AOS Treatment Flashcards
Principles of AOS Treatment
Principles of motor learning that involve drill, self-learning and instruction, feedback, specificity of training, consistent and variable practice, and speed accuracy tradeoff tasks are important in treatment”
5 Approaches to AOS Therapy
- Articulatory-Kinematic
- Rate/Rhythm
- Intersystemic Facilitation/Reorganization
- Augmentative-Alternative Communication (AAC)
- Other
Articuatory Kinematic
- Focused on improving:
— Articulatory accuracy
— Spatial and temporal components of speech
— Speech intelligibility
- Common treatment components
— Repeated practice (motoric)
— Modeling - repetition
— Articulatory Cueing
Integral Stimulation 1
- Articulatory kinematic
- “Watch me, listen to me, and say it with me”
- 8 step continuum
- Auditory-Visual Stimulation
1. Clinician says the target word while the client watches and listens and then they produce the word simultaneously.
2. Clinician says the target word, and after a delay, mimes or mouths the target word (visual cue) and client tries to produce the word (simultaneous auditory cues are faded)
3. Clinician says the target word, and after a delay, the client tries to repeat the word (no visual cues)
4. Clinician says the target word, and after a delay, the client attempts to say the word several times
Integral Stimulation 2
- Client reads the target word aloud (note card)
- Target word is presented (note card), client reads it silently, word is removed, and client says the word out loud
- Clinician asks the client questions that enable them to produce the target word spontaneously
- Client is able to produce the target word in role playing situations
Sound Production Treatment 1
- Articulatory Kinematic
- Sound Production Treatment (SPT) is a…treatment that focuses on improving timing of articulation at the segmental and syllable level.”
- “SPT relies repetition, integral stimulation, modeling, and phonetic placement cues and feedback to facilitate consonant production.”
SPT 2
- Step 1: The clinician says the target item and requests a repetition (e.g. say “sun”)
— If correct, the clinician requests five additional repetitions and then moves to Step 5.
— If incorrect, the clinician gives feedback, using a minimal pair item (e.g. “That’s not quite right. Try “ton”)
— If correct, the clinician gives feedback and says, “Let’s go back to the other word,”
then moves to Step 2 with the target word.
— If incorrect, the clinician gives feedback, attempts production with integral stimulation up to 3 times, and then moves to Step 2 with the target word.
SPT 3
- Step 2: The clinician shows the printed letter representing the target word, says the target word, and requests a repetition. (e.g. “Let’s focus on the sound on this card. Say ‘sun’”)
— If correct, the clinician requests an additional 5 repetitions and then moves to the next item.
— If incorrect, the clinician moves to Step 3
- Step 3: The clinician uses integral stimulation up to 3 times to elicit the target word.
— If correct, 5 additional repetitions are requested.
— If incorrect, move to Step 4
SPT 4
- Step 4: The clinician gives articulatory placement cues, and requests production of the target word again, after cueing using integral stimulation. Cues are dependent upon the errors produced by the client.
— If correct, 5 additional repetitions are requested.
— If incorrect, the clinician moves to Step 5.
Step 5: Go to the next item.
Phonetic Placement
- Articulatory Kinematic
- Phonetic placement consists of deriving target sounds from non-speech gestures.
- Biting the lower lip for /f/ or /v/
- Wiping the mouth for bilabials
- Smiling for /i/ or puckering for /u/
Rate/Rhythm Treatments
- Focused on improving:
— Prosodic features of rate/rhythm
— Speech intelligibility (improves articulatory accuracy)
- Purpose of rhythmic control and rate treatment:
— Slow the individual’s rate of speech (improves articulatory accuracy)
— Increase rate of speech
— Eliminate excess pauses
Rate/Rhythm Treatment Approaches
- Metrical Pacing
- Metronomic Pacing
- Pacing Boards
- Finger Counting
- Melodic Intonation Therapy
- Contrastive Stress Drills
Metrical Pacing
- Repeated practice to pacing mechanism
- Follows natural rhythm/prosody of target utterance (rhythmically specific to the target)
- “Target utterance becomes a rhythmical skeleton, represented as a sequence of short tones”
— Metronomic pacing involves pacing to a beat
- Uses computer generated tones
- Involves hand tapping and choral speaking
Metrical Pacing Procedure
- Target utterance is repeated to client through head phones (enables internalization of utterance)
- Client synchronizes utterance with the computer generated auditory signal
- Computer provides immediate feedback regarding the client’s production
Treatment effects:
— Generalization to 2 syllable words (including target syllable)
— Generalization to complex targets
— Rate and fluency improves (does not improve artic.)
Intersystemic Facilitation/ Reorganization Treatments 1
- Intersystemic reorganization introduces into the performance of an act a functional system or set of behaviors that was not previously integral to that performance… [It] is the rebuilding of speech by the introduction into the act of speaking a system or sets of responses in a unique form or with a unique regularity.”
- “The two major intersystemic reoganizers are vision and manual gesturing.”
