It is important to reassess the child’s speech after your block of therapy to determine whether the consonant cluster you chose triggered the changes we predicted.You will still likely have to provide many cues (e.g., placement cues, metaphors etc.) at the start of therapy to help the child learn a new, complex consonant cluster.Remember, not all children are ready to tackle something that is hard! Signs that this approach may not be best suited for your child include: refusal to copy words or participate in therapy, saying, “this is too hard” or “I can’t do it” over a number of sessions, withdrawing from consecutive sessions. I generally choose this approach for children with more resilience and perseverance.This means less time in therapy for these children!! I have seen significant changes and increases in intelligibility in clusters that I did not teach “appear” on their own. I generally target one or two complex clusters in a block of therapy (approx.In simple speech therapy terms: sounds and structures you have not targeted or worked on can “come through on their own” because we have triggered this change! So even if it “feels” counterintuitive to practice something really hard, the evidence shows that carefully selecting AND prioritizing complex targets (e.g., “fl” or “str”) can facilitate or trigger a greater system-wide change in both complex AND less complex sounds and structures. So when I learned about the theory and the principles, namely that we target complex structures (think 3-element clusters), often later developing or non-stimulable sounds… I’ll be honest, I had my doubts.īut here’s the thing: there is strong and continually growing evidence on the effectiveness of using the complexity approach to treat children with phonological impairments.

When I trained to become a speech-language pathologist, the Complexity Approach was never even mentioned in my speech sound disorders course.

Phonological processes chart asha