Firstly, if you see on your child's report that they have severely low intelligibility, I am not commenting on their cognition. Intelligibility ≠ Intelligence. Intelligibility does not directly refer to your child's IQ or academic skills. Rather, intelligibility is a functional measure that refers to the degree to which a listener can understand and comprehend a speaker's message on the first attempt. Intelligibility ratings will vary depending on the listener, the context of the conversation, and other factors. When considering possible goals for children with phonological disorders, I often prioritize the sounds or error processes which I believe will make the most impact on improving intelligibility quickly.
Why is it important to consider intelligibility?
1) It can increase opportunities for social interaction: A child who is more easily understood by peers will be more likely to initiate conversations and therefore have more opportunities to spontaneously build relationships with their peers.
2) It can increase opportunities to develop academic skills: A child who is more easily understood will be able to communicate their thoughts and knowledge in the classroom, and encourage positive experiences in the classroom. To illustrate this point, imagine the teacher points to the letter "G" on the board and asks the class to raise their hands if they know the name of the letter. A child who produces all of the speech sounds easily is likely to raise their hand if they know the answer. However, a child with decreased intelligibility may consider first if they think they will be understood before responding to the question. They may think: "well when I say 'G,' it sounds like a 'D' even though I know in my own head they aren't the same" which may result in the child choosing not to respond to avoid being "wrong" and result in frustration or withdrawal from these type of classroom conversations. This example illustrates how phonological skills can impact reading instruction.
What factors impact intelligibility?
- number/frequency of speech sound errors
- type of speech sound errors
- consistency of speech sound errors
-vowel distortions
- rate of speech (especially fast speech)
- abnormal prosody (intonation)
- length and leinguistic complexity of the utterance
- insufficient vocal intensity (too quiet)
- Other voice factors such as dysphonia, hyper or hyponasality
- severe disfluencies that disrupt the context
- presence or lack of gestures and other paralinguistic features
-lack of syntactic or morphological features that disrupt context
-environment (a client may feel more comfortable speaking at home than at a hospital for instance)
- clinician's ability to understand disordered speech
- familiarity of the listener to the specific person
- fatigue
How intelligible should my child be?
Age
19-24 months: 25-50%
2-3 years: 50-75%
4-5 years: 75-90%
5+: 90-100%
Pediatric speech therapy aims to improve speech clarity, accuracy, and overall communication skills to enhance a child's ability to be understood by others. By addressing factors such as articulation, phonological processes, prosody, and language skills, speech-language therapy is key in helping a child reach their goals for clear communication. If you have concerns about your child's intelligibility and how it impacts their daily life, please reach out for your free phone consultation or email me at rachelhomzaslp@gmail.com. We can discuss if your child would benefit from a speech-language evaluation. I am available immediately for telehealth appointments for families in Florida, Georgia, and Michigan, but if you are from outside those states, I would love to hear from you too, and may be able to refer you to another therapist who is licensed in your state!
Sources:
Lanza, J. R., & Flahive, L. K. (2008). Guide to communication milestones: Concepts, feeding, morphology, literacy, mean length of utterance, phonological awareness, pragmatics, pronouns, questions, speech sound acquisition, vocabulary. LinguiSystems.
Shipley, K. G., & McAfee, J. G. (2021). Assessment Procedures Common to Most Communicative Disorders. In Assessment in speech-language pathology: A resource manual (Sixth Edition). essay, Plural Publishing, Inc.
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