What is Cycles Approach?
The cycles approach, also officially known as the Cycles Phonological Remediation Approach , was designed to facilitate the development of intelligible speech patterns in children. It is one of the most common methods to treat preschool- and school-age children who use phonological processes, meaning error patterns, in speech.
Phonological processes are patterns of sound errors that are usually used by developing children as they are learning to talk, and they are a means to simplify the speech.
Barbara Hodson and colleagues developed this process based on over 30 years of clinical practice and research on cognitive psychology and developmental phonology. The approach is specifically designed for children with highly unintelligible speech. It has also been used to treat children with childhood apraxia of speech (CAS).
During the cycles approach, the therapist treats the phonological processes, meaning the error patterns, in the child’s speech. By targeting each phonological process for a short and fixed amount of time and then cycling through other phonological processes, cycles approach targets children who use a lot of error patterns in their speech and correct them. This approach is implemented over and over again for each process, until it is eliminated from the child’s speech.
When to Consider Using Cycles Approach
Cycles approach to speech therapy is specifically designed and used for children who use many phonological processes in their speech. You may want to consider utilizing cycles approach to speech therapy if your child:
- Is highly unintelligible in their speech, meaning that they are difficult to understand
- Doesn’t use many different consonant sounds
- Leave out speech sounds
Cycles approach is suitable for mid and moderate defects in speech, such as some omissions and substitutions. It can also be used to treat severe and profound defects where the child has extensive omissions and many substitutions in speech patterns.
It is important to do research and consult professionals before deciding on any approach to speech therapy for your child. This approach is not one-size-fits-all so you should consider your child’s needs and their suitability for this approach.
Goals of Cycles Approach
The main goal of the cycles approach is to eliminate the phonological processes from the child’s speech. It is meant to act similarly to the natural development of phonology in young children. Here, the development occurs gradually over time, starting from the easiest words at the beginning.
The claim presented by the researchers and developers of this method is that cycles approach improves the intelligibility of the child’s speech more quickly for highly unintelligible children than compared to other methods.
Specific targets of the speech therapy with cycles approach depends on the child’s need and speech development level. The therapy may target the phonological process of final consonant deletion for 6 weeks, for instance. After that, the target may switch to stopping of fricatives for the following 6 weeks.
The goal is to keep hitting all phonological processes as targets one after the other, and then the cycles start over again, targeting the original process. Once each of the processes is eliminated from the child’s speech, the therapy ends.
A long-term goal example could be increasing intelligibility by independently producing /s/-clusters and velars (/k/, /g/) in sentences during speech activities by ____ (date).
A short-term goal example could be independently producing the /k/ in words with 80% accuracy during speech activities by _ (date).
How to Implement Cycles Approach
Cycles Phonological Remediation Approach mainly consists of four parts: Determining therapy goals, targeting one primary pattern of error intensively for a period of time, using focused auditory bombardment, lots of practice.
While determining the therapy goals, the focus should be on the child’s main patterns of speech sound problems. Here, the focus should not be on individual sounds. In the speech therapy, the targets should be consistent error patterns that happen at least 40% of the time. According to Hodson, developer of the approach, these potential targets are divided into two categories: primary and secondary patterns.
Primary patterns are syllable structures, consonants on their own, velar sounds (/k/ and /g/), alveolar sounds (e.g. /t/ and /d/), hissy ”fricative” sounds (e.g. /s/, “sh”, “ch”, /f/, /v/, j, but not “th” and s-clusters like “sm”), and liquid sounds (e.g. /l/ and /r/). Secondary patterns are voicing errors. These include distorted vowels and individual fricative sounds, three consonant sequences, etc.
Once the target is determined, the cycle begins with one primary error pattern for a fixed period of time. Then comes the next pattern. Here, whether or not the child has corrected the first pattern is not taken into consideration. You move from one primary pattern to the next one, until all the primary error patterns have been targeted. This completes one cycle. The next cycle begins with the original error pattern but with more complicated targets.
Up next, the child listens to amplified recordings of the words and sounds with target patterns, where focused auditory bombardment (stimulation) is utilized. The last step is to do a lot of practice using the words with target sound in them. According to Hodson, these are the essential elements to implement during the therapy.
During a cycles session, which usually takes about an hour, there are seven steps:
- Revision of the words that have been covered in the previous session
- One to two minutes of auditory bombardment
- Introduction of that session’s target words
- Practicing the production target words through experiential play
- Looking for targets for the next session through stimulability probe
- Repeating auditory bombardment
- Homework or home program with optionally a list of target words to practice every day and auditory bombardment
Does Cycles Approach Work?
Several studies have been done on the effectiveness of the cycles approach. One trial provided results that children who were treated with a modified cycles approach showed greater accuracy in single word and conversational contexts compared to children who were untreated (Almost & Rosenbaum, 1998). In another study previously done, no significant improvement was observed following cycles training.
A recent study revealed that two out of three preschool children with moderate to severe speech sound disorders showed significant improvements in speech sound production after receiving 18 hours of treatment with an unmodified version of cycles. An improvement was also observed for all three children in terms of target sound accuracy two months after therapy finished.
These mixed results from studies show that generally, cycles approach can be effective. However, the results need to be interpreted with caution, considering the fact that the latest study had a really small sample size and the lack of randomized controls in others. The approach should be further studied. As we discussed before, not all approaches work for all children.