Jones & Bartlett Learning Health Blog

    Multiple Opposition Contrast Intervention by author Carol Koch

    Posted by Carol Koch on May 17, 2019 10:08:19 AM

    Children with speech sound disorders comprise a large portion of caseloads for speech-language pathologists working with pre-school and school-age children.  Selecting the most appropriate approach in order to yield the maximum change in the child’s phonological system is important to achieve optimal outcomes.  Due to the importance and scope of the topic, I am constantly fielding the question, ‘How do I determine targets for the multiple opposition contrast approach?’ I hope my response below can be of use to you if you are encountering the same problem.

    Children with phonological disorders often present challenges to SLPs in determining the most effective and efficient intervention approach, including the targets that will best facilitate significant progress. For some children, the loss of phonemic contrasts represents the core of the phonological disorder. Loss of phonemic contrasts is evident when production errors impact the intended meaning of a word, phrase or sentence. For example, a child may say [ti] for “tea”, but also for “key” and “see”. The words are produced as homonyms and the phonemes [k] and [s] are not use contrastively to create the different meanings represented in the words “key” and “see”.

    Children who demonstrate extensive loss of contrast may produce one phoneme for many target phonemes. A collapse of phonemes is identified when a child produces one sound across several different target sounds, thus representing loss of the contrasts needed to create different words. The phoneme identified as the substitution for the target phoneme can also be referred to as the preferred phoneme. For example, an extensive collapse might be represented in a child that substitutes [b] for [d, k, g, m, n, s, l, r, ʃ, ʧ, j, h]. Thus, the targets of do, coo, goo, moo, new, Sue, loo, roo, shoe, chew, you, and who are all produced as boo. The phoneme [b] is the preferred phoneme. This extensive collapse of contrast results in extensive homonymy. Rather than attempt to develop a list of target words for this extensive collapse, phonemes are selected from the error phonemes to represent different phoneme classes. A key feature of the contrast approaches is to promote generalization across sound classes, thus each individual phoneme in the collapse does not need to be targeted. Further examination of the significant collapse where the child substitutes the preferred phoneme [b] for [d, k, g, m, n, s, l, r, ʃ, ʧ, j, h], the collapse represents multiple errors related to the following phoneme classes:
    stops [d, k, g],
    nasals [m, n],
    fricatives [s, ʃ, h],
    liquids [l, r],
    glides [j], and
    affricates [ʧ].

    Koch ASHA 2Selecting targets to include the preferred phoneme as well as few of the error phoneme classes would result in a set of phoneme targets. Targets for intervention might include [b, d, m, s, ʃ]. This set of minimal pair target words represents the phoneme classes of stops, nasals, and fricatives. The result would be a target word set of boo, do, moo, sue, shoe. Additional target sets might include: bee, dee, me, see, she and bay, day, may, say, shay.

    The strategy for targeting several phonemes from a collapse is designed to facilitate the most learning about the phonological system. The underlying premise is that the child’s system requires systematic reorganization through contrasting the error with several of the target sounds, thus creating multiple sets of target words. You can learn more by reading Chapter 16: Multiple Oppositions Contrast Approach from my textbook, Clinical Management of Speech Sound Disorders: A Case- Based Approach. - Carol Koch, EdD, CCC-SLP


    About the text:
    Designed for the speech sound disorders course, Clinical Management of Speech Sound Disorders: A Case-Based Approach combines foundational knowledge, clinical theory and principles, evidence-based practice, and practical insight into clinical management strategies. Case-based learning serves as a cornerstone of this resource, facilitating critical thinking and problem solving in a clinical context using clinical vignettes and applications. Accompanying video segments highlight assessment and intervention strategies and are designed to be utilized to support and enhance instruction and student learning.


    Topics: speech-language pathology, SLP, phonological disorder, carol koch

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