ETSU speech language pathologist Dr. Lynn Williams developed a new treatment model, called multiple oppositions that will hopefully reduce the amount of time children with speech disorders will spend in therapy.
“The major difference with the multiple oppositions model is that the therapy takes a more holistic approach,” Williams said in a press release.
“Most traditional models focus on correcting one or more sounds that are incorrect. With Multiple Oppositions, emphasis is placed on the child’s entire sound system.”
In a recent study, a group of 10 children – each diagnosed as having a moderate to severe speech disorder – were administered the multiple oppositions treatment. These children were released with successful treatment in one to two years. Although the average time for children such as these to be successfully treated is between five to seven years.
For Williams, who is an associate professor of communicative disorders at ETSU, one of the greatest benefits of the program is that it greatly reduces the amount of time children must spend in treatment.
“It is crucial that we treat speech disorders in a timely and effective manner,” she said. “Research indicates that phonological (speech) disorders are often related to later problems such as reading difficulties. The sooner we treat the speech disorder the better.”
The typical assessment by most therapists lasts around 15-20 minutes. Williams spends more than two hours including one-on-one conversations and a picture identifying session of more than 200 pictures. This type of assessment allows Williams to determine the rules and sounds that are a part of a child’s language. For her the most important part of the multiple oppositions is that initial assessment.
“After the assessment, we are able to map the child’s sound system onto the adult system and determine how much is known and how much is unknown,” she said.
Williams said that by comparing these two systems that therapists can identify the areas of `mismatch’ and establish a treatment plan.
According to Williams most average speakers have a one-to-one ratio between their sound system and the target system. Children that are diagnosed with disordered speech have a `one-to-many’ system where the patient puts several sounds into one.
Children with speech disorders often produce several different sounds for the one adult sound. For example, a child might pronounce “t” for the sounds “s,” “t,” “sh,” “k,” and “ch,” so that the words “sip,” “ship,” and “chip,” are all pronounced as “tip”.
This is referred to as collapsed sounds.
Children in Williams study were between the ages of 4 to 6 years. On average, the patients knowledge of the English sound system was 37 percent.
After participating in the multiple opposition systems treatment plan they improved to an average of 85.1 percent.
In one extreme case a child speech abilities improved from 14 to 99 percent in only 19 months.
Findings of the study, along with a discussion of the multiple oppositions approach, are featured in the in the November issue of the American Journal of Speech- Language Pathology.
Williams received support from the National Institutes of Health to continue her research with the multiple opposition’s treatment approach. In cooperation with ETSU’s Speech- Language and hearing clinic she is continuing the model with clients.
For more information about the multiple oppositions model or treatment contact Williams at (423)439-7188.

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