The use of facilitative vowel contexts in the treatment of post-alveolar fronting: a case study


Address correspondence to: Stephanie F. Stokes, Psychology, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia; e-mail:


Background: School-aged children with persisting speech sound disorders (SSDs) may show little improvement in speech accuracy following phonological or articulation therapy.

Aims: To determine the effects of establishing consonant production in facilitative vowel contexts for a 7-year-old boy (CD) with persisting post-alveolar fronting. CD had received phonological awareness therapy and traditional articulation therapy as part of a community caseload. However, his post-alveolar fronting showed resistance to therapy.

Methods & Procedures: CD received individual therapy for nine 45–55-min sessions. A checklist of quality indicators for single-subject research was used to explore the likelihood that a community clinic could meet quality indicators. Fifteen test words in each of target, generalization and control sets were measured at five times pre-, during and post-therapy. A trend analysis was used to measure the statistical significance of the results and to demonstrate the efficacy of therapy.

Outcomes & Results: Therapy was successful. Gains on treatment and generalization test items were rapid and significantly higher than gains on control test items. Only three of 21 single-subject research quality indicators were not met in this research.

Conclusions & Implications: Targeting facilitative vowel contexts was successful for this 7-year-old boy with persisting post-alveolar fronting which had been resistant to other therapy techniques. Speech and language therapists are encouraged to ensure that quality indicators for single-subject interventions are built into regular practice.