Ch. 7: A Comprehensive & Evidence Based Treatment Program Flashcards
I. When selecting potential target behaviors, one must:
Target behaviors
Select short-term objectives and long-term goals.
In the schools we say benchmarks.
We also must consider:
Select Tx targets that are linguistically and culturally appropriate for the client.
Select targets that will make an immediate & socially significant in the client’s communication skills.
When selecting potential target behaviors, one must:
Target behaviors
Select short-term objectives and long-term goals.
In the schools we say benchmarks.
We also must consider:
Select Tx targets that are linguistically and culturally appropriate for the client.
Select targets that will make an immediate & socially significant in the client’s communication skills.
Remember to: (I.)
Connect Tx to classroom curriculum
Always keep Common Core state standards in mind
Dr. R always treats speech sound errors and language together.
Also, select more readily taught treatment targets such as;
Stimulable sounds treated before non-stimulable sounds
Teach visible sounds before non-visible sounds, lingua-dental /th/ before lingua-palatal /r/.
For a phonological process to be treated, should occur at least 40% of the time.
Remember to:
Connect Tx to classroom curriculum
Always keep Common Core state standards in mind
Dr. R always treats speech sound errors and language together.
Also, select more readily taught treatment targets such as;
Stimulable sounds treated before non-stimulable sounds
Teach visible sounds before non-visible sounds, lingua-dental /th/ before lingua-palatal /r/.
For a phonological process to be treated, should occur at least 40% of the time.
Select targets that affect intelligibility the most: (I.)
Select phonological processes that affect the most sounds
Processes that contribute the most to the child’s lack of intelligibility.
For example, stopping affects many sounds.
Select targets that affect intelligibility the most:
Select phonological processes that affect the most sounds
Processes that contribute the most to the child’s lack of intelligibility.
For example, stopping affects many sounds.
II. Deciding on the Number of Sounds or Patterns to teach:
If the child has 1-2 errors, the decision is easy
If the child has multiple errors, then we need to decide: do we train many sounds at once, or just a few?
Variables impacting this decision include:
Motivation, sometimes based on intellectual level
Age
Language and Learning skills
Time frame, do you have him/her for 1 year or 2 months.
II. Deciding on the Number of Sounds or Patterns to teach:
If the child has 1-2 errors, the decision is easy
If the child has multiple errors, then we need to decide: do we train many sounds at once, or just a few?
Variables impacting this decision include:
Motivation, sometimes based on intellectual level
Age
Language and Learning skills
Time frame, do you have him/her for 1 year or 2 months
III. Establishing Baselines:
When we give artic/phono tests and gather conversational speech samples, usually each phoneme is not adequately sampled.
An artic test might test /r/ in initial, medial, and final position only once. This very limited sampling, allow mistakes to be made.
For example, a child might not make /f/ correctly, substituting /t/ for /f/.
But later, the child makes the /f/ with 90% accuracy on repeated measures.
We counteract this by establishing a baseline before therapy starts.
Baselines are measured rates of behaviors in the absence of Tx.
III. Establishing Baselines:
When we give artic/phono tests and gather conversational speech samples, usually each phoneme is not adequately sampled.
An artic test might test /r/ in initial, medial, and final position only once. This very limited sampling, allow mistakes to be made.
For example, a child might not make /f/ correctly, substituting /t/ for /f/.
But later, the child makes the /f/ with 90% accuracy on repeated measures.
We counteract this by establishing a baseline before therapy starts.
Baselines are measured rates of behaviors in the absence of Tx.
Three purposes of baselines: (III)
- Establish clinician accountability: many third parties want numbers or quantitative data to evaluate progress.
- Evaluate child’s progress over time.
- Modify Tx procedures if child is not improving as expected.
Baseline procedures:
Specify the Tx targets in measurable items.
For example, produce /r/ in word-final position with 80% accuracy.
We need to be sure to specify response topography, which refers to the linguistic level of training.
Do we want to begin with /r/ in isolation or with /r/ in word-initial position in sentences?
Three purposes of baselines:
- Establish clinician accountability: many third parties want numbers or quantitative data to evaluate progress.
- Evaluate child’s progress over time.
- Modify Tx procedures if child is not improving as expected.
Baseline procedures:
Specify the Tx targets in measurable items.
For example, produce /r/ in word-final position with 80% accuracy.
We need to be sure to specify response topography, which refers to the linguistic level of training.
Do we want to begin with /r/ in isolation or with /r/ in word-initial position in sentences?
IV. Selecting the Initial Level and Sequence of Training:
Baselines help us create appropriate Tx objectives.
Pena-Brooks Hadge think it’s best to start Tx at word level, especially functional words.
For example, school, first, pencil, and please are functional words with /s/ in word-initial, medial, and final position.
IV. Selecting the Initial Level and Sequence of Training:
Baselines help us create appropriate Tx objectives.
Pena-Brooks Hadge think it’s best to start Tx at word level, especially functional words.
For example, school, first, pencil, and please are functional words with /s/ in word-initial, medial, and final position.
V. Developing Measurable Objectives
Tx or short-term objectives are the skills the clinician plans to teach on the way toward achieving the selected Tx targets or long-term goals.
Ex of long-term goals, “Increase the client’s intelligibility of speech.”
However, measurable short-term goals are needed:
These objectives specify how a goal will be achieved.
The objectives must be measurable so that external observers can verify the results of the clinical services provided.
Many third party players like insurance companies demand detailed documentation of improvement.
V. Developing Measurable Objectives
Tx or short-term objectives are the skills the clinician plans to teach on the way toward achieving the selected Tx targets or long-term goals.
Ex of long-term goals, “Increase the client’s intelligibility of speech.”
However, measurable short-term goals are needed:
These objectives specify how a goal will be achieved.
The objectives must be measurable so that external observers can verify the results of the clinical services provided.
Many third party players like insurance companies demand detailed documentation of improvement.
To Write a Good Objective: (V.)
Use observable behaviors by using verbal prompts like “point to” or “write”
Do not use words with non-observable behaviors like “memorize” or “understand”
Remember that data collection: (V.)
Should be done throughout Tx
A good baseline will support this
To Write a Good Objective: (V.)
Use observable behaviors by using verbal prompts like “point to” or “write”
Do not use words with non-observable behaviors like “memorize” or “understand”
Remember that data collection: (V.)
Should be done throughout Tx
A good baseline will support this
VI. Planning & Developing a Treatment Program or Plan:
Phonetic placement techniques are direct methods to teach clients how to position the articulators and produce the sound appropriately.
Successive Approximation or Shaping:
We take advantage of a sound the client can already make. Have them make /g/ and gradually move toward /r/
We Can Begin Training the Sound at One of several levels:
1. Isolation, 2. Syllable, 3. Word, 4. Phrase, 5. Sentence
If child can’t create a phrase/sentence with the target word:
We can use a carrier phrase: “I see ….”
VI. Planning & Developing a Treatment Program or Plan:
Phonetic placement techniques are direct methods to teach clients how to position the articulators and produce the sound appropriately.
Successive Approximation or Shaping:
We take advantage of a sound the client can already make. Have them make /g/ and gradually move toward /r/
We Can Begin Training the Sound at One of several levels:
1. Isolation, 2. Syllable, 3. Word, 4. Phrase, 5. Sentence
If child can’t create a phrase/sentence with the target word:
We can use a carrier phrase: “I see ….”
VII. Structuring Treatment Sessions:
Initial Tx sessions highly structured
Tx sessions gradually loosed up to replicate natural “real world” more
Helps child generalize target sounds to spontaneous speech
VII. Structuring Treatment Sessions:
Initial Tx sessions highly structured
Tx sessions gradually loosed up to replicate natural “real world” more
Helps child generalize target sounds to spontaneous speech
VIII. Increasing and Strengthening Established Behaviors
Selecting potential reinforcers
Positive Reinforcers are rewards and strengthens the behavior
Primary reinforcers like food and water.
Secondary reinforcers incorporate social values like verbal praise, tokens, stickers, Dr. R’s treasure chest
VIII. Increasing and Strengthening Established Behaviors
Selecting potential reinforcers
Positive Reinforcers are rewards and strengthens the behavior
Primary reinforcers like food and water.
Secondary reinforcers incorporate social values like verbal praise, tokens, stickers, Dr. R’s treasure chest
IX. Generalization usually refers to the child’s producing learned responses in settings outside of clinic
Child uses sound in other locations with other audiences
IX. Generalization usually refers to the child’s producing learned responses in settings outside of clinic
Child uses sound in other locations with other audiences
X. Implementing A Maintenance Program
General considerations:
Maintenance is the ultimate goal
Skills sustained over time
Select stimuli from client’s natural environment
X. Implementing A Maintenance Program
General considerations:
Maintenance is the ultimate goal
Skills sustained over time
Select stimuli from client’s natural environment
We should vary the physical setting (V.)
Conduct therapy in different environments
We need to teach multiple exemplars like:
quick children on /r/ in word-initial position may get up to 90% accuracy after 20 pictures
Some children may need 50 pictures, 30 objects, and 10 books with /r/ initial stimuli before they achieve 90% accuracy
We should vary the physical setting (V.)
Conduct therapy in different environments
We need to teach multiple exemplars like:
quick children on /r/ in word-initial position may get up to 90% accuracy after 20 pictures
Some children may need 50 pictures, 30 objects, and 10 books with /r/ initial stimuli before they achieve 90% accuracy
