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Developing Morphological Awareness

the control words for two of the participants provides support for the internal validity of the study results. Data from postintervention HAPP-3 also support this claim. For two of the boys, although some decreases in phonological processes were evident in patterns that were not targeted during the intervention, the most significant decreases were evident in the targeted speech sounds. When considering data from these two levels of experimental control evident, the results are convincing that this intervention program led to significant increases in their ability to produce targeted speech sounds. The boys in this study had received a diagnosis of CAS; they all imitated natural speech, and AAC was not their preferred mode of communication. The ability to imitate has been shown to be a significant predictor of natural speech development. Because all the participants were imitators, it is unclear whether this type of treatment would be effective with populations of children who did not have imitation skills. Although there is growing evidence for the value of using integrated and multimodal interventions to target children’s speech production, clinical practice still seems to prefer targeting isolated skills one at a time. This study offers a systemic approach that clinicians can adopt to communicatively engage clients in a clinical setting and simultaneously provide diverse and repeated opportunities for treating speech sound production. Success of the IMI in this study required the researcher (a) to carefully select activities and meaningful target words for each child; (b) to function flexibly as a communication partner throughout the session; (c) to take advantage of the repeated use of treatment words across activities to model and draw attention to target speech sounds; and (d) to modify the child’s productions of those sounds in meaningful words. In this way, the IMI components should be seen as a clinical tool kit that clinicians can adapt to use within meaningful activities and with salient words designed for specific clients.