Phonologically Similar, High-Density Targets to Improve Intelligibility: A Single-Case Study in a Cypriot-Greek–Speaking Child with Consistent Phonological Disorder

Abstract

This study examined whether training with phonologically similar, high–neighborhood-density word cohorts promotes expressive phonological gains in a 4-year-old bidialectal Cypriot-Greek–speaking child with a consistent phonological disorder. Using a single-case design with baseline, intervention, post-test, and 1-month follow-up phases, the child received sixteen 45-minute intervention sessions delivered twice weekly over 2 months. Stimuli consisted of phonologically similar, high-density word cohorts, and all outcomes were scored by a second speech-language pathologist blinded to phase and target selection. Expressive phonology was assessed using a 49-item picture-naming probe, and maintenance/generalization was evaluated with an additional 20 untreated items at follow-up. Dependent measures included Proportion of Consonants Correct, Whole-Word Matches, Phonetic Inventory Size, and phonological processes, while the Intelligibility in Context Scale was completed by the child's teacher at baseline and follow-up. The results showed clear improvements from pre- to post-test across all measures, with gains maintained and generalized to untreated items at follow-up, accompanied by improved Intelligibility in Context Scale ratings. These findings suggest that implementing phonologically similar, high-density cohorts within a structured intervention can yield clinically meaningful and lasting improvements in expressive phonology and functional intelligibility in Cypriot-Greek, offering preliminary cross-linguistic support for neighborhood-density–informed target selection in speech sound disorder intervention.