Under which condition should a child be scheduled for higher intensity intervention?

• A. An articulation disorder at the 12th percentile on articulation test.
• B. A child with phonological delay at the 3rd percentile on a phonological skills test.
• C. A child who scores at the 20th percentile on an articulation test and has participation restrictions.
• D. A child with a phonological disorder at the 17th percentile on a phonological skills test.

Answer: (B)

The main idea is that how intensively you intervene should match how severely a child’s phonological system is affected and how much that affects everyday communication. When a child shows a phonological delay and tests extremely low on a phonological skills measure, it signals a broad and significant gap in phonological knowledge and processing. That level of difficulty is unlikely to improve with light, brief therapy, so higher intensity—more frequent sessions, a wider set of targets, and intensive practice of phonological processes—is appropriate to drive meaningful progress and prevent persistent difficulties.

In contrast, an articulation disorder with a lower but not extreme percentile suggests relatively fewer production problems and often doesn’t necessitate the same level of intensity unless other factors are present. A scenario where articulation scores are low but not severely limiting, even with some participation restrictions, may still be served with standard to moderate intensity rather than high intensity. Similarly, a phonological disorder at a higher percentile indicates difficulties exist but are not as severe as the extremely low percentile case. The key point is that the combination of a very low percentile and phonological delay points to a more substantial, widespread impact, justifying higher intensity intervention.