Final Flashcards
What are the three major treatment approaches
Traditional
Phonological
Motor Learning
If you want immediate success you should focus on …
Inconsistant errors
Stimulable sounds
Less phonetically complex sounds
Early developing sounds
If you want more immediate generalized productions and marked intelligibility you should focus on..
Consistant errors
Less stimulable sounds
More phonetically complex sounds
Later developing sounds
What is the complexity approach
treating more complex sounds creates change in less complex sounds and contexts
Complexity Approach
Inventory Laws
Velars --> Alveolars and Palatals Affricates --> Fricatives Fricatives --> Stops Liquids --> Nasals Voiced obs --> Voiceless obs
Complexity Approach
Syllable Structure Laws
Clusters –> Singletons
Fricatives + liquid clusters –> Stops + liquid clusters
3 element clusters –> 2 element clusters
What words do you want to use in therapy?
High frequency
Real words
High/Low density for phono
Low density for artic
What is a SMART goal?
Specific Measurable Attainable Realistic Time sensitive
Traditional Approach
AKA the ladder approach
- Treat each sound error individually
- Specific hierarchy
- Progress to more difficult task
“The Ladder”
- Auditory bombardment
- Auditory discrimination
- Teaching the phoneme in isolation
- Teaching the phoneme in syllabic context
- Teaching the phoneme in words
- Teaching the phoneme in phrase
- Teaching the phoneme in sentence
- Teach in natural context
The variations in each level are..
Imitation or spontaneous
What are the fix up strategies
- Imitation with verbal/visual cue
- Phonetic placement or metaphor
- Shaping or sound modification
- Moto-kinesthetic
What are fix up strategies for /s/
1-5
What are the similarities between phonological approach and traditional approach
both have an order hierarchy
both progress to more difficult levels
Differences between phonological approach and traditional approach
Traditional goal: changel the childs pronunciation of a sound in error
- treats an individual sound
Phonological goal: change childs underlying rule system for sound production
- treats groups of sounds with similar patterns of error
Phonological approach principles
- therapy begins at word level
- focuses on the phono system
- targets multiple sounds
Minimal Opposition contrast
use minimal pairs where the sound only differs by one or two PMV
When do you use minimal opposition
- for simple substitutions
- for stimulable sounds
- small number of errors
- not for distortions (like lateralized sounds)
Teaching minimal opposition
Phase 1: Discussion of words
Phase 2: Discrim testing and training
Phase 3: Production training
Phase 4: Carryover training
Minimal opposition
Phase 1
Ensure that the concepts portrayed are known to the child
Minimal Opposition
Phase 2
CDA repeats the words in random order and ask the child to point to the correct picture
Minimal Opposition
Phase 3
CDA would point to the picture that the child produces
Here is where they learn that the sounds change the meaning
Minimal Opposition
Phase 4
Utterances become more complex
Maximal Oppositional Contrast
These sounds differ as much as possible according to PMV
- Address multiple complex targets which will yield the most change
When to use Maximal opposition
- For non stimulable sounds
- For clients with moderate to severe phonological disorders
Teaching maximal opposition
Phase 1: Initiation training
Phase 2: Spontaneous training
You are still using minimal pairs
Using high frequency and a mix of high/low density
What is the best contrast in maximal opposition
A sonorant and obstruent
Motor Learning Approach
Principle is that the most closely related mvmt creates the most improvement in overall skills
- Child learns more flexibility
- requires more self monitoring
Difference between motor learning and traditional
Traditional gradually gets more difficult
Motor learning teaches mixed levels
Teaching motor learning
Phase 1: Pre-practice phase
Phase 2: Practice phase
Phase 3: Generalization
Motor Teaching
Phase 1
Should stay here till 80% Teach basic fix up strategies 1. Imitation 2. Phonetic placement 3. Phonetic placement (metaphore) 4. Shaping 5. Moto-kinesthetic
Motor Teaching
Phase 2
Student will practice at different levels or context during each session
Want to randomize practice
Motor Learning
Phase 3
Provide a more natural sequence of the childs performance
Helps them learn self monitoring
Fix up strategies for /f/
common errors
- /p/ for /f/ fish
- /s/ for /f/ hass
Fix up strategies “sh”
Common errors
- /s/ for “sh” fiss
- lateral lisp /d/ for “sh”
Fix up strategies of /s/ blends
errors include an omission for C1 ex. ticky for sticky
or C2 ex. sop for stop
Fix up strategies for /r/
errors include
/w/ for r
“y” for r
r with distortion
Fix up strategies for “th”
/f/ for th
/s/ for th
What is childhood apraxia
Difficulty with sequencing and organization of muscle movements specially for the production of speech
How does childhood apraxia occur
From a known neurological impairment
Could be idopathic
Prevalence rates of childhood apraxia
1-2/1000
What does childhood apraxia look like
- Inconsistent errors on Cs and Vs
- Slow, broken or difficult transitions between sounds and syllables
- Inappropriate prosody
What are errors in childhood apraxia
- Errors are made on more complex sounds
- Unusual errors, not typically found in children with SSD
- Large number of omissions
- Difficulty producing and maintaing appropriate voicing
- Vowel and dipthong errors
- Difficulty sequencing sounds and syllables
- Difficulty with nasality
- Groping behaviour and silent posturing
Childhood Apraxia
complex sound errors
consonant clusters, fricatives and affricates
Childhood Apraxia
unusual errors
sound additions, prolongations, unusual substitutions
Childhood Apraxia
omission errors
poly-syllabic= more omissions
spontaneous speech= more omissions
Childhood Apraxia
vowel and dipthong errors
trouble between lax and tense
usually a limited repertoire of vowels
Childhood Apraxia
difficulty sequencing
increases with length of complexity of utterances
Childhood Apraxia
groping and silent posturing
groping: ongoing series of movements in the articulators in an attempt to find the desired artic positions
silent posturing: the positioning of the articulators for a specific artic
Assessment procedures for childhood apraxia
- standardized articulation testing (WITH VOWELS)
- Language sample
- Prosody
- OME
- Hearing assessment
Implications for therapy in childhood apraxia
They need very intensive therapy
