A multi-modal approach to intervention for one adolescent's frontal lisp

Abstract

An adolescent with a persistent frontal lisp participated in a two-part 11-session intervention case study. The first phase used ultrasound imagery and acoustic, phonetic and voice education to provide information about articulatory setting (AS) and general awareness of the speech production process. The second phase used traditional articulation therapy, online visual–acoustic biofeedback and fluency strategies to target the frontal lisp directly (specifically /s/, /z/, /ʃ/ and /ʧ/). Trained listener evaluations of pre-intervention, post-phase 1 and post-phase 2 assessments showed no improvement after phase 1, but notable improvement in all treatment targets immediately after phase 2. These improvements were substantially maintained at assessment 4 months post-intervention. The outcomes suggest that direct training was more effective than the AS approach; however, the client's ability to self-monitor in phase 2, rapid acquisition of the targets and maintenance at 4 months post-intervention possibly reflected the knowledge gained in phase 1 about AS.

Keywords:

• frontal lisp
• alveolar fricatives
• residual error
• articulatory setting
• phonological awareness
• spectrographic visual feedback
• self-monitoring, traditional articulatory therapy
• ultrasound
• adolescent

Acknowledgements

The authors thank the participant and his family, Bryan Gick, Penelope Bacsfalvi, Shelagh Davies, Linda Rammage, Haley Tsui and the anonymous reviewers who provided insightful comments on drafts of this article.

Declaration of Interest: The second author is a co-author of the test used for elicitation of single words, that is, the Computerized Articulation and Phonology Evaluation System (CAPES, Masterson & Bernhardt, 2001).