An amazing speech-language pathologist named Barbara Hodson created the cycles approach, sometimes called the Cycles Phonological Remediation Approach as a way to help children with many phonological processes make faster progress in speech therapy.

Hodson’s research showed that children can improve their intelligibility faster by cycling through all of the different phonological processes that they need to target

Instead of working on one phonological process until it is mastered, you work on each process for a set amount of time and then move on to the next.

You can read Barbara Hodson’s in-depth research here.

1. Choose your patterns for the first cycle: Hodson has a list of “primary set” targets that you can use for the first rounds. Choose the error patterns from that list that the child is stimulable for. (We don’t work on non-stimulable error patterns yet)
2. Choose at least 2 phonemes per pattern: For example, if you’re working on final consonant deletion, then you might work on final /t/ one week and final /k/ the next week.
3. Practice each phoneme for a week: Each phoneme (e.g. /k/) within a pattern (e.g. velars) is targeted for 60 minutes in one week (two 30-minutes or three 20)
4. Choose 4-5 targets to practice: Choose 4-5 words to practice repeatedly during those 60 minutes. They should be stimulable for these words so that all productions are successful
5. Cycle back around: Once cycle is done, reassess convo and see what they still need. Recycle any patterns that aren’t emerging in conversation

When to Use the Cycles Approach:

The cycles approach to speech therapy is intended for children who meet the following criteria:

• Highly unintelligible (very difficult to understand)
• Frequently leave out or omit speech sounds
• Replace some sounds with other sounds
• Don’t use very many different consonant sounds

The Purpose of the Cycles Approach:

The cycles approach is meant to more closely mirror the natural development of phonology in young children where many processes are developed gradually over time by mastering easiest words first.

The researchers of this method claim that it improves intelligibility more quickly for highly unintelligible children than other methods.

Here at Speech and Language Kids, we’ve created a full program and materials kit for using the Cycles Approach. You can get access to this through our SLK Curriculum portal:

Barbara Hodson laid out a nice plan for which phonological processes to target first when using the cycles approach. First, you start with processes that are on Hodson’s “primary set” of targets. These are the processes that impact speech intelligibility the most.

The key is to only include targets (phonological processes) that the child is stimulable for. The goal is to have them practice these targets successfully as many times per cycle as possible. The only exception is gliding, which is targeted with all clients even if they are not stimulable. For this process, you will help them approximate the /l/ and /r/ if they are not stimulable for those sounds yet.

If there is a phonological process in the primary set that the child is not yet stimulable for, use a few minutes each session to work on increasing their stimulability of those sounds.

Primary Set of Targets:

1. Syllable deletion: make sure each syllable is marked, even if not all sounds are present
2. Sound deletion (FCD, ICD)
3. /s/ clusters: significantly improves intelligibility
4. Fronting/Backing (Anterior/Posterior Contrasts): Work on velars if fronting or alveolars/labials if backing
5. Liquids are targeted at the end of each cycle even if they aren’t stimulable (this is the only exception to the stimulability rule): Target /l/ and /r/ (by emphasizing vowel to suppress the /w/ substitution, go for an approximation)

Criteria for Moving on to Secondary Targets:

Secondary patterns are not targeted until the following criteria have been achieved in spontaneous utterances:

1. Appropriate syllableness (including all syllables)
2. Productions of singleton consonants (not omitting sounds)
3. Some emergence of /s/ clusters and velars in conversation
4. Productions of practice words for /l/ and /r/ without inserting the glide

Secondary Targets:

The most common secondary targets to choose include:

1. Palatals (glide /j/, sibilants “sh”/”zh”, /r/)
2. All other consonant clusters/sequences (eg. /j/ clusters, medial /s/ clusters, 3-consonant clusters)
3. Other singleton stridents (/f/, /s/, /z/)
4. Any remaining vowel/diphthong or prevocalic voicing/devoicing difficulties

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Cycles Approach Steps

Here’s how you’ll run your cycles during the cycles approach:

• Choose your phonological processes for the first cycle (example: “final consonant deletion”)
• Choose at least 2 phonemes per pattern (example: “final /t/ and final /p/”)
• Each phoneme (e.g. /k/) within a process (e.g. velars) is targeted for 60 minutes in one week (two 30-minutes or three 20-minutes)
• Choose 4-5 words to target over and over during those 60 minutes. They should be stimulable for these words so that all productions are successful
• Once cycle is done, reassess convo and see what they still need. Recycle any phonological process that aren’t emerging in conversation

Cycles Approach Steps for Each Therapy Session

1. Review: Review the previous session’s word cards.
2. Auditory Bombardment: Amplified auditory stimulation is provided for 1-2 minutes: the clinician reads around 12 words that contain the target pattern for the session.
3. Target Word Cards: The client draws, colors, or pastes pictures of 3-5 target words on large index cards. Child repeats the words modeled by the clinician.
4. Production Practice through Experiential Play: While playing games, clinician and child take turns naming the pictures on the cards. Clinician provides models and tactile cues. The child should achieve 100% accuracy (choose words that are the easiest for the child to produce).
5. Stimulability Probe: The clinician asks the child to say a bunch of words that contain the target pattern for the next session. Whichever sound is easiest for the child will be targeted during the next session (for example, the child may have to say a bunch of /s/ clusters and the easiest one is selected for practice).
6. Auditory Bombardment: Repeat step 2.
7. Home Program: The child practices 2 minutes per day by having a parent or aide read the list aloud and then naming the picture cards of the production practice words.

What Phonemes to Choose for Each Phonological Process/Pattern:

• Syllable Deletion:
  • Compound words (cowboy, baseball)
  • Three-syllable/word combinations (cowboy hat, baseball bat)
• Sound Deletion
  • Initial consonants: labial stops (/p/, /b/, /m/), glide /w/
  • Final consonants: Voiceless word-final stops (/p/, /t/, /k/), /m/, /n/ (only if those sounds are in their spontaneous speech somewhere)
  • Medial sounds in VCV, like “apple”
• /s/ Clusters
  • Add /s/ to consonants the child is already producing
  • Word initial: /sp/, /st/, sm/, etc.)
  • Word final: /ts/, /ps/
  • Incorporate “It’s a ____” when able to produce /s/ clusters in practice words (typically by third cycle)
• Anterior/Posterior Contrast
  • Velars (if fronting)
  • Word-final /k/ (before prevocalic velars, never final /g/)
  • Word-initial /k, g/
  • Alveolars/labials (if backing)
• Facilitation of Liquids (even if not stimulable)
  • Word-initial /l/ (preceded by week of tongue tip clicking)
  • Word-initial /r/ (suppress gliding initially): Exaggerate and prolong the vowel (rather that the /r/), do not blend initially
  • Incorporate /kr/, and /gr/ when child has velars (typically by third cycle)

Our Cycles Approach Materials Kit:

I know you don’t have a lot of extra time in your day so I’ve made this all simpler.  I’ve created a full materials kit that provides you worksheets and homework for every phoneme in the primary set of phonological approaches.  You can plan out which processes you’ll hit in a cycle with our planning sheets (below) and then grab the correct page and you’re ready for therapy!