3.9b Facilitating Techniques Flashcards

1
Q

Anterior/posterior Nasal fricatives

A
  • Occlude nostrils if there is a VPI or not easily stimulable
    • This eliminates the nasal air loss
  • Release /t/ to make /s/:
    • This uses a correctly produced stop sound to teach the equivalent fricative
      1. Have the child produce a loud /t/ sound
      2. Then have the child produce the /t/ with the teeth closed. This will result in /ts/
      3. Have the child prolong the production until it becomes /tsss/
      4. Have the child note the position of the tongue and the air stream flowing over the tongue during production
      5. Finally, eliminate the tongue tip movement for the /t/ component
  • This technique can also be used to target: /sh, ch, dg/
  • If unable to produce /t/ Extend tongue for /th/ and pull back to form /s/
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2
Q

Anterior/posterior nasal fricatives

A
  • Use auditory feedback (straw):
    - This provides the clinician and patient with feedback about oral pressure and oral air flow.
    1. Place a straw at the point of your own central incisors during production of a sibilant sound
    2. Note the sound of the airflow through the straw
    3. Have the child put a straw in front of his incisors and amplify the air through the straw during production. If necessary, have him start with a /t/ sound
    4. This can be fashioned into different phonemes: /s, sh, ch, dg)
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3
Q

Anterior/posterior nasal fricatives

A
  • Establish oral airflow for fricative sounds:
    - Teach oral airflow through blowing
    - Blow bubbles, use cotton balls/packing peanuts (ie: speech puffs)
    - May need to use nasal occlusion

As soon as oral airflow established teach consonant production with:

 - Bite bottom lip + blow to make /f/ (add voicing for /v/)
 - Stick tongue out/between teeth + blow for /th/: 
 - Pucker lips + blow for /sh/ 

This helps focus articulation in the mouth rather than the pharynx or velum

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4
Q

Mid-Dorsum Palatal Stops

A
  • For /t/ and /d/
    Model an over-exaggerated, labio-dental anterior tongue placement
    • Cue child to “put tongue between teeth”
    • A mirror can provide helpful feedback
  • For /k/ and /g/
    Have the child bite on a tongue blade so that it is between the canine or molar teeth
    - Make sure it is back far enough to depress the middle part of the tongue, which prevents a dorsal production 

Have the child produce velar sounds (/k/, /g/, and /ng/) behind the tongue blade

Can also utilize release of /ng/ for /k/ strategy (say “ink”)

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5
Q

Lateral Distortions

A

Treat when not related to dentition and /or/ for errors persisting following dental correction

Release /t/ to make /s/:
- This uses a stop sound with central airflow to teach central airflow for the sibilant. This requires that airflow for the /t/ is central.

Release /t/ and pucker to create /sh/

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6
Q

How to eliminate very mild hypernasality

A
  • auditory feedback
  • tactile feedback
  • lower back of tongue
  • increase volume (just during therapy)
  • Open mouth
  • Slow rate of speech
  • Eliminate nasal emission
  • CPAP therapy
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7
Q

Why do we whisper as a facilitating technique?

A

eliminates distortion of hypernasality and allows more isolated evaluation of articulation. Eliminates or lessens glottal stop

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8
Q

Why do we occlude nostrils as a facilitating technique?

A
  • Increase oral air pressure by preventing nasal pressure loss
  • Prevent nasal air flow associated with “nasal fricatives”
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9
Q

Why do we over enunciate/aspirate (e.g. puff out cheeks) as a facilitating technique?

A
  • Maximizes oral air pressure and velar elevation, which improves intelligibility
  • May achieve closure for small VPI
  • The amount of velopharyngeal movements is directly related to oral pressure (moon and Kuehn)
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10
Q

Why do we utilize straw placed at central incisors or attached to see-scape for facilitating technique?

A
  • provides auditory biofeedback
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11
Q

Why do we establish oral airflow with blowing as a facilitating technique?

A

can be fashioned into sibilant sounds

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12
Q

Why do we use tongue blade to restrict anterior tongue elevation as a facilitating technique?

A

Used in t/k substitutions, prevents tongue-tip elevation, posterior tongue usually elevates spontaneously

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13
Q

Why do we use tongue blade between canines as a facilitating technique?

A

Open bite when there is an overbite and lateralization of /s/. can help establish placement for mid-dorsum palatal stops

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14
Q

Why do we use reverse chaining as a facilitating technique?

A

Useful for: blends, e.g. “nake” …. “sssnake”
Syllables: “Na” …. “Li-na” … “Ca-ro-li-na”
Example: coo?ee –> kee, kee, kee-coo–kee coo—kee

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15
Q

Why do we use a bendable straw?

A

aka: The variable Directional Air turbulence Detector

- Establish appropriate tongue position-central air flow

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16
Q

Why do we use the see-scape?

A

Feedback of oral pressure and flow

17
Q

Why do we use tactile (back of hand)?

A

Helps maximize oral pressure and articulation

18
Q

Why do we use oral listening tube/toobaloo?

A

Amplifies oral sounds

19
Q

Why do we use air paddle?

A
  • Cut from a piece of paper, it can identify nasal air emission
  • Placed in front of the mouth, emphasize oral airflow
20
Q

What do we need to know about speech viewer/sound recorders?

A
  • Provides different options for displaying and analyzing a signal
  • Statistics can be used for assessment and feedback purposes
  • Various displays visually differentiate voiced and voiceless cognates
  • The displays from a waveform and a spectrogram can be compared
21
Q

What do we need to know about audacity/voice recorders?

A
  • Great for long distance follow-up

- Can be used to visualize voice onset time

22
Q

What Ipad apps are good to use?

A
  • Word vault
  • Recorder and editor
  • Notability
23
Q

Why do we use nasometer games?

A
  • provide biofeedback
  • ability to set a nasalance threshold
  • children speak target utterances while wearing headset
  • when threshold is achieved, the image on the screen reacts
24
Q

What apps should we use for reinforcement and motivation?

A
  1. Bla bla bla
  2. Make a scene: sticker pages
  3. Timer+