Top 5 Phonological Patterns in Children treated by SLPs

Kimberly Martins, M.A. CCC-SLP
November 18, 2021

Phonological Patterns/Processes

Language can be divided into several different areas such as semantics, syntax, pragmatics and phonology. Today’s post will focus on phonology which is the language system regarding the rules of sound combinations in a language. More specifically, I will discuss phonological patterns/processes that are used by children to simplify adult speech. As they develop their speech and language skills, children will use certain phonological patterns to try and produce what they hear, then they will eliminate the use of these patterns once they have mastered the rules and can produce speech that sounds like that of adults.

Children using phonological patterns will sound like they are not using adequate speech and some people may think that they make articulation errors. However, articulation is an issue with the speech mechanism whereas using phonological patterns past the appropriate age of elimination is a language issue and not anatomical. Usually, if the child has a phonological process disorder that means that they are using a process/pattern for a group of sounds which is no longer age-appropriate. For example, the phonological pattern called final consonant deletion means that the child does not produce the ending sounds in words such as “ca” for “cat” and “mo” for “mom.”

Phonological Treatment

Treatment of phonological process disorders can be divided into three components: identification/increasing awareness for different sound patterns, discrimination between incorrect and correct sound/syllable patterns in words, and target speech productions of correct sound/syllable pattern.

Auditory Discrimination

A big component in phonological pattern treatment is increasing the child’s awareness of where/how sounds are produced and the ability to discriminate between sounds. For instance, a child who using the pattern of fronting saying “tat” for  “cat” and “dame” for “game” may not auditorily hear a difference between phonemes /t, d/ and /k, g/. This is not an issue with their physical hearing but more their perception of sounds. Although, we always recommend a hearing evaluation to eliminate the possibility of a hearing loss for this reason.

Therefore, in the majority of cases, phonology treatment starts with what we call auditory bombardment and minimal pair discrimination. Auditory bombardment is when we stimulate the auditory processing system by listening to words with the target sounds in specific positions. For instance, I would have a child sit doing a mundane task such as a puzzle or coloring while listening to me say words with a lot of /k, g/ sounds to stimulate their auditory processing system for these sounds.

Before using minimal pair discrimination, I like to have the child discriminate between sounds in isolation to increase their awareness. I like to increase awareness by having the child name the different patterns or sounds and adding a visual to it.

Initial Treatment Sessions of Phonological Patterns

These are examples of initial treatment session activities I use for children who are fronting phonemes /k, g/.

First, I discuss the differences between the two sets of sounds. Phonemes /t, d/ are produced with the tip of our tongue whereas phonemes /k, g/ are produced with the back of our tongue and sound like they are coming from way far back in our throat. We can name /t, d/ as the “tippy” category and /k, g/ as the “throaty” category. Then I will have pictures that illustrate tippy and throaty. It is important to have the child collaborate to choose the visuals and names of the patterns to further increase the internalization of their understanding of the patterns.

It is crucial at this stage that children do not practice producing sounds until they can discriminate accurately, because we don’t want them making speech errors and reinforcing the wrong production pattern.

Then, I work on identification and discrimination. I say the sound in isolation such as /t/ or /k/ and then ask the child to point to the picture to identify the sound as a tippy/throaty or they can verbally label it. Once they have done this, I move up to syllables and words depending how fast they catch on. It can take one to two sessions or more. Once you start working on productions, you can have the child try to produce the different sounds and you label them (e.g. tippy or throaty). This will also increase their awareness because if they are trying to say a /k, g/ but produce /t, d/ you will label it as a “tippy.” Be careful! This can lead to frustration when they are unable to produce the sound. Always wait until they can actually get some success with /k, g/ productions before attempting targeted speech productions.

Minimal Pairs

Minimal pairs are words that differentiate in meaning by a single sound. For instance, a minimal pair for the process of consonant deletion would be the words “cow” and “couch.” This technique helps the child increase their awareness to the final sound and how that sound changes the meaning of the word. Your child will learn that using different sounds or deleting sounds changes the meaning of the word and increase their understanding of the sound rules of their language.

Target Productions

Once your child can fully discriminate and understand the differences between sounds, they can move to practicing productions. This part resembles that of articulation therapy, your child will practice target words, phrases, and sentences to eliminate their use of a phonological pattern. Depending on the phonological pattern, therapy targets and structure will differ.

For example, I had a child who would use the process of stopping. Meaning they would not use fricative sounds such as /f, v, s, z/ instead they would produce oral-plosive stops such as /p, b, t, d/. Once he was able to discriminate between the sounds and label them as a “windy” or “not-windy” sound (chosen by myself and the child along with the visual), I began targeted productions. There are many factors that go into the decision of which sounds to practice first or if you should practice all of them at once. For this particular case, I decided to practice speech for sounds /f, v/ first because the child was preschool age, sounds /f, v/ emerge developmentally earlier than /s, z/, and he was stimulable for those sounds (i.e. he could actually produce an /f, v/ given a model).

Intelligibility

Using few or several phonological patterns past a certain age will contribute to a child’s intelligibility. Intelligibility is how well a child is understood by others. If a child uses a lot of phonological patterns, chances are that their intelligibility will be lower because peers and adults will have difficulty understanding their speech.

Intelligibility is usually measured as a percentage, which refers to the amount that a listener understands the speaker. For instance, if a child spoke 100 words and was judged to be 25% intelligible, then that means the listener only understood 25 spoken words produced by the child within the entire 100 word conversation.

For reference, here is a table guideline for conversational intelligibility according to age to an unfamiliar listener (i.e. someone who does not interact consistently with the child).

Age

  • 1 year old
  • 2 years old
  • 3 years old
  • 4 years old

% Intelligible

  • 25%
  • 50%
  • 75%
  • 100%

TOP 5 Phonological Patterns treated by Speech-Language Pathologists

The following are the 5 most common phonological patterns used by children that receive speech and language services. I will provide some information about each pattern, the age by which it should be eliminated in English and Spanish, and ways to help eliminate use of the pattern past the appropriate age.

#1 Final Consonant Deletion

Final consonant deletion is a phonological pattern where children will omit the final consonant in a word. Typically this is seen in words referred to as CVC words by SLPs. CVC words are words such as cat, dog, mom, and dad. Phonology is different from the alphabet, therefore even though a word may have 4/5 letters it can still be considered CVC because it has 3 sounds. For example, “cake, couch, white” are considered CVC words because when we say them we are producing 3 sounds. The child who deletes the final consonant or “sound” will say things such as “cou” for “couch”, “ca” for “cake”, “da” for “dad”, and “whi” for “white.” Similarly in Spanish, they would say “sa” for “sal.”

All children use the phonological pattern of final consonant deletion when acquiring their speech and language skills. Both children speaking Spanish and English stop using the pattern of final consonant deletion by 3 years old. There are differences between English and Spanish in terms of what types of sounds can be produced at the end of a word. For instance, in Spanish only /n, d, s, r, l/ can be found in final position of a word whereas in English all sounds can be produced in final position with the exception of /h/.

Example (Final Consonant Deletion)

If your child is 4 years old and is still using the phonological pattern of final consonant deletion then that is no longer appropriate. You can consult an SLP to help eliminate the use of this process and you can also practice activities at home with your child. As previously mentioned, you can use pictures and words that differ only by one sound. You’d use words that have different meanings if you do not say the last sound such as “bow” and “boat.” You can play matching games with picture cards and have your child find what you say (e.g. find the “bow” or find the “boat”), if they point to the bow but you said “boat” then help them. You could say “No, that’s a bow! Bow. Find the boat. Boat” and emphasize the last sound. Remember do not have your child produce the words unless they can make the sounds you ask of them. A 4-year-old could say final sounds like /b, p, m, n, k, g, t, d/ very easily if they can use those sounds in other positions as well, but there are other sounds that they may not yet have because they develop later and that is okay!

#2 Consonant Cluster Reduction

Consonant cluster reduction is a phonological pattern where children will delete one of two consonants within a cluster in a word. Typically this pattern is seen at the beginning of words such as “spoon, train, plane” but can also occur in the middle or at the end of the word (e.g. hopscotch, boats). The child who reduces consonant clusters will say things such as “poon” for “spoon”, “pane” for “plane”, “hopcotch” for “hopscotch”, “boat” for “boats.” Similarly, in Spanish a child would say “puma” for “pluma.”

Generally, the child will produce the earlier developing sound within the consonant cluster and delete sounds /s, z, l, r/ but each child might vary in their production patterns. The majority of consonant clusters in English are composed primarily of letters /s, r, l/.  Given these are sounds that emerge later it may be difficult to differentiate whether your child has a phonological process disorder or an articulation disorder. The SLP would then assess whether your child can produce sounds in other positions and simply omit them when in combination with another sound.

All children use the phonological pattern of consonant cluster reduction when acquiring their speech and language skills. Children speaking Spanish eliminate the use of this pattern later than children speaking English. English speaking children stop using the pattern of consonant cluster reduction by 4 years old whereas Spanish speakers stop by 5 years old. This information is helpful when assessing bilingual children and verifying the use of phonological patterns in each language.

Example (Consonant Cluster Reduction)

If your English speaking child is 5/6 years old and is still using the phonological pattern of consonant cluster reduction then that is no longer appropriate. You can consult an SLP to help eliminate the use of this process and you can also practice activities at home with your child. After having completed the usual auditory discrimination and identification tasks. You can practice producing consonant clusters in words. One way to do so, is by first segmenting (separating) the sounds to emphasize the different sounds and then blending the sounds (saying them together). It is crucial to always say the blended word after having segmented the sounds or else you are giving a very robotic unnatural model.

For example, for the word “spoon”, I would have the child say “s” first and maybe even prolong it a few seconds “ssss” and then say “poon” so it would sound like “sssss-poon”, then I would produce it normally “spoon.” The child can then copy and practice. Make sure every sound is produced. Use a picture for the word and write it out, have your child point to each sound as they say it to help increase their awareness and then say all the sounds together into the blended word (e.g. “t-r-a-p” then “trap”). Be careful when using words with multiple letters that represent a single sound as it could be confusing for your child (e.g. “plane” has the final “e” so segmenting each sound would be odd, instead you could use the word “plan”). Easier and simpler written words are best for this activity.

#3 Fronting

Fronting is a phonological pattern where children will replace a sound made in the back of the mouth (velar position) /k, g/ with a sound made in the front of the mouth (alveloar position) /t, d/. The pattern is typically used in all position of words – initial (e.g. game/key), medial (e.g. kangaroo/baking), and final (leg/book). The child who uses the pattern of fronting will say things such as “tea” for “key”, “bating” for “baking”, and “led” for “leg.”  Similarly, in Spanish a child would say “tasa” for “casa.” Children who “front” use the incorrect tongue position – tongue tip up vs. back of the tongue up ( i.e. tip down).

All children use the phonological pattern of fronting when acquiring their speech and language skills. Children speaking Spanish eliminate the use of this pattern earlier than children speaking English. English speaking children stop using the pattern of fronting by 3 1/2 to 4 years old whereas Spanish speakers stop by 3 years old. This information is helpful when assessing bilingual children and verifying the use of phonological patterns in each language.

Example (Fronting)

If your child is 5 years old and is still using the phonological pattern of fronting then that is no longer appropriate. You can consult an SLP to help eliminate the use of this process and you can also practice activities at home with your child. Fronting can be tricky because of the awareness the child requires for tongue positioning. Some children catch on really fast and others need a lot of different feedback (auditory, visual, and tactile) to understand the correct pattern and tongue position. If your child has accurate discrimination between the sounds and is able to produce /k, g/ then a fun game to play is Go Fish with minimal pair cards. This activity is great to help generalize their skills at a higher level. For instance, when playing children have to ask “Do you have a _?” and say “go fish” to help them practice their /k, g/ sounds. If they say “Do you have a dame?” and meant “game” give them the dame and see if they realize their error. You can also say “I don’t have a dame but I do have a game” or if you don’t have the cards and are unsure of what he/she wants then ask “Did you want a dame or a game?” This activity will only be beneficial if children can correct themselves and use their target sounds correctly.

#4 Syllable Deletion

Syllable deletion (weak syllable deletion) is a phonological pattern where children will omit the weak or unstressed syllable in a multisyllabic word. In each language we place stress in different positions of words when producing multisyllabic words and stress changes the sound. For example, in the word “potato”, the first syllable is unstressed/weak so the written syllable “po” sounds like “puh” whereas the written syllable “to” sounds like “toe” and not “tuh” because of the stress. Therefore children that use this phonological pattern would say things like “tato” for “potato”, “nana” for “banana”, and “ephant” for “elephant.” Similarly, in Spanish, a child would say “sana” for “mansana.”

All children use the phonological pattern of weak syllable deletion when acquiring their speech and language skills. Children speaking Spanish eliminate the use of this pattern earlier than children speaking English. English speaking children stop using the pattern of weak syllable deletion by 4 years old whereas Spanish speakers stop by 3 years old. This information is helpful when assessing bilingual children and verifying the use of phonological patterns in each language.

Example (Weak Syllable Deletion)

If your English speaking child is 5 years old and is still using the phonological pattern of weak syllable deletion then that is no longer appropriate. You can consult an SLP to help eliminate the use of this process and you can also practice activities at home with your child. For children who delete syllables, I like to work on segmenting multisyllabic words first. By counting out the syllables in words, your child will also improve their phonological awareness skills.

For example, the word “banana” has three syllables. I would show a picture of a banana to the child and write out the word. Then we would say the word by segmenting the syllables while clapping the syllables out “ba-na-na.” I’d then say that banana has three syllables/parts and repeat the blended word “banana.” Then I’d show the child the picture again and ask “What is this?”, if they say “nana”, I’d say “Oops, I didn’t hear the whole word, there is a part missing, let’s try it again”, then  I’d clap it out again and say the blended word “banana.” After I’d ask “What is it?” again to see if the child could tell me “banana.” Remember! It is crucial to always say the blended word after having segmented the sounds/parts or else you are giving a very robotic unnatural model. You can do this activity for all multisyllabic words (e.g. tomato, computer, television, dinosaur), providing a visual and the written word as well as the tactile feedback from clapping/tapping out the parts of the word will be facilitate your child’s elimination of the pattern.

#5 Gliding

Gliding is a phonological pattern where children will replace sounds known as liquids /r, l/ with sounds known as glides /w, j/. The speech sound /j/ sounds like “y.” The pattern is typically used in all position of words – initial (e.g. red/lake), medial (e.g. boring/yellow), and final (bear/ball). The child who uses the pattern of gliding will say things such as “wed” for “red”, “yeyow” for “yellow”, and “baw” for “ball.”  Similarly, in Spanish a child would say “yosa” for “rosa.”

All children use the phonological pattern of gliding when acquiring their speech and language skills. Both children speaking Spanish and English stop using the pattern of gliding by 5 years old. However, in English, children acquire sound /r/ developmentally up until age 6-7 years old. Therefore, it is possible that they continue to produce /w/ for /r/ or omit /r/ entirely. Although, this becomes more of an articulation issue once the phonological pattern is eliminated.

Example (Gliding)

If your child is 6 years old and is still using the phonological pattern of gliding then that is no longer appropriate. You can consult an SLP to help eliminate the use of this process and you can also practice activities at home with your child. As previously mentioned, you can use pictures and words that differ only by one sound (i.e. minimal pairs). You’d use words that have different meanings if you do not say the liquid sound /l, r/ such as “wizard” and “lizard.” Once the child can fully discriminate between the sounds you can use a higher level task such as following directions using minimal pairs. For instance, using the pictures, you could have them do different actions or hide the cards by saying “Put the lizard on top of the sink and the wizard under the couch” and correct them if they picked the wrong cards. Just make sure beforehand that your child understands the direction and is able to follow it.

Treatment of phonological patterns can be time-consuming and must undergo several stages from discrimination to production. Therefore, it is always best to follow the recommendations set by your Speech-Language Pathologist. I hope you enjoyed this post and learned a bit more about phonology and phonological patterns! If you have any questions or want to share information please feel free to drop a comment below!