The use of facilitative vowel contexts in the treatment of post-alveolar fronting: a case study

School-aged children with persisting speech sound disorders (SSDs) may show little improvement in speech accuracy following phonological or articulation therapy.

To determine the effects of establishing consonant production in facilitative vowel contexts for a 7-year-old boy (CD) with persisting post-alveolar fronting. CD had received phonological awareness therapy and traditional articulation therapy as part of a community caseload. However, his post-alveolar fronting showed resistance to therapy.

CD received individual therapy for nine 45-55-min sessions. A checklist of quality indicators for single-subject research was used to explore the likelihood that a community clinic could meet quality indicators. Fifteen test words in each of target, generalization and control sets were measured at five times pre-, during and post-therapy. A trend analysis was used to measure the statistical significance of the results and to demonstrate the efficacy of therapy.

Therapy was successful. Gains on treatment and generalization test items were rapid and significantly higher than gains on control test items. Only three of 21 single-subject research quality indicators were not met in this research.

Targeting facilitative vowel contexts was successful for this 7-year-old boy with persisting post-alveolar fronting which had been resistant to other therapy techniques. Speech and language therapists are encouraged to ensure that quality indicators for single-subject interventions are built into regular practice.