Unit 1 Flashcards
Operational definitions
definitions that can be used jointly
consistent format: general statement, 3 feature elements, examples
They define behaviors (descriptive)
Three essential components of observation
- The structure and function
- Stimulus and response
- The cognitive- linguistic social whole
Structure and function vs. stimulus and response
Structure and function: say hi to a girl and she doesn’t respond: hearing loss?
Stimulus and response: gesture and she comes: language barrier?
Transactional model of language
social, linguistic, and cognition
Communication in the middle: speech, voice, fluency
language, grammar
discourse: narrative, expository, conversation
Necessary Observation skills for communication disorders
- Skill of observing to determine the causes of behavior
- Skill of predicting possible communicative dysfunction
- Skill of identifying factors that maintain a behavior
- Skill of observing the effects of treatment
Skill of observing to determine the causes of behavior
learn to rule in or rule out organicity, some are temporary organic
ex: speech delay: Organic: hearing loss
Temporary reason: ear infection
Non organic: not associated to much speech
Skill of predicting possible communicative dysfunction
the concept of appraising communication for possible disorder is based on clinical observation skills
Skill of predicting possible communicative dysfunction: Prediction of communication disorder
the selection of the diagnostic battery and how well it is supplemented by observation, your skills to make comparisons to the normative data, your ability to check for stimulability of the target
Skill of identifying factors that maintain a behavior
- Inter and intra socio-cultural dimensions supporting the maintenance of a behavior
- familial environment
- language spoken at home
- how similar and different the diagnostic settings are
- degree of lang stimulation
Skill of observing the effects of treatment
S portion is soap and clinical impressions, feedback
Types of observation
diagnostic observation, behavioral description, data collection, Interpersonal interactions
Diagnostic observation
Assessment: get data and information
evaluation: interpretation of the data
Behavioral description
A way of providing supplemental information to the assessment process through reporting observable behaviors
How?
Start with a judgment and move backwards
Ask: What behaviors led me to reach this judgment?
Describe those behaviors
Practice: Did not stay seated for 3 minutes
Data collection
Information about the goals of the client, specifically the measurable target of change
Two subtypes:
Baseline Data: collected prior to treatment
Ongoing Data: data continuously collected and
compared back to the baseline
Tracking Systems: anecdotal information, progress notes, SOAP notes, percentages, graphs, charts, numerical accounts, grading or rating systems, etc.
Interpersonal Interactions
The interpersonal behavior between the clinician and client can add to or detract from the enrichment of the established dyad
4 dimensions of interpersonal behavior:
body language, verbal following, empathy
Elements that constitute observable Information
Structural information, behavioral information, communication information, environmental information, cultural- linguistic diversity information
Structural Information
physical appearances, syndromes, examples, see if they have normal hearing and vision
Behavioral Information
comprehension and socio-linguistic are two elements necessary for the successful judgement of behavioral output
Communication Information
In the S-R-rf- cycle it is the clinician that needs to adapt his/ her delivery by modifying the “S” portion of this cycle (the clinician is the constant provider of stimuli to the client
Shifting Down in the difficulty Continum
Why-> what question -> fill in the blank question -> multiple choice -> forced choice -> point to show me
Instructional Objectives
identify the therapy objectives, distinguish between a receptive or expressive goal
Procedures
how is the clinician going to the get the client to meet this goal
what kind of procedures?
Reinforcement
continuous vs. intermittent
- verbal
- social
- token
- tangible
Interpersonal skills
Body language, verbal following (feedback the client is listening), talk time ratio, empathy
Commensurate delay/ disorder
+/- 3-4 months
delay
6-9 months
delay/ disorder
9-12-15 months
disorder
15-18+ months
delay disorder continuum steps
step 1: identify CA, MA, LA
step 2: identify age difference on the chart
step 3: consider the structure and function and the S-R cycle
step 4: identify all entering characteristics
Most common way to monitor a client’s progress is to use
data system
Rationale for using data system
- to determine if the client is changing
- to better prepare for goal selection
- to address the accountability issue
- to keep the client informed of his/ her progress
2 types of data
- baseline data
2. Ongoing data collection
Baseline data
measured ratios of behaviors in the absence of treatment
data collected as the first step in the treatment sequence, prior to intervention
a reference point in treatment, all other data are compared to this to determine progress
Specific procedures used in obtaining baseline data
un-reinforced: do not reinforce correct pronunciation,
use a consistent and representative sample,
use consistent procedural design, can’t count if you went from elicitation to modeling
Rationale for establishing baseline
to establish present level of performance, to allow for comparisons to be made
Ongoing data collection
to determine if the client is making progress by comparing ongoing data to the baseline, provides data to support or refute goal selection, provides information for re-assessment, provides information on meeting established criteria
Treatment principles
rules from which Tx procedures are derived; knowing a principle well can lead to a host of effective procedures
General, Few, Abstract
Treatment Procedures
Technical operations the clinician performs in order to affect change in the clients communicative behavior
(client) specific, many, concrete
6 Treatment principles
stimulus-response reinforcement system discrimination (between error and target) Extinction Generalization Teaching style. learning strategies
3 Options when developing a treatment plan
existing program problems: may not be client geared
Modification of existing programs: document any modifications used in an existing program
creating an individualized treatment program (used most frequently)
Treatment plans based on 4 criteria
Objectives or goals, procedures, strategies, activities
Length of treatment plans
Federal regulation: 1 year
avg length of treatment plan: 4-6 months
School: 9-12 months
Hospital: short term
Statement of the problem: 3 characteristics
- severity level
- Disorder- delay/difference
- Characterized by: (ex: cluster reduction, final consonant deletion)
Assessment
Pooling the information
Evaluation
Interpreting the information
The 5 components of Long Term Objective
direction of change. target behavior, present level of performance, expected level of performance, resources
Short term objective components
repeatable condition, measurable performance of target behavior, standards (3/4x 2 consecutive sessions)
4 clinician strategies for procedures
- teaching style and learning strategy
- reinforcement and reward system
- approaches to organizing LTO (horizontal, vertical, cyclical)
- Management of the communication behavior
Horizontal
15 minutes/ 10/ 5/ 15 short activities
Vertical
working on that one goal until it is met
cyclical
2 weeks TB 1, 2 weeks TB 2, 2 weeks TB 3
Description
describes an object, use variety of stimuli, “tell me about that picture”
Elaboration
Must expand on a topic, ask for elaboration of a topic already introduced, “tell me more”
Expressive
personal response to a stimulus, ask for reason for picking a certain toy/ ask for a story with a conflict, “tell me about a time you embarrassed yourself”
Explicitation
provides information about a procedure or process, directions, how to make pasta, “Tell me step by step”
Games/ problem solving
must verbally respond to a problem, how a toy works, guessing games, “whats wrong with it”
Interpretation
provides meaning of a stimulus, interpreted musician’s meaning, “why would the guy want to do that”
Narration
describes a sequence of an event, play/ movie, “what did he do”
Probe
responds to open/ close ended questions, yes/ no/ short response, “ why did he break the egg”
Paraphrase
ask to express an idea, express an idea in a different way without changing the meaning, “how else could i say this”
Role- play
must use language appropriate to situation, teacher/ student, “how may i help you”
Sustained production
produce a stream of uninterrupted language, recite as many words as possible without stopping, “say as many words as you can in english”
Chain of event treatment plan
Correlation to treatment plan
Referral: parents, teacher, doctors, SLP screenings (pass/fail)
Evaluation phase: need to have assessment, between the referral time and evaluation phase you have 30 days
Recommendation phase: where you craft the treatment plan, take all the assessment results from SLP, and possibly the PT, OT, etc. and give present level of performance so get baseline data, identify classification of disability, where you are going to give therapy
Implementation: how the program gets carried out, who is the team manager, criteria is established, how every member will be accountable
Annual review: quarterly review, 30 day review
Correlation to tx plan: picking out target behaviors, strategies, activities, STOs, LTOs
Overlaps of cognitive, linguistic, and social
Cognitive social: receptive, perception Interpretation of emotion Inference Prediction (Intention) Causality
Perception: reduced ability to (not inability)
Sociolinguistic: cultural experiences that influence language
Cultural linguistic: expressive
CLIP
Central: in the brain
Linguistic: applying language somehow
Integration: two pieces coming together
Process: the steps in the process
Sequential processing strategies
Definition: Information that is processes by mentally arranging small amounts of information in consecutive, linear, step-by-step order
Key Words (descriptors): consecutive, linear, logical, temporal, auditory, verbal. Related to when and why questions Academic Examples: arithmetic facts, spelling lists, associations of letters and sounds, rules of grammar, chronologies, steps of an event, following directions, experiment, recipes, social/ classroom directions
Simultaneous processing strategies
Definition: Information processed by mentally integrating and synthesizing parallel pieces of information at the same time
Key Words (descriptors): holistic, relational, analogous, visual, spatial. Related to who, what, which, where questions (early questions) Academic Examples: recognize shapes, physical appearances, solving problems with visual assistance, interpretation of the general overall idea, and generalizations kills
Processing strategies: introduction
Sequential Auditory, Verbal, Oral “Okay, Let’s get started…” “Now, Where did we leave off? Word marking time: (Temporal markers) Now First Next Then Later
Simultaneous Visual, Relational, Holistic “Today, we’ll work on…” “Let’s see what we have for today.” Represents the visual and/or the whole of what will be done Charts, Graphs Visual mapping Visual schedule Outline
Processing strategies: Concept
Sequential Auditory, Verbal, Oral Specific to General Examples: Puzzles Story: Once, on a really cold, windy, and very dark October night, a strong wind was hollowing as a small group of frightened children huddled together on a rickety old front porch”
Calendar (daily, weekly)
Simultaneous Visual, Relational, Holistic General to specific Examples: Puzzles Story: “This is a story about Halloween”.
Calendar (monthly, yearly)
Processing strategies: memory
Sequential
A one –to one connection that is highly sequential
Practice
Examples:
How did you sequence the learning of the Six Principles before being introduced to “Dr Legs?”
New informational bits
New Vocabulary
Does December come before January?
Simultaneous
Relational memory (clusters, chunking, grouping for meaning)
Practice
Examples:
How and why does Dr Legs work for you?
Graphic/ physical cues (color in Paris Subway)
New vocabulary
Does December come before January
Processing strategies: emphasis
Sequential Examples: Music: single notes sequenced Teddy bear Learning new vocabulary Practice Pony Story Oral rehearsal
Simultaneous Examples: Music: entire song Teddy bear Learning new vocabulary Practice Pony Story Oral rehearsal
Processing strategies: closure
Sequential Examples: “Oh my goodness! It’s time to go.” “OK, we’re all done for today.” “Time’s up!” “Hurry up, Mommy’s waiting.”
Simultaneous 3 part closure” Summary (of the session’s objectives) Assessment Client Clinician Forcast
Impairment, disability, handicap
Impairment: some kind of structure function difficulty, dysfunctional difficulty
Disability: the functional component has a consequence, the consequence means problem in daily activity or communication or any kind of thing
Handicap: the consequence of impairment or disability; limitation, what career you can even pursue
Group 1
Existence: labeling; cookie; bottle; mama; dada; up; bye- bye
Non-existence: all- gone; no; no more; away
Recurrence: more; more (noun); more (verb)
Rejection: no; no want
Denial: no; not
Denial is the earliest emergence of sequencing
Different categories of basic concepts
Different categories:
Spatial – “on, in, under, over, next to …”
Quantity - “many, some, all, same …”
Oppositional - “ up-down, in-out, hot-cold …” (early oppositional)
Temporal – “ after, always, sometimes, next …”
Auditory association
Auditory Associations are critical to the language process as they connect the elements of receptive and expressive language.
Auditory Association allows the speaker to recall words from “storage” and connect them with specific situations.
E.g.: routines (bedtime/ eating/ brushing teeth/ bathing/ etc.
Auditory Association can not be fully examined until the SLP recognizes the level of comprehension of the learner.
The two components of comprehension include:
A: context/ situation
B: linguistic message
Auditory Associations of terms not usually related to the situation can indicate poor processing skills. Obscure or idiosyncratic responses may represent creativity or learning difficulties. The difference is that the child with learning difficulties is often unable to self-correct to the usual response.
Auditory association definition
The process Of attaching meaning To auditory stimuli Then interconnecting it To receptive language concepts And assimilating it to experiences For linguistic expression
AA addresses the link between receptive and expressive language and develops the relationship between word meaning and word usage
Standardization studies [Language Processing Test (Richard and Hanner, 2006)] report that children begin to make auditory associations at approximately 36-48 months.
The purpose of developing auditory association skills is to develop:
Auditory discrimination – to discriminate sufficient intensity, frequency and duration of sound patterns to enable accurate perception production, and self-monitoring of speech. Critical to distinguish between target and error (see the Six Principles)
Short term sequential memory – to demonstrate the ability to recall and reproduce, in sequence, spoken information of appropriate length to age and cognitive level.
Word retrieval– to recall vocabulary without abnormal delay during spontaneous communication. Discussion of Word Test (Germann, 2009)
It may become necessary to supply visual cues in formation of auditory association, if weakness appears. Cues can vary from the formation of the phoneme to pointing to a picture of the desired response. Gradual fading of these cues is expected.
Remediation of this deficit should be carried out in an environmental context. E.g.: questions pertaining to daily activities while performing that activity. Always important to utilize pre-established vocabulary.
Categorization
Categorization = AA + Vocabulary
When we categorize , we group vocabulary by common features and use auditory association skills to recognize shared characteristics
Learning to categorize expressively involves several processing steps (labels the category and attaches meaning to it).
Categorization involves sorting and retrieving information from past experiences.
Categorization skills emerge as early as 30-42 months of age
To shift the level of difficulty: increase number, increase vocabulary, and/or increase similarity.
Categorization offers an excellent opportunity to observe the client’s learning strategies.
4 types of categorization skills
Labeling a category
Uses both sequential and simultaneous approach
Examples: red/blue/green/yellow/brown… these are called: colors
Completing a category
Uses both sequential and simultaneous
Examples: apple/ cherry/ banana/ ____/ _____/ _____/
Generating a category Discussion of Word Test (Germann, 2009)
Uses both sequential and simultaneous
Discussion of Word Test
Fast and accurate vs. slow and inaccurate
Discriminating a category
[Excellent opportunity to observe clients learning processing]
Sequential and Simultaneous can be separated
RECEPTIVE Simultaneous: identification/ sorting (process of exclusion)
EXPRESSIVE Sequential: providing reasoning/ explanation (process of sequencing)
Attribution
At this level of language processing a child learns that:
nouns are paired with modifiers
categories are used
functions of objects and people are described
In learning to state a function, the child must attach 2 levels of meaning to the noun – a label for the noun and a verb which describes its use or action Now the child has the experience of objects and what to do with them. (receptively attained by about 30 months) Eg:
Children begin to generate language representing early levels of attribution processing by 4.0.
Common approaches to attain this development include:
description of activities eg: birthday party
description of animals and their habitat eg: what lives on the farm
description of common objects eg: jewelry
Suggested Hierarchy of Difficulty for Adjectival Comprehension by Children with Language-Learning Differences
Color Size Shape Color/ size/ shape Length/ height Width Age Taste/ smell/ texture Attractiveness Affect Speed/ distance Comparatives
Semantic relations
Many children with language disorders exhibit limited concrete comprehension and usage of word relationships
Eg:
Concreteness (cat and raccoon look the same)
Prerequisites include:
basic concepts and auditory association,
the task involves the client’s ability to recognize characteristics of objects that are the same as well as different
Same comes in first, comes in a year before different
Age 3: same
Age 3.6, 4: different
4-5: similarities
Similarities and differences
we process similarities between two items by comparing them and determining their common features
Remediation:
clue charts
shift from verbal to pictorial to object level
Use of category, attribute, and function
teach receptive prior to expressive
Receptive – sorting and pairing
Expressive – labeling and explaining
Language Processing Test standardization data identifies that:
Similarities begin to emerge at age 5.0
Differences begin to emerge at age 5.6
Analogies
Analogies are comparisons expressing logical relationships between words and/or concepts
Must have comprehension of the vocabulary used in the analogy
Must earn to discern relationships between words and realize that the first word pair must have the same relationship as the second
Part of the child’s ability to manipulate semantic information, becomes sophisticated and is the beginning of meta-linguistic processing.
Children with communication difficulties often have limited concrete understanding of words and word relationships. They tend to learn partial word meanings and they do not show flexibility in word usage, as a result, they lack the strong semantic knowledge that is necessary to support verbal reasoning skills.
Remediation include a set series: Comprehending Choosing answers Answering reasoning
An established hierarchy is established:
- Character tics (size color) 6. Opposites
- Part/ whole & whole/ part 7. Synonyms
- Location 8. Familial
- Action- Object 9. Grammatical
- Agent- Object GAP
10. Tempooral
An established hierarchy is established:
- Character tics (size color) 6. Opposites
- Part/ whole & whole/ part 7. Synonyms
- Location 8. Familial
- Action- Object 9. Grammatical
- Agent- Object GAP
10. Tempooral
Group 2
Basic concepts Auditory association categorization attribution semantic relationship
Group 3
Temporality
- Causality
- Morphological acq.
- Syntactical acq.
- Adv. Semantic relationships
MLU: Post 4.0
Discourse skills developed
Factors to consider when devising intervention:
Use age appropriate temporal markers and teach what needs to be learned
In gradual shifts vary the setting and usage
Use associative grouping and cuing strategies
Use imagery to facilitate retrieval
Causality
The child needs a foundation in the areas identified as Groups I and II
Cause and effect crosses multiple dimensions of language
Child needs to have a large enough semantic repertoire to develop word relationships
Morpho-syntactic rule acquisition
Triangulated information provides the most accurate sample, vary the:
Context (purpose)
Situation (place)
Person
The instructional objectives for planning such intervention are as individual as the client’s specific needs
Emphasize the rules behind the structure
Structure simple situations, practices, routines that will elicit many examples
Then build up:
semantics
cognitive level
pragmatic demands
Making the situations simple may be necessary especially for adults who lost language
Routines are good because they are predictable
Predictability between cognitive and social
False assertion: break from routine
Potential Morphological Syntactic Target Structure Related to MLU
Work with FORM, CONTEXT, FUNCTION (receptively and expressively)
Form: the target structure
Context: changes from example to example
Function: social use/purpose (alternating the communicative
demand)
Advanced semantic relationships
Multiple Meaning Vocabulary
understanding (R) that a word can have different meanings when used in a variety of contexts
learning to explain (E) the meaning of the word for that situation using synonyms or definitions
use of multiple meanings becomes more abstracts as the processing demand increases
According to standardization studies of the Language Processing Test, this ability begins emerging by age 7.0
Seriation
Sequencing; graduated degrees, continua
E.g.: now understanding grades
Semantic Transformations
Idiomatic Expressions: idioms that we tend to use are advanced (4+), “use your noodle”
Figurative Language: metaphor; high as a kite, need to learn how they are addressed, hyperbole,
Ambiguities and Absurdities: “John hates shooting guns”, surprised when there are too answers, you might need to ask for more information
Verbal reasoning skills
Three major elements in the development of VRS:
Inferencing
R: making an inference
E: explaining an inference
Predicting
Outcome (What If… Questions)
Comparability
Answering Why questions
▲ Sequential processing [process of sequencing ]
▼ Simultaneous processing [process of exclusion
Discourse
EXPOSITORY (scripted)
NARRATIVE (Generated/Retell)
CONVERSATIONAL
Sample Pragmatic (Conversational)Behaviors
Initiating a conversation: the ability to know how and when it is acceptable to initiate a conversation devices included comments and requests
Maintaining a topic: statements which are directly related to the given topic, information that we share
Signaling a topic shift: transitions must be made from one topic to another and a listener must know when the topic is changed
Requesting information: gestures and utterances that direct the listener to provide information about an action or object or any location. Many children will have to signal this.
Pre: reqs: command of the wh questions: who, what, where, when
Requesting for classification: we can use through gesture (raising hand, facial expression) utterances still directed to listener to provide info but this time clarification. Set up situations that elicit this (LTO #5), setting up situations that were ambiguous or information that was interrupted.
Discourse
EXPOSITORY (scripted)
NARRATIVE (Generated/Retell)
CONVERSATIONAL
Sample Pragmatic (Conversational)Behaviors
Initiating a conversation: the ability to know how and when it is acceptable to initiate a conversation devices included comments and requests
Maintaining a topic: statements which are directly related to the given topic, information that we share
Signaling a topic shift: transitions must be made from one topic to another and a listener must know when the topic is changed
Requesting information: gestures and utterances that direct the listener to provide information about an action or object or any location. Many children will have to signal this.
Pre: reqs: command of the wh questions: who, what, where, when
Requesting for classification: we can use through gesture (raising hand, facial expression) utterances still directed to listener to provide info but this time clarification. Set up situations that elicit this (LTO #5), setting up situations that were ambiguous or information that was interrupted.
Selecting phonological processes for remedition
Work on more than one processes at a time
1. Consider the approach selected: Vertical, Horizontal, Cyclical.
What are the 4 Strategies of the TX Plan design? Organizations of LTO Management of communication behavior…
2. Choose process in which the child may have relatively early success.
3. If possible, select processes that are context or position specific (velar fronting)
4. Select processes that contribute significantly to the child’s unintelligibility
Selecting Target Sounds Affected by Phonological Processes
- Choose sounds that appear in the child’s phonetic repertoire
- Choose sounds for which the child is easily stimulable
- Choose sounds that frequently occur in the child’s vocabulary
- Choose sounds that are acquired early
Intervention
General Suggestions
- Discrimination Training
- Organic or Non-organic … Phonetic or Motoric
- Plan for use of real words
- Choose target words that are within the child’s syllabic capabilities
- Plan for generalization from the beginning (both S and R generalization)
Remediating specific processes
Syllable Structure Processes:Cluster Reduction: use paired word techniques (eg: pill/spill)
FCD: contrast words with and without final consonants, keeping all other sounds in the word constant (eg: sew/soap; boo/boot; toe/toad)
Syllable Deletion: contrast monosyllabic and polysyllabic words using a paired word technique that involves a clapping-pair-sensory-motor approach.
Substitution Processes: Use a Distinctive Feature approach having the child discriminate between minimal pairs and produce sounds that differ by one feature. (eg: pan/fan; think/sink; ship/chip).
Assimilation Processes:
Note: minimal contrast pairs are typically NOT applicable in the remediation of assimilation process errors because the nature of assimilation prevents contrasts based on real words.
Final Devoicing: use a variation of paired stimuli by combing in words in which assimilation can and cannot occur (eg: ).
Velar Assimilation: If the child produces [gog] for “dog” and [g k] for ‘duck”, these words should be paired with or directly followed by the target (eg: “mad duck or sad dog).
Using contrasting pairs
Teach target word of CV construction (eg: toe, boo, see, hoe)
- Teach receptive vocabulary of CVC matching the CV above
- Teach a receptive game
- TEACH THE CVC RULE*
- Reverse the role of the receptive game having the child assume the expressive
- Easy to do, receptive E CV/ T CVC, don’t even have to say toe or boo, just have them point
- Receptive CVC and CV words: point to tire, time, type, boot, boom, robe, rose
- Game : point to, out a circle around, or put your foot on a card (twister)
- Teach the rule, roooo pe, tiiiiiiiiii me, you can use your fingers running off the table, or draw a line on the table and say I can use a tissue and the tissue can travel across the line with cuuuu p and the p will blow air
- Child tell me what to put my marker on
FCD 4 years
