The case for morphophonological intervention: Evidence from a Greek-speaking child with speech difficulties

Intervention with children with speech and language difficulties has been proven beneficial compared with no treatment yet, knowing what type of intervention to provide remains a challenge. Studies of English-speaking children indicate that intervention targeting the production of morphological targets may have a positive effect on phonological aspects and vice versa. However, studies have not reported on generalization effects to untreated morphemes and little is yet known about morphological intervention in the context of a highly inflected language. The purpose of the current intervention case study was to investigate the effect of intervention in relation to phonological and morphological targets in Greek, a language characterized by complex inflectional morphology. A single subject research design was used with pre- and post-intervention assessment carried out. The participant was a four-year-old Greek-speaking boy with speech difficulties. The production of /s/, a phoneme used in multiple phonological and morphological contexts was targeted with alternating focus of intervention between phonological and morphological targets. Assessment took place at two levels: macro-assessment to monitor broad changes in speech; micro-assessment to measure therapy-specific changes in the production of treated targets and generalization to untreated targets and control items. There were four phases of intervention with a total of 24 hours of therapy. Significant improvement in performance accuracy was found between assessment scores immediately pre- and post-intervention. Intervention targeting the production of a phoneme in the word stem was not sufficient to accomplish the accurate production of morphemes requiring the same phoneme; intervention directly targeting morphemes was successful. Within-domain generalization was observed in both domains. Improved naming accuracy was observed post-intervention that was maintained at follow-up. The present study supports the case for morphophonological intervention. Morphological elements should be addressed in a comprehensive intervention for speech sound disorders.