Paediatric Speech Intervention

Question 1

What are the main differences between CAS and an inconsistent SSD?

Answer 1

Children with CAS present with groping movements, vowel errors, and a small phonetic inventory.

Question 2

What are the 5 SSDs?

Answer 2

1. Phonological impairment
2. Inconsistent Phonological Impairment
3. Articulation impairment
4. Childhood Apraxia of Speech (CAS)
5. Childhood dysarthria

Question 3

Explain the difference between the most knowledge method and least knowledge method.

Answer 3

Most knowledge: Select sounds/processes that: are earlier developing, Are stimulable, Are produced correctly in particular contextual environments
Least knowledge: are non-stimulable, are phonetically more complex, reflect least phonological knowledge,
are later acquired

Question 4

What are the 5 types of data SPs collect?

Answer 4

The 5 types of data SLPs collect are:

1. Assessment data
2. Baseline data
3. Generalisation probe data
4. Control data
5. Treatment data

Question 5

What are the 3 stages of the intervention continuum?

Answer 5

The 3 stages of the intervention continuum are:

1. Establishment
2. Generalisation
3. Maintenance

Question 6

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

Answer 6

sip, sock = Most knowledge approach as they are in word initial position, so are easier for the child to produce (developmentally acquired first)

skirt, skip = Least knowledge approach as they are in consonant clusters, so are harder for the child to produce (developed later)

scissors, fussy = Least knowlege approach 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

sugar, shoe = Not targeting the /s/ sound. While orthographically these words start with ‘s’, the first sound is /ʃ/.

Question 7

Minimal pairs:

Answer 7

for mild to moderate impairment, 1 target sound.
point out to child that semantic information/meaning changes in words if we change the sounds: tap-sap

Children that have sounds within their repertoire but fail to use them contrastively.

Mild-to-moderate speech sound impairment

Question 8

Core Vocabulary

Answer 8

• Only used for inconsistent errors
• Teaches how to plan the phonemes in words
• eg book -b-oo-k, practice sound multiple times, then combine sounds.
• Uses child’s most stable production (doesn’t have to be correct – e.g. /wε/ for red)
• Severe speech-sound disorder
• Theory…. that children with inconsistent errors have a phonological planning deficit.
• Strength: it targets functional words that are meaningful for the child and help will with overall intelligibility.
• Core Vocabulary approach is best suited to clients with a severe speech sound disorder, specifically inconsisent speech disorder as it aims to target lexical consistency.
• a limitation is that it may not be able to help the child produce word correctly, rather it will focus on a consistent production.

Question 9

Which phonological intervention approach is suitable for clients with a mild phonological impairment who present with one-to-two phonological processes?

Answer 9

Minimal pairs

Question 10

Which phonological intervention is most suitable for children who have a moderate-to-severe phonological impairment and present with multiple collapses of contrasts?

Answer 10

Multiple oppositions

Question 11

Core vocabulary is an appropriate intervention for clients with which type of speech sound disorder?

Answer 11

Inconsistent speech sound disorder. It can also be used with children who have childhood apraxia of speech (CAS)

Question 12

Accuracy percentage before moving on?

Answer 12

80-90%

Question 13

Phonological Contrastive approaches

Answer 13

• Minimal pairs
• Maximal pairs and treatment of the empty set
• Multiple oppositions
• Metaphonological

Question 14

Phonological Non-constrastive

Answer 14

• Cycles
• Speech perception
• Morphosyntax
• Stimulability
• Core vocabulary

Question 15

Multiple Oppositions

Answer 15

similar to minimal pairs
used for children with moderate to severe impairment, phoneme collapse.

working on several target sound/error sounds at the same time: k, p, h, tr
tie- Kai, pie, hi, try

Suitable clients:
Multiple collapses of contrasts
Moderate-to-severe phonological impairment

A strength is that this targets several error sounds – related to one collapse - during the same intervention. So in this way, we are targeting the system / systemic nature of phonology.

A drawback is that this is taking the complexity approach. So if a child is not a risk taker, is feeling shy and/or uncertain, they won’t get quick success and it may be frustrating for them.

Question 16

The cycles approach

Answer 16

The Cycles Approach
- Period of time for targeting phonological patterns
- moderate to severe impairment, used for highly unintelligible speech
non-contrastive approach
Suitable clients
• Highly unintelligible children with a severe speech sound impairment
• Children with numerous processes

Strength: parents can easily be involved, focuses on errorless production and targets within the child’s zone of proximal development which is positive for the clients’ confidence.

Limitation: might be that unlike core vocabulary some sounds or words that are important to the child and their interests might not be targeted.

Follows:

1. Auditory bombardment
2. Production Practice
3. Stimulability probing
4. Homework

Question 17

Articulation intervention

Answer 17

Based on principles of motor learning (Lof, 2010)
› Multi-modal cues (auditory, visual, tactile & cognitive cues)
› Frequent practice
› Multiple step hierarchy
› Support is faded as success is achieved
› Feedback

Question 18

Treatment for CAS

Answer 18

Nuffield Centre Dyspraxia Program

• intergral stimulation approach
• core vocab

Question 19

Treatment for Childhood Dysrathria

Answer 19

Systems approach

• six-week intensive treatment
• targets children’s control of respiratory and phonatory effort, phrase length or syllables per breath, and speech rate.
• research shows intelligibility gains at word level and in narrative speech
• positive effects of internet delivery

Question 20

Which phonological intervention approach is suitable for clients with a mild phonological impairment who present with one-to-two phonological processes?

Answer 20

Minimal pairs

Question 21

Which phonological intervention is most suitable for children who have a moderate-to-severe phonological impairment and present with multiple collapses of contrasts?

Answer 21

Multiple Oppositions

Question 22

Core vocabularly is an appropriate intervention for clients with which type of speech sound disorder?

Answer 22

Inconsistent speech sound disorder. It can also be used with children who have childhood apraxia of speech (CAS)

Question 23

Maximal Oppositions/Empty Set

Answer 23

Maximal oppositions and the empty set

It is targeted at children with at least 6 sounds missing from their inventories
Strength – targets multiple missing phonemes
Limitation – uses nonsense words so limits generalisability

Question 24

Cycles Approach

Answer 24

The cycles approach is suitable for children with highly unintelligible speech.

A strength of the intervention includes amplified auditory stimulation and the parents can easily be involved in this at home. Another strength is that it focuses on errorless production and targets within the child’s zone of proximal development which is positive for the clients’ confidence.

A limitation might be that unlike core vocabulary some sounds or words that are important to the child and their interests might not be targeted. This is because in this system primary patterns (eg. word structures, /s/ consonant clusters) must first be established before moving on to targets that are classified as secondary (eg. assimilation).

Question 25

maximal oppositions vs empty set

Answer 25

If you use maximal oppositions, you are contrasting one sound that IS known (i.e., is in the child’s inventory) with a sound that IS NOT known (i.e., not in the child’s inventory).

Treatment of the empty set, is an extension of minimal pairs, and you are completely correct in saying that is the least knowledge/complexity approach. For treatment of the empty set, both of your contrasting sounds ARE NOT known (i.e., not in the child’s inventory)…so theoretically, this will speed up the intervention process - but only if you have a confident child who is a risk taker (not afraid of failure).

Question 26

Metaphonological

Answer 26

• This approach assumes that children with phonological disorders have failed to acquire the rules of the phonological system.
• Focus on Sound properties
• Builds awareness of structure of words, identifying sounds in words, swapping them to create new words, tap- t, swap t to s.

Strength: Supports children with early literacy as well.

Question 27

What intervention approach is appropriate for Childhood Dysarthria?

Answer 27

Systems approach

- AAC for severe cases

Question 28

Articulation Intervention

Answer 28

• Starts at phoneme level
• Focuses on placement and movement of articulators AND auditory stimulation
• ## modelling and imitation of soundsTheory: based on Principle of motor learning
  —
  Steps:
  1. Perceptual training
  2. Prepractice: teaching child to produce target sound w/ cues
  3. Practice: once stimulable, target sound needs to be practiced/stabilised (in isolation, syllables, words and sentences)
  4. Transfer into spontaneous speech
  5. Matainence

Question 29

Principles of Motor Learning

Answer 29

1. Cues
2. Frequent practice
3. Multi-step hierachy
4. Support is faded as success is achieved
5. Feedback