By 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?”

The effect is ideally to try and achieve something clear and obvious 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.

The key points here are guidance and discovery, as emphasised by Lada Aidarova  in her 1982 book. She shows that the consciousness of words and meanings helps the development of reading and writing skills. As emphasised by Aidarova’s one-time student, Galina Zuckerman, in private correspondence, the key points by Aidarova’s approach are guidance and discovery.

Intervention

Possible Words Therapy builds on work by William Holder (1669), John Thelwall (1812, 1814), and Alexander Melville Bell (1849, 1896), giving the child a sequence of pretend words to repeat. None of them elaborate on the detail. By my interpetation of this idea, I make each trial different enough from the last to avoid confusion, but similar enough to make the sequence logical. I give each form just once with with only thanks and praise for whatever the child says, giving no correction or critical feedback if the repetition is not  quite right, unless the child explicitly asks for this – as some children do. 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 able to hear the similarity beteween hippopotamus and HEPPOPUTAMUS. This is a typical aspect of what is known as ‘metalinguistic awareness‘. A defect here is one of the most characteristic co-morbidities in children’s speech and language disorders.

By Possible Words Therapy, each form given to the child to say is a possible word. The question of whether it is a real word or not appears to be irrelevant. As far as the child is concerned, 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.

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 is 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. I once involved a normally-developing small relative in an experiment saying some long and difficult words. The idea was to measure the variation in the incompetences. Correctly detecting that this was not a game, as she had been told, but an experiment, she asked: What would happen if I got it wrong? Not expecting such searching interrogation, 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.

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

Typicalities

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.

Many children say cardigan as KARDIDAN replacing the G by a D, in way that is easily understood. Interestingly, many children who say cardigan this way 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.

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. Even though the syllable is unstressed, such a pronunciation can be hard or impossible to understand unless the hearer happens to know in advance or be able to guess 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, 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 that I was starting to develop the approach to treatment described here – what I now call ‘Possible Words Therapy’. Brett, Chiat and Pilcher (1987) compare the realisation of common words and nonsense words with various stress patterns. They conclude that the unfamiliarity of the pseudo words does not bear on the pronunciation. Chiat (1987) identifies the key variable is the ‘foot’ in the first two syllables of cardigan and hospital. Possible Words Therapy is quite different from the approach by ReST, also using polysyllabic forms, but with the focus on feedback and correction, rather than discovery by the child.

Summary

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. The behaviour corrects itself.