INT J LANG COMMUN DISORD, MAY–JUNE 2012,VOL. 47, NO. 3, 345

Book Review

Interventions for Speech Sound Disorders in Children

Edited by A. LYNN WILLIAMS, SHARYNNE MCCLEOD

and REBECCA MCCAULEY

(Baltimore, MD: Paul H. Brookes, 2010)including a DVD of practical intervention techniques [Pp. 644.]ISBN 13:978-59857-018-2, ISBN-10:1-59857-018-8. £62.50

This book is aims to be give a comprehensive and contemporaryview of the evidence base for intervention in speech sound disorders(phonological difficulties, childhood apraxia of speech, dysarthriaand cleft palate are all included). Other recent books on the marketcover similar ground, and so it is important to emphasize whatthis volume does that is different and adds value for the reader.The Introduction and Conclusion by the authors are excellentsyntheses of the issues involved in intervention for these childrenand clearly explain the ethos of the book. The authors, in settingout the reasoning behind the organization, admit that it might notbe the model that every clinician would have in mind when theystart reading, but hopefully it is persuasive. The organization ofthis book is thus based around three sections. The first, ‘DirectSpeech Production Interventions’, encompasses seven approaches;the second, ‘Speech Interventions in Broader Contexts’, outlines 12approaches; and the third, ‘Interventions for Speech Movements’,has just four approaches. Each section begins with a summaryof the clinical reasoning and theoretical basis for the use of thetechniques included. A table (extending over several pages given that23 approaches are included in this book) summarizes the develop-mental level, the stage of production and the targeted outcomes foreach intervention. A very useful resource included with the book is aDVD giving practical demonstrations of almost every intervention.

One key feature is that each chapter follows the same layoutso that approaches can be directly compared for the three mainprerequisites for evidence-based practice (EBP): treatment efficacy,clients’ preferences and clinician expertise (Dollaghan 2007). Thereare also consistent subheadings that outline the theoretical andempirical basis for the intervention, target groups, the assessmentprocedure for determining the ‘relevance’ of the intervention andthe practical requirements including time demands. More usefullystill, each author considers their approach in terms of cultural andlinguistic diversity. The final part of each chapter comprises exemplarcase studies.

There is no room in a review to describe the contentof each chapter, but the approaches covered are mainly thosethat predominate in the extant research and practice literature.The first section on direct interventions includes chapters onminimal pairs, multiple oppositions, complexity approaches, corevocabulary, ‘cycles’ phonological remediation, the Nuffield dyspraxiaprogramme and a stimulability intervention. The second sectionincludes those interventions that impact on literacy and languageas well as direct work on meta-awareness and indirect environ-

mental approaches, e.g. a psycholinguistic model, metaphonologicalintervention, computer-based intervention, speech perception, non-linear phonology, dynamic systems and whole language, morphosyn-tax, naturalistic intervention for speech intelligibility, parents andchildren together (PACT), enhanced milieu training, PROMPT(tactual cued approach), and family-friendly intervention. The finalsection covers electropalatography, vowel intervention, developmen-tal dysarthria intervention and non-speech oral motor intervention.

The number of approaches covered is a feat in itself, but one hasto assess whether a surfeit of riches is in fact presented and that someoverlapping elements could have been synthesized as key featuresof a competent clinician’s essential ‘toolbox’ rather than presentedseparately. It also meant that each author justifies their own work tothe exclusion of other similar approaches. The final chapter suggeststhat, given the wealth of approaches covered in this book, clinicalpractice should begin by developing mastery in one well-developedintervention that ‘has been devised for the clients you serve andthe need(s) they have’ [p602] and then repeat the process as theclinician gains experience. (It would be important to say that clientsshould not be shoehorned into an approach simply because onehas done the course, however!) One approach from each categorywould be more likely to meet the need of a typical caseload andthat a good clinician should not have difficulty learning to masterboth indirect (context-based) and direct approaches for perceptionand production. A decision-making flow diagram might have helpedhere to enable clinicians to decide which approach(es) are most likelyto be appropriate for their needs. In the resumes some such criticalissues are raised, e.g. that approaches may not be totally mutuallyexclusive and the needs of the client may well change over time.

It is especially useful that the evidence base includes ‘timedemands’, i.e. the intensity of intervention required to producechange. It follows therefore that the level of resourcing availableto a clinician may mean that a highly appropriate technical approachmight have to give way to an approach that can be supported byother professionals and carers. The book, of course, highlights futuredirections not only for each intervention, but also for the professionin general. Overall, this book is certainly an excellent addition to theclinical practitioner’s and researcher’s bookshelf and it celebrates thetrue hands-on skills that speech and language therapists/pathologistspossess. Hopefully, it will help us to maintain and develop our veryspecial contribution to child wellness and development.

HILARY GARDNER

Department of Human Communication Sciences, University ofSheffield, Sheffield, UK

e-mail: h.gardner@sheffield.ac.uk

Reference

DOLLAGHAN, C. A., 2007. The Handbook for Evidence BasedPractice in Communication Disorders. Baltimore, MD: PaulH. Brookes.

International Journal of Language & Communication DisordersISSN 1368-2822 print/ISSN 1460-6984 online c© 2011 Royal College of Speech & Language Therapists

DOI: 10.1111/j.1460-6984.2011.00097.x