Paed Speech Ax Flashcards
Early sounds
p, h, n, y, b, m, d, w
Middle sounds
f, k, ng, v, g, j, t, ch
What is assimilation?
sound changing to be like another sound e.g. bus to bub
What is prevocalic voicing?
syllable initial phoneme voiceless to voiced pea -> bee
What is postvocalic voicing?
syllable final phoneme voiced to voiceless e.g. bib to bip
What is stopping?
Fricatives/affricates to stops e.g. fish -> tish, soap -> dope, very -> berry, them -> dem
What is deaffrication?
affricate (ch, zh) or -> fricative (e.g. sh) or stop (e.g. d)
What is Weak syllable deletion
potato -> tato
Cluster reduction
star -> tar
Backing
alveolar /d/, /t/ -> velar /k/, /g/ e.g. dog -> gog
Gliding
r or l -> w
5 SSDs
phonological impairment, articulation impairment, inconsistent speech disorder, CAS and dysarthria
2 phonological SSDs
phonological impairment, inconsistent speech disorder
3 motor speech SSDs
CAS, dysarthria, articulation impairment
Characteristics of phonological impairment
consistent errors
errors beyond sibilant and rhotic errors
Characteristics of inconsistent speech disorder
inconsistent errors in consonants
no wowel errors
imitation better than spontaneous
Characteristics of Articulation impairment
1-2 speech errors only in sibilants and rhotics (lisps)
Characteristics of CAS
inconsistent errors in consonants and vowels
groping movements
inappropriate prosody
spontaneous better than imitated
Characteristics of dysarthria in chn
shorter phonation rate on MPT
slow repetition rates
breathiness
Characteristics of speech sound difference
errors acceptable in child’s own community
Phonological process that should be eliminated by 2
Reduplication (Grunwell 1987)
Phonological processes that should be eliminated by 2;6
fronting, assimilation and context sensitive voicing (pea->bee, or lid->lit) (Grunwell 1987)
Phonological process that should be eliminated by 3
FCD (Grunwell 1987)
Phonological processes that should be eliminated by 3;6
weak syllable deletion, cluster reduction, (Grunwell 1987) cluster simplification (Watson & Sukanec 1997) and backing (acc to Michelle Brown)
Phonological processes that should be eliminated by 5
stopping, gliding (Grunwell 1987)
Phonological process that should be eliminated by 7
fricative simplification (Thumb -> fum) (Grunwell 1987)
General reference for Paed Speech
McLeod and Baker 2017
CALD reference
Verdon 2015
ICF-CY reference
WHO 2007
6 target selection approaches
traditional developmental (most knowledge) complexity (least knowledge) cyclical systemic nonlinear neural network
traditional developmental approach suitable for..
any child with SSD
reactive temperament/fear of failure/need early success
traditional developmental targets
phonological process that affect
- early developing sounds
- more stimulable sounds
traditional developmental approach based on assumption that..
acq of earlier sounds and syllable/word shapes are prereqs for later developing sounds
EBP for traditional approach
- better progress than complexity approach (Rvachew and Nowak (2001)
- parents greater satisfaction with this approach (M&B 2017)
Rx aligned with Traditional developmental approach
minimal pairs, metaphon, alternating morphosyntax, speech perception
Complexity approach is based on research showing that…
targeting not stimulable sounds and complex phonetic distinctions is associated with more widespread change than stimulable less complex sounds (M&B 2017)
Complexity approach aligned rx approaches
maximal oppositions, treatment of the empty set
complexity targets are
non-stimulable
phonetically more complex
later developing
complexity approach is suitable for
confident risk takers (M&B 2017)
chn with small phonetic inventories (Gierut 1992)
Cyclical approach
targets patterns of speech errors, divided into primary, secondary and advanced, for a set amount of time and cycles through them
Systemic approach
targets the phonological function of a group of sounds (collapse of contrasts)
rx approach aligned with systemic approach
multiple oppositions
clients suitable for multiple oppositions rx / systemic approach
mod-severe phonological impairment
large collapse of contrasts
ICF-CY guided target selection: BS and F
targets selected based on traditional and complexity approaches
ICF-CY guided target selection: Environmental factors
family preferences, service policies
ICF-CY guided target selection: Personal factors
motivation child's name, family members names salient word to family temperament and response to failure language skills
Rx for late talkers and chn at risk of SSD
- Provide a child with access to augmentative and alternative communication (AAC).
- Minimize pressure on the child to speak.
- Imitate the child, and in doing so model the skill of imitation to the child.
- Use a slower tempo and exaggerated intonation when talking with the child.
- Augment auditory, visual, tactile, and proprioceptive feedback to enhance the child’s sensory experience when attempting to speak.
- Avoid emphasis on non-speech-like movements of the articulators and focus on function.
Goals for late talking showing signs of SSD:
• Expand consonant inventory
• Expand syllable shape inventory
• Increase vocab size and inc words from a variety of grammatical classes
• Encourage the development of 2 word utterances
• Encourage caregiver responsiveness
(Adapted from Stoel-Gammon, 2011 and Bauman-Waengler, 2014)
EBP strategies for late talkers and infants at risk of SSD:
(Adapted from Stoel-Gamon 2011, see M&B 2017:471)
• Encourage first words containing sound in infant repertoire already
• Facilitate babbling in infants at risk (e.g. Down Syndrome) in terms of quantity and quality (canonical sequences)
• Encourage caregivers to be responsive to, imitate and expand babbling
• Analyse phonological characteristics of current lexicon to determine whether individualised selection avoidance strategies being used, and encourage acquisition of new words containing the phonological characteristics of known words
• Select words characterisied by CVCV, CV and CVC syllable shapes, words beginning with stops, and disyllabic words with stressed onsets
Goals for infants at risk of SSD due to delayed onset of canonical babbling:
(adapted from Stoel-Gammon, 2011)
• Increase amount of vocalisation
• Increase quality of babbling (-> canonical with varied vowel and consonants in CV syllable strings)
• Develop ability to imitate, starting with non-speech e.g. raspberries
• Encourage care-giver responsiveness
Multiple oppositions short term goal
X will contrast /a/ with each of the following singleton consonants and consonant clusters /b,c,d/ during 20mins of conversational speech with the clinician in the clinic with 50% accuracy by the end of the 8 week block of therapy
3 goal attack schedules
block (one domain for a period of time)
alternating (ssd one week other ROPA the next)
simultaneous (2+ domains in each session)
best goal attack schedule for concomitant language and speech impairments ?
alternating (SSD on week and other ROPA the next)
3 goal attack strategies
vertical: one or 2 targets at a time til criterion met
horizontal: several speech sounds in within a session e.g multiple oppositions
cyclical: 1 speech target for set amount of time
Horizontal goal attack is good for:
phonological impairment to help chn discover relationships between targets in system
motor speech difficulties to enhance motor learning
Vertical goal attack is good for
articulation and phon impairment
Behavioural goals include
- Performance – what the learner is expected to do or perform in order to show mastery of an objective
- Condition – condition under which the performance is to be done / occur (home with parents/playground with peers)
- Criterion – how well the learner is expected to perform (7/10 trials, %)
% accuracy starting point for production goal
50%
% accuracy starting point for auditory discrimination goal
80-90%
% accuracy starting point for multiple oppositions
30%
order of difficulty for word positions
word initial, final, medial
Goal for auditory discrimination in SSD
X will use auditory discrimination to discriminate between the minimal pairs /k/ and /t/, using the words, ‘key’ and ‘tea’, for fronting, with 90% accuracy, with the clinician, in the clinic
Phonological impairment goals include
- the phonological process you aim to suppress (e.g., fronting)
- the intervention approach you aim to use (e.g., minimal pairs)
- NOT word position
Phonological impairment goal example
Zack will produce /n/ using minimal pairs with 50% accuracy with the clinician in the clinic during the therapy session.
Articulation goals include
- The intervention approach you aim to use (e.g., traditional articulation)
- Position (initial, medial, or final)
- whether it is at the sound, word, utterance, or sentence level, conversation
- If you are using consonant clusters, you also need to specify this
Example articulation goal
Oliver will produce /s/ in word initial position correctly 90% of the time, in two word utterances, with the clinician in the clinic, during the therapy session
Goals for Inconsistent speech disorder include
- consistent productions of a core vocab of words, selected by child and family in collab w/ SLP and teacher
- Activities and participation goals
Goals for CAS include:
- Establishing phonetic inventories and basic movement sequences
- Increase word length, develop lexical stress, smooth transitions, and use appropriate intonation
- Intelligibility, activities and participation goals
Goals for dysarthria might focus on…
- Improve artic accuracy of problematic consonants and/or vowels, syllable shapes or word lengths;
- Encourage respiratory support and breath control, improving intelligibility
- Reduce hypernasality
- Increase naturalness of phonation through increasing child’s awareness of and use of appropriate pitch and vocal loudness.
Caregiver goal
• Mo will be able to implement auditory discrimination, using minimal pairs intervention, with the sounds /k/ and /t/, with 80% accuracy, with child, in the clinic, during the therapy session.
Outcome measure for paed speech goals
PCC - %consonants correct through alphas and betas
ICS - intelligibility in context scale
DEAP
models of intervention: family and therapist combination
- Ideal = Family centred: Family direct Rx and actively involved in each stage of the intervention, including the planning
- Therapist centred: SLP directs Rx
- Parent-as-therapy-aid: SLP directs Rx and family is involved in implementation (not planning)
- Family-friendly practice: Families involved in each stage of the intervention; however, SLPs guide the Rx
Rx settings
- Pull out/Push in = out of classroom or preschool/in classroom
- Consultation vs Collaboration
- In person vs Telehealth (phone, on-line session)
- Multi/Inter/Transdisciplinary
- Individual vs Group
Intervention continuum
- Establishment - elicit target behaviours and stabilise behaviours
- Generalisation - Transfer behaviours to different contexts
- Maintenance – facilitate retention of behaviours
Management plan includes
Background info Family preferences Intervention goals Intervention approach Service delivery Plan Evaluation Plan
Session Plans include
- Background Info
- Description of family involvement including description of home activities.
- Data to be collected
- Activities and resources including description of the resources/materials required.
- Intervention stimulus - types of intervention words, phrases, sentences, or conversation topics that you will use
- Dialogue for rx and teaching and learning moment including antecedent event, response and consequent event
- Rx approach
- Service delivery plan inc agent, setting, intensity, push-in vs pullout/collaborative consultation/telepractice, individual vs group, continuity (ongoing vs block)
- Goals
2 types of generalisation
stimulus generalisation
response generalisation
stimulus generalisation
When a trained behaviour (behaviour targeted in intervention) is elicited with different stimuli.
• E.g. child can say chicken to the SLP (audience stimuli) in response to being shown a pic (physical stimuli), the SLP saying “what is this?” (verbal stimuli), in a clinic room (setting stimuli). Stimulus generalisation occurs when the child says the affricate tʃ in the word chicken to his father (audience) in response to seeing pic of chicken in book (physical), the father pointing and saying “what animal lives on a farm?”(verbal stimuli) at home (setting stimuli).
response generalisation
When a targeted speech skill shows an improvement in unrelated contexts (such as untreated word positions or conversational speech) and/or in related but untreated behaviours.
• E.g. child who is taught to say tʃ in chicken shows response generalisation when they say ‘cheese’ (to other words not used in intervention); ‘catching’ (across word positions not targeted in intervention); ‘I had chicken for dinner’ (to more complex linguistic units like sentences and conversation); ‘jump’ (to other sounds in same class – affricates); ‘shop’ (and to sounds across other sound classes – fricatives).
3 Criteria for moving on to the next goal?
- Performance-based criteria – specify a level of performance the child must achieve. Eg 80% accuracy on a generalisation probe.
- Time-based criteria – specify a time during which a particular skill is worked on. E.g. cycles
- Flexible criteria – accommodate child factors, changing to new target(s) if child becomes disinterested or overly frustrated.
5 types of data for intervention
Assessment data Baseline data Control data Generalisation probe data Treatment data
mnemonic: ABC +G&T
Purpose of Assessment data:
Helps determine if there is a problem requiring intervention
Purpose of Baseline data
Helps determine if the problem is improving, deteriorating, or remaining the same
Purpose of Control Data
o provides a measure of a behaviour unrelated to behaviour targeted in rx as a result of treatment
o Collect some words pre-Rx to check they are still saying correctly post rx
Purpose of Generalisation probe data
o gathered outside the treatment conditions
o provides a measure of the client’s skills when teaching procedures not being used, and help determine if improvement is evident and if child is ready for discharge
Purpose of Treatment data
o provides a measure of a client’s response to the to teaching procedures
o Collect correct and incorrect data during the session- use alphas and betas
Discharge criteria
• long-term goal has been achieved
• no longer qualifies for services
• When problem is no longer apparent / meets eligibility criteria.
• Intelligible speech in conversational speech and any remaining phon patterns being below 40%
• Speech appropriate for chronological age, based on speech intelligibility ratings by SLP
• Intervention targets being produced correctly in spontaneous speech 75-90% of the time, higher % used if concerns about regression after int.
• the child develops functional comm skills in accordance w/ physical capability (ror chn w/ complex or persistent SSD ass w/ concomitant condition e.g. cerebral palsy).
• Plateau,
• poor motivation and attendance,
• cessation of intervention at parent request.
• Not right time to address issue developmentally
*** make sure follow up in 6mo
2 types of Phonological intervention approaches
Contrastive and non-contrastive
Contrastive phonological rx
o Minimal pairs
o Maximal pairs and treatment of the empty set
o Multiple oppositions
o Metaphon
Non-contrastive phonological rx
o Cycles o Speech perception o Morphosyntax o Stimulability o Core vocabulary
Factors for working with CALD chn
- Language/s spoken and characteristics of all languages
- Which language you will target in Rx? Order of languages targeted?
- Is Rx intervention suitable (e.g., no minimal pairs in Icelandic)?
- Who will conduct the Rx? Are the sounds we want child to produce present in those languages
- Cultural appropriateness /f/ can be appropriate for /th/ dialectal error
- Past and present learning experiences
- findings of phonological analysis of speech samples for each of languages learned by child
- suitable goal attack strategies
- service delivery options preferences of child and family
Articulation rx
- goal target
- starting level
- phonetic placement y/n
- imitation? y/n
- Goal = phoneme (usually only 1 or 2)
- Start at phoneme level
- Focuses on the placement and movement of articulators and auditory stimulation
- Modelling and imitation of sounds
Phonological rx:
- goal target
- starting level
- phonetic placement y/n
- imitation? y/n
- Goal = phonological rule
- Start at word level
- No information given re: phonetic placement of articulators
- No direct imitation
Articulation intervention procedure
- Sensory-perceptual training – identifying and discriminating sound from its error through scanning and comparing
- Varying and correcting the various productions of the sound until it is produced correctly
- Strengthening and stabilising the correct production (practice through imitation and spontaneous productions).
- Transferring the new speech skill to everyday communication situations: isolation > syllable > word > sentences.
- Maintenance
Sensory perceptual train in articulation rx involves..
o Identifying – listening to and learning about the auditory, visual and movement features of a target sound in iso.
o Locating – detecting sound in a variety of linguistic contexts (words, phrases, oral reading, convo).
o Stimulation – listen to multiple productions of target sound (also by variety of ppl).
o Discrimination – differentiating the sound from other sounds (including error). Auditory discrimination and judgement of correctness in others speech; error correction - child detecting then correcting an error in others’ speech. Can help chn to detect and self-correct own errors once they start production practice.
(Can work on all 4 in a session > once achieved move on to next level…)
Articulation hierarchy for PML practice and progressing to conversation
isolation nonsense syllables Words (initial, final then medial) Phrases Sentences Stories Conversation
PML pre practice for articulation rx
Involves teaching a child how to articulate a targeted speech sound with cues as necessary.
• Auditory cues – such as auditory detection of a target sound
• Phonetic placement instruction
• Orthographic cues
• Shaping
• Facilitating phonetic context
• Metaphor
EBP for artic vs phonological impairment
phonological intervention is better suited to chn with phonological impairment, while
traditional articulation rx is better suited to articulation impairment involving residual speech sound errors e.g. (Klein, 1996b)
How to cue /s/ articulation
smile showing our teeth, put tongue behind our teeth, and make the snake sound /s::::/
How to cue /z/ articulation
smile showing our teeth, put our tongue behind our teeth and make a buzzy bee noise /z::::/
How to cue /r/ articulation
make your tongue curl up towards the back of your mouth and then make that long /ɹ::::/ sound like a motorbike starting up, leaving your lips relaxed
rx for CAS
Nuffield Centre Dyspraxia Program 3 (NDP-3)
May need to add Core Vocabulary and/or AAC
Also…
Dynamic Temporal and Tactile Curing (DTTC)
Rapid Syllable Transition Treatment (REST)
PROMPT
Integrating Phonological Awareness Intervenention
Nuffield Centre Dyspraxia Program 3 process
small graded achievable steps: - single sounds - contrastive sequencing graded: o E.g. child who used to say /t/ for /k/ & has recently learnt to articulate /k/ • Repetitions: k-k-k-k • Very distant contrast: m-k, m-k • Less distant: b-k, b-k • Less distant again: p-k, p-k • Close contrast: t-k, t-k
- moving on from single sounds: • cv words • cvcv words • cvc words • multisyllablic words • consonant cluster words • phrases and sentences • connected speech
Intervention approach for Childhood dysarthria with potential for speech
Systems approach - broad-based method for addressing one or more of the speech subsystems to increase speech intelligibility: • respiration • phonation (laryngeal) • resonance (velopharyngeal) • articulation
Intervention approach for Childhood dysarthria with limited potential for speech
AAC
Childhood dysarthria - rx for respiration
- increasing chn awareness of breathing, correct seating and posture, speech production exercises (where principles of motor learning are applied) and exercises to practice breath control. Can improve word and conversational speech intelligibility with range of ages
Childhood dysarthria - rx for hypernasality
- surgery to reduce nasal air escape,
- palatal lift,
- reduced speaking rate (behavioural strategy) – may only be suitable for mild cases
Childhood dysarthria - rx for articulation
- traditional articulation approach
- minimal pairs for phono impairment, or
- targeting another subsystem – more precise articulation through breath control and slowing rate
- PROMPT
Childhood dysarthria - rx for adequate loudness
LSVT LOUD (Lee Silverman Voice Treatment) can improve speech function in chn with CP.
Possible underlying cause of childhood dysarthria
cerebral palsy
2 types of AAC
Aided - device required
Unaided - no device required e.g. sign-language
The least knowledge approach is suitable for children who:
a) are reluctant and shy
b) have a phonological impairment
c) have an articulation impairment
d) are confident and risk takers
d) are confident and risk takers
Children with a phonological impairment have difficulties with:
a) motor production
b) articulation of speech
c) acceptability of speech
d) mental organisation of speech
d) mental organisation of speech
Which of the following phonological interventions uses a non-contrastive approach?
a) Treatment of the empty set
b) Cycles
c) Minimal pairs
d) Multiple oppositions
b) Cycles
How does CAS differ from articulation impairment?
- both are motor speech disorders
- CAS involves difficulty planning and programming movement sequences, while articulation impairment involves difficulty with the articulation of specific speech sounds.
- Articulation impairment results in consistent errors and CAS errors are inconsistent
- The treatments for each are different : artic requires and articulation approach while CAS requires a program like the Nuffield plus possible AAC and Core Vocabulary Rx
How does CAS differ from a phonological impairment?
- Both are SSDs but CAS is a motor speech impairment while phonological impairment is phonological.
- PI has pattern based errors on consonants, while CAS has inconsistent errors with both consonants and vowels
- PI has no groping movements while CAS does
- Rx is different
Producing the word ‘star’ as /tɐː/ is an example of consonant cluster reduction - True/False
True
A child with an interdental lisp has a phonological impairment - True/False
False
The main differences between childhood apraxia of speech (CAS) and an inconsistent phonological impairment, is that a child with childhood apraxia of speech produces consistent errors - True/False
False - both have inconsistent errors. main differences are that children with CAS also present with groping movements, increased vowel errors, and a small phonetic inventory
Children with a phonological impairment have difficulties with their articulators - True/False
False
The CHIRPA is an analysis tool for children with 1-2 phonetic errors - True/False
False
Relational analysis includes an inventory of consonants and vowels - True/False
False - Relational analysis DOES NOT include an inventory of consonants and vowels as it is comparing the child’s form to the adults form (such as examining % of consonants correct)
The Intelligibility in Context Scale (ICS) is a useful measure for examining body function and structure - True/False
False - examines intelligibility
A lateral lisp is an example of which SSD?
Articulation Impairment
The goal provided below is a SMART goal.
Ben will decrease the occurrence of final consonant deletion to 10% usage with the clinician in the clinic, during the therapy session. True/False
False - it does not include which FCD sounds are being targeted AND which phonological intervention approach is being implemented. This has resulted in the goal not being specific enough>
The least knowledge approach is also known as the complexity approach.
True
When clients are provided with a high dose of intervention and frequent sessions, a better outcome is obtained.True/False
True
You are providing therapy to a child with an interdental lisp of /s/ and /z/ .
Identify which words from the list below you would select as intervention targets, if using the most knowledge approach
sugar, sip, skirt, scissors, fussy, sock, skip, shoe
= least difficult
Sock , sip as they are in word initial position, so are easier for the child to produce (developmentally acquired first)
You are providing therapy to a child with an interdental lisp of /s/ and /z/ .
Identify which words from the list below you would select as intervention targets, if using the least knowledge approach
sugar, sip, skirt, scissors, fussy, sock, skip, shoe
= most difficult
scissors, fussy as scissors has /s/ in word initial position and /z/ in word medial and final position, making it a complex word to produce. Fussy has /s/ in word medial position, which is harder than both word initial, and word final position
Which phonological intervention approach is suitable for clients with a mild phonological impairment who present with one-to-two phonological processes?
Minimal pairs
Which phonological intervention is most suitable for children who have a moderate-to-severe phonological impairment and present with multiple collapses of contrasts?
Multiple oppositions
Core vocabulary is an appropriate intervention for clients with which type of speech sound disorder?
Inconsistent speech disorder and CAS
Minimal pairs is an appropriate intervention for children with an interdental lisp - True/False
False
How do you conduct minimal pairs therapy?
- explain the meanings of the pictures and differences in the sounds.
- ask child to point to key and tea to make sure he can hear the difference.
- Once it is understood, (at least 90%) switch and child will have a turn to tell me to point to each picture.
Explain a phonemic loss of contrast
Loss of phonemic contrast is when lots of different sounds are being produced as one sound, instead of different sounds, creating difficulties with the listener being able to understand what the child is trying to say. For example Sophie is pronouncing sh, ch, s and z as d which means that the sounds that the words ship, chip, sip and zip are all pronounced as dip making it hard for her to get her meaning across.
How do you conduct multiple oppositions rx?
- choose which sounds to work on, then we will make some picture cards up and talk about the differences in the sounds.
- auditory discrimination
- production.
- practice in longer sentences.
What is core vocab rx
Core vocabulary is an approach used to help chn who say words differently each time become more consistent in their pronunciation of words by selecting a set of important words, selecting the most stable way James says them, then working on achieving a consistent production of those words to increase James’ ability to be understood.
Why would you recommend core vocabulary for severe inconsistent speech disorder?
Other approaches, like contrastive approaches, have been found to be ineffective for this disorder (M&B 2017;465). The core vocabulary approach has been specifically designed for children who pronounce words differently each time, so is well suited the level (severe) and type of difficulty (inconsistency).
Explain what a lateral lisp is
What they are doing is instead of air coming out the front of their mouth like this…, it’s coming out the sides of their mouth when they want to produce an /s/ or /z/ sound like this ….
Why would you choose the least knowledge approach for Stephanie, a 6 yo girl with an interdental lisp. She has recently started school. Stephanie is a confident risk taker who happily participates in most activities; however, she really enjoys cooking with her Nana (Gwen) and arts and crafts.
Evidence shows that if we target a harder area the easier areas will follow and develop quickly afterwards. This approach is suited to confident risk takers, and focussing on the ‘St’ at start of Stephanie will be really functional for her at school.
Explain phonological processes for a parent?
patterns of sound errors all typically developing chn make when learning to talk, where they swap some sounds for others that are easier to say. This may impact their ability to get their meaning across
What are minimal pairs?
words that differ by one phoneme which results in a change of meaning
advantages of minimal pair rx
uses meaningful words and focuses on communicative function of speech
limitation of minimal pairs
- can be frustrating
- not all langs have minimal pairs
- need to consider tones in tonal languages
suitable client for minimal pairs
mild mod severity, consistent phonological impairment
what are maximal oppositions
when you contrast one known sound with one unknown sound
what is treatment of the empty set
contrasting 2 unknown words - uses novel words
Maximal oppositions and treatment of the empty set are suitable for
mild to moderate phonological impairments, with at least 6 sounds missing from repertoire
process for maximal oppositions
- Analyse sample, identify excluded sounds and select 2 that are maximally different,
- 8 word pairs are developed; assign lexical meaning to nonsense words;
- train the words via imitation and spontaneous production.
Process of multiple oppositions
3-4 errors sounds are selected (can include clusters) to target all at once
4 phases:
- Familiarisation and production of contrasts
- contrasts and interactive play
- contrasts within communication context
- conversational recasts.
benefit of maximal oppositions approach
phonetic distinctiveness facilitates learnability of new sound
limitation of maximal oppositions
use of non words
Complexity approach – may be very difficult for chn who need early success
advantages of multiple oppositions
can be effectively parent delivered with training (Sudgen et al 2020)
limitation of multiple oppositions
Complexity approach – may be very difficult for chn who need early success
what is metaphon rx
minimal pairs at word level plus metaphonological knowledge
process for metaphon rx
Phase 1: listening and developing phonological awareness at the concept, sound, phoneme, syllable and word levels.
Phase 2: speech production and developing metaphonological awareness and metacommunication, at word and sentence level.
Theory: Change occurs when chn understand need to change, learn that change can be made, and acquire info on how change can be achieved
metaphon suitable for
mild-mod consistent phonological impairment (not younger than preschool due to the metalinguistic skills required).
process for core vocab
Select a ‘core vocabulary’ set of 50 functional and meaningful words w/ client and family. Work on 10 each week. Working on sequencing of phonemes.
Decide on child’s most stable production; work on developing consistency w/ what the child is able to say (doesn’t have to be correct). Work on each individual sound by sound drill. Monitor generalisation
Suitable clients for core vocab rx
Chn with inconsistent speech disorder;- Severe SSD
Cycles rx is suitable for
Highly unintelligible chn w/ severe speech sound impairment; chn w/ multiple processes.
Advantage of cycles
Practice w/ multiple sounds
