Thank you, Edythe Strand and Rebecca McCauley, for writing about "Differential Diagnosis of Severe Speech Impairment in Young Children" in the Aug. 12, 2008, issue. Since 2003 I have been providing speech and language treatment to young children in New York City.
Many clinicians can significantly benefit from adopting your proposed linguistic/phonological, motor planning, and motor execution framework to better diagnose and treat the young child with a speech impairment. However, the reality is that many speech-language pathologists here continue to see the speech-delayed child through an "oral-motor" lens: the child's speech is delayed due to low oral muscle tone and/or oral muscle weakness.
Until the majority of SLPs understand and adopt a scientific approach to differential diagnosis in significant speech delay, continued misunderstanding and misapplication of treatment will prevail.
Craig Selinger
Brooklyn, New York
cselinger@gmail.com