chapter 8 Flashcards
treatment sequence principles
antecedent event
response
consequent events
antecedent event
stimuli designed to elicit a response
verbal model, pictures, instructions
response
targeted behaviors ranging from approximatioins to correct productions in complex contexts
consequent events
feedback following a response
reinforcement like praise –> positive reinforcement crucial
goal attack strategies
vertical
horizontal
cyclical
vertical
1-2 goals until mastery
good for persistent / residual errors
useful for clients w/ limited goals
mass practice promotes generalization
horizontal
multiple goals at the same time
exposes clients to wide range of examples –
facilitating broader phonological development
good for clients w/ multiple errors
cyclical
combines veritcal & horizontal
1 target for a fixed amount of time before moving to another
variety in sessions
effective for clients w/ multiple errors
child level factors for scheduling
age
severity of disorder
attention span
environmental level factors for scheduling
pull out vs classroom based intervention style
clinician caseload
parent preference
intense scheduling
4-5 sessions / week for 8-10 weeks
higher initial gains & dismissal rates
intermittent scheduling
2-3 sessions / week over extended periods
better for sever disorders
what kind of sessions yield better results
shorter, more frequent sessions
what may be more effective than intermittent scheudling
block scheduling (daily sessions)
what else may be effective for children in therapy regarding scheduling
breaks (10 weeks on, 10 weeks off)
w/ added parent education
pull out therapy
client leaves the classroom for individual or small group therapy
traditionally used for articulation / Phonological disorders
classroom based instruction
therapy integrated into daily routines
leveraging academic or social contexts
can be really effective if done well – seeing classmates learn
individual instruction
targeted, 1-on-1 intervention
often used for severe disorders or specific motor-based training
group sessions
groups of 3-4 w/ similar age (within 3 years) & target behaviors
comparable effectiveness to individual sessions when session duration & frequency are controlled
potential downside to group sessions
sessions may limit individual focus / variability
common intervention styles
drill - repeat over & over again
drill play - repeat so many times to get to play the game
structured play - toys revolve around target
play - spontaneous speech?
generalization
ultimate goal of therapy
producing the target sound correctly in all contexts
stimulus generalization
generalization of a learned skill w/ & w/out presence of a particular stimuli
child can produce the sound correctly w/ different stimuli or no stimuli
response generalization
responses taught transfer to untrained behaviors
teaching /s/ results in correct production of /z/ because they share features
across word position generalization
gen of correct productions from one word position to another
sound/feature generalization
correct productions of 1 sound generalizes to another within the same class or w/ similar features
teaching /f/ may generalize to other fricatives
may initially overgeneralize
contextual generalization
transfer of sounds across phonetic contexts
/s/ in “ask” to /s/ in “biscuit”
success depends on stabilizing correct productions in facilitating contexts
across linguistic unit generalization
Shifting sound production across linguistic levels (syllables, words, sentences)
across situation generalization
critical for dismissal from therapy
correct productions of all sounds in places outside of therapy (classroom, playtime, at home, etc)
how to support across situation generalization
Collab w/ parents & teachers
teach child self-monitoring techniques
across linguistic unit generalization
shifting sound productions across linguistic levels
syllables –> words –> sentences
across linguistic unit generalization approaches
begin at client’s highest level of competence
teach sounds in nonsense syllables or words to reduce interference from error
benefits for targeting non-stimulable sounds
may lead to more system wide change
facilitates generalization
benefits of targeting stimulable sounds
builds confidence w/ faster progress
enhances motivation which enhances long term retention
developmentally / linguistically they may not be ready to hit their non-stimulable sounds
who can help in the generalization process
parents - if able to provide appropriate feedback & discriminate differences in sound productions correctly
paraprofessionals
teachers
special education
factors influencing generalization
individual variability
training strategies
role of contexts – facilitative
error patterns – type & severity influence time & success
maintenance phase
final phase of therapy
involves habituation of new target behaviors & client self-monitoring
automization
automization
automatic production of correct articulation in spontaneous speech
mastery of linguistic rules & phonemic contrasts
mastery of motor behaviors
consistent use of target behaviors in everyday speech
self-monitoring
encouraged during maintenance phase to consolidate learning
ability to correct themselves
factors influencing retention
meaningfulness of material
degree of learning
freq & distribution of practice
motivation
meaningfulness of material
use familiar & relevant words for better long term retention
nonsense syllables may be useful in early stages
degree of learning
greater number of trials/challenges during learning = improved retention
freq & distribution of practice
short, frequent sessions are more effective
motivation
higher motivation can enhance retention
dismissal criteria vary depending on
client’s age
nature & severity of speech issues
external factors – policy constraints or caseload
dismissal criteria preschool
often improve w/out stringent criteria after learning new sounds
dismissal criteria older clients
may need stricter criteria due to more habituated errors resistant to change
guidelines for maintenance & dismissal
intermittent reinforcement during maintenance phase
clients should take increasing responsibility for self-monitoring
monitor phonologic behavior periodically to inform decisions
avoid retaining clients longer than necessary
evidence based practice
ensures therapy interventions are effective & document changes in client communication
ongoing assessment essential for objective performance measurement
document treatment outcomes systematically to support accountability
probes
used to monitor progress
targets not used in treatment
help determine what is actually causing change
other factors possibly responsible for clinical change
natural growth
placebo
hawthorne
Regression to the mean
treatment from another clinician
parent practice at home
teacher practice in the classroom
controlling extraneous factors
multiple base line approach
are you seeing generalization based on what you’ve worked on
going back & seeing if they can still produce the sound
3 key components of EBP
best available evidence
clinical expertise
client preferences & values
best available evidence
prioritize approaches proven efficient through research
clinical expertise
collect accurate data during intervention to minimize extraneous effects
clients preferences & values
incorporate client / family input into treatment options
