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Multiple Oppositions Therapy Overview

Sep 23, 2025

Overview

This lecture covers the Multiple Oppositions approach for children with speech sound disorders, focusing on practical implementation, target selection, dosage, generalization, and tools.

Introduction to Multiple Oppositions

  • Multiple Oppositions is a therapy approach for children with extensive sound errors and phoneme collapses.
  • It is ideal for children who substitute one sound for many, rather than just isolated errors.
  • Children with milder errors or only a few error patterns may benefit from minimal pairs therapy instead.

Target Selection and Phoneme Collapse

  • Multiple Oppositions requires choosing up to four target sounds maximally different from each other and from the child’s error.
  • "Distance metric" involves selecting sounds with the greatest phonetic distance for optimal learning.
  • Tools like phoneme collapse worksheets and place-voice-manner charts help systematically organize errors and targets.
  • Collapses are analyzed vertically by manner (stops, fricatives, etc.), place, and voicing.

Treatment Implementation

  • Therapy contrasts the child’s consistent error with each target sound (e.g., "dee" vs. "key," "dee" vs. "chee," etc.).
  • Treatment phases start with imitation, then progress to spontaneous production and conversational activities.
  • Therapy should address both articulation (production) and phonological (rule) aspects of speech.

Dosage, Generalization, and Tools

  • Aim for 50-60 practice trials in 30 minutes; minimum is 100 trials per session where possible.
  • Both narrow (untrained words) and broad (conversational speech) generalization should be measured.
  • Data sheets and digital tools/apps (like the SKIP app) can track progress and generate word lists.
  • If a child cannot produce a target sound, use tailored articulation practice (e.g., 20 CV repetitions) before reintroducing oppositions.

Parent and School Involvement

  • Parent and teacher training, explicit instructions, and resource sharing improve home/school practice.
  • Short videos or written communication can help support home practice when regular therapy isn’t possible.

Key Terms & Definitions

  • Multiple Oppositions — An intervention contrasting one error sound with multiple target sounds at once.
  • Phoneme Collapse — When a child substitutes one sound for several target sounds.
  • Distance Metric — The method of selecting targets maximally different from the error and each other.
  • Generalization — Carryover of correct production to new words or spontaneous speech.
  • Narrow Generalization — Correct production in untrained probe words.
  • Broad Generalization — Correct production in spontaneous conversational speech.

Action Items / Next Steps

  • Review phoneme collapse worksheets and place-voice-manner charts for target selection.
  • Access the SKIP app or similar tools to streamline word list generation and data tracking.
  • Aim for at least 50-60 practice trials per 30-minute session.
  • Train parents and teachers with explicit guidance and use digital resources as needed.
  • Consult provided supplemental materials and research articles for further details.