This investigation compared the effectiveness of the Cycles Approach with and without auditory stimulation. Using an alternating treatment design (AATD), three preschool-aged children with severe phonological disorders received a modified Cycles Approach targeting two phonological patterns. Effectiveness was measured by the percentage of occurrence of errors. Treatment outcomes were analyzed across experimental conditions and participants with respect to the effectiveness of the Cycles Approach, modified by including and excluding auditory stimulation. All participants demonstrated improvements in speech sound production skills when auditory stimulation was withheld. Two participants demonstrated a statistically significant change in speech intelligibility from baseline to intervention regardless of auditory stimulation inclusion. One participant experienced a statistically significant difference in speech intelligibility when auditory stimulation was withheld. Parents of all participants indicated improvements in their child's speech intelligibility on a posttreatment questionnaire. This investigation substantiates prior research suggesting that a modified Cycles Approach is an effective intervention to treat preschool children with phonological disorders. For the three participants in this study, implementing auditory stimulation techniques did not improve or expedite speech intelligibility outcomes, and for one participant, improved clinical outcomes were achieved without the use of auditory stimulation.

Received: 13 February 2025

Accepted: 08 October 2025

Article published online:
18 December 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA