Using Developmental Norms for Speech Sounds as a Means of Determining Treatment Eligibility in Schools

Purpose: For a child to receive treatment of a speech sound disorder in public schools, the child must demonstrate evidence of an exceptionality in producing speech sounds. One method advocated by some state or local guidelines is to use developmental norms for speech sounds to define impaired speech. However, current practices, as codified in state or local guidelines, may not be encouraging optimal use of this data source. The purpose of this article is to outline best practices in using developmental norms to determine eligibility for speech treatment in school settings. Method: Three commonly used sets of developmental norms (Sander, 1972; Shriberg, 1993; Smit, Hand, Freilinger, Bernthal, & Bird, 1990) are reviewed to generate best practices in the use of developmental norms to establish eligibility for speech treatment in schools. Three clinical scenarios then are used to illustrate implementation of these best practices. Results: The review of the normative studies indicates that a strict age cutoff used in isolation is counter to the intended use of developmental norms, representing a conceptualization of normal development that is too narrow. Best practice entails using a richer representation of development, specifically reflecting the range and variability inherent in development. Moreover, diagnosing the presence of a speech sound disorder requires more than just a single measure. Conclusion: Clinicians may need to advocate for change in state or local guidelines to better align these guidelines with best practices in using speech sound norms to determine eligibility for services in schools