Week Eight

Question 1

What is stimulability?

Answer 1

Testing whether or not a client can do what is required of them to address treatment target

Can be done by shaping and coaching

Question 2

What are the key points in shaping?

Answer 2

• Getting the client to do it
• Helping them to achieve it (e.g., modelling, feedback)
• Client needs to know the difference between their habitual speech and required speech
• Making them aware (“what did you do to achieve clear speech”)

Question 3

What are oral motor exercises?

Answer 3

• Non speech exercises
• Might be described as active muscles exercise, muscle stretching, passive exercise, or sensory stimulation
• Used by up to 70% clinicians
• However, not proven to be effective (doesn’t use gestures required for speech production, specificity of training not maintained)

Question 4

What is the process of treatment planning?

Answer 4

1. Identify any existing compensatory strategies the client is using
2. Identify which aspects of speech can be modified and will result in improvements to intelligibility
   - Trial various behavioral modifications
   - check stimulability

Question 5

What are the compensatory treatment options for the activity level?

Answer 5

1. Behavioural compensation
   - rate control
   - Altering stress patterns
   -…
2. Prosthetic devices
   - palatal lift
   - Portable voice amplification device
   - SpeechVive

Question 6

What is a palatal lift prosthesis?

Answer 6

• Type of prosthetic device
• Aims to improve resonance by displacing the soft palate to the level of normal palate elevation
• Usually necessary to combine palatal lift and speech therapy
• Improvement in articulation and intelligibility

Question 7

What is a portable voice amplification device?

Answer 7

• A type of prosthetic device
• Aims to increase loudness of voice/speech
• Candidates:
  cannot follow simple demands
  do not respond to cueing and modelling
  do not commit to treatment schedule

Question 8

Why might someone be suitable for a prosthetic device?

Answer 8

• Someone who has sensory and cognitive problems
• Someone who cannot tell the difference between their voice and target voice
• someone who cannot generalise outside of treatment

Question 9

What is Speechvive?

Answer 9

• A prosthetic device
• For people with Parkinson’s disease
• Aim to increase the loudness of voice/speech
• Uses the lombard effect (we reflexively speak louder in noise)
• When the wearer speaks, loud noise is played to get them to naturally talk louder.

Question 10

When creating a session plan for behavioural compensation, you need to include principles of motor learning. True or false

Answer 10

True

Question 11

How do you structure a session?

Answer 11

Pre Practise
- Prepares the client for practise
- makes sure client understands task and how if fits with goals of treatment
- specific goals
-

Practise
- small vs large practise
- distribution: massed or distributed
- variable: constant vs variable
- schedule: blocked or random
- complexity: simple vs complex
- type of feedback: knowledge of performance vs knowledge of results
- frequency of feedback: high vs low
- Timing of feedback: immediate vs delayed