A Psycholinguistic Framework for Diagnosis and Treatment Planning of Developmental Speech Disorders

Abstract

Background: Differential diagnosis and treatment planning of developmental speech disorders (DSD) remains a major challenge in paediatric speech-language pathology. Different classification systems exist, in which subtypes are differentiated based on their theoretical cause and in which the definitions generally refer to speech production processes. Accordingly, various intervention methods have been developed aiming at different parts of the speech production process. Diagnostic classification in these systems, however, is primarily based on a description of behavioural speech symptoms rather than on underlying deficits.

Purpose: In this paper, we present a process-oriented approach to diagnosis and treatment planning of DSD. Our framework comprises two general diagnostic categories: developmental delay and developmental disorder. Within these categories, treatment goals/targets and treatment methods are formulated at the level of processes and rules/representations.

Conclusion: A process-oriented approach to diagnosis and treatment planning holds important advantages, offering direct leads for treatment aimed at the underlying impairment, tailored to the specific needs of the individual and adjusted to the developmental trajectory.

Keywords: Differential diagnosis; Speech development; Speech disorders; Treatment planning.

Fig. 1

Adult model of speech processing [33, 34] (adapted from Levelt [39, 51], Van der Merwe [40, 50], and Guenther [45, 53]), displaying the sensorimotor and memory functions involved in speech production and perception.