Integrating Literacy Targets Into Speech Sound Therapy for Children With Speech Sound Disorders: A Case Study

Purpose: Due to an increased risk for developing reading and writing difficulties, research literature recommends integrating literacy targets into speech sound therapy for children with speech sound disorders. Translating guidance from research into daily practice warrants looking closely at applying evidence-based practices from more controlled environments into authentic settings because most speech-language pathologists practice in these real-world settings. This clinical focus article describes how embedding phonics and phonemic awareness activities into speech sound therapy in a real-world setting influenced speech sound production, letter naming, grapheme–phoneme correspondence, and phonemic segmentation in a preschool client with a speech sound disorder. Method: A female aged 4;5 (years;months) with a speech sound disorder was seen for 10 individual therapy sessions in a university speech clinic collaboratively with a graduate student clinician. The parent observed all sessions and was given specific feedback on how to implement strategies at home that were introduced in therapy. Data were collected for speech sound production, letter naming, grapheme–phoneme correspondence, and phonemic segmentation prior to therapy at the beginning, at midpoint, and at the end of the therapy sessions. Results: The client's speech sound errors decreased, phonemic repertoire expanded, phonological processes such as phoneme collapse decreased, and both letter naming and grapheme–phoneme correspondence increased; however, analyses indicated that the differences were not statistically significant. Phonemic segmentation remained unchanged. Conclusions: It is feasible to apply recommendations to integrate phonics and phonemic awareness activities into speech sound therapy. However, a clear understanding of literacy development is an important consideration when selecting targets. Results are discussed in the context of balancing clinical and statistical significance, and therapeutic decision making may benefit from integrating both.