Motor Speech Flashcards
Dynamic Temporal and Tactile
Cueing (DTTC)
- A form of integral stimulation later designating it as DTTC focuses on movement sequences in an effort to address the motor planning and programming difficulties that underlie CAS
- Uses various types of imitation, multiple cues, in addition to a slowed speech rate to shape movement sequences and practice of those sequences in speech
- It is dynamic because of the back-and-forth way that cues are provided in response to children’s speech production attempts
- It is temporal because of the variations in time between a clinician’s antecedent event and a child’s response
- It is tactile because of the type of cues (e.g., tactile-phonetic cues, manual guidance) used to guide a child through a movement sequence
- There is no prescribed incremental hierarchy
- Uses intervention procedures guided by principles of motor learning, providing cues based on individual children’s ages, ability, and difficulties, and most importantly, their moment-to-moment response to intervention
- It is suitable for young as well as older children with severe CAS
Rapid Syllable Transition Treatment (ReST)
- ReST is an intervention approach for children with CAS, designed to target difficulties with lexical stress.
- The main focus is on the intensive practice of multisyllabic pseudo-words (nonwords) covering a variety of stress patterns (e.g., wS, Sw, wSs, Sws)
- Difficulty transitioning from sound to sound or syllable to syllable, and articulation accuracy are also considered.
- Prepare pseudo-word stimuli two or three syllables in length
- adhere to the phonotactic rules of the child’s ambient language contain consonants and vowels that a child is capable of producing accurately
- Presented in written form
- Prepractice: Child learns to produce target words via knowlage of preformace.
- Practice: drill-style practice with a brief activity between seet where feedback is delayed and limited to knowlage of results.
- Children with mild or moderate CAS with difficulties with lexical stress
strong syllables can be shown in bold font to contrast with the weak syllables, such as baateegoo (Sws) versus baateegoo (wSs) OR written with spelling orthographically biased towards strong or weak syllables such as example, bedoon (wS), and farbegee (Sws)
Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT)
- A tactile-kinesthetic method for assessing and treating motor speech disorders (including CAS and childhood dysarthria) in children and adults.
- Four different types of PROMPT cues are to be used in intervention: parameter, syllable, complex, and surface prompts.
- The cues are faded as speech movements improve
- Must complete post-qualification training with a certified PROMPT trainer associated with the PROMPT Institute to conduct this approach
- Certification involves training over 1.5 to 2 years
- Children and adults with motor speech disorder (CAS and Dysarthria)
What treatment is suitable for young and old chidlren with severe CAS?
Dynamic Temporal and Tactile Cueing (DTTC)
What treatment is suitable for children with mild or moderate CAS with difficulties in lexical stress?
Rapid Syllable Transition Treatment (ReST)
What treatment is suitable for for children and adults with motor speech disorder? (CAS and Dysarthria)?
Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT)
Traditional Articulation Intervention
- The hallmark of traditional articulation intervention is the progressive sequence of easier to more challenging activities.
- Originally, sequence (or staircase) of
activities included four successive levels:
isolation, syllables, words, and sentences - At each level four activities were completed: sensory-perceptual training, learning how to produce the target, stabilizing [practicing] the target, and transferring the target (e.g., Van Riper & Erickson, 1996)
- “Blocked practice”
- Pre-practice instruction, stabilizing activities, incremental production practice
- Five conponents: Ear training, pre-Practice, Practice, transfer and carryover, maintenance.
- The approach is suitable for children with an articulation impairment
Concurrent Treatment
- Concurrent treatment adopts the idea of levels of practice (including syllables, words, two- to four- word phrases, sentences, conversation) but arranges them randomly
- A randomized variable schedule typifies concurrent treatment
- Suitable for children with an articulation impairment involving residual speech
sound errors or CAS
Chaining
- Based on principles of motor learning
- Blocked practice for establishment
- Randomized practice for generalization/carryover
- Includes prosody
- Tested with children with CAS and children with articulation impairment/persistent errors
Visual Biofeedback
- Relationship between F2-F3 in /r/ –low F3
- Distance between F2 and F3 should be small—ARC 12 pre
- Using visual information to help children change their tongue gestures
- Can be combined with other interventions (e.g., SMC)
- Spectral biofeedback
- Ultrasound biofeedback
Systems Approach
- Intervention targeting speech subsystems in children with dysarthria
- Speech intelligibility is targeted via intervention addressing one or more of the four speech subsystems: respiratory, laryngeal (phonation), velopharyngeal (resonance) and articulatory
- Goals are individualized according to the speech subsystem(s) impacting intelligibility
- Goals may include:
- Encouraging respiratory support and breath control for speech
- reducing hypernasality
- Improving speech intelligibility through targeting articulation
- Increasing healthy loudness
- The intervention procedures used will depend on the speech subsystem(s) being addressed
- Procedures involving practice of a particular motor skill are usually based on principles of motor learning
Augmentative and Alternative Communication (AAC)
- Children with motor speech disorders, particularly children with severe CAS or childhood dysarthria, may benefit from using augmentative or alternative communication (AAC)
- Types of AAC: unaided and aided communication
- Unaided communication does not need an additional device (e.g., hands for sign language)
- Aided communication uses external equipment (e.g., alphabet supplementation board, speech-generating devices)
- A range of issues need to be discussed with children and their families before introducing AAC (e.g., when to introduce AAC, type of AAC)
- AAC is suitable for individuals of all ages who have difficulty with natural speech and language.
Who is the Systems approach suitable for?
Children with childhood dysarthria who have been assessed as having the potential to use speech.
Who is chaining suitable for?
Tested with children with CAS and children with articulation impairment/persistent errors.
Who is concurent treatment suitable for?
Children with an articulation impairment involving residual speech sound errors or CAS
Who is the traditional approach suitable for?
Children with an articulation impairment involving residual speech sound errors
