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exam 4 sphp126 > Specific Treatment Programs and Approaches > Flashcards

Specific Treatment Programs and Approaches Flashcards

1
Q

Using class room language arts books for therapy – help us help kids achieve…

A

common core standards

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2
Q

According to our text ch 8…

A
  • most treatment approaches move from a simple to complex level of training (except the concurrent approach)
  • Some approaches do contradict each other (e.g., start with stimulable vs. non stimulable sounds)
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3
Q

The point is to remain flexible

A

-and do what is best for each individual client

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4
Q

Non-speech oral motor exercises

A
  • PBH do not believe that oral motor exercises are beneficial for anybody
  • They say research has not proven that oral motor exercises help
  • roseberrys position: these exercises are very helpful for children with oral motor problems
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5
Q

Kent R.D. (2015 November) Non-speech oral motor movements and disorders: a narrative review. American journal of speech language pathology

A
  • He said that NSOMMs can be part of practice in orofacial myology
  • can be used with persons with dysarthria and dysphagia (swallowing disorder)
  • don’t reject NSOMMS wholesale
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6
Q

Traditional Approach

A
  • around since 1920’s
  • still popular and WIDELY-USED today
  • however, most SLPs really don’t do ear training any more
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7
Q

Production Training: Sound Establishment

A
  • establish correct sound production in ISOLATION
  • use PHONETIC PLACEMENT techniques
  • successive approximation
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8
Q

Production Training: Sound Stabilization

A 
Stage 1: isolation
Stage 2: nonsense syllables
Stage 3: Words
Stage 4: Phrases
Stage 5: Sentences 
Stage 6: Conversation
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9
Q

Stage 1, 2,3

A
  1. Isolation: use variety of fun activities
  2. Nonsense syllables: I don’t really use these
  3. Words: begin with words that are meaningful to the child. I work on sounds:
  4. word-initial (Soup,See, Sun)
  5. word-final( buS, faCe, pieCe)
  6. word-medial (claSSes, Lesson)
  7. cluster (cruST,STop, faSTer)
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10
Q

Stage 4, 5

A
  1. Phrases : in-between stage -carrier phrases common –e.g., I see ____, This is ____.
  2. Sentences: various length and complexity
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11
Q

To establish sound sentences

A
  • corrective set: SLP makes an error and kids “catch” her

- slow motion speech: SLP and ch say sentence together very slow

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12
Q

Stage 6

A

Conversation: -started with structured conv. –e.g., SLP gives a topic or specific pictures to talk about
-transition to natural conv. –open ended e.g., “Tell me what costume you wore for Halloween”

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13
Q

Transfer and Carryover

A
  • vary the audience and settings

- speech assignments

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14
Q

Maintenance

A
  • book: follow up sessions

- Dr. R: in schools, keep on IEP, but reduce to treatment once a week

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15
Q

Concurrent Approach

A
  • said SLPs don’t have to use hierarchy we just described
  • first establish sound in isolation and CV VC combos 80% accuracy
  • then mix it up
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16
Q

CSHA Dr. Steve Skelton

A

-if we vary the response topography in each treatment session, ch will make increase gains than if we just go up the hierarchy like a ladder

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17
Q

For example in one session (dr.skelton)

A
  1. /r/ in final position of words
  2. /r/ in VC combos
  3. /r/ in sentences in word-initial position
  4. /r/ in word-medial position in phrases
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18
Q

Dr. skelton: Activities and ideas for eliciting at least 150 productions per group session

A
  • kids take own data
  • SUBVOCALIZE (say it with your voice turned off) while other students taking their turns
  • tally counters –> challenge students –150+ productions
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19
Q

Dr.skelton acitivites cont.

A
  • post charts –> individual/group competition
  • create stations– students do something different every minute or so while practicing sounds
  • e.g., one ch on white board, one putting puzzle together, one lying on floor, one using flashcards at table
  • then you yell “switch”
  • ask students to create cards with cerative ideas for more interesting drill
  • they draw card, practice sound the way card says
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20
Q

activites cont.

A

e.g., “Say /r/ 10 times by itself while you are doing jumping jacks”
-“say at least 3 sentences with /s/ while you draw a picture on the white board”
“say ‘the’ while you are doing hopscotch”
-echo microphone
-puppets,costumes
-roll a dice or draw number from envelope to determine how many productions they have to make

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21
Q

other ideas for centers

A
  • read books or stories with target sounds
  • hula hoops
  • jump rope
  • create stories with flip books
  • put stickers or stamps on a paper
  • legos
  • kick a ball
  • blocks
  • put bingo chip into a jar
  • pick up sticks
  • blow bubbles
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22
Q

Phonological Contrast Approaches

A

-these approaches have become popular and are supported by research

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23
Q

Minimal Contrast training

A
  • use minimal pairs which only differ by ONE FEATURE such as
  • voicing (to-do, pan-ban)
  • place of articulation (tea-key)
24
Q

Maximal contrast training

A
  • sounds differ by at least 2 features
  • cane-lane: /k/ is a voiceless linguavelar stop; /l/ is a voiced lingual-alveolar glidfe
  • ten-men: /t/ is a voiceless tip-alveolar plosive; /m/ is a voiced bilabial nasal
25
Q

I [roseberry] really like contrast training because

A

-the child sees that the sound used to makes a semantic difference

26
Q

Complexity approach

A
  • most setting research done with individual children in a university setting (not tried in schools with diverse groups)
  • best for ch with individual sound errors (e.g., w/r; j/l)
  • assumes that the complex sounds are AFFRICATES, FRICATIVES, AND CLUSTERS and sounds that are NOT STIMULABLE
  • also assumes that LATER-DEVELOPING sounds (e.g., /tʃ/, /r/) are more complex that earlier developing sounds (e.g., /m/ and /p/)
27
Q

Premise:

A
  • START with HARDEST sounds for ch
  • assumes: if train hardest sounds first, automatic GENERALIZATION to easier sounds
  • e.g., ch produces /j/ 30% accuracy, /s/ 20% accuracy, /ð/ with 0% accuracy
  • START WITH /ð/ and assume that /s/ and /j/ will be positively
28
Q

Hodsons approach

A

general procedures

  1. STIMULATION: use of auditory, tactile, visual cues to increase awareness of target sounds
  2. PRODUCTION TRAINING: produce correct sound
  3. SEMANTIC AWARENESS CONTASTS: minimal pair training
29
Q

hodsons approach cont.

A
  • remediation program planned around a cycle
  • cycle: time period required for child to focus on each deficient phonological pattern for 2-6 hours
  • pattern= phonological process
  • focuses on teaching STIMULABLE sounds
  • early on, stick to simple CVC words
30
Q

Selection of Target Patterns and phonemes

A
  • top priority
    1. early developing phonological patterns:
  • initial and final CONSONANT DELETION of stops, nasals, and glides
  • CVC and VCV words structures
  • posterior-anterior contrasts (k-g, t-d,h)
  • /s/ clusters - word initial clusters /sp, st, sm, sn, sk/ and word final clusters /ts, ps, ks/
  • liquids /r/ and /l/ and clusters containing these liquids
31
Q

in order to move onto secondary patters the child must demo:

A
  • appropriate syllablessness
  • production of single consonants
  • some emergence of velars and /s/ clusters
  • production of practice words /l/ and /r/ w/o gliding (no w/r or j/l)
32
Q

Secondary patterns

A

A: /j/, silibants /s,z/ /r/
B: consonant clusters
C: singleton stridents (e.g., /s,z,f/
D: multisyllabic words

33
Q

structure of remediation cycles

A
  1. train each phoneme exemplar within a target pattern for 60 min per cycle before going to the next phoneme
  2. train 2 or more target phonemes in successive weeks within a patter before changing to the next target patters
    (2+ hours on each pattern within a cycle)
34
Q

structure of rem. cycles #3-5

A
  1. target only ONE PHONOLOGICAL PATTERN PER SESSION
  2. when all target patterns have been taught, a cycle is complete
  3. intiate second cycle. review patterns not yet corrected, intro new ones as necessaty
    * * to become intelligible, most ch need 3-6 cycles of therapy
35
Q

structure of therapy sessions

A
  1. review words cards from previous
  2. auditory bombardment (use amplification!) SLP reads list of 12 words for about 2 min. , 2x if ch paying attention
  3. target word CARDS - 3-5 NEW TARGET WORDS. ch draws, colors etc. and SLP writes name of pic on card
36
Q

structure of therapy sessions #4-6

A
  1. production practice- games shift activities every 5-7 minutes
  2. stimulability probing– check if ch stimulable for phoneme planned for next session
  3. repeat auditory bombaredment w/ 12-item words list used at beginning of session
37
Q

home program

A
  • caretakers are asked to read the 12-item word list once a day
  • child is asked to name the 3-5 pictures once a day (may also produce other target words)
38
Q

Naturalistic approach

A
  • focuses on improving childs overall intelligibility and whole-word accuracy first, then works on individual phonemes in error
  • for severely involved children like preschoolers those with down syndrome, autism spectrum disorder, cerebral palsy
  • approximation of sounds ok
39
Q

work in the childs natural setting and have fun

A
  • establish word and sound approximations so listener understands ch better
  • use NATURAL RECASTS – corrective feedback given in naturalistic fashion- correct model given w/o ch being interrupted and asked to repeated
40
Q

Speech recast

A
  • adult feedback that immediately follows a chs utterance and provides an exact or reduced imitation of the chs words
  • uses adult pronunciation
41
Q

Core vocabulary approach

A
  • designed for the 10% of children with functional SSDs characterized by INCOSSISTENT ERRORS on the same words
  • these ch. don’t have childhood apraxia of speech
  • been used with 2-yr olds, bilingual ch, down syndrom
42
Q

inconsistent SSD: assess childs multiple productions of the same word in the same phonetic context

A

for ex: (25 diff pics on 3 separate trails within one session)

  1. child is asked to produce “cat” and 24 other pcitures
  2. activitiy
  3. asked to produce “Cat” and 24 other pictures
  4. activity
  5. asked to produce “Cat” and other 24 pictures
43
Q

New slide

A
  • “a word produced identically regardless of accuracy receives a score of zero”
  • a word produced differently on at least one of the trials receives a score of 1”
44
Q

Scoring

A

incorrect prod= 0
correct prod= 1
-total score converted to % age –40% meets criterion for inconsistent SSD

45
Q

structure of intervention

A
  • ch at least 2yrs old
  • individual treatment 2x/week 30 min for 8 weeks
  • goal= increase ch intelligibility
  • select 70 words that are important to the indiv. ch
46
Q

struct. of intervention cont

A
  • objective= best possible production (intelligible, not perfect) consistently
  • developmental errors accepted
  • parents and teachers must be involved–feedback
  • intended as foundation for more traditional methods
47
Q

I [roseberry] love it

A
  • gives ch immediate increase intelligibility
  • words are important in chs immediate environment
  • immediately decrease frustration
48
Q

language treatment for phonological disorders –PBH

A
  • pbh: research is inconclusive

- bottom line: if the ch has a lang and speech disorder, best to do both lang and speech therapy simultaneously

49
Q

combining therapy for lang and speech sound disorders

A
  • we can connect speech sound production to childrens morphosyntactic skills
  • if children have final consonant deletion or cluster reduction they will have probs with some morphemes
50
Q

ann tyler- ASHA the phonology morphology interface in children with SSD: development assessment and treatment considerations

A
  • concomitant SSD and language impairment (LI) is the strongest predictor of literacy outcomes
  • children with both SSD and LI have many omissions while children with just SSD have many more substitutions
51
Q

tyler 2015:

A

-eliminating errors patterns like final consonant deletion and cluster reduction will improve production of grammatical morphemes

52
Q

tyler recommends

A
  • an integrated speech approach

- combine therapy for speech and lang

53
Q

these morphemes include

A
  • past tense -ed (jumped, scarED)
  • plural -s (potS, sidewalkS)
  • regular 3rd person -s (eatS, runS)
  • possessive -s (grantS,bobS)
54
Q

therapy suggestions

A

-if ch has final consonant deletion, use minimal pairs which include grammatical morphemes

55
Q

for example (FCD)

A
  • plurals : toe-toes key-keys
  • possessives: joe-joe’s Ray-ray’s
  • regular past tense -ed show-showed
56
Q

if the child uses cluster reducation

A
  • plural: boat- boats cup- cups
  • possessives: cat- cat’s dad- dad’s
  • regular past: walk-walked
  • irregular past: drink-drank hold-held
57
Q

we can also connect phonology semantics

A
  • children with lang impairments often have difficulty with VERBS
  • for velar fronting: tame-came; taught-caught
  • stopping of fricatives: tee-see, toe-sew, tip-ship
  • final consonant deletion: shoe-shott, ray-rake; say-sail

exam 4 sphp126 (4 decks)

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