Week Six Flashcards
What are the general principles of treatment?
- Treatment should be:
- Theoretically sound e.g., MOTOR speech treatment should follow the principles of MOTOR learning
- Supported by empirical evidence
- Goals should be realistic
- A degenerative disorder will not be a healthy speaker
What are some influences on intervention management?
- Medical prognosis
- Impairment, activity limitations, and participation restrictions
- Environment and communication partners
- motivation and needs
- Associated physical, cognitive and linguistic processing deficits
- severity
(duffy, 2013)
How do you categorise severity?
Severe
- Unable to communicate verbally in ordinary situations
Moderate
- Able to use speech as sole means of communication, but not entirely intelligible
Mild
- Intelligible, but less efficient and less natural than speech of healthy speakers
True or False: you need to evaluate after initial assessment
True, you need to know if a strategy is working and if it isn’t you need to try a different approach
What is behavioural management?
Working on own client’s speech behaviour and trying to change it
What is the rationale behind behavioural treatment?
The brain is not static - it can change
The brain is able to learn - neuroplasticity
What are the principles of behavioral management?
The brain can remodel itself in response to experience/training
Motor reorganization after injury requires USE (ICF activity level)
Compensating (i.e., becoming louder, slower…) for the deficit to improve intelligibility requires that speech production becomes conscious
What is an initial consideration that needs to be made when thinking about treatment?
Physiologic Support - improving functions that support speech (modifying posture, increasing strength, range of movement) (ICF impairment level)
What is motor learning?
The process in which the client acquires the ability to produce skilled actions (Schmidt, 1988)
It is achieved through practice and experience
Attention and memory are required for motor learning to be effective
Impaired attention, cognitive, memory problems may mean prosthetic management or listener based strategies will be more effective
What are the principles of motor skill learning?
- Improving speech requires speaking
- Practise and experience –> drill is essential
- Consistent (blocked) and variable (random) practise may have different effects
- Instruction/demonstration (therapist based) and self-learning (client reflection) are both valuable
- Feedback and type of feedback is important
- Specificity of training and salience are important
- training should be as specific as possible to the movement patterns
- Speech should be the focus of treatment activities
True/false: The best time to start treatment is later
False - the evidence suggests the best time to start is early
Why do we need baseline data?
So we can establish goals and measure change
How is the organization of sessions important?
Frequency - more training = better performance
Task ordering - start easy, then harder but finish with tasks that ensure success
Error rates - start at 60% accuracy, move to 80,90…
Fatigue - therapy most productive in the morning; not immediately after physical therapy or occupational therapy
Individual vs group intervention - advantages of individual: focus on specific aspects, opportunity to alter activities quickly and to obtain maximum number of responses
What are some goals based of severity?
Severe
- Establish function means of communication (AAC, educate family)
Moderate
- Maximise intelligibility (change speech behaviour - reduce rate, speak louder)
Mild
- Individuals may experience restricted participation
- Maximise communication efficiency and naturalness
What levels of the ICF does intervention need to target?
- Impairment
- Activity
- Participation
- Environmental
