
  features impaired as well as the severities of
  phonological disorders.

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PURPOSE

• This work aims to compare the changes before and
  after treatment regarding the phonetic inventory,
  phonological system and distinctive features
  impaired of children with different severities of
  phonological disorders.

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METHOD

• The group of subjects was composed of 96 children
  with phonological disorder, being them 3 years
  and 9 months to 10 years old, both genders.
• The project was registered at Projects Office and
  it was approved by the Research and Ethics
  Committee.

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METHOD

• The following evaluations were carried out
• language
• phonological evaluation (Yavas, Hernandorena
  Lamprecht, 1991)
• articulatory-repetition test
• vocabulary
• stomatognathic system
• phonemic perception
• psychomotor
• phonologic awareness
• memory
• simplified evaluation of the central hearing
  processing
• and otorhinolaryngological, hearing and
  neurological evaluation.
• The results were in agreement with the age
  pattern except for the phonological evaluation.
  Phonological disorder was diagnosed (Grunwell,
  1990).

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METHOD

• The severity level of phonological disorders was
  calculated based on the Percentage of Correct
  Consonants-Revised (PCC-R) proposed by Shriberg
  et al. (1997), and it was classified in
• Severe (PCC-Rlt50)
• 6 subjects
• Moderate-Severe (PCC-R51 to 65)
• 18 subjects
• Mild-Moderate (PCC-R66 to 85)
• 47 subjects
• Mild (PCC-R86 to 100).
• 25 subjects

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METHOD

• The subjects were divided into three groups
  according to different therapeutic models which
  were
• Modified Cycles (Tyler, Edwards Saxman, 1987)
• 22 subjects
• Maximal Oppositions (Gierut, 1992)
• 33 subjects
• ABAB-Withdrawal and Multiple Probes (Tyler
  Figurski, 1994)
• 41 subjects

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METHOD

• According to the number of sessions there were
• 0 to 18 sessions (? 2 months)
• 19 to 36 sessions (? 4 months)
• more than 37 sessions (more than 4 months).

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METHOD

• Every one was compared with
• the number of absent sounds in the phonetic
  inventory (PI), phonological system (PS) and the
  distinctive features (DF) impaired pretreatment
  and postreatment
• the severity levels of phonological disorders
• three therapeutic models.

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METHOD

• Comparison was made of the severities of
  phonological disorders in each therapeutic model
  referring to the phonetic inventory, phonological
  system and distinctive features impaired.
• Also compared were the therapeutic models in each
  severity of phonological disorder related to the
  phonetic inventory, phonological system and
  distinctive features impaired.
• In this analysis it was used the following
  statistical tests ANOVA, Scheffe and the
  non-Parametric T Test with significance level of
  5(plt0, 05).

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RESULTS and DISCUSSIONS

• Table 1
• It shows the difference in the phonetic
  inventory, phonological system and the
  distinctive features impaired in
• different therapeutic models
• severities of phonological disorders
• the number of sessions.
• It is also found the results of the statistical
  analyses.

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RESULTS and DISCUSSIONS
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RESULTS and DISCUSSIONS

• Regarding the comparison of therapeutic models in
  the phonetic inventory the results do not show
  statistical difference (p0,473) among the
  researched models due to the number of absent
  sounds being similar to the studied subjects
  treated in the three models.

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RESULTS and DISCUSSIONS

• However, in the phonological system and
  distinctive features impaired the results showed
  a statistical difference (p 0,034 and p0,003
  respectively) what may be observed for the
  difference in the number of absent sounds.
• Moreover, the distinctive impaired features
  ABAB-Withdrawal and Multiple Probes model showed
  a statistical difference from the Maximal
  Oppositions and Modified Cycles.

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RESULTS and DISCUSSIONS

• In the severities of phonological disorders, it
  was observed that the severity decreases
  according to the number of absent sounds in the
  phonetic inventory and phonological system
  decreases as well (p0,000).
• Regarding the distinctive features impaired it
  was noticed a reduction in the number of
  features impaired as the severity decreased, what
  showed statistical difference (p0,000).

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RESULTS and DISCUSSIONS

• These results are justified by the fact that the
  smaller the severity is there is less absent
  sounds in the phonetic inventory and phonological
  system, as well as a smaller amount of
  distinctive features impaired.

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RESULTS and DISCUSSIONS

• In the number of sessions done there was a
  statistical difference between the phonetic
  inventory (p0,003), phonological system
  (p0,000) and the distinctive features
  impaired(p0,009).
• It was observed in each session the acquirement
  of sounds with a decrease on the number of
  impaired features.

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RESULTS AND DISCUSSIONS

• Table 2
• It is possible to observe the obtained
  difference in the phonetic inventory,
  phonological system and distinctive features
  impaired among the severity levels of
  phonological disorders in each therapeutic model.
• In this table is also found the statistic
  analyses of the results comparing the severities.

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RESULTS and DISCUSSIONS
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RESULTS and DISCUSSIONS

• The results from the statistical analyses showed
  a significant difference in the phonetic
  inventory, phonological system and distinctive
  features impaired considering the severities in
  the model of Maximal Oppositions and
  ABAB-Withdrawal and Multiple Probes.
• The statistical differences are mainly found when
  comparing the severe and the mild severities.

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RESULTS and DISCUSSIONS

• The phonetic inventory, phonological system and
  distinctive features impaired did not differ
  statistically among the severities in the
  Modified Cycles model.
• It is also possible to observe that the number of
  absent sounds in the phonetic inventory,
  phonological system and distinctive features
  impaired decrease as the severity decreases in
  the three studied models.

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RESULTS and DISCUSSIONS

• The relevance of making comparisons among the
  therapeutic models is mentioned by Mota et al.
  (2007) in order to help the clinician to select
  the most efficient methods for treatments.
• Ingram (1989) affirms that the phonological
  therapy has the purpose of reorganizing the
  system of sounds of a child based on the adult
  model.

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RESULTS and DISCUSSIONS

• Table 3
• It is observed the difference obtained by the
  treatment in the phonetic inventory, phonological
  system and distinctive features impaired
  comparing the therapeutic models considering the
  severities of phonological disorder.
• In general there was no statistical difference in
  the phonetic inventories, phonological systems
  and distinctive features impaired among the
  researched models in the different severity
  levels of phonological disorders.

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RESULTS and DISCUSSIONS
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RESULTS and DISCUSSIONS

• The three models of therapy were efficient to
  the acquisitions in the phonetic inventory,
  phonological system and to the decreasing of
  distinctive features impaired in any of the
  severities analyzed.
• Gierut (1996) affirmed that the phonological
  intervention facilitates the changes in the
  phonological system of children and/or adults.

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CONCLUSIONS

• It was possible to conclude that there was a
  favorable evolution regarding the acquisition in
  the phonetic inventory, phonological system and
  distinctive features impaired comparing the
  different therapeutic models, the severities of
  phonological disorders and the number of sessions.

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CONCLUSIONS

• All of the therapy models (Modified Cycles,
  Maximal Oppositions and ABAB-Withdrawal and
  Multiple Probes) used were effective to the
  treatment of phonological disorder.
• In phonological disorders considered more severe
  the absence of sounds in the phonetic inventory,
  in the phonological system and the number of
  distinctive features impaired are bigger.

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REFERENCES

• GIERUT, J. A., 1989, Maximal opposition approach
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• GIERUT, J. A., 1992, The conditions and course of
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• GIERUT, J. A., 1996, Categorization and feature
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• GRUNWELL, P. Os desvios fonológicos numa
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• TYLER, A. A., EDWARDS, M. L. and SAXMAN, J.
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• TYLER, A. A. and FIGURSKI, G. R., 1994, Phonetic
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• YAVAS, M., HERNANDORENA, C. L. M. and LAMPRECHT,
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• Thank you!
• Márcia Keske-Soares
• keske-soares_at_uol.com.br
• Marizete Ilha Ceron
• marizeteceron_at_hotmail.com
• Karina Carlesso Pagliarin
• karinap_fono_at_yahoo.com.br