Does the Cycles approach work for speech therapy?

The Cycles approach can help some children with very hard-to-understand speech, but the research behind it is still small, so it is best seen as one option rather than a proven first choice.

What it is: according to the American Speech-Language-Hearing Association, the Cycles approach is designed for children with highly unintelligible speech who leave out many sounds, substitute some and use a limited set of consonants. Instead of drilling one sound at a time, the speech-language pathologist (SLP) targets error patterns. Therapy runs in cycles of 5 to 16 weeks, with one or more patterns worked on in each cycle, aiming to follow the gradual way speech typically develops. It can also be used with children who speak more than one language.

What the evidence says:

• A 2014 study of a very small group of preschool children with severe speech sound disorders reported gains. This is encouraging, but a study that small cannot show the approach works better than others.

• A broad 2011 review of speech sound treatment research found many different approaches, most tested with lower-level designs such as case studies, and called for more rigorous research comparing them.

What this means for you: the right approach depends on your child's specific error patterns, age and needs. It is reasonable to ask your SLP why they chose an approach and how they will measure progress.

If your child is often hard to understand, talk with a registered speech-language pathologist, who can assess their speech and explain which treatment fits.