how to do cycles approach speech therapy

• Special Needs
• Tips and Activities
• Special Education

How to Apply Cycles Approach to Speech Therapy

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.

This article is examined by Clinical Child Psychologist and Ph. D. Researcher Kevser Çakmak, and produced by Otsimo Editorial Team.

Certified special education app

Get Otsimo for iOS and Android now.

Otsimo Special Education

Download for Free

Otsimo Speech Therapy

This post does not provide medical advice. See Additional Information.

• Cycles Approach
• Phonological processes
• Intelligible speech
• Highly unintelligible speech
• Phonological patterns
• Childhood apraxia of speech (CAS)
• Target phonological processes

Related Articles

August 14, 2023

• Understanding Speech Disabilities and Language Disorders

July 27, 2023

• Articulation Disorder: Understanding the Basics

March 28, 2023

Speech Development in Children

April 19, 2023

”R” Words Speech Therapy

• Signs of Autism In Different Age Groups and Genders
• How to Help Your Nonverbal Child with Autism Speak
• How To Restrict YouTube on Android Devices
• How to Calm an Autistic Child During a Meltdown
• Difference Between Speech Delay and Autism

RECENT POSTS

• Understanding Chromosome 21 and Down Syndrome
• Why Distance Learning May Be More Challenging For Families of Students With Disabilities
• How Autism and Anxiety May be Linked
• Career with Impact
• Privacy Policy

Otsimo AAC | Tap and Talk

How to treat speech sound problems 1: the Cycles Approach

So we’ve written more than a few articles about speech sound disorders , including common and less common phonological problems.  So how do you treat them?

One of the most common methods for treating pre-schoolers and school-age kids with severe phonological problems  is the “Cycles Approach”.

Who developed it?

This approach was developed by Barbara Hodson  and her colleagues and is based on principles of developmental phonology , cognitive psychology and research in phonological acquisition .

Who is it for?

The Cycles Approach was developed for children with highly unintelligible speech.  But it has been used with children with a wide range of speech sound and other communication problems.

What is it?

The official name of the program is the “Cycles Phonological Remediation Approach”.  It consists of 4 parts:

1. Choosing therapy goals focusing on a child’s main patterns of speech sound problems (rather than individual sounds) – eligible targets are consistent patterns or errors that occur at least 40% of the time.  Hodson divides these potential targets into two categories:

a. primary patterns : these include (in order of importance) 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/); and

b. secondary patterns : these include voicing errors like prevocalic voicing , distorted vowels, individual fricative sounds that have not been corrected after the primary patterns have been remediated, “glide sequences” and three consonant sequences (e.g. /str/).  The idea is that most secondary patterns take care of themselves;

2. Targeting one primary pattern of error intensively for a fixed time, before moving on to the next pattern (regardless of whether the child has corrected the first pattern of error), and then thee next primary pattern and so on until all primary patterns of error have been targeted, completing one cycle.  The second cycle then begins, starting again with the first pattern, but with more complicated targets;

3. Using focused auditory bombardment, where the child listens to amplified recordings of words and sentences containing the target patterns; and

4. Lots of practice producing words containing the target sound in treatment sessions.

Hodson considers all of these elements to be essential to the therapy.  The idea is that, by targeting patterns of errors (rather than individual sounds), the treatment results in a system wide transfer of the trained sounds to other sounds and targets.

What happens in the sessions?

Cycles sessions usually take an hour and consist of 7 steps:

• Review words from the last session.
• Auditory bombardment (1-2 minutes).
• Introduction of target words for the session (usually 5-6 words).
• Play games requiring the child to practice the target words.
• Probe for next session targets.
• Repeat auditory bombardment.
• Homework – typically 2 minutes of auditory bombardment a day plus, optionally, a list of target words for the week to practice every day.

How long does it take?

As designed, Hodson’s treatment protocol is quite intensive and based on the idea that phonological acquisition happens slowly: 1 hour sessions, 3 times a week.  Each pattern is targetted for 1-2 hours. Each cycle may last for up to 18 hours, depending on the number of error patterns the child’s speech contains.  This means it can take more than 40 hours of treatment for clients with severe speech sound disorders to become intelligible to strangers.  In practice, many researchers and clinicians have adapted Hodson’s approach to deal with research or service-delivery constraints (e.g. parents who are too busy or can’t afford to do three 1 hour sessions a week) (Baker & McLeod, 2011).

Does it work?

At least five studies have looked at the efficacy of cycles-based procedures using experimental designs.  A randomised controlled trial showed that children treated with a modified cycles approach showed significantly greater accuracy in single word and conversational contexts than untreated children (Almost & Rosenbaum, 1998).  However, other studies showed little or no improvement following cycles training (e.g. Tyler & Watson, 1991).  These mixed results are hard to interpret because each of the studies used different outcome measurements, and modified cycles in different ways.

In a very recent study (cited below), researchers found that two out of three pre-school children with moderate-severe speech sound disorders exhibited statistically and clinically significant improvements in speech sound production after 18 hours of treatment using an unmodified version of cycles.  They also found that target sound accuracy two months after therapy finished were stable or had improved for all three children.  These results generally support he efficacy of cycles.  However, they need to be interpreted with caution because of the small sample size (only 3 children), the lack of randomised controls and the fact that probes were administered by the clinician running the trial (which could perhaps have unconsciously biased the results).

One thing we don’t know is whether all components of the treatment are necessary to get good results.  This is an important question for future research – particularly given the significant time and financial costs  associated with implementing cycles in practice.

Principal source : Rudolph, J.M. and Wendt, O. (2014). The efficacy of the cycles approach: A multiple baseline design. Journal of Communication Disorders, 47 , 1-16.

Related articles :

• Speech sound disorders
• How to treat speech sound disorders 2: the Complexity Approach
• How to treat speech sound disorders 3: the Contrastive Approach – Minimal and Maximal Pairs
• FAQ: 10 common speech error patterns seen in children of 3-5 years of age – and when you should be concerned

Image : http://tinyurl.com/p4noxkq

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

Share this:

David Kinnane

My child’s speech is hard to understand. Which therapy approach is appropriate?

Lifting the lid on speech therapy: How we assess and treat children with unclear speech – and why

Leave a reply cancel reply.

Your email address will not be published.

Notify me of follow-up comments by email.

Notify me of new posts by email.

This site uses Akismet to reduce spam. Learn how your comment data is processed .

© 2024 Banter Speech & Language ° Call us 0287573838

Copy Link to Clipboard

• Physical Products
• Digital Products
• All Products
• Play Boards
• Subscription Boxes
• Subscription
• Your Cart is Empty

Inside look at a therapy session with the cycles approach

April 24, 2022

You may also enjoy these resources: Blog: Cycles 101 Blog: How to choose targets and set up your cycle Product: Comprehensive Cycles Unit

Want your cycles therapy sessions planned out for you? Check out this INSTAGRAM REE L to see how simple a session can be using the comprehensive cycles unit.

How to set up your cycles sessions:

You have your cycle prepared and you are ready to begin therapy. If you need more information about what cycles is or how to set up the cycle and choose targets, refer to one of the blogs or products mentioned above.

The thing I love most about the cycles approach is that the outline of each therapy session is given to you! Sessions are predictable and require little to no prep time. Each phoneme in each pattern is targeted for 60 minutes before moving on to the next phoneme/pattern (regardless of mastery). Sessions can be broken up if needed (e.g., 2 30-minute sessions, 3 20-minute sessions). Reassess phonology between cycles. Each session follows the following format:

1. Auditory Bombardment: Read a list of words (with amplification) that contain the target pattern/phoneme while your child listens quietly. Do this at the beginning and end of each session for about one minute.  Rationale: Children with normal hearing typically acquire the adult sound system primarily by listening (Van Riper, 1939).

2. Production Practice: Engage the child in a few 5-10 minute, engaging activities that are designed to get a high number of trials of the target words. Try to aim for around 100 trials of the 3-5 target words. These trials should be accurate. Give as many prompts and cues as the child needs in order to be close to 100% accurate during production practice. "A major goal for phonological remediation in cycles is for the child to experience immediate and tangible success" (Hodson, 2007). Practice the target words at the word level. Choose enjoyable and motivating activities so the child is actively involved in their treatment. 

3. Incorporate Metaphonological Activities: Metaphonological tasks (e.g., rhyming, syllable segmentation) should be incorporated for a few minutes during each session. Incorporating these tasks will help the child improve their primary literacy skills.

4. Auditory Bombardment:

5. Check stimulability of next weeks target.

6. Home Program: Send home the list of the 2-5 target words that were addressed in that session and a short auditory bombardment list. Caregivers will read the auditory bombardment list (30 seconds to a minute) to the child while they listen quietly. Then, the child will ACCURATELY produce the 2-5 target words for about 2 minutes. This should be done daily. 

Check out this instagram reel to see what my sessions look like while using my comprehensive cycles unit mentioned below.  

Do you use the cycles approach with your students? Click the photo below to check out this comprehensive, engaging, and effective cycles unit!

Leave a comment

Comments will be approved before showing up.

Also in Therapy Ideas

How to choose targets and set up your cycle: CYCLES APPROACH FOR PHONOLOGY

How to Incorporate Play into Minimal Pairs Therapy

June 29, 2021

+ Recent Articles

• How to choose targets and set up your cycle: CYCLES APPROACH FOR PHONOLOGY April 24, 2022
• Inside look at a therapy session with the cycles approach April 24, 2022
• Cycles 101 April 24, 2022
• How to Incorporate Play into Minimal Pairs Therapy June 29, 2021
• Why you Need FEWER Words & MORE Trials for Phonological Therapy April 18, 2021
• HOW to teach basic concepts April 13, 2021
• The WHAT and WHY of Basic Concepts April 13, 2021
• Weather Themed Speech Therapy Ideas March 22, 2021
• The 3 do's of treating final consonant deletion March 08, 2021
• Pet Themed Speech Therapy Ideas January 17, 2021

© 2024 Speech Tree Co . All Rights Reserved Powered by Shopify

Get access to FREEBIES for speech & language therapy!

Click HERE to grab your downloads 🙌🏼

• Conferences

M.A. CCC-SLP

Amy Graham is a speech language pathologist and owner of Graham Speech Therapy, a private practice in Colorado Springs that specializes in pediatric speech sound disorders. She received both her bachelors and masters degrees in Communicative Disorders from California State University, Fullerton and has been an SLP for over 20 years. Amy is the creator of the Graham Speech Therapy Oral-Facial Exam, the Bjorem Speech Decks for Lateralization and Cycles, is an international speaker and frequent podcasts guest. She has a particular interest in supporting and equipping SLPs to help them provide evidence-based treatment for speech sound disorders by posting frequent therapy videos and practical therapy tips on social media platforms.

Amy has developed materials available for purchase on her private practice website, GrahamSpeechTherapy.com, Bjorem Speech Publications, Teachers Pay Teachers, Boom Learning, and Holland Healthcare. Amy was paid a flat fee for this course and receives a percentage of course sales.

Amy has no nonfinancial relationships related to the content of course to disclose.

A portion of this course demonstrates how the Bjorem Speech Cycles Decks and Boom Learning Cards that Amy created can be used to implement the cycles approach.

This course, and all courses in The Speech Sound Disorder Series, are being sponsored by SLP Toolkit, Bjorem Speech Publications, Graham Speech Therapy, and Adventures in Speech Pathology.

• Identify which children with speech sound disorders may be good candidates for the cycles approach.
• Describe how to choose phonological error patterns to target during a cycle.
• Discuss how to organize a cycles therapy session.

Participants must provide course feedback and pass a course exam with a score of 80% or higher in order to receive a certificate of completion for certification maintenance hours (CMHs). Additionally, participants must complete a final opt in step for your completion to be submitted to the ASHA Continuing Education Board.

ASHA CEUs are awarded by the ASHA Continuing Education Board once eligibility requirements are met. The exam, course evaluation, and CE paperwork for this course must be completed by the date outlined for the course offering. If you do not correctly and completely finish all steps by the deadline, you will not be eligible to receive ASHA CEUs for this course. If you have questions about this process, email us at [email protected].

To read more about CMHs vs. ASHA CEUs, click here.