Q: It seems that every SLP has a different opinion on phoneme development and the age at which sounds should be treated. For example, some SLP’s work on R at age 6 while others wait until clients are age 7 or 8. What is your opinion on sound development?

I have been re-studying the developmental articulation norms for the past two years in preparation for my next book, and I have to admit the data is all over the place. Researchers today talk about the age of mastery, the age of customary use, the age of development, the age of routine production, and the age of emergence. The criteria for each are different. For example, the age of mastery is the average age at which a certain percentage of children produce a sound correctly in all positions, whereas the age of emergence is the age at which phonemes have been shown to appear in the pre-speech behavior of infants.

When to enroll a child in Rx is a topic of considerable debate. Therapists in private practice often pick kids up early because they allow themselves to, and the parents want them to. Therapists in the schools tend to wait. In private practice, I certainly have seen very young children for mild artic errors. I always tell the parents that we do not have to do this right now. Then I agree to give the child a few lessons to see what happens. If the child responds positively, and the parents and I agree that it is worth it to continue, then we do so. The case is different if the child is very immature, doesn’t get it, can’t do it, is fussy about the work, and so forth. Then I tell the parents we should wait until he is a little older.

Any child can be given a boost at any age to see what happens. The old timers often did this in the form of “speech improvement lessons.” They went into the classrooms in the early grades to work with the whole class. This was coordinated during the week during which each sound was being taught. Then by the end of the year, the SLP’s could tell which children did not benefit from the process. Children who did not fix their error with this type of general stimulation would be picked up the next year for therapy right from the beginning of the school year.

There are other good reasons to wait until kids are older, too. For example, some therapists don’t see any of these mild cases until the children are in third or forth grade in order to keep the caseload small and to see who will outgrow the problem spontaneously. Other school districts enroll these children while they are in K or 1st grade in order to get them in and out before the incorrect speech pattern sets in. Therapists also use the emergence of the adult teeth to mark the time when children can work on the sibilants.

So…. The upshot of all this is that today’s therapists can do whatever is best for them and their situation. Professor Marvin Hanson said it like this:

“Each speech-language pathologist, or each school district or speech correction facility, selects or devises a set of norms. The number of sets available affords some latitude to the clinician.”

Hanson, M. L., 1983, Articulation. Philadelphia: W. B. Saunders