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Arnold School of Public Health

A Comparison of Articulation Interventions

Funding: American Speech-Language Hearing Association Advancing Academic-Research Careers Award (PI: Werfel)

According to the American Speech-Language-Hearing Association, an articulation disorder is defined as “the atypical production of speech sounds characterized by substitutions, omissions, additions or distortions that may interfere with intelligibility” (ASHA, 1993). Individuals with persistent articulation disorders (i.e., those that continue past age 5 or 6) are at higher risk for later literacy impairments than individuals with no history of articulation disorder or whose articulation disorder has resolved (Raitano et al., 2004). Importantly, articulation therapy is effective at improving speech sound errors (e.g., Sommers et al., 1967).

Traditional articulation therapy utilizes flashcards in to display pictures of stimulus words for teaching particular sounds. With the recent rise in popularity of tablets, such as the iPad, speech-language pathologists have shifted to utilizing such technology to display pictures of stimulus words in therapy. However, the use of tablets in articulation therapy has not been adequately evaluated. This study evaluates the effect of therapy modality on children’s gains in speech sound production during articulation therapy.

We found that all children met mastery on all sounds using either modality within a short period of time. Three of the four children met mastery faster in the flashcard condition; however, overall performance was higher in the tablet condition. This finding was driven by the one child who met mastery faster in the tablet condition. We conclude that SLPs can be confident in using either high-tech or low-tech modalities in speech sound intervention and that most children may make faster progress with low-tech flashcards. 


Impact: This study provided knowledge about the efficiency and effectiveness of different modalities of articulation interventions.


Werfel, K. L., Brooks, M. C., & Fitton, L. (2019). The comparative efficiency of speech sound interventions that differ by delivery modality: flashcards versus tablet. Communication Disorders Quarterly, OnlineFirst, 1-9. doi: 1177/1525740119859520 Infographic


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