Integrated approach on the acquisition of phonological targets in 4-to-6-year-old children


  • Lauren Kawasaki-Knight Blue Dove Rehabilitation, Inc.
  • Keith Wolgemuth Loma Linda University
  • Benjamin J. Becerra California State University


cues, self-cueing, integrated intervention, maximal opposition treatment approach, phonological processes


The purpose of this study was to examine the effects of an integrated approach on the acquisition of phonological targets in 4-to-6-year-old children enrolled in maximum oppositional therapy (MOT). MOT is an alternative approach to traditional phonological intervention designed to promote systemic changes to untreated phonemes from the same or different manner class.
Two groups of children 4 to 6 years of age underwent MOT treatment, with one of the groups also receiving concurrent training in the use of self-cueing strategies (using tactile gestures phonemic cues) to promote self-generated feedback. MOT targeted phonemes with maximal contrasts in placement, manner and voicing in two groups of children. One group also received instruction in the use of two tactile cues to self-monitor production of phonological targets. A comparison of therapy duration required to meet target acquisition criteria was made between the two groups.
MOT and tactile self-cues demonstrated larger gains in phonological target acquisition over a 10-week period. The tactile self-cueing MOT group achieved target accuracy in less time across three phonemic contexts. The integrated approach using MOT resulted in an increase in phonological accuracy, including untreated phonemes across manner of classes.
This study offers preliminary support and extends prior research of a novel integrated phonological intervention approach in clinical practice. The results suggest potential increases in phonological self-awareness and accuracy, reduced duration of intervention, and an increase in phonological target acquisition. Further research in this area is merited.

Author Biographies

Lauren Kawasaki-Knight, Blue Dove Rehabilitation, Inc.

Blue Dove Rehabilitation, Inc.

Speech and Language Services

Multi-lingual Clinical Director, Owner

Keith Wolgemuth, Loma Linda University

Loma Linda University

School of Allied Health Professions

Department of Communication Sciences and Disorders


Benjamin J. Becerra, California State University

California State University, San Bernardino

Jack H. Brown College of Business and Public Administration

Department of Information & Decision Sciences

Assistant Professor



How to Cite

Kawasaki-Knight, L., Wolgemuth, K. S., & Becerra, B. J. (2021). Integrated approach on the acquisition of phonological targets in 4-to-6-year-old children. Journal of Child Language Acquisition and Development-JCLAD, 249–283. Retrieved from



Research Articles