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Phonological & Articulation Disorders > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

phonological therapy approach is best for:

A

children with phonological-based error patterns

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2
Q

intervention begins at the WORD level - where sounds have value in “meaning” (e.g., fin vs chin, sad vs sat)

A

principle of phonological therapy approach

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3
Q

error patterns are taken into consideration when selecting targets

A

principle of phonological therapy approach

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4
Q

may address multiple targets and/or entire sound classes

A

principle of phonological therapy approach

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5
Q

minimal pair

A

word pair that differs by only one phoneme

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6
Q

target word: cool
comparison: tool

A

minimal pair

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7
Q

select two sounds that are as similar as possible

A

minimal contrasts/opposition (phoneme contrast (e.g., t/k, d/t, t/s, p/f))

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8
Q

differ by only a phoneme or single feature

A

minimal contrasts/opposition (phoneme contrast)

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9
Q

minimal contrasts/opposition examples

A

bat-pat: voicing
tea-key: place
toe-so: manner

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10
Q

minimal contrasts/opposition is best for:

A

children with mild to moderate phonological impairment
< 6 errors patterns; error subst. are consistent
phonological delay

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11
Q

minimal contrasts/opposition targets

A

5-10 word pairs that mirror the child’s typical errors

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12
Q

maximal contrasts/opposition is best for:

A

children with moderate to severe phonological impairment
AKA: +6 sounds missing from the phonemic inventory

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13
Q

maximal contrasts/opposition targets:

A

5-10 word pairs that do NOT mirror the child’s errors
ideally, sounds in both word pairs are not in client’s sound inventory
two sounds are selected that are different
differ by production of all phonological features if possible

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14
Q

the goal: teach new sounds that represent different aspects of the phonological system and highlight the diversity of the phonological system

A

maximal contrasts/opposition

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15
Q

maximal contrasts/opposition activities

A

speech production practice (e.g., drill-play) + sorting + matching

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16
Q

multiple contrasts/opposition is best for:

A

children with moderate to severe phonological impairment (3-6 yo)
+6 error patterns across three manner categories

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17
Q

multiple contrasts/opposition targets

A

two to four sound to be used in word pair of the error sounds vs subst. (word 1 - contains a phoneme child can produce; word 2-4 - contains subst. that are maximally distinct from the error sounds)

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18
Q

primary focus: to enhance speech intelligibility by selecting a phoneme collapse as the target

A

multiple contrasts/opposition

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19
Q

multiple contrasts/opposition intervention includes

A

drill practice -> less drill-based and with more communicative context

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20
Q

therapy progression for minimal contrasts: step 1

A

discussion of words: clinician teaches the child the concepts within the words

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21
Q

therapy progression for minimal contrasts: step 1 procedure

A

clinician asks the child questions about each picture; child is required to point to the correct picture

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22
Q

therapy progression for minimal contrasts: step 2

A

discrimination testing and training: clinician tests child’s ability to discriminate between two targets

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23
Q

therapy progression for minimal contrasts: step 2 procedure

A

clinician produces word pairs in random order while patient points to the picture the clinician names; criteria is 7 consecutive correct responses

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24
Q

therapy progression for minimal contrasts: step 3

A

production training: clinician prompts child to produce minimal word pairs; sound teaching strategies are used as needed to teach target sounds

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25
Q

therapy progression for minimal contrasts: step 3 activity

A

child acts as the “teacher” prompting clinician to point to picture he/she says; “hide the penny”

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26
Q

therapy progression for minimal contrasts: step 4

A

carryover training: clinician prompts child to produce minimal word pairs in phrases/sentences of increasing length

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27
Q

generalization

A

production of a learning response in a new context
production of an untrained response

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28
Q

maintenance

A

ability to continue producing sounds correctly over time and across situations

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29
Q

select targets that have functional impact on child

A

promotes maintenance and generalization

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30
Q

select treatment stimuli from child’s environment

A

promotes maintenance and generalization

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31
Q

continue treatment until mastery is achieved in conversation

A

promotes maintenance and generalization

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32
Q

use natural reinforcers

A

promotes maintenance and generalization

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33
Q

fade reinforcement

A

promotes maintenance and generalization

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34
Q

invite various people into therapy

A

promotes maintenance and generalization

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35
Q

move treatment outside of the therapy room

A

promotes maintenance and generalization

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36
Q

teach self-monitoring

A

promotes maintenance and generalization

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37
Q

work closely with families

A

promotes maintenance and generalization

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38
Q

phonetic placement

A

teaching the articulatory placement of a sound

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39
Q

how to use phonetic placement

A

model the position (mirror)
show pictures of the correct articulatory position
use manual guidance (hands, cotton swab, etc)

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40
Q

Successive Approximation: sound shaping

A

use of a sound the child can ALREADY make to learn a new sound

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41
Q

successive approximation: sound shaping example

A

t to sh
produce a hard t with lip protrusion
maintaining lip protrusion, produce the t again, but slowly pull the tongue back

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42
Q

Modeling

A

clinician models (produces) the target response

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43
Q

therapy using modeling

A

child carefully watches clinician produce the target and is then encouraged to repeat the production
can use VOCAL EMPHASIS to highlight the sound

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44
Q

modeling example

A

Johnny, say [rrrrrrrrred]

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45
Q

verbal instruction

A

verbal stimuli to help facilitate a client’s actions
often given prior to a model

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46
Q

verbal instruction example

A

for /k,g/ “see the back of my tongue, I’m going to make it go up really high to touch the top of my mouth in the back”

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47
Q

Prompt

A

hints or cues that help facilitate an expected response

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48
Q

types of prompts

A

verbal
nonverbal

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49
Q

verbal prompt

A

use of vocal emphasis
“remember where your tongue goes for that sound”
“don’t forget the sounda t the end of the word”

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50
Q

nonverbal prompt

A

AKA physical prompts, visual cues, visual stimulation
physical signs and gestures that might help the child visualize correct production of the sound

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51
Q

example of nonverbal prompt

A

apraxia hand signals

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52
Q

positive reinforcement

A

an event that follows a response that increases the response’s frequency

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53
Q

types of positive reinforcement

A

primary
secondary
fading

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54
Q

primary reinforcement

A

food and drink

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55
Q

secondary reinforcement

A

verbal praise, positive attention, smiles, tokens, stickers, etc.

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56
Q

fading reinforcement

A

being with consistent/continuous reinforcement and fade as accuracy increases

57
Q

guidelines for positive reinforcement

A

Reinforce promptly
Provide clear statements
Be positive
Vary use of phrases

58
Q

corrective feedback

A

feedback that informs the child when an error has been made

59
Q

how to use corrective feedback

A

provide feedback for ALL incorrect productions
withdraw positive reinforcement
make sure positive reinforcement EXCEEDS corrective feedback

60
Q

touch the child’s alveolar ridge with a tongue depressor to indicate the place of articulation for /l/

A

phonetic placement

61
Q

“Rebecca, say [sssssup]

A

modeling

62
Q

“I like how you produce /s/. Good work!”

A

positive reinforcement

63
Q

hand gesture to facilitate /r/ production

A

nonverbal prompt

64
Q

general philosophies or ways of thinking

A

approach

65
Q

guides your ENTIRE course of treatment

A

approach

66
Q

specific actions implemented to facilitate execution of a desired behavior

A

strategy

67
Q

also known as: techniques

A

strategy

68
Q

measured rate of behavior in the absence of treatment

A

baseline

69
Q

MAIN purpose of establishing baseline

A

measure the child’s performance of a skill prior to beginning treatment
help with identifying a “starting point” for therapy

70
Q

other purposes for establishing baseline

A

evaluate child’s progress over time
establish clinician accountability
modify treatment as needed

71
Q

establishing baseline: evoked

A

ask child to name pictures with target sound in all positions. no model provided
develop a list of questions or fill in the blank sentences in which answers are words that contain target sounds

72
Q

establishing baseline: modeled

A

ask child to name pictures with target sound in all positions given a model
develop a list of words and ask child to say following a model

73
Q

how many targets to select with TRADITIONAL

A

no more than 2 targets at a time
targeting more sounds can cause confusion

74
Q

how many targets to select with CURRENT

A

work on multiple targets (2+ sounds) at one time
targeting multiple sounds/errors yields faster progress

75
Q

approaches to target selection

A

developmental norms
easy to teach
hard to teach
impact on intelligibility

76
Q

developmental norms

A

based on selection of age appropriate sounds and patterns
age appropriate sounds are easier to teach
makes sense to teach sounds in the normal sequence

77
Q

developmental norms examples

A

5 yo would work on sounds typically mastered by children 5 yo or younger
4 yo would work on error patterns typically suppressed by children 4 yo or younger

78
Q

developmental norms: criticisms

A

not challenged as an approach
current research suggests teaching AHEAD of developmental norms might be beneficial

79
Q

easy to teach

A

ideal targets
sounds in the child’s current repertoire
phonological processes that are unstable/inconsistent

80
Q

easy to teach: criteria for SOUNDS

A

20-40% accuracy - IDEAL TARGET
sounds the child is stimulable for
visible sounds (p b f)

81
Q

easy to teach: criteria for PHONOLOGICAL PROCESSES

A

error with a percentage of occurrence less than 100% (but more than 40%)
errors that occur only in certain contexts

82
Q

hard to teach

A

ideal targets:
complex phonological patterns
sounds that are consistently omitted by the child
sounds nonexistent in child’s sound repertoire
sounds the child is NOT stimulable for

83
Q

hard to teach: research support

A

acquisition of easier sounds and patterns achieved with no therapy
higher rate of generalization to settings outside of therapy

84
Q

impact on intelligibility

A

ideal targets are ones that make a notable difference in intelligibility:
phonological or sound errors that occur frequently
phonological errors that affect large numbers of sounds (e.g., stopping)
phonological errors that are idiosyncratic (backing, glottal replacement)

85
Q

impact on intelligibility: other considerations

A

address multiple sounds if needed
address sounds that occur frequently in the child’s speech (AKA high frequency words)

86
Q

Client will improve articulation skills to an age-appropriate level as measured by an intelligibility rating of ≥ 90% in settings outside of the clinic.

A

LTG: broad (long term goal)

87
Q

In 3-months of therapy, the client will correctly produce /r/, /l/ phonemes in words with 80% accuracy given minimal cues.

A

STO: specific (short term objective)

88
Q

long term goal

A

broad communication behaviors
age appropriate articulation, phonological skills, intelligibility, etc.

89
Q

short term objective

A

skills that can be taught in a relatively short period of time
steps to achieve the LTG
production of specific sounds or elimination of error patterns
2 weeks, 1 month, 3 months

90
Q

target behavior

A

any skill or action that is taught to a client
treatment “goals” & “objectives”

91
Q

Common elements of an individual treatment program

A

Development of follow up procedures
Involvement of child’s family in treatment
Establishment of baseline measures
Implementation of strategies to facilitate generalization
Selection of stimulus materials
use of sound evoking techniques
selection of target behaviors

92
Q

best practice for approaches to speech sound disorders

A

take elements from well-researched approaches to develop an individualized, comprehensive treatment plan for each client

93
Q

The SLP selected the /r/ phoneme as target for therapy because her client was able to produce those sounds correctly on her own on approximately 30% of opportunities in words.

A

easy to teach

94
Q

Which one of the following minimal pair words could be the most appropriate pair of MINIMAL CONTRAST if the target was fronting of [k]?
A. cake – shake
B. key – bee
C. keep – deep
D. coast – toast
E. keep- cheap

A

coast - toast

95
Q

An SLP using a minimal contrast approach to target stopping is using the minimal pairs “wide” and “ride” with his client. The activity he uses requires the patient to use each target within the carrier phrase, “I see
the _________”. What type of activity is the SLP using in this example?

A

carryover training

96
Q

children in the early stage of phonological development

A

< 50 words in vocabulary
reduced inventory of sounds in PHONETIC INVENTORY when compared to others of the same age
reduced inventory of SYLLABLE STRUCTURES when compared to others of the same age
typically children 3 and under

97
Q

a UNIFIED approach

A

vocabulary + phonetic inventory + syllable structures

98
Q

Consideration 1: phonetic inventory

A

child’s current phonetic inventory
select specific WORD TARGETS that contain sounds the child can already produce

99
Q

Consideration 1: phonetic inventory - GOAL

A

in 3 months of therapy, child will add at least 10 novel words to his expressive lexicon based on therapy data and parent report

100
Q

Consideration 1: phonetic inventory - Example

A

phonetic inventory: m n p b t d h
possible targets: my mine no puppy baby bye bye toe happy

101
Q

Consideration 2: syllable structure

A

child’s current syllable structure
select specific WORD TARGETS that contain syllable structures that child can already produced AND basic, novel syllable structures the child cannot produce

102
Q

consideration 2: syllable structure - GOAL

A

in 3 months of therapy, child will add at least 10 novel CV, CVCV, and/or CVC words to his expressive lexicon based on therapy data and parent report

103
Q

consideration 2: syllable structure - Example

A

syllable structure inventory: V CV CVCV
possible targets: mom dad baa-baa moo-moo hi bye

104
Q

consideration 3 - developmental sequence

A

developmental sequence of sound acquisition
select WORD TARGETS that contain age appropriate sounds that are not in child’s inventory

105
Q

consideration 3 - developmental sequence - GOAL

A

in 3 months of therapy, child will increase phonetic inventory to include at least 12 english phonemes within word approximations based on therapy data and/or parent report

106
Q

consideration 3 - developmental sequence - Example

A

phonetic inventory: m n p b t d h
syllable structure inventory: V CV CVCV
possible targets: kitty go wagon sun

107
Q

consideration 4: individual contexts to choose words

A

words that are important to the child
target words that are normally developing and/or that are important to the

108
Q

consideration 4: individual contexts to choose words - GOAL

A

in 3 months of therapy, child will increase functional vocabulary to include approximations of at least 10 novel words as evidenced by therapy data and parent report

109
Q

consideration 4: individual contexts to choose words - Example

A

phonetic inventory - m n p b t d h
syllable structure inventory - V CV CVCV
possible targets - teddy bubba tie pee pee poo poo

110
Q

consideration 5: word classes

A

target words are from a variety of word classes

111
Q

consideration 5: word classes - GOAL

A

in 3 months of therapy, child will increase vocabulary to include at least 10 novel VC and CVC action words given clinician model as needed based on therapy data and parent report

112
Q

consideration 5: word classes - Example

A

phonetic inventory: m n p b t d h
syllable structure: V CV CVCV
possible targets: eat in out up down top hot

113
Q

strategies

A

model
wait time
sabotage/communication temptation

114
Q

activities

A

pretend play
books
songs and fingerplays
gross motor play
sensory play
parent training and education

115
Q

Articulation therapy is best for:

A

children with ARTICULATION and/or motor based errors

116
Q

Articulation therapy: main objective

A

treat substitutions, omissions and distortions of each isolated error phoneme

117
Q

articulation therapy- sequence/progression

A

treatment progresses in a specified sequence
client does not progress to next level until mastery is achieved
each error sound individually one after the other

118
Q

Articulation therapy progression stages

A

Sensory perceptual training
1. Sound in isolation
2. Nonsense syllables
3. Words
4. Phrases
5. Sentences
6. Spontaneous Speech

119
Q

purpose of sensory perceptual training

A

(ear training)
teach AUDITORY DISCRIMINATION between correct vs incorrect forms of the target sound
build awareness of client’s own correct vs incorrect productions

120
Q

sensory perceptual training - sample activities

A

client is asked to determine if a sound is a target sound or a different sound following clinician production
clinician produces words with target sounds; child is asked to detect if target sound is produced correct or incorrect

121
Q

articulation therapy stage 1

A

isolation

122
Q

purpose of articulation therapy stage 1

A

elicit correct production of sound alone; NOT in combo with other sounds
fricative and approximants can be achieved easily in isolation
stop-plosives may require central vowel or with a noticeable aspiration

123
Q

articulation therapy stage 1 -sample activities

A

Clinician prompts client to produce sound in isolation; client receives a sticker on a chart for each correct production
Play a game that uses numbers (e.g., Chutes and Ladders, Hi Ho Cherrio); client is required to say sound number of times indicated by game before taking a turn

124
Q

articulation therapy stage 2

A

nonsense syllables

125
Q

purpose of articulation therapy stage 2

A

elicit correct production of sound when embedded in varying vowel contexts
common sequence: CV -> VC -> VCV -> CVC

126
Q

articulation therapy stage 2 - sample activities

A

Client and clinician make “articulation cards” with nonsense syllables; child can add stickers or stamps to decorate the cards
Require patient to say 5 nonsense syllables from “articulation cards”; patient earns a piece to add to a puzzle.

127
Q

articulation therapy stage 3

A

words

128
Q

purpose and considerations for articulation therapy stage 3

A

maintain production accuracy of the target sound in words
EASIER-
word length: fewer syllables
sound position: initial
syllable structure: open
syllable stress: stressed

129
Q

articulation therapy stage 3 - sample activities

A

Card games: Memory
Gross Motor: Crawling through a tunnel, Basketball, Egg Hunt
Board Games: Candyland, Connect 4,
Token activity: stickers on a chart, smiley faces on a white board, Bracelet

130
Q

articulation therapy stage 4

A

phrases

131
Q

purpose of articulation therapy stage 4

A

maintain production accuracy of the target sound in structured 2-4 word phrases

132
Q

articulation therapy stage 4 - sample activities

A

Client can answer basic questions that would elicit use of phrases with target sound (e.g., Where does a cow live? In a farm.)
Can require child to use the same carrier phrase when naming pictures: “I see a _______”

133
Q

articulation therapy stage 5

A

sentences

134
Q

purpose & considerations articulation therapy stage 5

A

maintain production accuracy of the target sound in sentences of varying length and complexity
progress from simple/short sentences to complex sentences
progress from sentences with one instance of the target to multiple instances of the target

135
Q

articulation therapy stage 5 - sample activities

A

Slow motion speech vs. shadowing
Correcting the clinician

136
Q

articulation therapy stage 6

A

spontaneous speech

137
Q

purpose of articulation therapy stage 6

A

maintain production accuracy of the target sound in spontaneous conversation
first addressed in therapy ut then carried over into settings outside of the clinic
progress from structured conversation to naturalistic conversation

138
Q

articulation therapy stage 6 - sample activities

A

Tell story using pictures with target sounds
Games: Table Topics, Would You Rather

Phonological & Articulation Disorders (5 decks)

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