1. Virginia Burnside CD 601

2. Erin F. is a 4 year, 3 month old female that has a moderate-severe phonological disorder. She has received speech and language services at MUSHC since September 2012. Beginning in the spring semester of 2013 a maximal opposition approach was selected for Erin and has continued to this day. Minimal progress with this approach has occurred over this timeframe.

3. For preschool aged children with phonological processes does maximal opposition or multiple opposition have a greater effect on suppressing phonological processes?

4. Inclusion Inclusion Exclusion Phonological disorders Preschool aged children Maximal opposition Multiple opposition Suppressing phonological processes Adults Elementary school aged children and up Articulation Disorder Childhood Apraxia Hearing impairments

5. Databases Search Terms EBSCO: Host, ASHA, World Cat, Google Scholar, Cochrane Reviews, Academic Search Premier, ERIC, PubMed phonology, phonological disorders, preschool, preschool aged, maximal opposition, multiple opposition, phonological processes, intervention, intervention strategies of phonological disorders, treatment efficacy, speech sound disorders

6. Title Review: 24 Abstract Review: 9 Articles included: 5

7. Ib Allen, M. M. (January 01, 2013). Intervention efficacy and intensity for children with speech sound disorder. Journal of Speech, Language, and Hearing Research : Jslhr, 56,3, 865-77. IIa Pagliarin, K. C., Mota, H. B., & Keske-Soares, M. (January 01, 2009). Therapeutic efficacy analysis of three contrastive approach phonological models. Pró-fono : Revista DeAtualização Científica, 21, 4.) IIb Gierut, J. A. (January 01, 1989). Maximal opposition approach to phonological treatment.The Journal of Speech and Hearing Disorders, 54, 1, 9-19. Gierut, J. A. (January 01, 1990). Differential learning of phonological oppositions. Journal of Speech and Hearing Research, 33, 3, 540-9 III Ceron, M. I. & Keske-Soares, M. (2011). Phonological changes obtained in the treatment based on the multiple opposition approach. Revista CEFAC, 15(2), 314- 323.

8. Each study found maximal opposition and multiple opposition to be successful in select ways. In regards to maximal opposition, my investigation found it was effective in changing and improving the phonological system. Further research determined maximal opposition lead to greater improvement in production of treated sounds, more additions of untreated sounds and fewer changes in known sounds. Additionally, multiple opposition was found to be valuable in the increase of both the phonetic and phonemic inventories. As well the inquiry found multiple opposition to be most effective in a more intense frequency (3 times a week). Lastly in the study that compared both approaches, all approaches were effective in the treatment of phonological disorders however, multiple opposition most favored the acquisition in the phonological system. Whereas, maximal opposition acquired a great number of sound the phonetic inventory.

9. Only one study compared both maximal and multiple opposition Many studies required payment to access Searched many databases without success Some studies outside the United States

10. Research shows both maximal opposition and multiple opposition are effective in suppressing phonological disorders. In the study comparing both approaches, Multiple Opposition had the best performance in the acquisition of sounds in the phonological system.

11. Maximal opposition and multiple opposition should both be taken into consideration when deciding on an approach, seeing as there is limited research that determines the more efficient intervention. When determining an approach keep the clients individual characteristics in mind. It should be noted that further research must be conducted comparing the different interventions used for treating phonological disorders.

12. Allen, M. M. (January 01, 2013). Intervention efficacy and intensity for children with speech sound disorder. Journal of Speech, Language, and Hearing Research : Jslhr, 56,3, 865-77. Pagliarin, K. C., Mota, H. B., & Keske-Soares, M. (January 01, 2009). Therapeutic efficacy analysis of three contrastive approach phonological models. Pró-fono : Revista DeAtualização Científica, 21, 4.) Gierut, J. A. (January 01, 1990). Differential learning of phonological oppositions. Journal of Speech and Hearing Research, 33, 3, 540-9 Gierut, J. A. (January 01, 1989). Maximal opposition approach to phonological treatment. The Journal of Speech and Hearing Disorders, 54, 1, 9-19. Ceron, M. I. & Keske-Soares, M. (2011). Phonological changes obtained in the treatment based on the multiple opposition approach. Revista CEFAC, 15(2), 314-323.