A speech-language pathologist discharges one child with phonological delay but treats another with a phonological disorder. This decision is based on which approach to treatment planning?

• A. ICF approach (International Classification of Functioning, Disability, and Health)
• B. Medical approach
• C. Norm-referenced approach
• D. Predictive assessment approach

Answer: (B)

The decision reflects prognosis- and medical-need–driven planning. In a medical approach, the clinician weighs whether therapy will meaningfully change outcomes and whether ongoing treatment is medically or functionally necessary. A phonological delay means the child’s speech patterns are on a typical development path but slower to emerge; with time and normal development, many of these children catch up, so discharging them aligns with a favorable prognosis. A phonological disorder, by contrast, involves patterns that are persistent beyond the expected age and often require continued intervention to achieve functional speech, warranting ongoing treatment. This distinction between delay (usually resolves with time) and disorder (persistent and requiring therapy) is why the medical approach best explains the discharge versus continued treatment decision. The other approaches focus more on functioning, norms, or predictive forecasts, rather than directly tying treatment planning to prognosis and medical necessity.