JCPSLP Vol 21 No 2 2019 DIGITAL Edition

Second, SLPs used acquisition norms alongside other factors, when making decisions relating to the management of the velar stop sounds, namely: impact on intelligibility, stimulability, functionality, and literacy; and the presence of other speech errors. Third, remediation of /k/ and /g/ was perceived by SLPs as complex and variable, often involving the interplay of articulation and phonology. There were echoes of Stoel- Gammon (1996) who observed that velars may have a unique developmental pathway, from being absent from the phonetic repertoire, to irregular production in particular syllable positions, to adult-like production. See also MacLeod and Glaspey (2014) and Dyson and Paden (1983) for comparable findings. Such variability points to the importance of SLPs’ clinical experience or “internal evidence” (Dollaghan, 2007) in clinical decision-making. Fourth, 50% of the survey respondents and all in the focus group agreed with the proposal that /k/ and /g/ become established later than age-norms indicate, with some of those surveyed thinking that /k/ and /g/ may be acquired between 3;6 and 4;11 (cf. the 2;1 to 3;6 range for Australian children of Chirlian and Sharpley (1982); Kilminster and Laird (1978); and McIntosh and Dodd, 2008). This has both clinical and research implications because if the velar stop sounds are acquired later than norms suggest, then decisions relating to target selection, diagnosis and treatment goals may need to be reconsidered. More normative research may be required to substantiate this anecdotal report. Contrastingly, although some clinicians are of the view that the velar stop sounds may be acquired later than norms suggest, they are also suggesting that the sounds are ideally best treated by school age, or they become potentially harder to treat. Clinicians are therefore having to draw on all arms of the E3BP model (Dollaghan, 2007) when making clinical decisions around SSD. Another point for consideration is that clinicians who are often working with children that have delayed speech may have a skewed perception of what is considered “typical”. This may impact on the view that acquisition of the velar stop sounds may be later than norms suggest, and future research could focus on this phenomenon specifically. Fifth, there was general agreement about the value of norms in managing SSD, as attested by McLeod and Baker (2014), in relation to evaluation/assessment of speech production and acquisition, decisions relating to diagnosis and the nature and severity of the disorder, as well as around target selection for treatment. The participants saw that norms also had a role in early detection of SSD and instating timely intervention, thereby potentially avoiding potential negative implications relating to intelligibility, phonological awareness, literacy and ultimately social and cognitive well-being (Bryan, 2004); academic performance and vocational success (Ruben, 2000). Limitations This small study reflected the views of SLPs across three Australian states, and predominantly from NSW, so does not comprehensively reflect the views of Australian SLPs working with children with SSD generally and velar stop acquisition specifically, pointing to the need for more embracing Australia-wide research, with multiple focus groups. Our emphasis was on /k/ and /g/ acquisition by monolingual Australian children, but given this country’s multicultural demographics, future studies might well incorporate a more culturally and linguistically diverse agenda. Finally, this article has summarised only some of

the available normative data, and the authors acknowledge that this summary is not exhaustive. There are other normative data available that clinicians can and do draw on when making clinical decisions in relation to SSD (e.g., the early, middle, and late 8 sounds proposed by Shriberg (1993)). Conclusion Highlighting the need for further research into normal velar stop development, we provide preliminary data, drawn from Australian SLPs’ perceptions of normative data and issues in managing /k/ and /g/ acquisition. The SLPs reported that although they appeared unrealistic and contextually irrelevant, norms for speech sound acquisition were useful in guiding clinical decisions; that /k/ and /g/ may establish later than available norms indicate; that acquisition of these stops is variable; and that persistent velar fronting may be difficult to treat, especially if not “caught” early, before the advent of reading instruction. Overall, this preliminary research highlights not only what some clinicians think about the available normative data, but also how they are using the norms. That is, clinicians are using the E3BP model and thinking about their clinical experience, client preferences in addition to the available research evidence. Acknowledgments and declaration The authors, who have no conflict of interest to declare, sincerely thank our part 1 and part 2 SLP participants. References Arlt, P. B., & Goodban, M. T. (1976). A comparative study of articulation as based on a study of 240 normals, aged three to six. Language, Speech & Hearing Services in Schools , 17–280. Baker, E. (2004). Phonological analysis summary and management plan. Acquiring Knowledge in Speech, Language and Hearing , 6 (1), 14–18. Bowen, C. (2015). Children’s speech sound disorders (2nd ed.). Oxford: Wiley-Blackwell. Bryan, K. (2004). Preliminary study of the prevalence of speech and language difficulties in young offenders. International Journal of Language & Communication Disorders , 39 (3), 391–400. Chirlian, N. S., & Sharpley, C. F. (1982). Children’s articulation development: Some regional differences. Australian Journal of Human Communication Disorders , 10 (2), 23–30. Creswell, J. W. (2009). Research design: Qualitative, quantitative, and mixed methods approaches . London: Sage Publications. Dollaghan, C. (2007). The handbook for evidence-based practice in communication disorders . Baltimore, MD: Paul H. Brookes. Dyson, A., & Paden, E. (1983). Some phonological acquisition strategies used by two-year-olds. Journal of Childhood Communication Disorders , 7 (1), 6–18. Ezzy, D. (2013). Qualitative analysis: Practice and innovation . Crows Nest: Allen & Unwin. Gierut, J. (2005). The how or the what? . In A. Kamhi & K. Pollock (Eds.), Phonological disorders in children: Clinical decision making in assessment and intervention (pp. 109–120). Baltimore, MD: Paul H Brookes. Grunwell, P. (1997). Natural phonology. In M. Ball & R. Kent (Eds.), The new phonologies: Developments in clinical linguistics (pp. 35–77). San Diego: Singular.

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JCPSLP Volume 21, Number 2 2019

Journal of Clinical Practice in Speech-Language Pathology