A 4-year-old child presents with general speech patterns including liquid gliding, stridency deletion, final-consonant deletion, and consonant-cluster reduction. The most appropriate recommendation is to

• A. Treat immediately only if there is no improvement next year
• B. Focus treatment on /p/ since it is early-acquired
• C. Use a phonological approach and focus on final consonants first
• D. Counsel parents to read aloud and support correct repetitions without formal treatment

Answer: (C)

When a child shows several pattern-based simplifications, address the system rather than individual sounds. This is a phonological approach, which targets the underlying patterns that drive how the child simplifies speech across many words.

In this case, final-consonant deletion and consonant-cluster reduction are two patterns that distort syllable structure and intelligibility, along with other substitutions like liquid gliding and stridency deletion. Starting with final consonants first makes sense because restoring the final sound helps rebuild the usual word shapes (CV, CVC, CCV, etc.) across a wide range of words. Once final consonants are more consistent, the child is better positioned to tackle clusters and later get others like liquids more accurately. This approach yields broader, more efficient progress than trying to fix one sound in isolation.

So, choosing a phonological approach and focusing on final consonants first aligns with how multiple patterns are most effectively remediated and generalized in everyday speech.