PACT: Parents and children together in phonological therapy

PACT (parents and children together) is a broad-based intervention approach for children with phonological impairment, which involves the participation of caregivers in therapy. Its components are: Parent Education; Metalinguistic Training; Phonetic Production Training; Multiple Exemplar Training (minimal pair therapy and auditory bombardment); and Homework. Accommodating to the gradual nature of phonological change in typical development, PACT therapy is delivered in planned therapy blocks and breaks from therapy attendance, during which parents continue aspects of the therapy. A review of literature relevant to the theoretical underpinning, development and evaluation of PACT is provided, and unique features of the approach are highlighted. The processes of speech assessment using parent-observed screening, independent and relational analyses, treatment planning and scheduling, and target selection and goal-setting are presented and discussed in the context of Jarrod, a 7 year old boy with a severe, inconsistent phonological impairment. Difficulties in applying the PACT approach with Jarrod are noted, principally that PACT is most suited to the three to six year age-group. Alternative intervention approaches are suggested.

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