Outcomes of different speech and language goal attack strategies

The purpose of this study was to assess phonological and morphosyntactic change in children with co-occurring speech and language impairments using different goal attack strategies. Participants included 47 preschoolers, ages 3;0 (years;months) to 5;11, with impairments in both speech and language: 40 children in the experimental group and 7 in a no-treatment control group. Children in the experimental group were assigned at random to each of 4 different goal attack strategies: (a) in the phonology first condition, children received a 12-week block of phonological intervention followed by 12 weeks of work on morphosyntax; (b) the morphosyntax first condition was the same as phonology first, with the order of interventions reversed; (c) the alternating condition involved intervention on phonology and morphosyntax goals that alternated domains weekly; and (d) the simultaneous condition addressed phonological and morphosyntactic goals each session. Data were collected pretreatment, after the first intervention block, and posttreatment (after 24 weeks). For the control group, data were collected at the beginning and end of a period equivalent to 1 intervention block. Change in a finite morpheme composite and target generalization phoneme composite was assessed. Results showed that morphosyntactic change was greatest for children receiving the alternating strategy after 24 weeks of intervention. No single goal attack strategy was superior in facilitating gains in phonological performance. These results provide preliminary evidence that alternating phonological and morphosyntactic goals may be preferable when children have co-occurring deficits in these domains; further research regarding cross-domain intervention outcomes is necessary.