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About speech, language and swallowing therapy

“Speech disorders occur when a person has difficulty producing speech sounds correctly or fluently (e.g., stuttering is a form of disfluency) or has problems with his or her voice or resonance.” (ASHA, 2018). Speech therapy consists of the remediation and training of speech patterns so that an individual can be understood by others.

“Language disorders occur when a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings (expressive language). Language disorders may be spoken or written and may involve the form (phonology, morphology, syntax), content (semantics), and/or use (pragmatics) of language in functional and socially appropriate ways.” (ASHA, 2018). Language therapy includes treatment of receptive (understanding) and expressive (speaking) language as well as social language.

“Swallowing disorders (dysphagia) are feeding and swallowing difficulties.” (ASHA, 2018). Swallowing disorders can affect people of all ages, from babies to adults. Swallowing therapy is used to treat individuals who have difficulty feeding (i.e., baby nursing), eating, chewing, swallowing, etc. so that they may achieve adequate nutritional intake.

Visit the American Speech-Language and Hearing Association (ASHA) website for more information about these disorders and their therapies: https://www.asha.org/Students/Speech-Language-Pathologists/

About minimal pairs and phonological processes

Phonological Processes can be categorized into three types: Assimilation Processes, Syllable Structure Processes, Substitution Processes. Assimilation Processes occur when the child changes one sound to become more like another sound. The processes that fall in this category include: Denasalization, Assimilation, Post-Vocalic Devoicing, and Pre-Vocalic Voicing. Syllable Structure Processes occur when the child makes changes to modify the syllabic structure of a word. The processes that fall in this category include: Syllable Reduction, Unstressed Syllable Deletion, Reduplication, Epenthesis, Cluster Reduction, Initial Consonant Deletion, and Final Consonant Deletion. Substitution Processes occur when the child substitutes one class of sound for another class of sound. The processes that fall in this category include: Affrication, Velar and Palatal Fronting, Backing, Depalatalization, Deaffrication, Alveolarization, Labialization, Gliding, Vocalization, and Stopping. If a child presents with multiple phonological processes, the processes should be addressed in the following order: Assimilation Processes, Syllable Structure Processes, and Substitution Processes.

Minimal pairs are a set of two words that differ by one phoneme. The minimal pair therapy approach is generally used for reduction of phonological processes, but can be used for auditory habilitation and awareness tasks. Children who present with a phonological disorder typically demonstrate difficulty acquiring phonological knowledge which allows them to express meaning. Appropriate phonological therapy is necessary to help rearrange the child’s linguistic system. This allows the child to organize sounds into classes and sequences into structures, which leads to a greater understanding of the phonological system.

During minimal pair therapy the clinician uses few prompts and increases natural instances of communication breakdowns. This allows the child to confront these breakdowns, which helps him not only identify errors he is making, but also correct those errors. When minimal pair therapy is used, the child begins to recognize patterns of speech sounds in words and understand how similarities and differences between sounds create differences in the meaning of words.

Minimal pair therapy should first begin with the child demonstrating auditory awareness of the spoken target words by pointing to the corresponding pictures when named. Directions for playing the “I’m Aware” game are located on page iiB. After the child demonstrates the ability to identify the spoken target words, the clinician moves to the “Say It!” game, where the child is given the chance to produce the target words. Directions for this game are located on pages iii and iiiB.


Game Directions

Directions 1
Directions 2
Directions 3
Directions 4


American Speech-Language and Hearing Association (ASHA). (2018). Speech-Language Pathologists: About Speech-Language Pathology.
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