UC San Diego

Phonological disorder is a language impairment with no known cause that primarily affects the phonological domain. It is a highly prevalent and impactful communication disorder, yet it has a relatively stagnant history of standardized or relational assessment techniques and traditional, bottom-up remediation approaches designed, primarily, for monolingual speakers of majority varieties of English. Although assessment and treatment for phonological disorder is effective, traditional approaches are not optimized for maximizing efficient phonological growth, which may be achievable by incorporating knowledge of complex phonological structure into the target selection process. Further, the evidence base fails to address the diverse impairment profiles and language backgrounds of many children with phonological disorder. By drawing on our understanding of phonology, phonological analysis, and phonological development, we can work towards advancing efficient and equitable assessment and intervention approaches for a clinically and linguistically diverse population of children with phonological disorder.Chapter 1 provides an overview of the current state of intervention for phonological disorder, highlighting areas of need related to the efficiency and equity of clinical services for this population. Chapter 2 describes a new assessment tool, AutoPATT, and a study examining its validity and accuracy for generating independent, descriptive phonological assessment measures. Chapter 3 investigates the relationship between phonemic inventories generated by AutoPATT and more traditional accuracy measures by comparing both measures derived from single-word productions of 275 English-speaking children with phonological disorder. Chapter 4 examines the phonological influences affecting explicit marking of English tense and agreement morphemes in the connected speech of typically developing Spanish-English bilingual children. Chapter 5 presents a case study exploring the use of a word-final treatment target containing complex phonological and morphological components to remediate co-occurring phonological and morphosyntactic deficits. Chapter 6 is a study comparing the efficacy and efficiency of treatment with complex consonant clusters and singleton targets in Spanish for Spanish-English bilingual children with phonological disorder. Chapter 7 concludes with a general discussion of the findings from these studies and describes pathways for continued work to advance the efficiency and equity of assessment and treatment for phonological disorder.