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ECU ARTIC/PHON exam 1 > Chapter 9 > Flashcards

Chapter 9 Flashcards

1
Q

What are the two dichotomized approaches to treating SSDs?

Are these usually chosen between or combined?

A

Motor-Articulation

Linguistic-Phonologic

Combined

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2
Q

What are ASHA’s evidence levels?

A

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

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3
Q

What is Level Ia?

3

A

Well-designed meta-analysis

More than one controlled trial

Randomized

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4
Q

What is Level Ib?

2

A

Well-designed controlled study

Randomized

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5
Q

What is Level IIa?

2

A

Well-designed controlled study

Not randomized

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6
Q

What is Level IIb?

A

Well-designed, quasi-experimental study

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7
Q

What is Level III?

A

Well-designed, nonexperimental studies

i.e., correlational and case studies

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8
Q

What is Level IV?

3

A

Expert committee report

Consensus Conference

Clinical experience of respected authorities

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9
Q

What is the first stage of treatment?

A

Establishment

eliciting and stabilizing desired client behaviors at a voluntary level

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10
Q

How is Establishment accomplished with a motor-based approach?

A

Teaching correct production

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11
Q

How is Establishment accomplished with a linguistic-based approach?

What does this assume?

A

Using contrasting sounds to teach the difference

Assumes production skill is already present

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12
Q

What is the second stage of treatment?

A

Generalization

Facilitating transfer or carryover of learned behavior across various levels

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13
Q

How do new skills need to be Generalized?

9

A

Across positions

Across contexts

Across linguistical units

Across sounds

Across syllables

Across words

Across sentences

In conversation

Across situations

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14
Q

What is the third stage of treatment?

A

Maintenance

Facilitating stabilization and retention of new skills. Responsibility transferred to client.

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15
Q

Do Maintenance and Generalization overlap?

A

Yes

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16
Q

What are other names for Motor-Based Treatment?

2

A

Traditional Approach

Traditional Articulation Approach

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17
Q

What are the three parts of Motor Learning Principles?

3

A

Prepractice Goals

Principles of Practice

Principles of Feedback

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18
Q

What are Prepractice Goals in Motor Learning Principles?

3

A

Finding out what will motivate child

Making sure child understands how to do tasks

Making sure child’s perceptual abilities are adequate

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19
Q

What are the Principles of Practice in Motor Learning Principles?

(5)

A

More frequent but shorter sessions when possible

Practice under many conditions

Present targets in a random sequence

Focus should be on target - not individual articulator movements

Better to practice entire speech target than breaking it down into steps

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20
Q

What are Principles of Feedback in Motor Learning Principles?

(2)

A

Knowledge of Performance (what is being done correctly and incorrectly)

Knowledge of Results (was target produced correctly)

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21
Q

Why should there be a slight delay before giving feedback?

A

So that the child has a chance to judge their own performance

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22
Q

What are four different types of Perceptual Training?

A

Traditional Ear Training

Perceptual Training of Sound Contrasts

Perceptual Training Software

Amplified Auditory Stimulation

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23
Q

What is another name for Traditional Ear Training?

A

Speech Sound Discrimination Training

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24
Q

When is Perceptual Training needed?

A

When child cannot discriminate target from other speech sounds

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25
Q

Does Perceptual Training always need to be a separate step?

A

No - it can be incorporated into production training

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26
Q

What are the four steps to Traditional Ear Training?

A

Identification (learning target)

Isolation (listening for target in more complex environments)

Stimulation (auditory bombardment)

Discrimination (is target produced correctly or incorrectly?)

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27
Q

What is Perceptual Training of Sound Contrasts?

A

Perception training that focuses on minimal pair contrasts

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28
Q

What are the two steps to Perceptual Training of Sound Contrasts?

A

Introduction of a minimal pair

Contrast training (practice portion)

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29
Q

What is Perceptual Training Software? (2)

Is it designed to be used alone?

A

Software designed to improve perceptual skills

Provides visual feedback an keeps track of child’s accuracy

No - child works with an adult

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30
Q

What is another name for Amplified Auditory Stimulation?

A

Auditory Bombardment

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31
Q

What SSD treatment uses Amplified Auditory Stimulation?

When is it used?

A

Cycles approach

Beginning and end of each treatment session

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32
Q

What is Focused Auditory Input?

When is it used

A

Adult plays with child while producing as many models of target sound as possible

When a child cannot or will not produce a target

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33
Q

What is Production Training?

3

A

Motor-based intervention

Teaching child to produce target

Stablizing target production

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34
Q

What are the four approaches to Production Training?

A

Imitation (client repeats model)

Phonetic Placement (client is instructed in where to place articulators)

Successive Approximation (Shaping, modifying a sound in client’s repertoire)

Contextual Utilization (isolating a sound from a particular context where it is used correctly

35
Q

What are the three types of Motor-Based Treatment Approaches?

A

Traditional Articulation Approach

Context Utilization Approaches

Alternative Feedback Approaches

36
Q

What are the four steps to the Traditional Articulation Approach?

A

Identifying errors

Establishing correct productions

Generalize productions

Maintainenance

37
Q

What are the contexts used in the Traditional Articulation Approach?

(6)

A

Isolation

Nonsense Syllables

Words

Phrases

Sentences

Conversation

38
Q

What does the Traditional Articulation Approach assume?

2

A

Speech sound errors may be due to faulty perception

Speech sound errors may be due to poor motor production

39
Q

What are the strengths of Traditional Articulation Approach?

3

A

It is widely used and studied

Steps are logical

Useful for clients with an articulation disorder

40
Q

What are the weaknesses of Traditional Articulation Approach?

(2)

A

The need for perceptual training is questioned

Not as effective for clients who have a linguistic disorder

41
Q

Does research support the Traditional Articulation Approach?

A

Yes (minus perceptual training)

42
Q

What are Context Utilization Approaches?

2

A

Sensory-motor-based approach

Stimulability tasks followed by practice using nonsense syllables -> word/word-pair practice -> rehearsal sentences ->narratives

43
Q

What is the assumption behind Context Utilization Approaches?

A

Errors can be corrected by extensive motor practice is sound is in client’s repertoire

44
Q

What is unique about Context Utilization Approaches?

A

They emphasize imitated repetition of productions

45
Q

What are the strengths of Context Utilization Approaches?

3

A

Build on behaviors in the client’s repertoire

Capitalizes on syllables + auditory, tactile, and kinesthetic awareness or motor movements

Useful for clients who produce target inconsistently

46
Q

What are the weaknesses of Context Utilization Approaches?

A

Difficult to motivate children to do this much imitation and drill

47
Q

What are Alternate Feedback Approaches?

A

Gives child supplemental feedback about productions

48
Q

What are two types of Alternate Feedback Approaches?

A

Tactile feedback

Visual feedback

49
Q

What is a Tactile Feedback Approach?

3

A

Client wears removable device similar to an orthodontic retainer

Small acrylic block is built into device to give client a landmark for /r/ production

Used during therapy and practice sessions

50
Q

What are four types of Visual Feedback Approaches?

A

Ultrasound imaging

Palatography (creating images of how tongue contacts palate during speech)

Electroplatography (EPG, artificial palate with pressure sensors is inserted and connected to computer)

Spectrograms

51
Q

What are the assumptions behind Alternate Feedback Approaches?

A

Typical internal and external feedback does not help children with SSDs. They need something more.

52
Q

What are the strengths of Alternate Feedback Approaches?

A

Presence of novel feedback may help with long-established incorrect pronunciations

53
Q

What are the weaknesses of Alternate Feedback Approaches?

3

A

Cost

Most clinicians have limited experience with the technology

Most require something unnatural in oral cavity and may make speech unnatural (may impede generalization)

54
Q

Are Alternate Feedback Approaches supported by research? (3)

Spectrograms?

EPGs?

A

Tactile approaches supported by anecdotal evidence only

Most studies support positive outcomes with visual approaches

More research needed

Spectrogram studies limited

EPG most studied - some positive evidence

55
Q

What is the Core Vocabulary Approach?

5

A

Child learns 50 functionally-powerful words

Each week 10 of these words are randomly chosen and targeted

At end of twice-per-week sessions, child produces each word three times

Words produced consistently are removed from list

Untreated words are probed 3x every two weeks

56
Q

Who does the Core Vocabulary Approach target?

A

Children with severe and inconsistent speech sound productions

57
Q

What are Functionally-Powerful Words?

4

A

Names

Places

Foods

Child’s favorite things

58
Q

What is the assumption behind the Core Vocabulary Approach?

A

If child’s productions are more consistent, they will be better understood

59
Q

What are the strengths of the Core Vocabulary Approach?

A

Intelligibility is the overriding goal of all therapies

60
Q

What are the weaknesses of the Core Vocabulary Approach?

2

A

Only applicable to those with inconsistent speech

No detail provided on how to achieve consistency

61
Q

Is the Core Vocabulary Approach supported by research?

A

Few studies - seem positive

62
Q

What are Nonspeech Oral-Motor Activities?

A

Training as a precursor for teaching speech sounds

63
Q

What are three examples of Nonspeech Oral-Motor Activities?

A

Horn/whistle blowing

Sucking through straws

Tongue wagging

64
Q

Why are Nonspeech Oral-Motor Activities controversial?

2

A

They were only supported philosophically originally

Research does not support their use

65
Q

What sort of speech production is seen in children with CAS?

5

A

Difficulty with precise speech targets

Inconsistent productions

Trouble bridging all the various elements of speech

Difficulty transitioning between sounds (coarticulation, etc.)

Inappropriate prosody

66
Q

What is often comorbid with CAS?

3

A

Neuromuscular problems like dysarthria

Other apraxias (Oral, limb, etc.)

Specific Language Impairment

67
Q

Do we always know the etiology of CAS?

A

No

68
Q

Which is usually stronger in CAS: receptive or expressive skills?

A

Receptive

69
Q

How do we assess CAS?

7

A

Oral mech exam (is dysarthria or oral apraxia present)

Diadochokinetic tasks

Imitative utterances (V, CV, VC, C₁VC₁, C₁VC₂)

Connected speech sample

Phonological assessment imitating words of increasing syllables

Suprasegmental analysis

CAS-specific assessments

70
Q

What must clinician keep in mind when analyzing speech performance in CAS?

(2)

A

There will be trouble in syllable sequencing

Movements, transitions, and timing should be observed at various linguistic levels

71
Q

To whom might we refer seriously impaired children with CAS?

A

A neurologist to determine current status of neurological functioning

72
Q

Is treatment for CAS supported by research?

A

Not a lot of research has been done

73
Q

How do children with CAS progress in treatment?

A

Slowly

74
Q

How do we treat CAS?

5

A

Short-term goals

Learning production units

Frequent drill and practice emphasizing transitions and movement timing

Possibly AAC intervention

Tactile-kinesthetic prompts and cues

75
Q

What might be some short-term goals for CAS?

A

Functional, intelligible vocabulary

76
Q

What should all production activities include with CAS?

Why?

A

Attention to syllable structure and combinations

To learn building blocks of words

77
Q

Are more frequent, shorter sessions useful in treating CAS?

A

Yes

78
Q

What is a tactile-kinesthetic prompt program useful for CAS?

A

PROMPT

Prompts for Restructuring Oral Muscular Phonemic Targets

79
Q

What is a rhythmic/melodic facilitation approach useful in CAS?

A

Melodic Intonation Therapy

80
Q

What is the most comprehensive set of instructional materials for treating clients with motor planning difficulties?

A

Nuffield Centre Dyspraxia Programme

81
Q

What are the three stages of treatment?

A

Establishment

Generalization

Maintenance

82
Q

When do we need to teach/establish sounds?

4

A

Sound is not in client’s repertoire

Sound only exists in limited phonetic contexts

Sound is not perceived in minimal pairs

Sound is not easily incorporated into syllable/word units

83
Q

Is the traditional articulation method vertical or horizontal?

A

Vertical

ECU ARTIC/PHON exam 1 (13 decks)

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