Tutorial: Speech Motor Chaining Treatment for School-Age Children With Speech Sound Disorders

Abstract

Purpose Operationalized treatments for school-age children with speech sound disorders may result in more replicable and evidence-based interventions. This tutorial describes Speech Motor Chaining (SMC) procedures, which are designed to build complex speech around core movements by incorporating several principles of motor learning. The procedures systematically manipulate factors such as feedback type and frequency, practice variability, and stimulus complexity based on the child's performance. Method The rationale and procedures for SMC are described. Examples are presented of how to design stimuli, deliver feedback, and adapt the approach. Free resources are provided to guide clinicians through implementation of the procedure. Data on fidelity of implementation and dose per session are presented. Clinical and research evidence is provided to illustrate likely outcomes with the procedure. Results SMC is a method that can result in successful acquisition of target speech patterns and generalization to untrained words. Most clinicians can implement the procedure with over 90% fidelity, and most children can achieve over 200 trials per session. Conclusion Clinicians and researchers can use or adapt the operationally defined SMC procedures to incorporate several principles of motor learning into treatment for school-age children with speech sound disorders. Supplemental Material https://osf.io/5jmf9/.

Figures

Figure 1.

Target sound accuracy on untreated words for 39 children whose treatment included Speech Motor Chaining. Each line represents a separate participant.

Figure 2.

Mean accuracy on word-level generalization probe for six children with /ɹ/ distortion. B = baseline (pretreatment); P = posttreatment; 2M = 2 months follow-up. Error bars represent standard deviation. Treatment occurred for seven sessions (dashed box).

Figure 3.

Boxplot representing mean number of Speech Motor Chaining (SMC) trials per session for 36 participants with speech sound disorders. Each data point represents mean number of trials per session across 14–20 sessions.

Figure 4.

Acquisition data (bars) and generalization data (line) for a 10-year-old with /ɹ/ distortion. Generalization probe data were collected before, during, and after seven sessions of treatment with Speech Motor Chaining (SMC).