Final Exam Flashcards

Question

Manner: Stops

Answer 1

complete closure of the vocal tract, air builds up behind closure, air is released and produces burst of noise, p,d,k,g,b,t, shortest in duration

Answer 2

continuous airflow through restricted channel that results in hissing quality, v,f,s,z,,th,th,sh,zh,

Answer 3

stop and fricative component, build up behind and released as a fricative, ch, j,

Answer 4

lower the velum, air travels through nasal cavity, m,n,ng,

Answer 5

semivowels, transitioning from partly constricted state to a more open state, w, j

Answer 6

l,r, slightly more constricted than vowels, l can me lateral because the air flows laterally along the tongue, r can be rotic, retroflex or bunched r,

Answer 7

lips b.p.m.w

Answer 8

lips and teeth f and v

Answer 9

tongue and teeth: th voiced and voiceless

Answer 10

tongue tip touches ridge: s,z,t,d,n,l

Answer 11

tongue and hard palate: sh, zh, ch, j, r, y (j)

Answer 12

tongue to velum: k,g,ng

Answer 13

describes VF vibrations, b,d,g,z,v,m,n,l,r,w,y,thV,j,zh,ng

Answer 14

glottis open p,t,k,s,th,f,h,sh,ch

Answer 15

two sounds are alike in place and manner but differ only in voice, b/p, t/d, k/g, th/th, f/v

Answer 16

describe phonemes presence or absence, pluses or minuses, binary system,

Answer 17

do not have a marked constriction in the vocal tract. **Vowels and l and r can be considered

Answer 18

do have a marked constriction along the vocal tract. **Consonants (all except h, w, y(j)

Answer 19

made with the tongue elevated above the neutral position when producing a. entire tongue is elevated. * *Palatals sh, zh, y, ch, j, Velars, k,g,ng

Answer 20

Tongue is retracted paast the neutral a. | **Velars k,g,ng

Answer 21

Tongue is lower than neutral a. **only H

Answer 22

point of constriction farther forward than the palatal sh. **w,f,v,th,th,t,d,s,z,n,l,p,b,n

Answer 23

Tongue blade above neutral position a. | **h,th,t,d,s,z,n,l,sh,zh,r,ch,j

Answer 24

sounds with lips rounded or protruded. | **r,w

Answer 25

sounds with a relatively greater degree of muscle tension or contraction at the root of the tongue. * *voiceless p,t,k,ch,j,f,th-V,s,sh,l

Answer 26

sounds made with incomplete constriction. | **glides, fricatives and liquids

Answer 27

sounds that are resonated in the nasal cavity. | **n,m,ng

Answer 28

sounds that force the air stream through a small constriction, **fricatives and affricates

Answer 29

produced by passing airstream relatively unimpeded | **glides, liquids, nasals

Answer 30

complete closure, | **stops, affricates

Answer 31

only one **L tongue is placed on the alveolar ridge and air flows laterally around the tongue

Answer 32

sounds that are produced with vocal fold vibration

Answer 33

**stops, fricatives, affricates, consonants produced by complete closure or narrow constriction

Answer 34

high frequency, more strident quality, longer duration, **s,z,sh,zh,ch,j

Answer 35

sound is produced with approximating nature, doesn't completely make contact. **glides and liquids

Answer 36

R, sounds with r coloring

Answer 37

any sound that can stand as the nucleus of a syllable, any vowel, and l,n,m,r

Answer 38

pure vowels | single articulatory position

Answer 39

gliding from one vowel to another | cannot be perceptually separated

Answer 40

``` high‐front mid‐front low‐front mid‐central high‐back mid‐back low‐back All back vowels have lip rounding except /a/ ```

Answer 41

rounded | unrounded

Answer 42

Tense | Lax

Answer 43

Onset Nucleus Coda Rhyme

Answer 44

syllable structure processes that modify the syllabic structure of the adult model

Answer 45

or Weak syllable deletion, child omits one or more syllables in a multi-syllabic word

Answer 46

totally or partially repeats a syllable in a multi-syllabic word, total or partial

Answer 47

add an /i/ at the end of an word, cuppy

Answer 48

insert the schwa in between two phonemes in a cluster supoon

Answer 49

deletes the final consonant or cluster of a word bo for books

Answer 50

omit the initial consonant or cluster of a word, ap for cop, very rare for normal developing developing children

Answer 51

reducing one or more sounds or phonemes of a cluster, partial or total, Partial: top for stop, total: ap for stop. Cluster simplification: substitution of one or all of the phonemes of a cluster: det for street, wo for blue, stop liquid is reduced to a stop, liquid with nasal or stop they will delete the liquid, s wth stop or nasal they will delete the s

Answer 52

stopping fricatives or affricates pat for fat

Answer 53

producing a stop or a fricative for an affricate tear for chair, dob for job

Answer 54

replace a more front sound for a back sound. t/k, d/g, n/ng top for cop

Answer 55

substitution of an alveolar fricative for a palatal fricative. sell for shell

Answer 56

very rare in normal developing children, replacing back sounds for more anterior sounds. g/d, k/t, ng/n

Answer 57

substituting a glide for a liquid, /w/ or /j/ for a /l/ or /r/ wabbit for rabbit

Answer 58

vowelzation, substitution of a vowel for a syllabic liquid or syllabic nasal

Answer 59

a non labial consonant changes because of the influence of a labial sound in the word. bamana for banana: b effects the n to change to a m to make it a labial-would be partial assimilation

Answer 60

non velar sound is changed to a velar sound because of the influence of another velar sound in the word. krain krack for train track.

Answer 61

non nasal sound changed to a nasal sound because of the influence of another nasal sound in the word. non for nose

Answer 62

non alveolar sound is changed to an alveolar sound because of the influence of another alveolar sound in the word. dod for dog

Answer 63

voiceless sound preceding a vowel becomes voiced. botato for potato, stops are most commonly affected

Answer 64

voiced obstruent following a vowel becomes devoiced. pick for pig

Answer 65

Lecture 2 Slides

Answer 66

Stress, intonation, loudness, rate, juncture, or prosodic features -without these, speech is difficult to understand.

Answer 67

- degree of effort placed of a part of an utterance and usually it is carried on the vowel of a syllable. -The stressed syllable is produced with greater intensity, longer duration, and higher pitch. -In English, stress can vary but in other languages it is fixed. - Stress is important when you have to words spelled the same but the stress changes the meaning of the word.

Answer 68

the vocal contour of an utterance. It is the way the fundamental frequency changes the way you produce an utterance.

Answer 69

The amount of intensity produced

Answer 70

The fundamental frequency of a speaker

Answer 71

the vocal punctuation. The combination of intonation and the pausing to mark distinctions in speech.

Answer 72

measured in words per second or syllables per second. speaking rate varies among speakers and if you speak at too fast of a rate, speak intelligibility is affected.

Answer 73

-Way different phonemes as they are grouped together affect the way it is produced. -The one sound is influenced by another. the way as you produce sound the sounds preceding and following affect the way it is produced, place of articulation ex: allophonic variation. -Phonetic context helps you know why they produce it a certain way based on the context of the word.

Answer 74

-have to know how air pressure, flow and volume affects speech. -Airflow builds up and moves from greater pressure to lesser pressure. So when the vocal folds are closed the pressure builds up under the vocal folds and the pressure builds up under the folds until the pressure builds up egressively and the air moves from the lungs to the oral cavity. voiced consonants are produced with less intraoral pressure because the vocal folds are vibrating so there is not a complete closure so there is less pressure. Children generally speak with greater intraoral pressure than adults do. -The air supplied by the lungs is valved and modified

Answer 75

rate of airflow, its volume and its pressure results in the necessary modifications to produce different speech sounds.

Answer 76

1. VF, voiced or voiceless 2. Velopharyngeal mechanism 3. Constrictors of oral cavity: different articulators and amount of closure they have to produce different phonemes.

Answer 77

1. Frequency: rate of vibration, aster is higher pitch. 2. Amplitude: Strength of vibration, greater the magnitude produces louder voice. 3. Duration: the amount of time the vocal folds are in vibration.

Answer 78

Each phoneme has a different spectra, visual pattern of a sound.

Answer 79

Males due to longer vocal tract, children will have the highest fundamental frequency. Vowels are most intense and have low to mid frequencies and are longest in duration.

Answer 80

next intense after vowels, low to mid frequency, glides have a longer duration than liquids.

Answer 81

s/z/sh/ch/dj/zh/, moderate intensity, high frequency, fricatives have a longer duration than the affricates.

Answer 82

weak intensity and short duration, vary in frequency

Answer 83

f/v/th/th, weak in intensity, moderate duration

Answer 84

Before language

Answer 85

babbling and first word

Answer 86

before birth, 16 weeks gestation. 500 Hz and 250 hz at 27 | weeks 33-35 weeks can respond to 250, 500, 1000, 3000 Hz

Answer 87

perceive differences in sounds heart rate would increase when the baby would hear their mother's voice

Answer 88

3 days old, from a strangers voice. show a preference for their mothers voice. infants prefer child directed speech or motherease first year of life: their ability to discriminate non native sounds begins to diminish

Answer 89

:babbling is not random but is necessary in transition to first word

Answer 90

automatic responses, burping coughing, crying, sneezing, birth to 1 month

Answer 91

syllabic nasals , some, voluntary vocalization, cooing, gooing, screaming, vocal play

Answer 92

produces reflexive vocalizations

Answer 93

2-3 months, back vowels and back sounds like velars, begin to produce those in cv combinations gogo gaga, primative syllable sequences because they do not have the regular timing for syllable and consonant segments.

Answer 94

4-6 months, vocal play increases, squeal, growl, rasberries, bilabial trills, marginal babbling appears, cv, vc combinations, vowels have more adult like resonance and produce more consistent consonants with more consistent placement

Answer 95

reduplicated babbling, 7-9 months , may sound like words but have to assess if they have meaning, mostly stops, nasals and glides, and lax vowels start dropping the velars and start producing more fronted sounds

Answer 96

stringing different cv combinations together, vowel repertoiree increases significantly , start putting intonation in, crossover from redupicated, 10-12 months

Answer 97

important milestone, will continue to babble even with first words

Answer 98

stringing conversational cv's together with intonation

Answer 99

/E/, /a/, /uh/ /oo/

Answer 100

/h/, /d/, /b/, /m/, /t/, /w/, /j/, /k/, /g/, /s/, /n/, /p/

Answer 101

Affricates, fricatives, th's, ng, /r/, /l/

Answer 102

alvelars, labials, velars.

Answer 103

nasals, stops

Answer 104

frequently

Answer 105

V, CV, VCV, CVCV

Answer 106

Yes, hearing impaired sounds different and is less frequent, later fewer syllables, less likely to produce reduplicated babbling. late talkers will babble later and produce less cannonical babbling

Answer 107

crossover, true words and babbling can be in the same utterance

Answer 108

Aka: vocables, phonetically consistent forms, invented words, and quasi‐words -words that aren't true words because they do not have a recognizable adult model but are used consistently by the infant and meaningfully. hold meaning and usually with a gesture

Answer 109

1. have to have a phonetic relationship to the adult word | 2. have to be used consistently in a particular situation or with a particular object.

Answer 110

actually can produce in comparison to the lack of the phonological system

Answer 111

child's static or unchanging pronunciation of word's despite his/her more advanced phonological skills. generally nicknames, habits metathisis: switch sounds of different syllables

Answer 112

-Children’s pronunciation of their first 50 words appears to be constrained by their physiology, ambient language, and child‐specific factors -every child is different and there is great variability. -around the 2 birthday they are producing more words and 2 or more words and they have a larger lexical inventory -babbling, jargon and protowords become extinguished -words become more phonetically like the adult target know table for consonant aquistion

Answer 113

3-0: h,w,m,n,b,p,f 4-0: d.t.k.g.j.ng 6-0: l,j,ch,sh,v 8-0 to 9-0: should have all consonants and be producing the adult model -Children’s phonetic inventory was significantly larger in the initial position early on because they produce naturally more open syllable words

Answer 114

s+stops s+nasal stop with a liquid except for gr and a stop+/w/ in the initial position

Answer 115

younger children are more likely to produce CR and older children will produce Cluster Simplification

Answer 116

- By 18 months: - At 2 years: all vowels and diphthongs were produced with at least 80% accuracy accept stressed and unstressed. - By age 3-0: produced all vowels and diphthongs with 90-100% accuracy.

Answer 117

fricatives

Answer 118

denasalization of m and n is common, common to produce a /m/ or /ng/ for n common to substitute a /n/ for /ng/

Answer 119

common to delete the glides, substitute w for d, h or l for the /j/

Answer 120

common to delete the final stop, front the velar stops, t/k, d/g, deaspirate the initial voiceless stop

Answer 121

common to produce w for l/r, common to delete the initial liquid, substitute a vowel or a schwa for the final l or rvowelization, delete the final l and r

Answer 122

common to substitute the stop for a fricative, common to substitute f for the voiceless th, b/v, substitute f/v, substitute s or f for initial voiceless th and d for voiced th

Answer 123

common to delete final fricatives s,z,and sh, stopping of fricatives and affricates, devoicing of the final z and dj, depalatialization, deaffrication, dental distortions of s, stopping of initial s

Answer 124

by 2 years old a child can produce clusters they just may not be the adult model. word final clusters are developed earlier than word initial clusters thought to be the addition of morphemes in the final position clusters with a stop are going to be produced earlier two element clusters are going to be produced earlier than three

Answer 125

very first to develop +nasality, +grave (most anterior, most front), earliest to later, +voice, +diffuse(produced in the posterior part of the oral cavity), +strident, +continuant

Answer 126

every child goes through producing Phonological Processes. FCD, Cluster Reduction, Weak Syllable Deletion, Stopping, Fronting, Gliding are all the most common in Normal Developing children. -Most phonological Processes are absent by age 5

Answer 127

FCD, WSD, Velar Fronting, Reduplication, Prevocalic Voicing and Consonant Assimilation

Answer 128

Cluster Reduction, Epithisis, Gliding, Vowelization or Vocalization, Stopping, Depalatization, Final Devoicing

Answer 129

list of processes chart

Answer 130

By 5 years of age… ● Majority of children by first grade will have acquired the phonological skills of their language -Pg. 187 by 19-24 months should be 25-50% intelligible 2-3 years should be 50-75% intelligible 4-5 years should be 75-90% intelligible 5+ years 90-100% intelligible

Answer 131

1. Linguistic Models: what they can produce | 2. Behavioral Models: based on experimental data

Answer 132

- generally will be pass or fail. - can be conducted with a large number of individuals in a relatively short period of time - If a child has a speech disorder, it means the child should go through more in-depth testing - done in schools from preschool-1st grade, also in hospitals - look at cognitive, speech, and language

Answer 133

- Clinician tailors their own screening to a specific population - open-ended questions, objects, or pictures - note any abnormalities

Answer 134

process and procedures used to obtain a clear description of articulatory and phonological skills of a child with a view to determine the presence or absence of a disorder.

Answer 135

goal/outcome that you are trying to achieve

Answer 136

``` Reviewing client’s background ● Planning the diagnostic session ● Selecting appropriate tests ● Prepare test room ● Conduct an opening interview ● Administering the tests ● Assessing related areas ● Conduct closing interview ● Make recommendations ● Writing diagnostic report ```

Answer 137

Obtain case history form - be thorough - gather reports from other professionals - what is the client interested in? - use case history forms in outpatient hospitals

Answer 138

make sure it is appropriate for the age of the child and ethnocultural. -good to have a plan/structure but need to be flexible

Answer 139

- decrease distractions - keep things hidden until you are ready to bring them out - make sure there is adequate lighting and set up audio/video beforehand

Answer 140

● Seek additional information or clarification on the various sections of the case history

Answer 141

1. Hearing 2. Oral mech exam 3. Language/Building Repertoire Level of Stimulability 4. Speech rate 5. Speech Intelligibility 6. Assess Language/at least Screen for language

Answer 142

Make appropriate referrals as needed for structural abnormalities -look at the overall structure, the muscles, help to see if there is any neurological involvement

Answer 143

-Flashlight -Tongue Depressor -stop watch -small mirror -cotton gauze -

Answer 144

SMR: Same phonemes

Answer 145

alternating

Answer 146

especially important for CAOS, dysarthria, • speed and regularity is what you are looking for • count number of syllables over duration of time or have them produce 20 reps and see how long it takes. • Norms: pg 303 • Normal adults: 5-7 reps per sec for AMR, 2.6-7.5 reps per sec for SMR, children will be slower than adults • assess structural and functional integrity of the lips, jaw and tongue through the rapid repetition

Answer 147

If you do not have an audiometer you c • an refer to the health department. • before you assess so you can make appropriate accommodations • if they fail the screening let the parent's know that they need a more in depth audiological assessment. • use pure tone audiometer: 500Hz, 1000Hz, 2000Hz, 4000Hz either at 20 or 25 dB • If they fail and you recommend a more in depth assessment, for insurance to pay they will usually need a referral from a pedi

Answer 148

standardized: always adhere to the administration procedures • if you decide to move away from the exam guidelines, document that in the dx report. • take the assessment score will not be as valid

Answer 149

going to look at single words generally • traditional analysis: look at substitutions, omissions, additions, and distortions in word initial, medial, and final position. • artic tests will general look at all of the consonants • do provide norm based information, percentile ranks, age equivalents, standard scores • fast 15-20 minutes administration -delayed imitation • phonological assessment: generally longer, whole word transcription • PA: multiple misarticulations,

Answer 150

1. Correct/Incorrect: +/- used with screenings, does not offer what the child actually produced 2. Types of Errors: artic tests, omissions, substitutions, additions, distortions. Sub:k/t, Om: - or , Dis: diacritic markings, Add: whole word transcriptions 3. Whole Word Transcriptions: phonological analysis, advantage is that you can actually see where the breakdown is in the word and the errors won't get over looked.

Answer 151

gives all of the sounds • have the adult model and target • quick

Answer 152

only look at single words not conversational speech/connected speech where there will be a greater breakdown • may not be normed for specific cultures, or dialects • only hear a sound one time • inadequate sampling of vowels

Answer 153

build rapport with the child, find out what the child is interested in, start with parallel play, bring the parents in depending on the child, don't overload with questions, open-ended questions, sabotage,

Answer 154

record the session with audio and if possible video, and gloss over, restate things that they may say that is not clear.

Answer 155

50-150 utterances, 15-30 minutes, depending on the child. avoid noise making toys that will interfere with the recording. drawback: can't see gestures: jot those things down.

Answer 156

Look at the position at which the sounds are misarticulated: initial medial and final and the types of errors, omissions, subs, distortions and additions. Good for children who only have a few misarticulations. Relatively quick to do

Answer 157

Place, manner voice analysis, distinctive feature analysis, phonol ‣ ogical process analysis

Answer 158

Looking at where the errors are in place, manner and voice ‣ relatively quick ‣ artic, non standardized test and phonological process test.

Answer 159

* presence or absence of a DF | * overshadowed by phonological process analysis

Answer 160

‣ highly unintelligible with many misarticulations ‣ standardized tests are easy way to complete this because they give percentages. ‣ 40% using the process should be targeted in tx, must effect more than one sound in a given class

Answer 161

‣ comparing the sounds that they have to the normal age of mastery of sounds ‣ already gives you the norm based guidelines

Answer 162

◦ assess at conversational level ◦ subjective to you ◦ objective: math

Answer 163

◦ most standardized tests will give you this but it may be off. ◦ number of sounds in error, or process in error, consistency of errors, and the child's age ◦ Slight to severe number of consonants they can produce multiplied by total consonants divided by 100, BOOK

Answer 164

Looking for a context where they can produce the sound accurately. ‣ guideline of where to start therapy

Answer 165

‣ look at all the phonemes they can produce. in all word positions ‣ visual analysis

Answer 166

‣ different syllables they will produce

Answer 167

‣ if they are consistently producing an error 40% of the time or more that is something you want to target in therapy.

Answer 168

Independent Analysis | Relational Analysis

Answer 169

:looking at utterances without relation to the adult model, focusing on what the child can produce. Phonetic inventory without reference to the adult model. most used with children who are highly unintelligible or very young children.

Answer 170

:compare to the adult target. looking at specific types of errors, Phonological processes, patterns best practices is to look at both together

Answer 171

same sound for consistency of the error • not limited to single words • more representative of their phonological skills • syllable shapes, utterance length, speaking rate, language

Answer 172

``` Time consuming • No easy to find norms • no adult target • no guarantee that every sound is tested • the child may not talk ```

Answer 173

◦ before treatment to find out if there is something extra you con give to help them. ◦ informal, done early in therapy,

Answer 174

◦ help identify a facilitative phonetic context for correct production of a sound ◦ Deep test: different groupings of words, Clinical Probes Test: different Phonetic Contexts

Answer 175

◦ see if they can hear the difference in the target and their error ◦ use minimal pairs into a game ◦ include it with treatment

Answer 176

``` ◦ does the disorder exist? ◦ what is the nature of the problem? ◦ severity? ◦ any related factors? hearing screen, oral mech, case history, etc. ◦ treatment appropriate? ◦ prognosis? ```

Answer 177

◦ Articulation disorder | ◦ Phonological Disorder

Answer 178

◦ can be normal is the errors are related to a second language, dialect age appropriate speech, errors are slight not perceived by the average person. Take into account the parent and child's wishes.

Answer 179

◦ few errors | ◦ motor based

Answer 180

``` ◦ underlying rule or pattern that can be identified ◦ multiple misarticulations ◦ poor speech intelligibility ◦ various phonological processes ◦ limited syllable shapes ◦ limited or restricted phonemic inventory ◦ collapse in phonemic contrast ◦ rule based, suppression of processes ```

Answer 181

estimate of the severity of the disorder, usually one of the last statements on the dx report, ex in book

Answer 182

estimated course of a disorder under specified conditions, make at the time of assessment, educated guess

Answer 183

1. Goal Statement 2. Judgment of Success 3. Prognostic Variables

Answer 184

severity, chronological age, motivation, inconsistency is good, associated conditions, treatment history, family support we are ethically responsible to write a prognosis statement. It is just a judgement of success. Just because they have a poor prognosis does not mean it is not appropriate to not treatment. Reasonable statement according to ASHA Code of Ethics.

Answer 185

taking the information and determining the best plan for treatment. treatment is warranted at this time or not.

Answer 186

review all information gathered with parents, explain test scores, show deficits, visual illustrations, phonetic inventory, norms, ask questions to make sure they understand, clarify, don't talk down to the parent or use technical jargon they won't understand

Answer 187

compile information into diagnostic report, will look different everywhere, longest here, usually will always contain: identifying info, background, history, assessment, diagnostic statement, prognostic statement, treatment recommendations.

Answer 188

o A neurological childhood speech sound disorder in which the precision and the inconsistency of movements underlying speech are impaired in the absence of neuromuscular deficits. CAS may occur as a result of known neurological impairment or as an idiopathic speech sound disorder. The core impairment in planning and/or programming spatiotemporal parameters of movement sequences results in errors in speech sound production and prosody.

Answer 189

* Does not have neurologic deficits * Idiopathic speech sound disorder * KEY: It is a motor planning issue. * Sequencing of sounds * Breakdown in motor planning * Speech movement disorder * Presents like adult apraxia, but will find no neurologic impairment * Similar to apraxia because of the lack of volitional control * May be found in children with other disorders: CP, MR, ADD, Sensorineural Hearing Loss.

Answer 190

1. Difficulty in volitional production of phonemes and sequencing of phonemes the child can otherwise produce. The child will either lengthen or segment sounds. 2. Inconsistent speech errors. 3. Distorted vowels and diphthong reduction (monthongization) 4. Flat prosody or equal stress on each syllable.

Answer 191

* Groping * Difficulty executing isolated or sequential movements on command * Difficulty with sound imitation * Increased errors with increased utterance length * Poor oral awareness * Moderate to severe speech intelligibility varies based on complexity of utterances * Sometimes make addition errors (kwink for queen) * Prolongation errors * Omissions and substitutions, but their errors are very unusual, sometimes they present with voicing or devoing errors * Inconsistent hypernasality * Metathetic errors pagati for spaghetti * Slow devoicing of speech * Reduced phonetic inventory * Reduced percentage of consonants correct.

Answer 192

* In children with CAS, vowels were inaccurate (15-39%) even when they had acquired a relatively complete vowel inventory (NORM: is 8% at 2 years, and 7% at 3 years) * CAS children showed no consistent pattern of errors * CAS children did NOT use most stable vowel as substitute for errored vowels-whereas phonological children DID * CAS children had decreased rhotic vowels compared to norms * Example: A child may say “hup” for “hop” or may distort a vowel so that it does not sounds like an English vowel.

Answer 193

* A child with CAS produces a word, there may be lengthy pauses or breaks between the sounds and/or syllables within the word. This may be due to difficulty coordinating the motor movement of the articulators from one sound to the next. Or, the child may have a problem coordinating “voicing” such as going from a voiceless consonant to a voiced vowel (learning to play piano-long pauses while you figure out the next note). * Example: A child may be trying to say the word “top” and my effortfully separate each sound, resulting in a production that sounds like “t”---------“awe”—“puh”. Or a child may pause between sounds, syllables, and words so tha this utterance sounds “choppy” (I----want—huh—nee—oz—for—suh-nack- instead of “I want Honeyo’s for snack.”)

Answer 194

* Melody of speech pattern in affected, lacking inflection and appropriate stress pattern. A child may lack expression and sound robotic (like when learning to play the piano, notes separated, not fluid-not melodic) * Example: when asked who’s toy the child might say “It’s my toy” without placing stress on MY or the child may separate each letter in a word and produce in an over-precise way again resulting in robotic or staccato production. * Decrease in vowel colored /r/ * Lengthened pauses in-between words or even in words. A lot of breaks * No differentiation in stress * Progress in therapy is slow-poor prognosis * At risk for PA dificits. Ability to break down your own speech, which also puts them at risk for reading difficulty * Receptive language is better than expressive language * Increased self awareness of the problems with their speech * Mildly low muscle tone * May present with limb apraxia or oral apraxia

Answer 195

1. Look at automatic vs. volitional control 2. Look at simple vs. complex speaking tasks 3. Look at consistency of the production of the same word 4. Look at prosody. Stress is going to sound more equal and segmented. 5. Look at their phonetic inventory. (Not necessarily a red flag-could be limited or not) 6. Look at vowels and vowel imitation. 7. Assess language (receptive is going to be better and expressive is going to be lower.) 8. Oral mech (can look at groping, non-verbal oral motor tasks) 9. Phonological awareness-assess 10. Check stimulability 11. Look at their functional communication skills (can they express wants, needs, how do they express wants/needs)

Answer 196

List of words organized by syllable shape- beginning with simple and moving to complex - representative sample of all vowels and dipththongs - representative sample of all developmentally appropriate consonants - include some strings of words and phrases that get progressively longer, building on each other Have child say words in imitation and listen for: (have them say at least 2x to get instant % - vowels - Consistency from trial to trial - prosody - coarticulatory transitions between sounds and syllables - then comment on other features noted.

Answer 197

1. Speech sample (natural sample with parent and elicited speech sample) 2. Imitation tasks (more simple syllable shapes-have them imitate more than once, greater syllable shapes, 1-2 utterances, etc.) 3. Oral motor exam 4. Language assessment 5. Artic assessment (Goldman Fristoe: add vowel column, have them say each word twice, re-order to easier to harder words. 6. AAC (provide Boardmaker pictures)

Answer 198

``` a non-progressive neuromotor disorder resulting from brain damage before, during, or shortly after birth • Brain damage in utero, during birth and shortly after birth • 2 in 1,000 • No single etiology • Utero infections • Radiation • Trauma • Head trauma • Maternal drug use • Anoxia • Erupted placenta ```

Answer 199

o Increased muscle tone o Exaggerated reflex o Slow and effortful, jerky movements o Related in pyramidal lesions in 50%-most common

Answer 200

o Small, writhing involuntary movements when they are attempting volitional movements o Muscle movements can vary from normal at rest to hypertonic when moving o Higher involuntary movements with higher stress or distraction o 10% due to extrapyramidal lesions.

Answer 201

o Lesions in the cerebellum o Affects their equilibrium o Trouble with balance 5-10%

Answer 202

``` o All the muscles are affected simultaneously o Constant muscle tone o Movements are slow and effortful o Occurs in 1% o Damage to/in pyramidal lesions ```

Answer 203

o Most common is spastic and athetoid o Occurs in 30% o Degree of neurological impairment will affect the degree of the speech impairment o Will be a more dominant type in mixed

Answer 204

* Imprecise articulation due to muscle strength * May present with slurred speech-especially those who are ataxic * Those with athetoid CP have a higher increase in artic errors * Difficulty with tongue tip sounds * Predominance of omissions * Difficulty prolonging sounds * Greater errors in the final position (present with FCD) * 5-8-% of children with CP will show speech impairments can result in non-verbal speech. * Articulatory conspicuousness just sounds different * Common phonological processes: cluster reduction, stopping, gliding, fronting, depalatization

Answer 205

* Hypernasality due to the velopharyngeal mechanism dysfunction * May present with nasal emission * Overall poor oral resonance.

Answer 206

* Hard time controlling loudness so real loud bursts randomly * Can have strained voice quality due to the hyperadduction of the VF’s * Some present with a more weak and breathy voice due to the hypoadduction of the VF’s goes back to poor control * High pitch

Answer 207

* Breathing exercises * Control of breathing is poor * Poor breathing * Air ***stage * Excessive diaphragmatic breathing

Answer 208

* Sound monotone * Monoloud * Lack smooth, flowing speech * Overall disprosody

Answer 209

* During DKR, they are going to have slower rates | * May have MR, ADD, HL, language disoders

Answer 210

* Often will see the child before 1st birthday * Work on swallowing, feeding before speech * Work with OT, PT, social worker, parents, psychologist, MD, audiologists (sometimes) * Oral motor exam is important (note head control, coordinating suck, swallow, breath patterns in eating, vocal quality, and their breath support, VF adduction and abduction) * Look at psych report to look at their mental development * Looking at behavior checklist (feeding, swallowing, biting, sucking, etc) * Assessing for an AAC device * If they are talking, look at prosody and resonance. * Language

Answer 211

* Opening in a normally closed structure * Hard palate, soft palate, lip or all of the above * 50% of the clefts are lip and palate * Occurs in utero * Generally the lips close at the 5th or 6th week of gestation * Palate closes around the 8th or 9th week * Occurs in 1 in 500-750 live births * See more often in Native Americans * Affects more males (2x than females)

Answer 212

* More difficulty with voiced sounds * Difficulty with pressure consonants (stops, affricates) * Often times they substitute nasals for non-nasals * May produce nasal emission, especially on VL consonants * Substitute glottal stops for anterior (glottal clicks) * Substitute pharyngeal fricatives for palatal fricative * Substitute pharyngeal stops for palatal fricatives * 3 substitutions are normal compensatory strategies * Multifactorial in origin can be genetic or environmental, toxic and embryonic developmental factors. * Velopharyngeal inadequacy may present with distorted vowels and reduced speech intelligibility.

Answer 213

* High risk of vocal nodules because of greater strain and tension on vocal folds * Abduction of VF causes a strained vocal quality * Can cause edema to VFs * Can sound monotonous in their pitch

Answer 214

Hypernasal

Answer 215

* Eustachian tubes are developed around the same time as the palate * A lot will have hearing loss due to the recurrent middle ear infections * Hearing loss in approximately 50% * Generally a conductive HL * Want to repeatedly check hearing if it is a genetic syndrome, may have other things like a language disorder.

Answer 216

* Work with cleft palate team * In depth case history surgeries * Work with audiologists * Oral mech exam * Work at velopharyngeal mech * Artic assessment include lots of pressure consonants and nasal sounds vs. non-nasal sounds * Conversation sample * Reading sample * Assess language * Assess phonation (listen to vocal quality and make judgment) * Assess resonance.

Answer 217

* Trisomy 21 * FIND number in births and chromosome * Cognitive impairment range will depend on how bad their speech impairment is. * Relative Macroglossia: tongue isn’t any bigger than normal, oral cavity is smaller than normal. Tongue is protruding anteriorly. Swallowing will show tongue thrust. * Jaw will fall down, not as good jaw stability for speech. * Lower muscle tone * Frequent otitis media, which will effect hearing. * Overall delayed speech development.

Answer 218

* 1 in 4,000 births * Mutation on the X chromosome turns off a particular section * Occurs more often in males because they only have one x chromosome * Poor speech intelligibility * Varying degrees of cognitive impairment * Follow normal pattern of development but at a much slower rate

Answer 219

* Hear adult target | * Hear yourself for self monitoring

Answer 220

* Level of hearing sensitivity * Speech recognition skills * Configuration of the hearing loss * 2-3% of school age children have a hearing impairment that is greater than 25dB HL * can be deaf or hard of hearing but can still have residual hearing and need amplification to assist with hearing. * Deaf person can not use hearing to acquire speech * Earlier onset of hearing will greatly affect speech * Born without speech will affect worse.

Answer 221

``` effects the inner ear, auditory nerve, hairs of the cochlea. • Causes: o Presbycusis: general aging o Exposure to excessively loud noise o Vascular accident that affects the blood flow to the cochlea o Viral or bacterial infections, such as meningitis o Fetal Alcohol Syndrome o Ototoxicity o Maternal Drug Addiction o Low Birth Weight o VIII Cranial Tumor o Demylenialation o Congenital Disorders ```

Answer 222

* 1/3of children who have is due to recurrent otitis media * If not treated will cause permanent damage * Middle ear damage * Otitis Externa: Swimmers Ear * Ostiosclerosis: Footplate of the stapes is attached to the oval window * Collapsed ear canal * Stenosis: Narrowing of the external auditory canal * Aural Etresia: closed external auditory canal * Disarticulation of the ossicular chain * Ostiomias: benign bony tumors of the external auditory canal

Answer 223

1. Degree 2. Age of Onset 3. Age of Intervention Onset 4. Quality of Intervention 5. Family Support 6. Presence of Other Physical, Cognitive and Sensory Impairments

Answer 224

* FCD * /s/ high frequency, voiceless sound * ICD * Voiceless fricatives

Answer 225

* Voiced for voiceless * Nasals for non-nasals * Vowel substitutions * Sounds that are more tactile, kinesthetic, for those that are not (w/r)

Answer 226

* Wrong amount of force with sounds-too hard or too soft which makes it sound unnatural * Duration of vowels is usually longer than normal * Hypernasality with vowel production * Dipthongs produced with incorrect timing of the first and second vowel.

Answer 227

* Vowel between consonants-epenthesis * Aspirate the final stop consonant * Monothong vowels they will add another vowel-dipthongization?

Answer 228

* More high pitched * Can be more harsh * Can be more hoarse * Lack of normal intonation * Nasal emission voiced consonants * Hypernasality on voiced consonants

Answer 229

* Abnormal intonation * Abnormal rhythm * Slow rate of speech * Inappropriate pauses

Answer 230

* Grammatical Morphemes: past tense, plurals, different verb endings * Pragmatics: very literal, have trouble with abstract language (metaphors, idioms, understanding humor) * Difficulty with multiple meaning words * Limited vocabulary * Poor word comprehension * Poor reading comprehension * Writing mirrors their verbal output

Answer 231

* Know from the audiologist what their hearing level is, degree * What part of the spectrum they have more hearing loss in * Do an artic test * Being ready to use narrow phonetic transcription * Reading sample * Writing sample * Assess language * Assess voice * Assess prosody * Assess resonance

Answer 232

* Underlying knowledge that words are made up of sounds and sound combinations. * Ability to reflect on, think about, and manipulate sounds and utterances * Child’s ability to break down the word and analyze it * Skills are essential for reading and spelling development.

Answer 233

* First thing to develop, earliest benchmark of phonological awareness * Can develop as early as 2 * Ability to identify words that sound alike * Or the ability to produce a word that sounds like another word * Ability to distinguish rhyming words from non-rhyming words * DEMSS-Rhyming ways to assess rhyming

Answer 234

• Ability to identify words that begin or end with a certain sound.

Answer 235

• If a specific sound occurs at the beginning, middle, or end of a word.

Answer 236

• Have the child blend two or more sounds that are temporarily separated by a few seconds in a word.

Answer 237

• Identifying how many syllables in a word. (tapping, clapping or verbally)

Answer 238

* Ability to break down a word into its individual sound components. * Opposite of syllable identification * Later developing skill * Closer to age 6

Answer 239

* Spell the word phonetically how it sounds. * Phonetic in nature * Phone-fon * At a young age this is good, not correcting

Answer 240

* Deleting, adding or substituting a sound in a word to create other words. * Most advanced skill * Without this, high risk for reading delays and spelling. * Phonological delays-phonological deficits * Best indicators of literacy outcomes are sound segmentation and phoneme manipulation. * First learn words, and then learn smaller units. * Vocab development and letter knowledge are very important for PA in the preschool years.

Answer 241

* Incorporating into normal therapy * Using a book to target /s/ sounds for example * Point out the shape of the letter * New vocabulary words in books * Nursery rhymes in therapy-auditory discrimination by separating minimal pairs (rhyming, alliteration)

Answer 242

• Working with the teachers, reading specialist, special education teacher, early ed teachers to focus on those skills

Answer 243

• Assessing those different skills

Answer 244

• Make sure it is age appropriate

Answer 245

* Comprehensive Test of Phonological Processing * Test of Phonological Awareness- Second edition * Test of Awareness of Language Concepts * Phonological Awareness Test * Test of Phonological Awareness Skills * Assessment of Sound Awareness and Conceptualization Test-3 * Test of Phonological Awareness in Spanish

Answer 246

-Include phonological awareness as part of therapy when treating a preschool-aged child for articulation or phonological disorder • Will look like treatment of artic • Development of rhyming would be goal for example • Goal needs to be objective to be measured

Answer 247

• Word orthographically written under picture • Targeting sound show symbol as well • Dog-working on the g sound can break it down into each wound which also is phonological awareness • Using story books in therapy is good • Nursery rhymes-fill in is rhyming • Artic cards that they write on for take home cards-sound to letter correspondence Still having difficulty at the end of first grade with PA, initiate therapy. Even in kindergarten. Vocabulary: Send home topics to talk about.

Answer 248

* Application of variables that change behaviors * What the clinician does, not the client. * Use behavioral treatment principles

Answer 249

o Stimulus o Response o Reinforcement

Answer 250

o Things that can be trained in a relatively short period of time. o Semester, such as on our treatment plan o Hospital setting: few days, week o Measurable o Objective o So that you can chart their progress in therapy o Response recording is important so that you have the data to back your goal. o Observable behavior o Avoid words like think, assess

Answer 251

o More broad o What you want to achieve by the time they discharge o Age appropriate communication skills o Will always be changing o Articulation or phonological skills that the child is expected to learn by the end of a specified treatment period (i.e., semester or year) o STG help support the LTG

Answer 252

• Maintenance of the trained skill in the client’s natural environment across varied settings or situations.

Answer 253

* Actual skill you are targeting * Response mode: either production or discrimination * Response level: word level, sentence level, convo level * Quantitative criterion: 80% accuracy, etc. * Setting: clinical, classroom, home, structured therapy setting * Number of sessions: across three sessions,

Answer 254

* Generally, the higher the complexity you can start at, is most efficient. * However, you don’t want to start too complex where the child will shut down and become frustrated. * Take into consideration the child’s individual needs * Look at each child and make sure the behaviors you are targeting are beneficial, meaningful in their home environment.

Answer 255

1. First, select behaviors that will make an immediate and socially significant difference in the communicative skills of the client. • Social communication • Academic achievement • Occupational performance • Includes sounds that are used highly in vocabulary first to improve speech intelligibility faster. 2. Second, select the most useful behaviors that may be produced and reinforced at home and in other natural settings • Reinforced in the home. 3. Third, select behaviors that help expand the communicative skills • Phrases and sentences that can be easily expanded. 4. Lastly, select behaviors that are linguistically and culturally appropriate for the individual client • Find out what vocab is used culturally, pragmatics, language structures.

Answer 256

1. Select “age-appropriate” speech and language skills 2. Target sounds that the child is misarticulating that are produced by younger, normally developing children first 3. Treatment of sounds should follow from earliest-to-latest acquired sounds 4. It is generally considered unwise to select sounds that are mastered at older ages than the child’s current age 5. It has always been believed that skills mastered chronologically earlier are simpler than those acquired late 6. Normative sequence of skills acquisition may be inviolable 7. Individual sounds expected to be mastered by the age of the child, but which the child has not mastered, are targets 8. Phonological processes that disappear by the age the child has attained but have persisted are targets for elimination

Answer 257

1. Children learn phonological skills at varying rates 2. Individual differences are important 3. A child’s unique and individual needs may not be met if developmental norms were used exclusively 4. It is important to remember that developmental norms are a statistical representation of the average performance of an entire age group so don’t base treatment target selection solely on age-appropriateness

Answer 258

1. Initially select targets that are easier to teach 2. Treat targets that do exist, but not at the expected levels 3. Sounds that have a low base rate of correct production should be treated first (between 20% & 40%) 4. Treat sounds that are produced with visible articulatory movements (i.e., bilabials) 5. From a phonological processes standpoint, treat processes whose frequency is less than 100%, processes that only occur in certain phonetic contexts, and processes that affect sounds that the child produces correctly elsewhere; treat unstable or inconsistent processes. 6. Hodson & Paden (1991) recommend that if the frequency of a phonological process is less than 40%, it should not be treated

Answer 259

1. Initial treatment sessions may produce faster results 2. Strengthen what is already taking place in the speech of the child 3. Only problem: if the targets treated do not result in generalization to untreated error sounds

Answer 260

1. Generalization is an indirect behavioral effect of tx. 2. Generalized productions are a treatment goal, and positive changes in sounds not treated save much time and training effort 3. An example: treating a few fricatives with generalization to the remaining fricatives without additional treatment

Answer 261

1. Select targets that affect speech intelligibility the most in children should be the initial treatment targets 2. Select a phonological process that occurs frequently or the one that affects a large number of sounds since they might significantly reduce a child’s intelligibility 3. Select treatment targets that result in homonymy (replacement of a single word for multiple words, resulting in loss of meaning) 4. Another recommendation is to select any unusual, deviant, or idiosyncratic process (i.e., velarization, frication of stops or glottal replacement), which result in rapid improvement in intelligibility of speech 5. Another recommendation: treatment should simultaneously target multiple sounds 6. There is some limited evidence that when the treated words are of high frequency, better generalization may be obtained as opposed to the treatment of low frequency words

Answer 262

1. Easier to teach 2. Stimulable 3. Visible 4. At least produced inconsistently

Answer 263

1. Complex sounds that are produce consistently in error 2. Non-existent in repertoire 3. Processes that affect a greater number of sounds 4. Processes that are idiosyncratic 5. Reduce homonomy 6. Processes that are exhibited in 100% of opportunities 7. Phonemes that contain maximal phoneme feature contrast 8. Sounds that contain multiple phoneme feature oppositions

Answer 264

1. Ethnoculturally appropriate 2. Sounds that are in the child’s dialect 3. Sounds most frequently used in the child’s language or home environment

Answer 265

* Motivation * IQ * Home Support/family support * More targets you can target at one time the better * If they can handle it target 4 or 5 at one time, if overwhelming, back down. * Also know how much time you have, individual therapy is different than group therapy at school.

Answer 266

* Prior to starting therapy * Hospital: built into dx report * Schools: IEP * Clinic: actual PP

Answer 267

* Identifying Information: name age address background * Targets you will select in therapy * General procedures, tentative sequence of training * Listing goals * May include dismissal criterion possibly * Follow up * Will vary based on place

Answer 268

• Baselines: measured rates of behaviors in the absence of treatment o First session gather baseline o Will need to chart progress o Get quantitative information, what level you are looking at first. o Will help you establish accountability with yourself, with third party payers

Answer 269

``` 1. Specify Treatment Targets in Measurable Terms: clinician must have a clear idea of what the intervention targets are before their baselines can be established—STG • Specify at what level (word level, etc.) 2. Prepare the Stimulus Items: • 20 items per target sound • Can also use these later in treatment • Make sure you document cues given 3.Prepare a Recording Sheet: • Record results • Good recording sheet that you can plug in whatever target you are working on 4. Administer the Baseline Trials: • Evoked procedures • Carrier phrase • Modeled trials • +/- • Gather a percentage ```

Answer 270

• Establishment: o Teach the sound o Elicit the target behavior o Stabilize at whatever level you are at • Generalization: o Carrying over to different levels of complexity, different word positions, other situations, other sounds of the same process • Maintenance: o Stabilize or maintain retention of the behavior you taught o Frequency or duration of therapy will lessen and decrease o Client will take on self-monitoring role

Answer 271

• Speech is a motor skill, start at a simple level and build on that.

Answer 272

• Cognitive analysis: o Client is able to understand mentally the placement of sounds, discriminate the right production and incorrect production. o Learner’s ability to mentally evaluate their production. • Practice: key variable thought necessary for mastery of any skilled motor behavior o Artic is all about drill o More reps the better • Feedback: of great importance in the early development of a skill; as the error response is diminished, feedback becomes less important o Tactile o Verbal o As they progress, feedback will decrease.

Answer 273

o Have in repertoire but cannot produce in convo speech o Those who do not perceive minimal pairs o Those who have trouble with discrimination o Those who produce a sound on demand but cannot produce in convo, syllable level or beyond. (Such as apraxia).

Answer 274

o Controversial | o Pair with production training

Answer 275

Imitation Phonetic Placement Successive Approximation Contextual Utilization

Answer 276

* Correct consonant productions may be observed in clusters when absent in singletons * Curtis and Hardy reported that more correct responses of /r/ were elicited in consonant clusters than in consonant singletons. * Williams reported when teaching /s/ in clusters, the sound generalized to /s/ in singletons * Hodson supports this idea by suggesting the targeting of /s/ in clusters during treatment has the potential to facilitate widespread change within a child’s phonological system

Answer 277

events that increase the future probability of that response.

Answer 278

responses that remove, postpone or reduce an aversive behavior.

Answer 279

those that do not rely on past learning. Ex: food, candy. Good initially, but not well continually and may not be preferred with the family. Works well with the beginning stages of therapy, the young, or intellectually disabled. Problem: not a natural consequence or something they will get outside of the treatment room. Should also be accompanied with a social reinforcer. Talk to the parents to find out what they like or what they are allergic to.

Answer 280

events or actions that increase behaviors because of social or prior learning. Needs to be immediate. With speech therapy, needs to be quick reinforcement and effective, but don’t spend a lot of time with the reinforcement. Types include: • Social reinforcers: eye contact, facial expression, and verbal feedback. • Conditioned generalized reinforcers: tokens, stickers, check marks, play money, and beads. Immediately give.

Answer 281

: older, motivated, girls, competitive, you can show the chart to give feedback.

Answer 282

Continuous | Intermittent

Answer 283

Primarily, initially during therapy. Every correct production is reinforced. 1:1 reinforcement schedule.

Answer 284

a. Ratio schedule: b. Interval schedule: Period of time that goes by before you give reinforcement. Good for speaking rate and vocal quality, not so much speech sounds. c. Fixed ratio (FR) schedule: Every 2 correct productions or every 4. After the sound is established, the reinforcement is backed off. d. Variable ratio (VR) schedule: Constantly changing the amount of correct productions that receives a reinforcement. Can be an average of 5.

Answer 285

* Do not assume the same reinforcement is going to work for all children * Also do not assume that if it works one time that it will work every time. * Immediate * Eye contact don’t be looking down at your response sheet * Unambiguous manner so that they know exactly what you are reinforcing * Make sure reinforcement is very enthusiastic, they will relay on you verbal expression and gestures, keep the energy up with the child. * Be consistent, true to your word and follow up on your promises * Make sure the child knows why they are being reinforced

Answer 286

• Punisher: • Corrective feedback: • Clarification request: “Did you mean to say wabbit or rabbit?” • Mechanical feedback: using computer program or app, “Skip” program, if you say it correctly you get a happy face if you don’t you don’t get anything. • Stimulus Withdrawal: Incorrect or unacceptable response occurs, a. Time-out: Removal from what you are doing or a period where they can’t win any tokens. b. Non-exclusion time-out: stop therapy for a second to help them realize that this behavior is not acceptable. c. Response cost: Types include: i. Earn-and-lose: give for correct response, take for incorrect. ii. Lose-only: give the child so many tokens and with every incorrect response, you remove something from the child

Answer 287

* Targeting something that is too difficult? * Too difficult of a level? * Targeting too many sounds at once? * Does he understand the instructions and feedback? * Reinforcements positive? Reinforcing to him? * Sensory child: swinging, jumping on the trampoline before therapy, every 5-10 minutes do something active and then sit down, bear hug with deep pressure * Session may be too long? * Some of a group may not work well together in a school setting

Answer 288

* Drill: highly structured and efficient stimulus-response mode. Goal is as many reps as possibly. Good for trying to establish the sound, motor pattern. * Drill Play: Add in a motivational event or activity, majority of speech therapy sessions. Incorporating a game (Chutes and Ladders), what ever number they get they have to say they word that many numbers of times, Go fish, after they ask they have to say the word so many times before getting the car. * Structured Play: Training stimuli are presented in play activities but you have structured the play activity, such as words that begin with the /k/ sound, good later on in therapy, for a more natural setting. * Play: free play, good for language sample, conversational therapy, good for the very end of therapy. Natural play sample

Answer 289

1. Child or client | 2. Stage of treatment they are at

Answer 290

• When do I stop providing modeling or any other special prompting procedures? o What ever your criterion is, when they reach that, start fading the model. o Frequently probe, at least once a month with new stimulus words, or a new complexity level. If it’s a process bring out a new sound that has not been targeted in therapy. o Don’t model or cue during probe • How many target responses do I need to train before the client has learned the sound or phonological skill? o When they have reached 90% accuracy, move on to the next sound

Answer 291

• To be completed every time because that is what is tracking progress

Answer 292

o Either a temporary production of a recently learned response in different contexts and situations, or the production of new (untrained) responses based on recent or remote learning

Answer 293

* Learned response will evoke correct production in a target that you did not treat in therapy. * Focused on /k/, but generalized to /g/ without targeting. * Usually will happen with processes, but not all the time.

Answer 294

* Target one word position, and it generalizes to another word position. * Probe to see after treatment of one position, if it has generalized to another word position.

Answer 295

* Targeting at word, might generalize to sentences naturally. * Targeting at sentences, might generalize to conversation naturally.

Answer 296

* Place, manner, voice * Distinctive Feature * Phonological Process * Cognate Pairs

Answer 297

* Targeting /m/ and /s/ improves without targeting, random but it crosses the sound classes. * Book, voiceless fricative /s/, later probed and /l/ had generalized. Same placement, but different manner and voice. * Also improved final fricatives after teaching final stops.

Answer 298

• Target in therapy, see if it is generalizing outside of therapy.

Answer 299

* Discrete trial probes: No modeling, probing things you have not taught in therapy. No verbal feedback, no imitation. * Conversational probe: collecting a speech sample, talking at the end of the session and listening for generalization.

Answer 300

A carefully planned maintenance program not only increases the chances that the client will produce the target sounds or phonological skills during spontaneous speech, but also that he or she will maintain the trained skills over time. Take into careful consideration: Delay reinforcement Use more naturally occurring reinforcement, such as social Train the parents how to give appropriate feedback Teach self-monitoring and self-correcting. Reinforce the generalized responses that you hear that you haven’t targeted in therapy. Teach contingency priming: child is more responsible for asking if they are saying the sound correctly. Child is taking on more responsibility in the maintenance phase. Change the setting Naturally occurring stimuli Reinforce more complex productions

Answer 301

• Training peers to: (good to use in group therapy to help build auditory/awareness skills) o Give feedback and help with awareness skills • Train the teachers to: especially in maintenance phase since child spends majority of day there o Appropriate feedback o Sharing any nonverbal cues you may have established with the child.

Answer 302

o Non-verbal cues o Feedback o Teach how you prompt the child for correct production.

Answer 303

* If the goals have been established * If insurance has stopped * If the parents cant pay anymore * If the child seems to plateaued, can take a 6 month break and come back and re-evaluate * Poor Motivation

Answer 304

* Not always realistic * In the book * Follow up with the parents * Phone calls to check in and see how the child is doing * Speech sample, re-evaluate * Check in with the teacher in the schools * If you find out they have digressed, can see about booster treatment

Answer 305

* Generally, kids love therapy in the school * Want to keep the excitement and positivity * See a lot of kids * Teach the children to pass hall passes to each other to save time getting each group so that you can switch folders and prepare the next groups materials * Chart in hallway, can’t come in the room until you practice your sounds this many times * When they have a great day in therapy and follow the speech rules they get a sticker on the sticker chart and they get so many stickers they get a “cupcake party” make something special for them. * Externships will be a learning curve.

Answer 306

o Have a lot of repetition of the same motor sequence. o Large amounts of practice facilitate retention o Activities need to facilitate lots of repetition of the motor sequence o Start treatment by explaining what is expected and what you are targeting. o Focus on your mouth movement and what you say, “Watch and Listen” o Motor sequence, not specific sounds o Watch your face: mirror neurons-same as if you are doing it as if you are watching the action. o Important to slow speaking rate initially in therapy, then gradually fade as they have success in therapy. o Initially have block practice: target one motor sequence with one word for a period of time and once they hit the criterion level then randomly practice those words randomly each session. o Initially practice with same intonation, rate, prosody, and stress. As they have success, change those patterns. o Movement based feedback-what you want the articulators to do o Provide lots of feedback initially and gradually fade those cues.

Answer 307

o Severe: 4-5 targets (vocabulary words) | o Less Severe: 10-15 targets

Answer 308

o Build a core, functional vocabulary for the child o Talk to the parents about some words they wish they could say o A good starter word is no and yes

Answer 309

need to be seen 3-5x a week for shorter session (30min).

Answer 310

o Need 5X the number of sessions to achieve the same success as a child who has a normal artic disorder.

Answer 311

• Primary focus of treatment should be the movement patterns and sequence of sounds instead of drill on individual sound productions; attention to syllable structures and combinations of these syllables so that the child gains verbal building blocks for words. o A successful program is one that will facilitate correct production of varying syllable shapes and organization of these shapes into longer and increasingly complex patterns • Treatment may be started with vowel errors if they are dominant

Answer 312

o Use sounds child can already produce and change syllable shape o Not focusing just on consonant accuracy o Early phonemes: m, b, y, n, w, d, p, h o Mid phonemes: t, k, g, ng, f, v, ch, j o Late phonemes: sh, th(both), s, z, l, r, zh o Sounds that occur more frequently are better targets o Sounds may be treated in an order of increasing phonetic difficulty: vowels, plosives, nasals, laterals, fricatives, and affricates. Voiceless sounds may be treated before voiced o Sounds may be first trained in the word initial positions • Varied carrier phrases may be helpful in making the repeated trials more meaningful o I see a…. o I have a…. o I want a…

Answer 313

• Auditory, visual, and tactile cues are helpful and often used simultaneously o Touch/tactile cueing- • Prosodic cueing • Gestural cueing: phonetic placement techniques • Can use progressive assimilation the clinician attempts to reestablish production of the target sounds from sounds that are not affected or from other non-speech gestures

Answer 314

used to promote articulatory proficiency and natural prosody o Especially suited to teach appropriate stresses and rhythm of spoken language

Answer 315

o Hierarchy of temporal delay o Best and most ideal o 4 stages. o Allows for high level of success for the child, o Gradual building blocks. o A lot of repetition. 1. Simultaneous production: • Simultaneous production without cues • Slow model simultaneous • Verbal cue & slow model simultaneous • Tactile cue • Tactile cue • Once child has mastered back off cueing from step 4-step 1 • Once the child can produce 25 accurate responses simultaneously without cues move to the next level: Immediate Repetition 2. Immediate repetition: • SLP provides auditory model while child watches the clinician’s face and child repeats; SLP made mouth the gesture during the response if additional support is needed; then fade 3. Delayed repetition • SLP says target utterance • Insert a delay of 1-3 seconds before the child imitates the response 4. Spontaneous Speech • Child repeats the target several times without intervening stimuli • Once target is mastered, continue to add it into the mix in functional practice • Review learned targets at beginning of each session. • Allows for use of other cueing discussed earlier as needed • Positives

Answer 316

Prompts for Restructuring Oral Muscular Phonetic Targets-uses touch pressure, kinesthetic, and proprioceptive cues to facilitate speech production o Trains finger placements on the client’s face and neck to prompt the place of articulation and manner of production for the articulatory target o Finger placements also provide information about the degree of jaw movement needed and appropriate duration of the syllable o Most appropriate for chronic severe clients in which other tx have failed o Have to be certified $650-$700 • Also may teach sign language or use augmentative communication system if their apraxia is so severe that speech is not a realistic goal.

Answer 317

congenital disorder from brain damage before, during, or after birth; several types: spastic, athetoid, rigid, ataxic, mixed • Work with PT, OT, doctor, family • Early intervention with swallowing and feeding • Co-treat • Following same basic procedures as artic, but also language and feeding and swallowing and seeing child earlier than artic child.

Answer 318

* With some children who may have a language delay, a home-based early language stimulation program may be necessary-Sooner Start (work more with parents than client) * If a home language treatment does not produce the desired effects, formal language treatment may be necessary; periodic assessment is needed to make this determination * Some SLPs recommend muscle strengthening exercises or methods to control interfering movements of the head, neck, jaw, and other body parts…. may consider chin strap to stabilize jaw, steady an arm * A child’s articulation problems may be limited to a few sounds or they may be extensive; * Direct treatment targets include bilabial, linguavelar, lingua-alveolar, linguadental, articulatory contacts needed for various speech sound productions * Increasing the speed of the child’s articulatory movements once they have been established becomes the next goal * If the assessment reveals specific errors or patterns, the clinician can use the procedures described in the basic unit * Children with CP may have an accompanying prosody, breathing, sustaining ah, regular breaths, interval ratio reinforcement. * Children with CP may need some training in voice therapy, AAC, * Treatment should target prosodic features including speech rate, rhythm, stress patterns, and pitch variations * In some children, speech does not become a functional mode of communication

Answer 319

* Treatment may begin in infancy including parent education and counseling, and addressing feeding problems * Part of the craniofacial team or Cleft Palate Team (craniofacial team) * General behavioral treatment principles discussed previously in the basic unit would be appropriate in addressing articulation and phonological disorders * Should educate the parents * Consider an early language intervention program to stimulate language skills * Train the parents to withhold reinforcement for undesirable compensatory behaviors when the need for them has been eliminated by medical management i.e., pharyngeal fricatives

Answer 320

• Begin treatment with vowels and semi-vowels, w, y, l, r

Answer 321

fricatives before stops because they can’t build up the intraoral pressure, visible sounds first, move onto nasals, glides and aspirate consonants. • Teach accurate production of consonants that are produced with weak articulatory force, as this is a unique problem of children with cleft palate (pressure consonants, voiceless stops)

Answer 322

* Teach lingua-palatal sounds, lingua-alveolars and linguadentals in that order * Structure therapy so that it progresses from similar to artic. (basic to more advanced) * Use cueing as needed

Answer 323

* Start language stimulation program at an early age * Parent counseling on the effects of hearing loss and the special needs of the Deaf and HOH children will be essential * Parent training in providing language stimulation opportunities will be crucial during the infancy and preschool years that are crucial for oral language learning * Formal speech training as early as possible to get natural sounding speech * Family can be trained to conduct tx at home that parallel the clinician’s targets, objectives, and activities * Use of visual, tactile and kinesthetic cueing * Use general procedures discussed earlier * Pay special attention to stops, fricatives and affricates because they can be some of the harder sounds for hearing impairment. * Teach voiced and voiceless distinction * Target vocal quality and reducing hypernasality * Target improved * May need to train language and pragmatics * Need to constantly reevaluate to ensure that speech is an appropriate and realistic communication choice (Ling 6 sound test prior to starting sound test) * Cover mouth so that they are not focusing on lip reading

Answer 324

• Omission of consonants in the initial consonants, final consonants and s phonemes

Answer 325

* Charles van Riper * 1930s * 5 phases * Auditory Discrimination (foundation before treating) * Not producing anything * Pure artic disorder because you are targeting one sound at a time (best with) * Starts in isolation and moves through to conversation

Answer 326

• Mcdonald • 1964 • Goes with the Deep Test • Uses contextual facilitation to facilitate correct production • Using the context they can produce the sound correctly to produce the sound in other contexts • No auditory discrimination • No isolation • Begin at syllable level • Primary goal: increase auditory, tactile, and proprioceptive awareness of the motor patterns involved in the speech sound production through motor production oriented tasks • Begin with deep testing and start with the context that they can produce the sound in and build off of that *3 Primary Objectives: 1. Heightening child’s responsiveness 2. Reinforcing Correct Articulation 3. Facilitating Correct Production in Varied Contexts

Answer 327

* Multiple mis-articulations * Unintelligible * Target 5-6 targets at once * Highly structures with specific criterion at each level * Mcabe and Bradley * Phonological kids

Answer 328

* Good for sound distortions, or only one error * Once sound at a time * Initial and final position if necessary if they need both * Similar to sensory motor in that you are finding 4 key words that the child can produce the sound correctly. * 1st word initial position * 2nd final position * 3rd initial position * 4th final position * if you cannot find 4 key words, you teach 4 key words, have to produce with 90% accuracy. * Example: sea, peace, sip, bus * Get 10 training words for initial and 10 training words for final position paired with a picture stimuli. * Training words they incorrectly produce 2/3 times * Create a picture board with the key word in the middle and put 10 training words around it * Have them produce the word as you point to it, 1:1 continuous reinforcement, back to the key word every time before the training word. * Make sure the target is only in the word one time

Answer 329

• Few errors, artic client, revamped for any client • Strictly behavioral approach based on behavioral principles • Stimuli, get a response, give reinforcement • 1971 by Baker and Ryan • Continuous reinforcement initially, gradually decreasing the amount • Shift to a branching activity if the sound is in error 10x in a row or three sessions in a row and the sound is less than 80%. • Isolation • General Procedures: o Clinician presents stimuli--client responds--clinician reinforces the client’s accurate productions o Stimulus-response-consequence contingency paradigm o When clinician models, imitation is required o Stimuli can include modeling, pictures, questions, story-telling, and graphemes o Recommend an average of 300 responses per hour of instruction o Reinforcement is initially delivered on a continuous schedule, but shifts to an intermittent schedule (50%-10%) as the client’s productions improve o Advance to next step when the client produces 10 consecutive correct responses o Shift to branching activities if the sound is in error 10x in a row or 3 consecutive sessions with a correct response rate of less than 80%

Answer 330

• Chomsky and Hally • Features that are missing, rather than the process. • DF analysis first to find missing, then target those features • Hopefully it would generalize to other sounds with those same features • Good for children with Multiple misarticulations with common missing features • If you target +continuant and you target f, it would generalize to th, v, s, etc. • Not appropriate for children who have sound distortions or children whose errors lack a definite pattern • Not popular, been overshadowed by PP • McReynolds & Colleagues Program on Distinctive Features o Phase 1: Nonsense Syllables (initial position) containing the target feature • Step 1: child is instructed to produce a consonant in which the feature is lacking • Step 2: child is instructed to contrastively produce 2 consonant sounds in syllables, the segment learned in step 1, and a second consonant selected to contrast with the first ex s/z only differ by one feature o Phase 2: Nonsense Syllables (final position); just like phase 1 targeting final position • Recommend training initially be limited to sound units that reflect only one contrast • As treatment progress, may want to incorporate sound units that vary by 2 or more distinctive features • There is no new treatment procedures, but rather a different method of error analysis before and after tx • Sounds are taught by behavioral methods of modeling, positive reinforcement, corrective feedback, and assessment of generalization • Find patterns in error, target exemplars for training within patterns and measures expected generalization

Answer 331

• One of the most popular for PP • Hodson and Payden • To combine linguistic and motor oriented approaches • Designed for highly unintelligible children and those who have multiple processes going on. • General Procedures: o Stimulation- with the use of auditory, tactile, and visual stimulation cues, the child is made aware of the auditory, tactile, and visual characteristics of the target sound o Production Training: Offer occurrence of PP and the need for remediation. o Semantic Awareness Contrasts: minimal pairs o Remediation program is planned around cycles o Cycle: per process you target two sounds. o Another definition of a cycle: the time period required for the child to successively focus for 2-6 hours on each of his or her basic deficient patterns o Treatment cycles can range from 5-6 weeks to 15-16 weeks, depending on the client’s number of deficient patterns and the number of stimulable phonemes within each pattern o Identification & Selection of Target Patterns & Phonemes: *Only target if they have it 40%. Ex: velar fronting-k,g Stopping of fricatives-s,z,th,th,f,v Liquid gliding: r,l Only target 2: spend 60 minutes per sound you have chosen, once each sound gets 60 minutes-that is a cycle, then you begin at the beginning sound again.

Answer 332

• Phonology kids with multiple mis-articulations • Remediate phonological processes • Improve speech intelligibility • Goal: improve child’s communication by establishing the lost phonemic contrasts • Goal: promote generalization to untrained phonemes • Treatment procedures are still behavioral • Looking at contrasting sound features • Scep (skip) program good with all three 3 Phoneme Contrast Approaches 1. Minimal Contrast Method/Minimal Pairs Method 2. Maximal Contrast/maximal pairs 3. Multiple Oppositions/ Multiple Contrasts Approach

Answer 333

* Contrasting two sounds that only differ by one feature * Phoneme contrast is limited to one or just a few features * Use of word pairs that contrast the child’s typical (error) production and the target production * Use productions that are semantically meaningful so if a nonsense word add picture to make meaning, draw a fictitious animal * Select 8-10 word pairs * Pictures with the word that hold meaning. If it is a nonsense word, create a picture with the word.

Answer 334

* The word pairs selected for treatment have multiple feature contrasts or maximal opposition between contrasted phonemes; may involve contrasts in place, manner, and voice * Contrast 2 sounds only * As opposed to minimal pairs, the child’s incorrect production is not used, but rather a sound the child correctly produces but is maximally different from the error sound * Treatment procedures are the same once the target words have been identified

Answer 335

* Creating minimal pairs for all or most of the errors simultaneously * Especially helpful for children who substitute a single sound for multiple sounds, resulting in homonymy: one sound for multiple sounds * Multiple targets may be used within each set including all 4 contrasts

Answer 336

* Children that have PP disorder may also have language disorder * Target language instead of phonology * Target all together * Naturalistic play, language play to incorporate language into play * Norris & Hoffman (1990) described a storytelling language-based approach to phonologic intervention based on client generation of narratives.

Answer 337

* Not a disorder or a deviation. * Do not treat a dialect because it is not mainstream American English. * Definition: mutually intelligible forms of a language associated with a particular region or Socioeconomic group or ethnic group, Mainstream American English African American E, Eastern American English, Spanish influenced * No dialect is superior, although some hold more prestige based on what group is more dominant in that area. * Dialects are largely due to the lack of linguistic contact among groups due to geographical or socioeconomic reasons and that isolation has caused an increase in the number and pervasiveness of dialects

Answer 338

a simplified and limited system of communication that develops out of necessity between groups of people • Basic communication to trade • Simple syntactic structure • Disappeared as it wasn’t needed anymore

Answer 339

When pidgin is passed down to another generation it is known as a creole: • Creole: a more complex system of primary communication with its own phonological, semantic, syntactic, and pragmatic rules o Ex: Louisiana French Creole; African slaves brought to Louisiana with heavy Cajun influence

Answer 340

* Cultural background meaning how they express themselves, speak to each other, expectations (African Americans are emotional and touchy feely, Native Americans it is disrespectful to make eye contact.) * The language & phonological characteristics, properties, and rules of the linguistically diverse child’s primary language * How the primary language affects the learning of the secondary language. * How to determine whether there is a language or phonological disorder in the child’s first language, the second language or both, test both languages. * Gather a good case history to get goals for the family * Careful selection of standardized tests that give credit to dialect-sensitive items, an extensive conversational speech sampling, reading sample, a detailed interview of parents or caregivers, comparing the child’s speech to the caregivers, and a good understanding of the culture and communication pattern of the child and family help make an appropriate diagnosis. * Treatment goal should be improved phonological properties of the specific dialect of the child. * Phonemes whose pattern of usage is the same in mainstream American English (MAE) and the other dialect; those are the best first targets in therapy. * Second target should be phonemes the child does not use or misuses within the patterns of his primary dialect or language. * Specific phonological patterns targeted should be consistent with his dialect/language * Acquiring the sound patterns of MAE might be a pragmatic decision the client or the parents make.

Answer 341

* Based on several studies of bilingual children found that bilingual children maintain two different phonological systems for language and learn each one separately. * Phonetic development was similar to those of monolingual children * Exhibit phonological patterns that were not typical for monolingual speakers (i.e., atypical aspiration) * Overall lower intelligibility rating * Made more consonant and vowel errors * Distorted more sounds than monolingual speakers * These differences faded over time * Show cross-linguistic effects. * Less accurate on some aspects of the phonological system in comparison to their monolingual peers

Answer 342

Learning both languages at the same time.

Answer 343

grow up learning one language, and later learn another. Those who have Successive Bilingualism will rarely be equally competent in both languages.

Answer 344

when a speaker using a second language shows phonological approximations of his or her first language

Answer 345

fails to distinguish two phonemes in the second language because they are not distinguished in the first language. Ex: in Spanish the /d/ and the voiced /th/ are allophonic variations, so when speaking English they will have under-differentiation of those phonemes.

Answer 346

Making and unnecessary distinction between allophonic variations. Ex: English speaker, when trying to speak Spanish will over differentiate /d/ and voiced /th/ when.

Answer 347

* Omission of phonemes: Don’t have phonemes in their language, will omit when speaking English. * It should be noted that interference does not explain all variations found in 2nd language production * Critical age of acquisition of phonology is from 18 months to onset of puberty (12-15 years), but others say it may be as low as 6.

Answer 348

* Cluster Reduction * FCD * Weak Syllable Deletion * Post-Vocalic Devoicing * Stopping of Fricatives * Fronting of velars and palatals * Liquid gliding * Assimilation processes

Answer 349

differentiate true speech sound errors from developmental errors from atypical/disordered patterns from cross-linguistic effect. assess in both languages May rely heavily on family, siblings, and others in the speech community if you are unfamiliar with the dialect or language. A parent’s speech may be considered a standard against which a child’s speech and language skills may be evaluated.

Answer 350

* Understand the characteristics of the child’s first language (phonological, morphologic, syntactic, & pragmatic features) & how they contrast with English * Appreciate the communication style of the child & his or her family * Assess the family resources to obtain & continue treatment services for the child * Procure help from government or other agencies that support clinical services for the child * Appraise the family members’ dispositions toward and beliefs regarding speech disorders, their causes, and chances of improvement and what they feel is most important (Treatment plan) * Obtain available information on the phonological development in the child’s first language * Study the patterns of interference from the child’s first language or the varied English dialect * Prefer standardized tests that have been normed on children from the ethnic group you are assessing * Avoid tests that are known to be culture-biased or are suspected to be biased against the child’s ethno cultural background * Let the conversational speech samples from the child and family be the primary data for analysis of phonological skills * Analyze phonological deviations or disorders in light of the first language or first dialect of the child * Determine the presence or absence of a disorder in both the languages or dialects * Make sure that multiple family members understand treatment recommendations & that they agree with the planned treatment * Select treatment targets in both the languages * Treat the disorder in the primary language as well as in the 2nd language or dialect * Assume tentatively that the basic treatment principles may hold good across languages * Expect to modify treatment procedures to suit the child * Carefully collect treatment data to sustain or modify the assumptions made in assessing & treating children * Target the MAE dialect only if the family, the child, or both prefer * Note that according to ASHA, no dialectal variation of a language is a deviation or a disorder * Develop resources on the language and culture of minority children in the service area * Refer the child to a bilingual SLP who speaks the child’s language * Be the child’s advocate

Answer 351

* Obtain the services of a competent interpreter who speaks the child’s native language in completing assessment & treatment planning * Train the interpreter in conversational speech sampling, helping with clinical interviews, & test administration

Answer 352

1st: Treat sounds or targets that occur with equal frequency in both languages. 2nd: Still occur in both languages, but with different frequency. 3rd: Those errors that just occur in one or the other language.

Answer 353

* Accent Mod Client * Know their language in comparison to MAE to know the targets * Targeting the suprasegmentals, rate, stress patterns, intonation * Frequently occurring sounds first to increase intelligibility * Know rules of primary dialect or language * Talk to them about their personal opinion and how they feel about their speech and what they are missing

Answer 354

* 99% of frontal lisps are related to jaw lowering * 1st problem: the jaw is unstable: it is too low * 2nd problem: the tongue is unstable: it is not anchored in the back

Answer 355

* Hold the straw on the outside of the teeth as the client produces each individual sibilant. * Move the straw from left to right across the teeth to determine where air is escaping. * Airflow will amplify at the point where it is escaping.

Answer 356

* Practice diminutives: doggie, kitty, mommy, daddy, baby, birdie, horsie, piggy, mousie * Rub sides of tongue against inside of upper molars * Use tactile awareness * Bite down on wads of gum, fingertips, dental picks, toothettes while saying Long E * Smile really big, emphasize the e

Answer 357

• Make a wide smile and say E. • Pant through this position. • Round the lips while continuing to pant. • Fine tune the sound (anchor the jaw) Next: focus on motor movement not words Important key to success: the client has to be able to hold firm to each position while he adds the next change in position. 1. E---pant while holding E—round the lips while holding E and panting—O= SHOW 2. E—pant while holding E—round the lips while holding E and panting—E=SHE 3. E—pant while holding E—round the lips while holding E and panting—I=SHY 4. E—pant while holding E—round the lips while holding E and panting—Ah=SHOP Take these into sentences: “I E-Pant-Round-op at the mall.” Straight to sentences from the word level for success. In case of lateral /s/ have them retract lips sharply. (narrow and lifted, VS) straw for feedback. Use Sh to teach Zh---turn on voice box

Answer 358

1. Shhh—prolong Sh and lift the tip to stop the air. 2. Shhh—lift tip—Shhh 3. Shhh—lift tip—Shhh-lift tip—Shhh 4. Go faster and faster. Keep air going. * Key- don't release /t/. just ‘shut the door’

Answer 359

turn on voice box

Answer 360

• Use Long T Method: don’t try to fix /s/, just make a long T. • Use facilitative phonetic contexts in which [ts] is present. • Request them to make the Long T for initial S • To get rid of T in [ts]: o Produce Long T o Then pant in and out through the low tip position. o Now you have gross S o Use straws to narrow it

Answer 361

* but-buts-bus * mitt-mitts-miss * hit-hits-hiss * pete—pete’s—peace * light-lights-lice * mate-mates-mace

Answer 362

adding voice or going from D to Z

Answer 363

• If they have one correct R then use it to teach other R-words. If they have initial R use it to teach final R. If they have final R then use it to teach initial R. If they have one R-cluster, use it to teach more words. • If the child correctly produces R in one word, abstract the syllable out of the word and use the syllable in other words. o Example: • If the client can say Rebecca, have her say Rebec. • If client can say Rebec, have her say Re (Ruh) • If client can say Ruh, have her say other words with it. (run) • Practice words with a pause Ruh-n, Ruh-b, Ruh-m Control phonetic environment so well that you can advance from syllable to word to phrase to sentence and even to paragraphs.

Answer 364

• Step 1: Take the R off of the “bad” word o car become “cah” • Step 2: Sequence the words with a pause o Cah---rat • Step 3: Blend the words together without pause o cahrat • Step 4: Take off the final T o cahra • Step 5: Change the vowel to the schwa o Cahruh • Step 6: Omit the schwa o cahr—car Slow down to exaggerate the transition between Ruh and the vowel. Help him hear each sound. Teach him to take out the sound that doesn’t belong by limiting his jaw movements. Assume they cannot generalize and stay there for awhile with schwa at end.

Answer 365

• Take a word they can say –“rain” • Produce a schwa before it—“uh-rain” • Now add other consonants before the schwa- buh-rain, puh-rain, tuh-rain • Now produce words but keep the schwa- “buh-rain” (brain), kuh-rain (crane), guh-rain (grain) • Perfect the cluster • Prolong R and add a consonant to the prolongation (remember this is for clients who already have an R) • Start with Br because it is the easiest o Rrrrrrrbrrrrrrrbrrrrrrrrb o Make it a word rrrrrrburrrrrburrrrrr o More complexity: brown, bride, broom • Then practice Pr, Mr, and Wr the same way • Then practice Gr, Kr, and Skr the same way • The practice Dr, Tr, and Str the same way

Answer 366

• Teach Tip R (retroflex R): easier to teach but not natural • Teach Back R (bunched R): more natural in conversation, but harder to teach o The butterfly: tongue widens, the back lateral margins elevate, and the whole tongue retracts o Separate—lift—pull back o Butterfly –voice—retract

Answer 367

Teaching movement patterns not phonemes!!! Sequencing—sound blending—co-articulation Get familiar with materials room and things we like that we can buy later iPad apps are really helpful Keep different themes each week Artic: main goal is drill and repetition

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