Speech Sound Disorders Lab

Director

Dr. Lynn Williams, Ph.D. 

Teaching

1988 | Ph.D., Indiana University

1980 | M.S., West Virginia University

1978 | B.S., West Virginia University

Teaching

Clinical Phonology

IPE Faculty Facilitator 

Clinical Interests 

Speech Sound Disorders in Children

Research Interests

Multiple Oppositions Approach

Translational Research

Phonological Intervention Taxonomy

Service

Dr. Williams has a strong track record of over 175 publications (books, book chapters, peer reviewed articles) and presentations. As an international expert on intervention for speech sound disorders in children, her research has been funded through NIH, which also supported the development of computer- and app-based resources to facilitate speech-language pathologists’ implementation of intervention. Dr. Williams was named an ASHA Fellow in 2006, was inducted into the West Virginia University College of Human Resources and Education Hall of Fame in 2004, and was an Erskine Fellow at the University of Canterbury in Christchurch, New Zealand in 2011. She previously served as ASHA Vice President for Academic Affairs in Speech-Language Pathology (2016-2018) and recently chaired the ASHA Ad Hoc Committee on Graduate Education in Speech-Language Pathology (2018-2020). Dr. Williams is the 2021 ASHA President. 

People

• Dr. Lynn Williams
  • Email: williamL@etsu.edu
  • Phone: 423-439-7469
• Kevante Drew
  • Email: drewkt@etsu.edu
• Javan Marshall
  • Email: marshalljw@etsu.edu 

Projects

My research involves applied, clinical investigations that involve models of intervention, target selection, and assessment of speech sound disorders in children who are highly unintelligible. My research typically includes intervention studies using single-subject designs in order to carefully examine individual client’s response to treatment in a detailed manner. These lines of inquiry form the majority of my research with my development of the multiple oppositions approach (Williams, 2000a; 2000b; 2003a; 2003c; 2004; 2005a; 2005c; 2006; 2010). I have conducted funded studies through the National Institute of Deafness and Other Communication Disorders (NIDCD) to experimentally examine the effectiveness of this approach. Since 2006, my work has involved translational research in making the newer models of phonological intervention, including multiple oppositions, accessible to practicing clinicians. This translational research was funded by Small Business Innovative Research (SBIR) Phase I and Phase II grants by the NIDCD and the National Institute of Child Health and Human Development (NICHD). In collaboration with EBS Healthcare, Sound Contrasts in Phonology (SCIP) is an intervention app I developed that translates the research from the newer, evidence-based models of speech intervention (including multiple oppositions) into a digital tool that provides a time-saving resource for speech language pathologists to use in designing individualized treatment materials for the children in their clinical practice.

My current focus on intervention models has been with a research team who I’ve worked with over the past decade (Professor Sharynne McLeod: Charles Sturt University, Bathurst, Australia; Professor Elise Baker: University of Sydney, Australia; and Dr. Rebecca McCauley: Ohio State University) to develop a Phonological Intervention Taxonomy (Baker, Williams, McLeod, & McCauley, 2018). The taxonomy was created after (1) conducting a qualitative investigation into the range and type of elements that comprise phonological interventions, and (2) coding the intervention elements within each intervention as required, optional, or absent. The taxonomy allows comparison among interventions with regard to density of intervention elements, flexibility, and uniqueness. The Phonological Intervention Taxonomy has clinical, pedagogical, and research implications with regard to clinicians’ ability to implement an intervention with fidelity, how interventions are taught to student clinicians, and identifying the active intervention elements that contribute to phonological outcomes.

Parallel to my research in intervention is the development of a model of assessment of speech disorders in children called Systemic Analysis of Child Speech (SPACS; Williams, 2001; 2002a; 2002b; 2003c; 2005a; 2006). As we get better methods for describing disordered sound systems, we have the capability of designing more effective treatment plans for each child. Using linguistic methodology, SPACS provides an in-depth description of a child’s sound system as a unique, independent, and self-contained language. Once the child’s system is described as a unique and separate language, it is then mapped onto the adult sound system via phoneme collapses. These phoneme collapses represent how the two systems align since the ultimate goal is for the child to be intelligible in the ambient language.

A logical extension of this line of clinical investigation is examination of an approach that I have developed for selecting treatment targets from the phoneme collapses called the distance metric (Williams, 2003b; 2003c; 2005a; 2005b; 2006). Analogous to a puzzle, the distance metric is based on two parameters for selecting target sounds for treatment which will result in targets that are maximally distinct from each other and from the child’s error substitute. Therefore, the treatment targets are more salient and considered to be more learnable, similar to the corner puzzle pieces, as the child works to restructure his/her sound system to be more like the adult sound system and hence increase his/her speech intelligibility.

The integration of a systemic perspective to intervention, assessment, and target selection provides a unified approach to the clinical management of speech disorders in children. From a systemic view, the multiple oppositions approach, SPACS, and the distance metric have the potential to result in the greatest amount of change in the least amount of time with the least amount of effort.

My latest endeavor involves another assessment tool, but with younger children. In collaboration with Dr. Carol Stoel-Gammon, linguist at University of Washington, Seattle, we have developed a developmentally appropriate and comprehensive test of early phonological skills in young children (18-36 months of age). PEEPS: Profiles of Early Expressive Phonological Skills incorporates a broad-based analysis that is designed to be used by researchers and clinicians in diverse clinical settings. PEEPS will be published by Brookes Publishing in 2020.

Finally, my research interests have broadened to examine the impact of communication disabilities on health. I’m currently working with Loretta Nunez, ASHA Director for Academic Affairs & Research Education, to conduct a narrative analysis of communication disabilities and health disparities. There is a significant literature on the impact of communication disabilities on health outcomes with regard to co-occurring chronic health conditions, increased number of office visits, hospitalizations and emergency department visits, increased medical errors, and lower patient satisfaction coupled with higher provider frustration. These are critical findings given that 10% of the US adult population has a communication disability.

Achievements

2020

Baker, E., & Williams, A.L. (in press). Learning how to implement interventions. In A.L. Williams,  S. McLeod, & R. McCauley (Eds). Interventions for speech sound disorders in children (2nd ed.). Baltimore: Paul H. Brookes.

Baker, E., McCauley, R.J., Williams, A.L., & McLeod, S. (2020). A taxonomy for phonological intervention (pp. 375-399). In E. Babatsouli (Ed.). On under-reported monolingual child phonology. Bristol, UK: Multilingual Matters.

Dunn, S., Williams, A.L., Dunkel, J., & Meade, A. (2020). Creative Collaborative Partnerships in            Healthcare. Invited panel to present at the annual Tennessee Physical Therapy        Association, virtual conference.

Miccio, A., & Williams, A.L. (in press). Stimulability approach. In A.L. Williams, S. McLeod, & R. McCauley (Eds). Interventions for speech sound disorders in children (2nd ed.). Baltimore: Paul H. Brookes.

Sugden, E., Baker, E., Williams, A.L., Munro, N., & Trivette, C.M. (2020). Evaluation of parent  and speech-language pathologist delivered multiple oppositions intervention for children with phonological impairment: A multiple-baseline design. American Journal of Speech-Language Pathology, 29(1), 111–126. doi:10.1044/2019_AJSLP-18-0248

Williams, A.L. (2020, Feb). Advocacy, leadership, and volunteerism: Strategies for member success. Keynote address at the annual state convention of the Georgia Speech-Language-Hearing Association. Stone Mountain: GA.

Williams, A.L. (2020, June). Thriving amid change and uncertainty. Keynote address at the   annual ASHA Connect Conference. Virtual presentation.

Williams, A.L., McCauley, R., & McLeod, S. (in press). Choosing the best intervention: The nexus among interventions, clients, and clinicians. In A.L. Williams, S. McLeod, & R.  McCauley (Eds). Interventions for speech sound disorders in children (2nd ed.). Baltimore: Paul H. Brookes.

Williams, A.L., McLeod, S., & McCauley, R. (Eds.) (in press). Interventions for speech sound disorders in children (2nd ed). Baltimore: Paul H. Brookes.

Williams, A.L., McLeod, S., & McCauley, R. (in press). Introduction to intervention for speech sound disorders in children. In A.L. Williams, S. McLeod, & R. McCauley (Eds). Interventions for speech sound disorders in children (2nd ed.). Baltimore: Paul H. Brookes.

Williams, A.L., McLeod, S., McCauley, R., Bernhardt, B.M., Camarata, S., Cleland, J., Crosbie, S., Hayden, D., Leece, M., Morrisette, M., Pennington, L., Prezas, R., Rvachew, S.,  Scherer, N., Strand, E., Tyler, A., Williams, P., Wren, Y. Interventions for speech sound disorders in 2020. Proposal accepted at the annual convention of the American Speech- Language-Hearing Association, San Diego, CA (Convention cancelled).

Williams, A.L., Rogers, M., McNeilly, L., Nunez, L., Sampson, M., Ashby, T., & Pietranton, A.  (2020, Oct). My communication problem, your listening problem, and my frustration: Navigating health care with communication disabilities. Presentation accepted to the All Together Better Health Conference. Qatar. Cancelled due to COVID-19.

Williams, A.L., & Stoel-Gammon, C. (2020, Nov). Toddler talk: Findings from a developmentally          appropriate phonological assessment. Proposal accepted at the annual convention of the American Speech-Language-Hearing Association, San Diego, CA (Convention cancelled).

Williams, A.L., & Sugden, E. (in press). Multiple oppositions intervention. In A.L. Williams, S. McLeod, & R. McCauley (Eds). Interventions for speech sound disorders in children (2nd ed.). Baltimore: Paul H. Brookes.

2019

Nunez, L., Koehnke, J., & Williams, A.L. (2019). Interprofessional Collaboration: How Audiologists Contribute to Population Health. The Hearing Journal, 72 (7), 12, 13, 19.

Sugden, E., Baker, E., Williams, A.L., Munro, N., & Trivette, C.M. (in press). Evaluation of parent and speech-language pathologist delivered multiple oppositions intervention for children with phonological impairment: A multiple-baseline design. American Journal of Speech-Language Pathology.

Sugden, E., Munro, N., Trivette, C. M. Baker, E. & Williams, A.L. (2019). Parents’ Experiences of Completing Home Practice for Speech Sound Disorders. Journal of Early Intervention, 41 (2), 159-181.

Scherer, N.J., Yamashita, R., Fukushiro, A., Keske-Soares, M., Natalia de Oliveira, D., Ingram, D., Williams, A.L., & Trindade, I. (in press). Assessment of early phonological development in Brazilian Portuguese. In E. Babatsouli (Ed.). On under-reported monolingual child phonology. Bristol, UK: Multilingual Matters.

Williams, A.L. (in press). Speech sound disorders in children. In L.M. Justice & E. Redle (Eds.).Communication sciences and disorders: A contemporary perspective (3rd ed.). Austin, TX: Pearson.

Williams, A.L., & Anderson, M. (2019). Dynamics of clinical education and supervision in interprofessional education and practice. In E. McCrea & J. Brasseur (Eds.). The supervisory process in speech-language pathology and audiology (2nd ed.). Thorofare, NJ: SLACK Publishing.

Williams, A.L. (2019, July 3). Sound advice: Assessing speech sound disorders. Medbridge Blog. 

Williams, A.L. (2019, Mar). Sound evidence: Clinical management of speech sound disorders in children. Iowa Conference on Communicative Disorders, University of Northern Iowa, Cedar Falls, IO.

Williams, A.L. (2019, May). Planning for successful IPE: A journey. Invited speaker to IPEC Faculty Institute, Washington, D.C.

Nunez, L., Williams, A.L., & Koehnke, J. (2019, Mar). Audiologists and Speech-Language Pathologists contribute to population health as members of interprofessional teams. Poster presentation at the annual meeting of the National Academy of Practice, Washington, D.C.

Nunez, L., Koehnke, J., & Williams, A.L. (2019, Mar). Audiologists contribute to population health as members of interprofessional teams. Poster presentation at the annual meeting of the American Academy of Audiology, Columbus, OH.

2018

Baker, E., Williams, A.L., McLeod, S. & McCauley, R. (2018). Elements of Phonological Interventions for Children With Speech Sound Disorders: The Development of a Taxonomy. American Journal of Speech-Language Pathology, 27(3), 906-935.

Sugden, E., Baker, E., Munro, N., Williams, A. L., & Trivette, C. M. (2018). Service delivery and intervention intensity for phonologybased speech sound disorders. International Journal of Language & Communication Disorders, 53: 718-734.

Williams, A.L., & Byrd, D. (2018, Nov). Scaling up IPE: The role of leadership. IPEC webinar: Learning from the successes of IPEC IDLP alumni.

Baker, E., Williams, A.L., McLeod, S., & McCauley, R. (2018, Nov). The Phonological intervention taxonomy: How do phonological interventions differ from one another? Seminar at the annual ASHA convention, Boston, MA.

Nunez, L., Williams, A.L., & Koehnke, J. (2018, Nov). ASHA’s role in fostering interprofessional education & collaboration. Seminar at the annual ASHA convention, Boston, MA.

Nunez, L., Williams, A.L., & Koehnke, J. (2018, Nov). Transforming the health of populations with speech-language pathologists & audiologists. Seminar at the annual ASHA convention, Boston, MA.

Sugden, E., Baker, E., Williams, A.L., & Munro, N. (2018, Oct). Interactions between phonological and motor learning: Insights from an intervention study. Presentation at the 17th International Clinical and Linguistics Association Conference, St. George’s Bay, Malta.

Baker, E., Williams, A.L., McLeod, S., McCauley, R. (2018, June). A taxonomy for phonological intervention. Invited presentation in the Special Symposium Honoring David Ingram at the International Child Phonology Conference, Chania, Crete.

Nunez, L., Williams, A.L., & Koehnke, J. (2018, September). Fostering interprofessional collaboration: The role of the professional association. Presentation at the All Together Better Health Conference, Auckland, New Zealand.

Nunez, L., Williams, A.L., & Koehnke, J. (2018, September). Transforming the health of populations with speech-language pathologists and audiologists. Presentation at the All Together Better Health Conference, Auckland, New Zealand.

Baker, E., Williams, A.L., McLeod, S., McCauley, R. (2018, May). There are so many different phonological intervention approaches: What’s the difference. Presentation at the Speech Pathology Australia National Conference, Adelaide, Australia.

Scherer, N.J., Yamashita, R., Oliveira, D., Keske-Soares, M., Trindade, I., Williams, A.L., & Ingram, D. (2018, June). Assessment of early phonological development in noncleft and children with cleft palate in Brazil. Presentation Ingram at the International Child Phonology Conference, Chania, Crete.

Sugden, E., Baker, E., Munro, N., Williams, A.L., & Trivette, C. (2018, May). The efficacy of training parents to deliver multiple oppositions intervention to children with speech sound disorders. Presentation at the Speech Pathology Australia National Conference, Adelaide, Australia.

2017

Ingram, D., Williams, A.L., Scherer, N. (2017). Are speech sound disorders phonological or          articulatory? A spectrum approach (pp. 27-48). In E. Babatsouli & D. Ingram (Eds.) Phonology in protolanguage and interlanguage. Sheffield: Equinox.

Stoel-Gammon, C., and Williams, A.L. (2017). Toddler Talk: Findings from a Phonological Assessment Test that Uses “Early” Words. International Child Phonology Conference, Washington, DC.

Sugden, E., Baker, E., Munro, N., Williams, A.L., & Trivette, C.M. (2017). An Australian survey of parent involvement in intervention for childhood speech sound disorders. International Journal of Speech-Language Pathology, 1-13. doi:10.1080/17549507.2017.1356936

Sugden, E., Baker, E., Munro, N., & Williams, A.L. (2017). The Value of Home Practice for Speech Sound Disorders: What do Parents Think? Speech Pathology Australia National Conference, Sydney, Australia.

Williams, A.L. (2017, May 1). Sound Proof: What’s the evidence on target selection for speech sound disorders? Medbridge Blog.

Williams, A.L. (2017, March). Sound management: It’s about time. Presentation at the Danish National Conference for Speech Language Therapists, Island of Funen, Denmark.

Williams, A.L. (2017, Nov). Critical APPraisal: EBP and phonology apps. Poster presentation at the annual ASHA convention, Los Angeles, CA.

Williams, A.L., & ASHA Ad Hoc Committee on Supervision Training Committee Members (2017, July). Updates on the role and importance of clinical education and supervision. Poster presented at the ASHA Connect Conference, New Orleans, LA.

Sugden, E., Baker, E., Munro, N., & Williams, A.L. (2017, May). The value of home practice for speech sound disorders: What do parents think? Speech Pathology Australia National Conference, Sydney, Australia.