By what I now call ‘Possible Words Therapy’, the goal is to help the child say whatever word or words he or she wants to say, guiding him or her towards an understanding (not necessarily a conscious one) of what makes a word a word – perhaps helping to define something which is not well-enough defined. This is not defining in the sense of an entry in a dictionary, but knowing that there is sense in the question: “What was the last word you said?”

Possible Words Therapy is for children whose speech is hard to understand, taking account of their age and geneal aptitude. The benefit of this approach is that it seems to both speed up progress and allow this to continue more easily to point that there no detectable problem. This is comparing Possible Words Therapy to all comparable therapies that I know of, including ReST, seemingly derived from it. Like Possible Words Therapy, ReST uses polysyllabic forms, but with the focus on feedback and correction, rather than discovery by the child. The goal and effect by Possible Words Tharapy is ideally to try and achieve something clear and obvious by every trial and in the course of every session, such as a word said correctly for the first time. This ideal may not be possible. But it is useful to keep a sense of this as an ideal.

Possible Words Therapy is not for children with no speech at all or for children whose main problem appears to be with respect to a particular speech sound. who may be better served by the Nuffield Dyspraxia Program or NDP, or some version of it. But unlike the NDP, inspired by a very different theoretical background, Possible Words Therapy does not seek to work on the sounds one by one, but rather on the child’s speech system or phonology as a whole. Rather than being confusing for the child, the tasks are very simple, just to say one word at a time. It is for the therapist to keep a clear track in his or her mind where the therapy is going.

Intervention

Possible Words Therapy builds on work by William Holder (1669), John Thelwall (1812, 1814), and Alexander Melville Bell (1849, 1896). The child is given an organised sequence of ‘pseudo’ or ‘pretend’ words to repeat. When I developed Possible Words Therapy I did not know of my predecessors. I was just thinking for myself on the basis of a one year MA in Theoretical Linguistics. Holder, Thelwall and Bell do not elaborate on the detail. But Possible Words Therapy effectively updates their work in the light of current research. In Possible Words Therapy I make each trial different enough from the last to avoid confusion, but similar enough to make the sequence logical. As far as the child is concerned, each form is a possible word. The question of whether it is a real word appears to be irrelevant. He or she is being led towards a more complete and accurate notion of what counts as a word in the target language, in this case, English. I give each form just once with with only thanks and praise for whatever the child says. I generally give no correction, criticism or feedback if the repetition is not  quite right. Some children ask for just that. If they do, I give them as much feedback as they seem to be asking for. But (in a way that may seem surprising) the feedback does not seem to be critical. The degree of difference between one pretend form or ‘word’ and the next will of course, vary from child to child. But in a very significant way, children with any sort of difficulty in the formation of words tend not to detect the relations between the sound patterns of words – between, say, hippopotamus and HEPPOPUTAMUS, both with primary stress on the third syllable and a secondary stress on the first. The normally developing child of seven is clearly and easily able to hear the similarity between hippopotamus and HEPPOPUTAMUS. This is a typical defect with respect to what is known as ‘metalinguistic awareness‘ in children with speech issues. Such a defect is a characteristic and diagnostic co-morbidity.

In the course of a session, an appropriate sequence of pretend words might be anything from a dozen to several hundred items. The clinical aim is to minimise any stress for the child by ensuring that as far as possible every trial can be said correctly. Obviously this means starting somewhere ‘below’ the point at which an error is expected – by some informed guess-work. The learning (and this is different from learning in school) is from the structure in the sequence of the ‘words’. Typically as soon as a word can be said correctly once, the correct form is maintained. Very occasionally the child is aware of the change.

Nunes (2002) describes this technically and less technically and more briefly in 2006.

A tease

Children want to talk. just like they want to walk and run. I have yet to meet the child who doesn’t. In 1991, in the first phase of the experimentation here, seeing how normally developing children say some long and difficult words, as predicted, the variation was not random. Correctly detecting that this was not a game, as she had been told, but an experiment, she asked: What happens if I get it wrong? Not expecting such a searching question, I vainly tried to continue the pretence. She then said the target word hippopotamus with a series of errors I had never heard before or since. It is always fun for experimenters to be foxed by a smart child.

The subjects of experiments are entitled. I believe, to have their fun, to tease the experimenter. But incompetence is not fun.

Typicalities

It might seem that any consistent patterns in children’s errors represent ways of makling words easier to say,

Many children say magnet as MAGNIK. Here the back of the tongue articulation of the G is copied into the tongue tip T, turning into a K sound. The sounds contrast in their ‘voicing’, or the time relation between the release of the closure by the tongue. But the opposite is either rare, or it doesn’t happen. Children don’t say the word as MADNET, with the tongue tip articulation of the T copied into the back of the tongue G. It is not obvious that MAGNIK is easier than MADNET.

Many children say cardigan as KARDIDAN replacing the G by a D, in way that is easily understood with the same tongue tip / back of the tongue relations, but the other way round. Interestingly, many children who say cardigan as KARDIDAN have no difficulty with crocodile, where the K sound in the middle and the D differ with respect to what is known as the ‘voicing’. That small difference seems to be critical, making crocodile easier to say than cardigan.

Or cardigan may be said as KARDINTON. Not so much normal development, but more of an indication of something going wrong with the acquisition process. Here there seems to be a sequence of steps, first changing the G to a D, then changing the D to a T, and then copying the N one syllable to the left. Again, it is not obvious  how changing a D to a T and adding a sound in the middle of the word makes it easier to say,

Or suppose the child says cardigan not with a D at the beginning of the last syllable but with a sound vaguely like an L and the final sound vaguely like the final sound in ring. Here the G is clearly influencing the sound at the end, which is itself influencing the L appr0ximation at the beginning. Here the sound is not part of English. Even though the syllable is unstressed, such a pronunciation can be hard or impossible to understand unless the hearer knows or guesses what the word is supposed to be. Once, towards the end of a series of thirteen therapy sessions, I was able to get from this unintelligible form to a normally competent form in a single session.

In spaghetti, the child’s system may reject the SP at the beginning of an unstressed syllable before the stressed syllable. So the S is said at the beginning of the stressed syllable, the G becomes K‘ to match the voicelessness in its new neighbour, and the left behind P becomes B. The word is said as BASKETI. This might seem like a more familiar word. But in some children’s speech, as the S is moved, the initial unstressed vowel is left unrealised. And an initial cluster of PSK is formed in a pronunciation as PSKETI. Nobody would call this a natural way of making the word ‘easier to say’. But it has a natural analysis by a grammar which allows S to cluster only in the onset of the stressed syllable and disallows any unstressed vowels on the left edge. Some languages – like Georgian – seem to do just this. Children who say spaghetti as PSKETI have not realised that English is not one of them.

In hospital, competently pronounced, the tongue tip T at the beginning of the final syllable contrasts with whatever is left of the L sound. This is often characterised as ‘syllabic’ because it works as a stand-alone syllable without an independent vowel. In hospital as HOSTIPU, the T and P are reversed by what is known as ‘metathesis’. The tongue tip gesturing of the L is partially or completely lost in favour of a lip gesture, triggering a matching change at the beginning of the syllable. There might seem to be three steps here. First the lip-rounding of the final syllable is exaggerated. Second the lip action of the P is copied rightwards to the onset of the final syllable. Third, what is left behind at the start of the second syllable is a stop without a defined articulator. This is then said as a T.

Such characteristic incompetences (commonly, but I think wrongly, described as the ‘processes‘ of child speech) can be analysed with respect to fractionally incorrect sequences in the formation of words. Even some apparently complex errors like cardigan as KARDINTAN can be reduced to the effect of minor misstatements of general, independently justified principles. But if such phenomena persist, this is likely to attract comment, especially if they persist into adulthood.

The difficulty

Both the structures of syllables and the stress contours are unusually complex in English. The pathway to learning them is long and hard. The pathway gets increasingly intricate as it proceeds. Unsurprisingly some children struggle.

Beyond the clinic

It might seem that this promises only one, two or perhaps three newly correct pronunciations per clinical session. Not very satisfactory progress with a child of four, five or six whose speech is mostly incomprehensible, with thousands of mispronunciations needing to be corrected. But the progress goes beyond the work that is done in the clinic. By working around such structures, the child explores for him or herself the freedoms which exist. The newly resulting skills are highly transferable. And the speech improves exponentially – faster than by working on the ‘processes’ like the exchange of features between the G and the N in that child’s pronunciation of cardigan.

Thinking alike – and references

Unbeknownst to me, in the early 1980s Shulamith Chiat and her colleagues were looking at the relation between word stress and the replacement of T by K at the same time that I was starting to develop the approach to treatment described here. Brett, Chiat and Pilcher (1987) compare the realisations of common words and pretend words with various stress patterns. They conclude that the unfamiliarity of the pretend words does not bear on the pronunciation. Chiat (1987) identifies the key variable as the ‘foot’. There is a foot in the first two syllables of cardigan and hospital.

Summary

The key points here are guidance and discovery, as emphasised by Lada Aidarova  in her 1982 book, and by Aidarova’s one-time student, Galina Zuckerman, in private correspondence. Aidarova shows that the consciousness of words and meanings helps the development of reading and writing skills. By Possible Words Therapy the focus is on the child’s unconscious graso of how the phonology works. Possible Words Therapy is inspired and informed by the enormous research project of biolinguistics. It addresses what is not yet working correctly in the child’s mind.