Parent Information Handout

Multiple Oppositions Therapy

What is Multiple Oppositions?

The goal of Multiple Oppositions is quite simple. Children will learn the function of
phonology, or the sounds that have meaning, by providing a large contrast between
the production of target sounds in place, manner and voicing.

Why is my child receiving Multiple Opposition therapy?

Your child is likely receiving Multiple Opposition therapy because they are between
the ages of 3 and 6 years old, have a limited sound inventory and may require extra
assistance in language or reading. Your child may also be exhibiting phonological
collapse. Phonological Collapse is the fancy name for substituting multiple sounds
for one sound. For example: Your child may use /t/ in the place of /s/, /h/, /tr/ and /k/.

What does this approach look like at school? Am I, the parent, involved?

Your child is receiving MO therapy with a licensed Speech Pathologist. They are
seen twice a week for 30-45 minutes depending on the clinicians caseload. There is
generally between 21-42 sessions (10-21 weeks). MO is set up in a way that your
child must achieve a certain criterion of mastery before continuing with the program.
There are 4 active phases in Multiple Oppositions:
o Phase 1: Familiarization and Production of the Contrasts
o Phase 2: Production of the contrasts and interactive play
o Phase 3: Production of the contrasts with communicative contexts
o Phase 4: Conversational recasts
When training your child with Multiple Oppositions they must achieve 70% accuracy
of correct productions across 2 sets to move to phase 3. In order to move to phase 4
your child must achieve 90% accuracy across 2 contrastive training sets. A
generalization probe (is the training sticking with my child without feedback) is used
with 10 untrained words. If the child gets 90% on the 10 untrained words we change
the stimuli given and start with phase 1.
You as the parent are involved in therapy. It has been proven in research studies
that at home practice promotes generalization of the stimuli and therefore your child
will move through the protocol quicker (acquire more sounds at a faster rate).

What does the research say about this approach?

Chris Goodman and Amanda Kidd

3rd Year Advanced Speech Sound Disorders
 Researchers have studied this therapy approach in depth. Overall, they have
concluded that in order to make the most gains the clinician and treatment should do
the following:
1. Clinician must adjust treatment based on the needs of the child receiving the
therapy.
2. The more sever phonological delay the child presents with the more intense
therapy or intervention should be.
3. The overall goal of this approach is for the acquisition of sounds to generalize
into all environments.
4. Parents play an important role. Without parent buy-in there is likely to be a
slower gain in sounds due to decrease in at-home practice.

As the parent what can I do to help my child succeed away from the therapy environment?

Do not be afraid to ask the clinician what they are doing in therapy. A good clinician
will educate you, the parents, on what is happening in therapy if they want their
treatment to generalize. Here are some things that we recommend doing at home:
1. Use a variety of games to elicit target sounds from therapy!
2. Play with your child and elicit the target sounds and their contrasts make
sure to give feedback on correct and incorrect productions.
3. Ask your childs SLP to make copies of stimulus cards for each new target
sound(s).
You can also create pictures from Google Images and create cards
yourself!

References:

Allen, M. M. (2013). Intervention efficacy and intensity for children with speech sound disorder.
Journal of Speech, Language, and Hearing Research, 56(3), 865-877.

Williams, A. L. (2012). Intensity in phonological intervention: Is there a prescribed amount?.

International journal of speech-language pathology, 14(5), 456-461.

Williams, A. L. (2000). Multiple oppositions: Case studies of variables in phonological

intervention. American Journal of Speech-Language Pathology, 9(4), 289-299.

Chris Goodman and Amanda Kidd

3rd Year Advanced Speech Sound Disorders