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Speech Sound Disorders > Principles of Tx for SSDs > Flashcards

Principles of Tx for SSDs Flashcards

1
Q

traditional approach (deep)

A
  • follow developmental sequence
  • stimulable phonemes first
  • minimal meaningful feature contrast
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2
Q

new approach (broad)

A
  • later developing sounds and structures first
  • non-stimulable phonemes first
  • maximal meaningful feature contrast
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3
Q

stimulability: traditional approach

A
  • select sounds that are stimulable
  • rationale: sounds that are stimulable are easier to learn
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4
Q

stimulability: non-traditional approach

A
  • select sounds that are not stimulable
  • rationale: stimulable sounds will emerge without direct intervention
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5
Q

developmental norms: traditional approach

A
  • select early developing sounds
  • rationale: early developing sounds are acquired first
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6
Q

developmental norms: non-traditional approach

A
  • select later developing sounds
  • rationale: training later developing sounds will result in greater system,-wide change
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7
Q

consistency: traditional approach

A
  • select sounds that are inconsistently produced in error
  • rationale: variability may be an important indicator of flexibility, change, and potential growth
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8
Q

consistency: non-traditional approach

A
  • select sounds that are consistent in their error production
  • rationale: consistent errors represent stable underlying representations, which will result in across-the-board change
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9
Q

knowledge: traditional approach

A
  • select sounds for which the child has most knowledge
  • rationale: sounds for which child has least knowledge
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10
Q

knowledge: non-traditional approach

A
  • select sounds for which child has least knowledge
  • rationale: training least knowledge results in greater system-wide change
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11
Q

deep (vertical) training

A
  • “traditional approach”
  • used to treat articulation-based errors
  • emphasis on training 1-2 sounds at a time
  • developmental norms are typically used to determine order of tx targets
  • new sounds often aren’t added to the targets until a criterion is reached
  • intensive drill
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12
Q

used to treat articulation-based errors

A

residual errors seen in school age population (e.g., /l, r/, distorted /s/)

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13
Q

broad (horizontal) training

A
  • used in linguistic (rule-based) approaches
  • assumption is addressing a wider range of targets impacts rules and effects broader change across the sound system
  • by addressing a set of targets, child’s sound system will be impacted as a whole (system-wide change)
  • later-developing, non-stimulable sounds are considered as first targets
  • tx makes change in meaning salient for the child
  • goal is more rapid generalization to spontaneous speech
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14
Q

used in linguistic (rule-based) approaches

A
  • phonological process treatment
  • application of PMV analysis
  • phoneme collapse errors
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15
Q

using combined artic. (traditional, narrow) + phonological (new, broad) approaches

A
  • speech perception tasks
  • motor learning tasks
  • phonological tasks
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16
Q

speech perception tasks

A
  • perceive differences and make judgment about accuracy of phonemes
  • various contexts
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17
Q

motor learning tasks

A
  • placement for production
  • repeated, varied, high intensity, accurate practice of targets
  • errorless learning
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18
Q

phonological tasks

A
  • targets facilitate generalization/widespread change
  • help child discover and learn rules of the phonological system in a meaning-based context
19
Q

general goals of therapy: improve intelligibility by

A
  • add new sounds (expand phonetic inventory)
  • add class of sounds
  • expand syllable shape options
  • reduce variability of productions
  • increase accuracy of phonemes/patterns
  • increase accuracy in longer linguistic units
20
Q

long term goals (LTG)

A
  • broadly defined statements that describe the “end point” of treatment
  • defines the general direction of treatment
  • typically do not define specific target behaviors
  • often written for 12 month time period and does not change from month to month
  • do not include criterion level
21
Q

example of common LTG for children with an SSD: to improve intelligibility of speech

A

The client will increase ability to produce age-appropriate consonants to improve overall intelligibility of speech production

22
Q

example of common LTG for children with an SSD: to improve communication effectiveness

A

The client will eliminate use of phonological patterns and increase consonant repertoire to facilitate functional communication in all settings.

23
Q

articulation tx objectives

A
  • usually target 1 phoneme
  • position: initial, medial, or final
  • linguistic level: isolation, syllable, single word, phrase, sentence, conversation/connected speech
  • syllable length and shape: single syllable, multi-syllable, CV, VC, CVC, etc.
24
Q

phonological tx objectives

A
  • one or more members of that rule/pattern each session
  • one or multiple positions in words
  • tx begins at word, not sound level
25
Q

articulation objective examples

A
  • The client will imitate and spontaneously produce /s/ in isolate and in the initial position of words with 70% accuracy.
  • Carey will produce initial /r/ and initial /r/ blends following a verbal model with 85% accuracy by the end of the semester.
  • Shayla will accurately produce /s/ in the initial position of words given tactile cueing and a verbal prompt with 60% accuracy within 3 months in order to decrease interdentalization.
26
Q

articulation objectives: write the objective for ease of data collection

A
  • imitate and spontaneously produce?
  • number of sounds in each individual objective
  • number of word positions
  • list specific syllable shapes?
  • more than 1 linguistic level?
  • also consider phonetic environment for your targets
27
Q

phonological objective examples

A
  • The client will reduce substitution of alveolar for velar stops in the initial and final position of words by correctly producing /g/ in CVC words with 80% accuracy.
  • Jono will produce velars /g, k/ at the word level following a verbal model with 75% accuracy by the end of the semester in order to reduce the phonological process of fronting.
  • Zoey will produce fricatives /f, v/ in sentences independently with 80% accuracy within 3 months in order to reduce the phonological process of stopping.
28
Q

cumulative intervention intensity

A
  • dose
  • session length
  • frequency
  • year
29
Q

dose

A

teaching episodes/session (often minutes, e.g. 20 minutes)

30
Q

session length

A

time, with client (e.g., 30 minutes)

31
Q

frequency

A

per day or week (e.g., 3 times per week)

32
Q

year

A

how long will this last? 6 months? 1 year? that’s duration

33
Q

cumulative intervention intensity equation

A

cumulative intervention intensity = dose x frequency x duration

34
Q

general recommendations for frequency, intensity, duration

A
  • minimum dose of 50 trials/30 minute sessions
  • the more severe the SSD, the greater the intensity needed
  • possible to decrease intensity over time
  • at least 30 sessions to see change
  • more frequent sessions that are shorter in duration tend to have greater impact (particularly for younger kids, kids with CAS)
35
Q

carryover

A
  • habitual use of targets in everyday conversation and all speaking contexts
  • metacognitive knowledge and control
  • motivation
  • homework
  • applying to PMLs
36
Q

metacognitive knowledge and control

A
  • awareness of the task
  • self-monitoring and self-evaluation
37
Q

homework

A
  • word list at easier level than what you’re targeting in tx
  • auditory bombardment
  • phonemic awareness
38
Q

applying to PMLs

A
  • generalized and retention are better with massed vs. distributed
  • random is better than blocked
39
Q

generalization and retention are better with massed vs. distributed

A
  • massed: trials clumped together
  • distributed: trials spread out over time
40
Q

random is better than blocked

A
  • random: different movements or contexts used from trial-to-trial so that learner can’t predict what trial follows another
  • blocked: participating the same movement over and over before moving on
41
Q

service delivery models

A
  • pull-out vs. push-in
  • individual vs. group
42
Q

pull-out vs. push-in

A
  • positive, collaborative relationship
  • adequate prep time
43
Q

individual vs. group

A
  • multiple speakers to target speech perception
  • increased motivation
  • indirectly target social skills
  • naturalistic context

Speech Sound Disorders (9 decks)

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