Establishing a sound instructional plan follows careful assessment that illuminates underlying deviations in physiological aspects of speech production and/or in phonological, semantic, and syntactic components of the language system.

Determining whether production errors are motor related or linguistic may be difficult. While segmental aspects of speech (articulation of vowels and consonants) do strongly influence a speaker’s intelligibility, difficulties with suprasegmental aspects (tone, intonation, stress) also impair fluent, coarticulated speech. Struggles coordinating respiration, phonation, and articulation will negatively impact overall speech intelligibility and fluency of speech production. When this occurs, improving segmental phonetic production should be secondary to developing effective coordination of respiration, phonation, and articulatory aspects of speech production. Modifying these physiological patterns may improve production across all types of phonemes.