What is nonegocentrism?
a stage of pragmatic development when a child learns to take someone else’s perspective; ch can consider what the listener knows about the context of the situation
What is decentration?
step in pragmatic development when the ch moves from one-dimensional descriptions to descriptions that involve more than one attribute (a pencil is not only yellow, but also thin, long, made of wood, etc.)
What are the three levels of culture?
concrete, behavioral, and symbolic
What is the concrete level of culture?
surface level features (e.g. clothes, food, games, music, etc.); cultural “festivals” based on this level
What is the behavioral level of culture?
deals with social rules, language, communication; sign language is the foundation of deaf culture; proximity during conversation; behaviors which reflect our values, such as lang, gender roles (genderlects), family structure, and political affiliation
What is the symbolic level of culture?
the most abstract level (e.g. value system, customs, religion, beliefs, worldview)
What does professional cultural competence include? 3
1 awareness of one’s own values and ideas, 2 active attempts to understand the values and ideas of the families we serve (read about specific lang and cultural groups, team up with members of cultural groups who can act as interpreters and informants)
3 developing assessment and treatment protocols that address individual client needs
What is culture?
a dynamic set of values and beliefs that shape the behaviors of individuals
What is an ethnic group?
is a group of individuals who share a common language, heritage, religion, or nationality
How many ethnicities are in the the US? What are they?
5: European American, Black American, Latino American, Asian American, and Native American
What are cultural frameworks?
beliefs and values individuals within a group use to develop social interaction practices: includes the way lang is used; lang is used to pass down those beliefs and values that are shared by the group
What is cultural pluralism?
exists when people from different cultural groups all live together, while perserving and valuing their distinguishing characteristics
What is cultural sensitivity?
demonstrating an awareness that cultural practices are different from your own; not judging cultural practices that are different from your own
What are 3 challenges associate with multicultural sensitivity?
- client-therapists ethnic mismatch (over 50% of kids in US receiving services from SLP’s are minority; over 90% of SLP’s in US are white females)
- practitioners raised in this country operate from a European cultural framework , regardless of ethnicity; 3. a lg # of SLP are not properly trained to diagnose and treat children from culturally and linguistically diverse backgrounds
What is balanced bilingualism?
equal proficiency in two languages (rare)
What is nonbalanced bilingualism?
higher proficiency in one language than language than another (more common)
What is semiproficient and semibilingualism?
mixed input/output of languages; considered a language disorder
What is simultaneous acquisition
the development of both languages prior to the age of three
what is successive acquisition?
developm one lang (l1) usually at home, then a secondary lang (l2) usually at school after age 3
What is a dialect?
a mutually intelligible forms of a language associated w/ a particular region, social class, or ethnic group; variations of a particular language and are spoken by a large group of people who share ethnic, regional, or national similarities. There are ethnic and regional dialects, but all are variations of a parent language: Standard or Mainstream American English (SAE or MAE)
What assessment considerations w/ ethnic minority populations?
if the assessment is done in the native language; used dynamic assessments rather than normed references when possible; improved retest scores
Why do we assess phonology and syntax in the native language?
because these areas produce the most differences
Why do we use dynamic assessments rather than normed references?
evals ch ability to learn rather than output product;
What method do we use in dynamic assessments?
uses test, teach, retest approach
Why can’t we always use dynamic assessments?
public schools require standardized tests (insurance companies want to see standardized #s); but it’s always good to supplement a standardized test with some kind of other test
What are 3 behaviors that could be attributed to pragmatic differences?
-proximity; eye contact; topic initiation w/ an adult/topic maintenance w/ an adult
What is an indication that cultural differences may have been the explanation behind the original low baseline score in a standardized assessment?
improved retest scores
What can you do for ch from some Asian cultures may not be used to interacting one-on-one w/ adults?
bring in another ch
What can you do to help ch from some Native American cultures who may not be used to the question answer format or timed responses? 2
take a language sample or give a parent questionaire/test
What can you do to help ch from some afro-american cultures who will not respond typically to “known” questions in which the answer is obvious?
provide better instruction (some of these will be really easy, but you need to help me out)
What can you do to help some Latino, African, and Asian cultures that consider it disrespectful to make direct eye contact w/ an adult?
don’t require eyecontact if this is suspect (or take a language sample)
How do we differentiate dialect from disorder?
determine if the ch’s phonological system is w/in normal limits for his linguistic community
How long has ASHA formally acknowledged dialectical difference vs. disorder?
since 1983
What can you do to minimize misdiagnoses based on dialectical differences? 7
- sample the adult speakers in the community;
- use interpreters and community support people as resources
- learn as much as you can about the dialectical features
- use minimal competency core as a screener (Stockman, 1996)
- be aware of your own dialect
- if ch is bilingual assess in L1 & L2 and compare qualitativ differences
- use formal assesment tools as well as informal
What is minimal core competency?
“the least amt of knowledge one must exhibit in order to be judged in a given age range”; using developmental criteria; if a ch’s phonological skills aren’t comparable to the minimum; you’re likely leaning towards a disorder
What are intervention considerations for ethnic minority pops? 2
- consider the family dynamics- some cultures have the family’s nucleus is more than just parents and children; 2. consider the family values for communication- some cult don’t value a lot of talking
What are some phonological considerations for treatment?
1 doing perceptual training, 2 be aware of the ch’s home language could be impacting your treatment, 3. adapt training procedures to individual cases (consider culture but also how that individual family operates in that culture
What is the best way to avoid cultural conflicts?
talk to the family prior to beginning intervention
What assessment process question need to be considered and answered? 5
1 does a child have a speech or language disorder? (just b/c there are errors doesn’t mean an error exists)
2 how severe is it? (mild, moderate, severe)
3 what kinds of error patterns does the child demonstrate? (consonant cluster reduction, lack of eye contact, etc.)
4 What aspects of speech or language are affected? (form, morphology, syntax, semantics, pragmatics, speech production)
5 is the child demonstrating a disorder or a difference?
What are the components of language assessment? 5
screening, case history/influencing variables, standardized tests, informal assessments, and responsiveness to intervention
The first step in assessment is a ___, which is _____
screening, a quickly obtained general view of skills.
What are some examples of a screening?
DIAL-3, Fluharty, DELV, Hearing
A quick snapshot of the child’s abilities is ____.
a screening
The actual evaluation of the skills to arrive at a diagnosis and potential plan of action is _____
an assessment
Describing and understanding the problem, and/or identifying a disorder category or cause for the problem is _____.
a diagnosis
What are some examples of assessments? 4
CELF (or CELF5 - 5th edition or CELF-P for presch age), PLS, GFTA, Arizona
What does CELF stand for?
Clinical Evaluation of Language Fundamentals
____ is the way we reach diagnosis.
assessment
How do we get pts?
through referrals from: pediatricians (too few words, stuttering)/neurologists/ENTs (ch w/ surgery, tubes in ears/freq ear inf, cranial-facial abnormalities); Dieticians (swallowing strategies); Teachers (comprehension/ production errors, pragmatic issues); School Nurses; Psychologists
What are the two possible outcomes from a language screening?
pass/fail, different screenings have different thresholds, results do NOT determine the presence of a disorder
What is a developmental screening?
a screening done during key dv. times (automatically done during presch)
What is a injury-related screening?
a screening done when we know there is a particular need to do it more often (chronic otitis media)
What does an assessment hope to acheive by observing speech and receptive and expressive lang skills? 3
- whether a problem exists, 2 the nature of the problem, 3 what action should be taken
What are the steps in designing the assessment protocol? 4
- individualized for that ch; 2. sensitive, but not oversensitive AND accurately determines severity, 3. comprehensive (asses all aspects of the problem), 4. unbiased (accurate regardless of race, culture, SES, etc.)
What does chart review/case history allow you to do?
view the case history/get a description of a ch’s skills from a parent and teacher pov; get info about prior assessments and treatments; get insight into fam hist of comm skills; educational history; home and school lang use; medical/dev history
What does the GFTA stand for?
Goldman Fristoe Test of Articulation
What does the PLS stand for?
Preschool Language Scale
What does interview allow you to do?
if you spend more time on this phase will help with cultural competency: allows you to ask relevant questions: what do YOU want to get out of therapy? do you read to your child? can you give me an example of ____? (blank comes from the form); gives you an opportunity to ask about specific questions rel to cultural practices, family, traditions, beliefs and values: Quality of the questions may have to outweigh the quantity if you are pressed for time
What are the two main genres of assessments?
formal and informal; ideally you should be able to give some combo
What are formal assessments? 2 definition types
traditional standardized tests that utilize norms for comparison to peers with strict administration guidelines; 1 norm referenced; 2 criterion-referenced
What are some examples of informal assessments?
- Speech and Language sample analysis
- Curriculum-based assessments
- Portfolio assessment
- Dynamic assessment (test, teach, retest)
What can be accomplished with speech and language sample analysis?
uses spontaneous or elicited lang samples to analyze different skills
What can be accomplished with curriculum-based assessments?
examines skills that are expected to be obtain via the curriculum, for curriculum-based lang assessments, the goal is to use samples of the real curriculum to analyze the student’s curriculum-based lang processing abilities - more useful for language as opposed to speech
What can be accomplished with a portfolio assessment?
a systematic purposeful collection of student work that provides insight into the student efforts progress or acheivement in certain curriculum areas - also more suited to language as opposed to speech
What can be accomplished with a dynamic assessment?
it examines a child’s ability to learn rather than their skills; often uses a test, teach, retest format, to look at improvement w/ teaching; for the teaching phase information, it is important to keep tract of examiner effort on dynamic assessment outcomes (8 prompts is a lot, conscious of # of cues)
What are high and low linguistic demand assessment tasks?
low: yes or no questions; high: re-telling a story
What are low and high naturalness assessments tasks?
low: flashcards; high: role playing
What are the characteristics of norm-referenced tests? 3
1 performance is compared to a group of standard performance (norms)
2 scores refer to relative standing in relation to group norms (std. dev from the norm)
3 provides insight into the child’s abilities on that day
What are advantages to norm-referenced assessments? 2
1 clear admin guidelines
2 yields standard scores (easily understood by SLPs, teachers, funding agencies, universal, qualifying services and insurance)
What are disadvantages to norm-referenced assessments? 4
context is not natural
often misdiagnosed child from difference culturally background
guidelines may not allow for modifications
not sensitive to subtle changes in skills
What are the characteristics of criterion-referenced assessments? 2 What is an example?
1 performance is interpreted based on a predetermined standard such as % correct
2 absolute std for performance
A hearing tests is an example of this.
What are advantages of criterion referenced assessments? 3
1 better to assist with functional goal writing
2 yield raw scores (# of correct responses, which is scoring simplicity)
3 good tool for tracking subtle progress
What are disadvantages of criterion referenced assessments? 1
guidelines are usually not as uniform (different clinicians administer differently and even the same clinician may vary on retest)
Why is it important to review the technical manual of a standardized test? 5
1 understand the purpose 2 evaluate the norming population 3 understand CORRECT administration 4 ages 5 theoretical perspective of the developers
What are the 2 types of scores that we see?
1 raw scores
2 standard scores
What is a raw score?
indicates the actual number of items students answer correctly; advantage: comparable if students take the same test; and is easy to calc; are good to determine student gains in acheivement on the same test; disadvantage: can’t be used to compare one subject to another; or from 1 test to the next even of the same topic; doesn’t provide a fram of reference for how well a student is doing (teaching to the test, doesn’t say anything about lang)
What is a standard score? 4
indicates how much a stud’s score deviates from the mean; provides an equal interval unit of measurement (mean of 100, Std deviation 15); can be used to be indicate gains in terms of overall development; since std scores are consistent across tests a person’s scores can be compared across tests
What are advantages of standard scores? 2
1 are linearly related to raw scores
2 display relative student performance w/in a group
What are disadvantages of standard scores?
1 may be confusing to parents and teachers
2 require an understanding of the scale being used
____ standard deviations is the limit for normal limits for standard scores.
1.5
A score of ____ is the limit for normal limits for standard scores.
77.5
What is test validity?
the extent to which the test measures what it purports to measure
What are test psychometrics?
measures of tests
What are categories of validity?
content validity and construct validity
What is content validity?
experts eval each item and judge if the test targets what it is supposed to
What is construct validity?
the degree to which scores are consistent w/ theoretical constructs; test should conform w/ theories on dev
What is criterion validity?
correlation w/ existing measure
What is predictive validity?
how well a test predicts performance on future tasks in the same domain
What is reliability validity?
the consistency of measurement on repeated observations; possible sources of error in measurement if not consistent
What are types of reliability?
interjudge/interexaminer (who gives the test shouldn't be a factor) internal consistency (degree to which items meas the same beh) split-half-reliability (scores on 1st 1/2 same as scoring on 2nd 1/2) test retest (stability of the scores over time)
Two sets of scores perfectly correlated will have a correlation of ____. (norm ref tests should be at least ____ reliability)
1.00 (.900)
What are pros of formal testing? 2
less time consuming than descriptive measure; provides scores often req by schools
What are cons of formal testing? 4
1 do not explore learning potential (no strengths)
2 do not provide info about comm competence in real-life situations (artificial info)
3 do not provide info about discourse skills
4 may be biased against Culturally Linguistically Diverse (CLD) bg students
What is language sample analysis?
has been proposed by some as the best means to identify language disorders in ch; used to provide more in depth info along w/ the norm ref test (use of MLU most commonly used); a form of informal testing
What are two forms of informal testing?
speech and language sample analysis
dynamic assessment
What specific skills can language sample analysis address? 2
1 use of pl morphemes
2 use of interaction strategies (topic maintenance)
How can speech and language sample analysis work qualitatively and quantitatively?
Qual: look at sentence complexity, interaction strategies (pragmatics)
Quan: can look at MLU
What different scenarios can language samples be gathered in?
spontaneous conversation, narrative productive, shared story book interactions, daily routines; can provide an individual context
What are the drawbacks of speech and language sample analysis?
has some subjectivity; very time consuming
What is a dynamic assessment?
can be used to ID learning potential by examing change over time, useful in helping decide the “difference v. disorder” in ch (procedure: test, teach re-test)
What are the pros of informal testing? 7
1 explore learning potential
2 provides info about comm competence in real-life situations
3 provides info about discourse skills
4 may be less biased against CLD students
5 can target the ch’s individual needs
6 flexible assessment options
7 use of software such as Salt can reduce analysis errors
What are the cons of informal testing? 4
1 more time consuming than formal structured measures
2 interpretation of results may vary from person to person
3 may not provide scores often req by schools (cannot qualify a ch for services)
4 ch may not produce the target skill in order to determine if there is a deficit
What settings do you work with infants, toddlers, preschoolers? 6
homes, preschools, daycares, schools, hospital, rehabilitation facilities
What programs are associated with infant /child assessments? 2
1 Early Childhood Intervention (birth - 3 years)(IFSP - Individual Family Service Plan - speech goals have their own section)
2 Preschool Program for Children with Disabilities (3-5) (IEP - Individual Education Plan, same idea, older children)
What are the general principles for assessment w/ infant, toddlers & preschoolers? 10
1 procedures should be family centered
2 start early monitoring (the sooner the beter)
3 include other professionals (more comprehensive assessment)
4 include family members
5 conduct interviews and case history
6 observe child-caregiver interactions
7 test hearing (screen, rule out hearing as the cause first!)
8 use multiple measures
9 use non-discriminatory measures
10 prevent future problems with oral language and literacy
What are 3 assessment strategies for infants, toddlers, and preschoolers?
1 observe play (communicative temptations)
2 have parents list words that their chs understand & use (may over/underestimate at times, but they are at the best as estimating)
3 use a spontaneous play sample or a narrative assessment (for preschoolers)
What do we want from a spontaneous language sample? Why? 3
representative (real world) communication (often play based)
- samples permit insight into functional communicative competence
samples allow a variety of skills to be assessed
samples can be taken under many conditions
How do we obtain and analyze a representative sample from a infant, toddler, or preschooler?
1 caregiver, sibling, nanny should be involved to gather it naturally. SLP could do it, but may hamper naturallyness
2 Activities could be pretend play, bath time, routines
3 SLP or person who does transcription can analyze
What analyses should you run on a language sample? 4
1 form (morpho-syntax & pragmatics) 2 semantic analysis (content) 3 communicative intent/pragmatic functions (use) 4 narrative structure (some early elements of narrative structure are present for preschoolers such as anticipated format and simple sentence elements - obj. verbs, subj)
What is MLU?
mean length of utterance ( the average number of morphemes per utterance (ttl morphemes produced/total utterances produced)
What is morphosyntactic analysis?
an evaluation of morphological and syntactic structures relative to developmental stage.
What are Brown’s 5 stages of development?
I 12-26 months (MLU 1-2) II 27-30 months (MLU 2-2.5) III 31-34 months (MLU 2.5-3)) IV 35-40 months (MLU 3-3.75) V 41-46 months (MLU 3.75-4.5)
What is done in semantic analysis?
how do ch express meaning and combine words thru incr complex utterances
What are 3 measures of complexity of semantics?
number of different words (NDW)
total number of words (TNW)
type token ratio is NDW/TNW
TTR of ½ (.5) is average for child 3-8 years old
A child with TTR of 1 and a MLU of 1 has a ____ vocabulary and ___ complexity
low; low (child is only using one word utterances, only repeating, we would not expect them to have a higher vocab)
A child with a TTR of 1 and a MLU of 6.3 has a ____ vocabulary and a ___ complexity.
high; high
A child with a TTR of .56 and a MLU of 4.5 has a ____ vocabulary and a ___ complexity.
typical/average for both
When we look a pragmatic analysis what else to we want to look at?
positive or negative assertiveness and responsiveness (either/or both/and, neither/nor), will they initiate and will they respond
What are the developmental ages of speech?
I 0-12 months
II 12-24 months
III 24 months - 5 years
IV 5 years - adolescence
What is a screening like for speech disorders?
determines if the client’s skill are appropriate for their age (or not); pass/fail, quickly performed
What are the types of screenings (screeners)? 3
1 primary function to assess speech
2 speech screening embedded w/in a language test
3 nonstandard screenings (asking parent specific questions to determine if the described skills are age appropriate: thumb sucking, PE tubes, dental work
What are the goals for pure speech samples in preschoolers?
1 Trying to get the child to talk
2 Try to get any type of vocalization, the younger the chidl is.
What is articulation assessments?
assessments that focus on the production of each sound (rabbit -> wabbit)
What is phonological assessments?
assessments that focus on the productions of patterns of sounds; (top -> kop; do -> go both backing)
What are the 3 primary steps in phonological/articulation assessments?
1 initial observation
2 collection of speech sample
3 hypothesis testing (more appropriate with school age children)
Why do we do artic and phon assessments? 3
1 to find current level of functioning
2 determine if therapy is needed
3 if needed, what goals are appropriate
What are the characteristics of the initial observation? 3
1 brief in length (3-5 minutes)
2 eval of the child’s spontaneous speech, gives you a sense of the ch’s functional intelligibility
3 depending on the child, it may be interaction with parent (or an ice breaker game) or may be causal conversation or play
What are options in initial observations? 5
1 answer questions
2 show them a picture and ask them to tell a story about it
3 talk about their dog, cat, or other pets
4 tell about a past experience
5 explain a movie
Why is a speech sample collected during the initial observation?
to find out how widespread the problem is
Which speech measure do we use for which age?
1 Standardized measures (for older kids (stage IV) - salient sounds emphasized, e.g. Goldman Fristo)
2 Speech Sample (for younger kids (stage I-II)
3 Both (for kids in btw older and younger (stage III))
What are the pros of nonstandard assessments? 4
1 flexible and adapts to clients learning style
2 any age/development level
3 use when client can’t be tested by other measures
4 can be more in-depth than standard assessments
What are the cons of nonstandard assessments? 3
1 req more clinician knowledge
2 less reliable (less structured procedures)
3 time consuming
What is intelligibility?
how easily a person’s speech can be understood by unfamiliar adults
3 y.o. speech should be at least ____ intelligible to unfamiliar adults.
70%
What are 3 ways to assess intelligibility?
1 Clinical Judgement Scales
2 Frequency Occurrence Analyses
3 Error Pattern Analyses
What are Clinical Judgement scales?
used by ch in stages 2-4; SLP compares the target ch’s speech to a ch of similar age & ranks them
What are Frequency Occurrence Analyses?
used w/ ch in stages 2-4; determining intelligibility by analyzing the most frequently occurring sounds; efficient won’t notice less frequently occurring words
What are error pattern analysis?
used w/ ch in stage 3; SLP classifies the ch’s error by types of errors (fronting, stopping, etc.)
What are 3 rules for collecting a speech sample?
1 use a high quality audio and/or video recorder (point the mic to the ch, set the device on a towel or something that will absorb atmospheric sounds)
2 repeat the ch’s utterance to help remember later (glossing)
3 transcribe soon (use consistent notation, if you’re not sure how to mark something, just be consistent and make corrections later; use only clinically relevant diacritics - too many can become complicated)
______ measures the degree of the ch’s articulation and phonological disorder?
severity
What is the clinical judgement scale for severity?
1 familiar listeners judge and rank artic and phonological ability
2 ranking basis on comparative w/ other ch the same age
3 use w/ all clients - most appropriate w/ stage 3-4
What is the Percent of Consonants Correct (PCC)?
measure of severity based on a percent of consonants produced and the toal attempted; generally around 50-65% for a referral (Stage 3)
A Percent of Consonants Correct of ____ or below is generally required for a referral.
50-65%
A PCC of ____ or above is considered normal development for preschool aged (18 months to 5 years).
85%
A PCC of ____ is considered mild to moderate disorder development for preschool aged (18 months to 5 years).
65-85%
A PCC of ____ is considered moderate to severe disorder development for preschool aged (18 months to 5 years).
50-65%
A PCC of ____ or below is considered severe disorder development for preschool aged (18 months to 5 years).
<50%
Intelligibility analysis is done for clients in stages __ to ___
2 to 4
How do you assess intelligibility? 2
1 Clinical Judgement Scale (sim. to clinical judgement scale for severity)
2 Error pattern analysis (assess the effects of error patterns on intelligibility; increases in error patterns usually decrease intelligibility; especially with assimilation, atypical patterns, multiple errors and variable errors)
_____ is done for clients in stages 2-4, uses clinical judgement scale and error pattern analysis to see the effects of error patterns.
Intelligibility analysis
___ are base assessments on average age at which the child without developmental delays acquire sounds.
Age norms
Age norms help to select ____ ___, by picking the targets that are most delayed (but also looking at error patterns).
therapy goals
What are 2 limitations of age norms?
1 ages such as those in the book are averages
2 norms may not be the same from culturally or linguistically diverse backgrounds (i.e. English as a second language kids)
What 4 aspects of the speech sample are most often analyzed with Age Norms?
1 pre-speech vocalizations (eval the existence of prespeech vocalizations such as cooing and babbling - relevant 18 month olds)
2 Phonetic inventories (eval which sounds are represented in the child’s inventory)
3 Error Patterns (eval phonological and artic errors)
4 consonants and consonant clusters (eval the ch’s production of consonants)
As a starting point for therapy, it’s best to start with the error patterns that are ____ % successful. Frequent sounds will often progress w/o intervention. What is this level of success called?
25-49%; present
What else should we look for in error patterns in the speech sample w/r/t age norms? 1
make note of atypical error patterns (also known as phonological process analysis)
What are the external elements of the oral motor screening? 3
1 facial symmetry
2 muscle tone
3 movement
What are the internal elements of the oral motor screening? 3
1 Teeth (condition & alignment)
2 Tongue movement & strength
3 Palate/pharynx - closure, movement (velum); tonsils
What are 3 related assessments to oral motor and speech screenings?
1 Case history
2 hearing screening
3 language screening
What settings do we complete school aged children? 3
1 schools
2 hospitals
3 rehabilitation facilities
Once children are told they are too old for ECI; their IFSP is replaced with ___
IEP (individual education plan)
What are the positives of standardized testing for school aged children language? 4
- tests are normed on a given pop
2 can test some higher-level skills (inference, multiple meanings, story completion)
3 complete tests as described in the manual
4 use charts to determine score
What should you remember when taking a language sample? 3
1 have a high qual recording device
2 keep mic aimed at the ch
3 say what they say to help understand better later (glossing)
____ is repeating what the child says after the child, to help with transcription.
glossing
What is different in a school aged child assessment?
inclusion of a narrative sample
What are the different types of narrative samples? 3
1 personal narrative (story that happened to them or a movie they saw) - easiest
2 re-tell story (ch retells a story that was told to them)
3 tell (ch tells a story from a book) (hardest) (wordless picture books)
What is difficult about wordless picture books telling?
1 picking the salient features of the story (ASD will focus non-salient features)
2 maintaining the sequence
What are language sample types? 3
1 narrative
2 spontaneous play
3 picture descriptions
What are some different picture descriptions? 2
1 problem solving: “what can she say to her friend to make things better?”
2 goal oriented: “how can she get the cookies if she can’t reach them?”
How do you analyze your sample? 4
1 MLU (form, morpho-syntax, phonology) 2 TTR (semantic analysis and content) 3 communicative intent/pragmatic functions (use, proximity, eye contact, topic maintainence)- assertiveness, responsiveness 4 narrative structure
What are aspects of a story that we look for? 8
1 Setting - info about people, place, imp things
2 initiating event - occurrence that influences the main characters
3 internal response - to the initiating event
4 plan - strategy to solve problem/obtain goal
5 attempt - action to solve problem/obtain goal
6 consequence - result of attempt
7 resolution - character’s feelings, thoughts or actions in response to the consequence
8 ending - close of the story
Older children with more than just residual errors will be _____.
in the lower stages
Older children in the lower stages, will frequently still have ____ ____.
error patterns
Older kids in the lower stages can be assessed with ____ and ___ for speech.
non-standardized and standardized measures.
____ are accuracy in producing sound patterns.
Error patterns
Older kids in lower stages are primarily assessed with ___.
standardized measures
Older kids error patterns frequently are chronic. True or false.
true
Some error patterns ____ with maturation. By what age?
dissipate; 5
Error patterns associated with maturation including __ & ___ (____)
[l] and [r] (glides); {also lateralized [s])
Generally error patterns that linger are considered ___, b/c the client’s speech resembles a younger child (not age appropriate).
delayed
At times ___ is a description that used after age 9.
disordered
Disordered speech is often linked with ___ error patterns or extreme (severe) impact on intelligibility and functionality.
atypical
___ ___ ___ exist where, for example, fronting and devoicing coexist.
multiple error patterns
In stage 4, client may have ____ errors (single word errors)
residual
In stage 4, speech eval is primarily ____, with ___.
standard measures; non-standard measures for support.
What are the pros of standardized tests? (older kids) 4
1 promotes reliability (at least .9 reliability)
2 gives an overview of the key speech assessment topics
3 gen. time efficient
4 freq accepted by insurance companies and others
What are the cons of standardized instruments? 2 (older kids)
1 not all clients have the cognitive capacity for test
2 may not have a complete analysis for severely disordered speech
What is the third step of older kid assessments?
hypothesis testing
What is the goal for hypothesis testing?
to obtain more in-depth information about the child’s speech disorder (error sounds)( (a ch subs /p/ for /f/ and you want to test if this is the case for all situations) (use word probes for error patterns)
____ are predetermined lists of words with certain sounds in certain positions.
word probes
___ is determined by what other sounds the individual can produce. (used to help select treatment targets)
stimulability
What are different areas we ID for stimulability? 5
1 imitation 2 key environments 3 key words 4 phonetic placement 5 shaping
___ is checking to see if a ch can say a target correctly when provided a direct model such as a word probe list.
Imitation (may be immediate or delayed)
If the child is successful in imitating he/she is said to be ____ for that sound.
stimulable
___ is targeting word positions, syllable positions, or in conjunction with other sounds to find stimulability.
key environment
____ is a particular word that the child naturally produces correctly, often a word that is special to the child.
key words
___ are nonsense words that address the child’s ability to produce new words correctly.
new/novel vocabulary
___ help a child understand how to physically produce the sound (may describe/demonstrate what to do with the articulators to make a sound). (more for older children). Also can involve instructions like “turn on your voice.”
phonetic placement
___ is taking a sound that they can already produce and getting them to move to another position (target sound).
Shaping
What actions should be taken after assessment? 3
1 Intervention (type and quantity)
2 Set goals
3 Measure progress
____ is what you hope to acheive in treatment.
Intervention goals
___ is how you get to your intervention goals.
Intervention procedure
What do all treatment goals have in common? 3
1 functional - make sure the goals will actually help them in real life
2 Measureable - how will you know if they completed the goals?
3 Attainable - should be realistic
Long term (range) goals look at __.
overall outcome, big picture (very broad goals) (Lauren will incr her expressive lang skills to a more age appropriate level)
___ is a step you take to achieve long term goal.
short term objective
___ is another term for short term objectives.
Semester objectives
How are short term objectives different than long term goals? 3
1 what you can acheive over the course of a semester
2 more specific than long term goal
3 a stepping stone to the long term goal
____ are related to one of the semester objectives, but on an even shorter time frame.
daily objectives
What are the 4 parts to a daily objective?
1 Condition
2 Learning
3 How the learning will be demonstrated (behavior)
4 the criteria
What is the condition in a daily objective?
the circumstances (during a story, when on the floor, when given multiple cues, when given auditory cues, while in the kitchen)
What is the learning in a daily objective?
the language skill (while reading a story, B will improve his ability to answer y/n questions; B will increase his MLU, B will increase his topic initiation skills)
What is the behavior in a daily objective?
how the learning will be demonstrated (usually indicated by the word “by”; by reducing his rate of speech; by telling a story, by correctly producing [r])
What is the criteria in a daily objective?
how you will measure the skill (w/ 80% accuracy; from 1.5 to 2.5, with fewer than 4 prompts)
How do you monitor progress and outcomes?
data collection (different skills are collected differently; everyone does it differently and it is determine in lg part by the objective; determines whether or not progress is being made)
Why should assessments should be given during certain intervals? 3
1 determine if progress is being made
2 deter mine if any changes need to be made to the treatment plan
3 determine if client needs to be discharged
GOALS: TOO HIGH, TOO LOW?
What are the two different methods for IDing students with Learning Disabilities (LD)? 3
- Traditional Discrepancy Model
2 Responsiveness-to-Intervention Model
____ (1975) defined “undersachievement” as discrepancy btw IQ and achievement.
Education of All Handicapped Children Act
Why was the discrepancy model criticized? 3
1 IQ tests don’t meas intelligence nece
2 Discrepancy btw IQ and achievement maybe inaccurate
3 Wait to fail paradigm (often results in delayed response to problems)
What is the RTI?
responsiveness to intervention is a systematic process of intervention to prevent school failure (intro’d in 2004); type of dynamic assessment
What is the one constant in the traditional model of intervention?
comparison to peers
What does RTI take into consideration that traditional model did not?
look at the students exposure to skills/instructional methods
The ___ philosophy believes that children may not do well while being assessed for certain skills b/c of lack of exposure or inadequate teaching.
RTI
What are 3 principles of RTI?
1 Evidenced based instruction should guide classroom teaching
2 Prevention is better than waiting
3 All children in a classroom will benefit from high quality instruction
RTI is for students who possess a profile of ____.
strengths and weaknesses (LD)
What are 3 advantages of RTI?
students ID’d w/ a LD only after effective instruction is not beneficial
- stud provided w/ intervention early
- stud assessment data informs teachers about appropriate instruction
What are the basic levels of RTI?
1 Primary Prevention Level
2 Secondary Prevention Level
3 Tertiary Prevention Level
What happens in primary prevention RTI?
all studs screened to determine present levels of performancy; rhyming is taught to all ch (w/ Evidence Based method) students who demo deficits remain in Tier 1, with progress monitoring; some students will not improve and must move to Tier 2
What happens in secondary prevention RTI?
in tier 2, focus on the target skill is more intense (provided in sm groups, w/ evidence based, ex. sm group shared story reading); at the end of tutorial trial progress monitoring is used to determine if students are improving (move to Tier 1) or determine further intervention in Tier 2 is necessary or or more intensive intervention needed (Tier 3)
What happens in tertiary prevention RTI?
1 individualized services (intensive, systematic, “pull out”); based on data; multidisciplinary eval preceds placement or ID of LD (reqs parental permission); progress monitoring is used to set goals for IEP; design individualized pgms, monitor student responsiveness; can move back down Tiers w/ significant progress
How do we determine which Tier a child should be moved to in RTI?
by viewing the individual progress monitoring
What is role of SLPs in Tier 1? 3
1: SLP provides “best practice” info a staff mtgs or other global sources; may give a teacher some gen suggestions for class or home activities; begin documenting intervention
What is the role of SLPs in Tier 2? 3
1 collaborate (Share roles, share all our best ideas w/ examples), give teacher specific instruction to target a specific ch (and help them keep the data); 2 include direct work in sm groups in class; 3 document change
What is the role of SLPs in Tier 3? 3
1: w/ permission, in-depth testing;
2 enter into special education w/ a formal IEP;
3 meet w/ all concerned parties and document progress
What should intervention techniques be based on?
Evidence based practice: external or internal
What are the two levels of evidence?
external and internal
What is external evidence?
research studies that used certain techniques
What is internal evidence?
considering why an intervention might be successful (based on language theory)
____ are methods which lack the external evidence, but are still promoted as evidence based therapy.
Fringe therapies
____ theory intervention may have adults model the appropriate behvavior in functional contexts.
social interaction
___ is adult’s description of what he/she is doing, thinking or feeling while playing with child. This is good for children with low verbal output to increase MLU.
self talk a.k.a. play by play announcing
____ is an adult’s description of what the child is doing, using the child’s name repeatedly.
parallel talk
___ is showing the child what to do.
modeling
Language during self/parallel talk and modeling should be in the _____ (not too far above or below the child’s lang level.
zone of proximal development
____ are two word utterances which are not grammatically correct (some believe it should never be used, others believe it is appropriate for ch w/ MLU of 2 or below.
telegraphic speech
____ is repetition of child’s utterance while adding semantic content.
extensions
____ is repetition of child’s utterance using correct adult grammar.
expansions
Extensions and expansion are used for children ____ (old).
18-24 months
____ intervention is based on the idea that language is learned through higher-order cognitive processes such as memory and problem solving.
cognitive theory based
___ is modelling the target behavior and requiring the child to repeat.
Imitation
___ is the often viewed as the first step in teaching behavior (highest level of prompting/cuing). Eventually the clinician can scale back to less involved intervention. Provides more opportunities for the behavior to occur.
imitation
____ is an aspect of imitation in which the child repeats the learned behavior over and over. It increases cognitive development.
practice
Scripting is an example of ____ in which written dialogue is rehearsed until they understand the target.
practice
Interventions are generally either ___ -directed or _____-directed
child; adult
What are the criteria for determining child or adult-directed therapy? 3
1 age & personality of the child
2 goal of therapy
3 specific goal & objectives (daily)
During the adult directed therapy the adult (4)
1 Plans game: chooses the activity
2 Plans ch role: determines what types of responses the child
3 Plans adult feedback: let’s the child know how s/he is doing on the task
4 Plans structure of the session: utilizes the discrete trial format
During the child directed therapy the adult (5)
1 DOESN’T CONTROL follows the child’s lead
2 RESPONDS responds appropriately, but waits for the child to engage before responding again
3 MODELS provides a lot of modeling through the natural interactions
4 FOLLOWS acts as facilitator rather than leading
5 reinforcements are natural consequences
_____ is a hybrid type of therapy in which the clinician exposes the child to a language target (form, content or use) in natural situation using a variety of examples.
focused stimulation
What is the purpose for infants/toddlers of intervention?
maximize expressive and receptive communicative competence in and social situations
How do we succeed in intervention in infants/toddlers? 4
1 eliminate the underlying problem (uncommon in language situations)
2 change specific disordered behavior (incr expressive vocab)
3 teach compensatory strategies (strategies for improving sequencing deficits)
4 change the environment (restructuring the environment to make it more conducive to learning)
_____ is based on developmental norms using what they should have and picking targets from that list. Usually morphosyntax are common language targets.
Developmental-normative approach
_____ is based on the observation of an individual need for specific skills in specific situations.
Functional approach
_____ often benefit from a focus on developmental skillls.
Young children
_____ often benefit from a functional/pragmatic approach.
Older children
____ is when the SLP provides the intervention services.
direct intervention
___ is when the SLP trains the parent or teacher on intervention techniques (modelling, imitation).
indirect intervention
___ is a strategy used in direct and indirect teach which use an enhanced environment (books, words on wall).
incidental teaching or Milieu Teaching
____ is a way to encourage the child to have natural ways to communicate through intentional errors. This can be taught to parents in indirect intervention.
Sabotage
What are incidental teaching techniques? 6
1 enhancing the environment/language rich
2 asking open ended questions (less yes/no)
3 allowing silences to occur in convos
4 providing choices
5 prompting peer interactions
6 sabotage
___ could involve Print Referencing or Vocabulary Elaboration and is a form of direct intervention.
Increasing Emergent Literacy
____ is when an adult uses cues to direct a child’s attention 2 the functions, features, and forms of written language during shared storybook reading. It is a form of Increasing Emergent Literacy
Print Referencing
____ is when the adult focuses on semantic aspects of words as pointing out multiple meanings. It is a form of Increasing Emergent Literacy.
Vocabulary Elaboration
___ is the building blocks to learning word attack skills and can include rhyming, blending, segmenting, and elision.
Phonological Awareness
____ is a natural approach where the adults work language goals into a functional communication context.
Incidental Teaching or Milieu Teaching
Modelling “more snack please” after giving only one cracker is an example of ___
Incidental Teaching
____ is repeated modeling of a targeted language structure in hopes that the child will use it.
Focused Stimulation
_____ is a clinician’s monologue about what s/he is doing.
Self-talk
___ is a clinician’s running commentary describing what the child is doing.
Parallel talk
____ are setting where language is used in the same way each time and increases the predictability of the situation.
Joint action routines
____ is demonstrating errors so that children correct them.
Sabotage
___ is demonstration of skills outside of the initial intervention setting.
Generalization
What changes need to be made to promote generalization? 3
1 stimuli (materials) 2 settings/contexts 3 interlocutors (peoples)
What are the 4 guiding principles of speech intervention (ITPS)?
1 purpose of intervention
2 goals for therapy
3 target sounds
4 administrative decisions
The speech stages purpose is to address the client’s stage of ___ rather than their ____.
phonological development; chronological age
In Stage ____, the purpose is to facilitate the development of vocal skills that underlie later speech development
I
In Stage 1, the purpose in treatment is to facilitate development of vocal skills that underlie _____.
later speech development
In Stage 2, the purpose of treatment is to facilitate development of a _____ _____for communication.
functional vocabulary
In stage ___, the purpose of treatment is to facilitate acquisition of major speech elements.
III
Stage ___, the purpose of treatment is to facilitate development of a functional vocabulary for purpose of communication.
II
In Stage 3, the purpose of facilitate the acquisition of ____ ___ ___.
major speech elements
Before the child develops functional speech, in stage 1, it will have to develop ____.
basic vocal skills
What is the common long term goal for ch stage 1-3 in speech treatment?
ch to have the artic and phonol dev appropriate compared to others with the same chornological or developmental age
What are the short term goals in stage 1? 3
1 initial awareness of sounds and using vocalization
2 ensure adequate changes to vocalize
3 functional work
What are the short term goals in stage 2? 4
1 word level acquisition
2 deficits in articulation and phonology limit expressive vocabulary
3 encouraging speech
4 incr the accuracy of sp and then gaining consistency in speech
How can you attack the deficits in artic and phono (b/c they limit expressive vocab)? 5
1 ID current vocab (be sure to include misarticulated words) 2 complete a phonetic inventory analysis 3 select target words 4 teach the words 5 monitor progress
How do you select target words in speech? 3
based on what the ch can already produce; based on emerging phonetic inventory; based on ch motivation
What is a way you can teach the words in speech?
use of and bombardment w/ occasional requests for the child to produce the target
___ is heavy repetition of the target sound.
auditory bombardment/auditory training
Accepting vocalizations that are close to encourage and reinforce speech in stage 2 treatment is an example of ___.
encouraging speech
___ are common in young children, because of limited accuracy in speech. “Muh” is truck, juice, and train.
Homonyms
In stage 3, the ch will focus on ___ ___ ___ and expanding speech through longer utterances and generalization.
error pattern reduction
____ is working with sounds that are w/in a class in stage 3 of speech treatment (i.e. velars, alveolars)
distinctive features
____ focusing on elimination of mispronunciations of a sound class.
error patterns
What are strategies we can use as speech targets that the child is likely to produce? 5
1 imitation 2 emerging sounds 3 key words 4 phonetic placement 5 shaping
___ is demonstrating tongue placement for a sound.
imitation/phonetic placement
____ is using sounds that are close to correct as targets.
emerging sounds
___ is using words that ch is targeting naturally (like their name) as speech targets.
key words
_____ is using one sound to show how to do another.
shaping
The __ method of speech targets selects treatment targets that have a minimal difference from the sound that the child can already make. (child can already produce ng & n; target m).
most knowledge
___ is targeting sounds that are very different from what the ch can already do.
least knowledge
If the ch has [p] and the target [z] is selected this is an example of ____ method.
least knowledge
In stage 1, it is recommended to use ____ for speech targets.
most knowledge
If the ch can make a stop (p), some possible goals for ___would be [b].
most knowledge
In stage 2, it is recommended to use ____ for speech targets.
combo of least and most knowledge
In stage 3 it is recommended to use ___ for speech targets
a combo of least and most knowledge (more least knowledge at the end)
With all treatments, we must make administrative decisions as to session type, which means ___ or ____.
individual; group
_____ sessions are best in beginning therapy.
Individual
In Group Sessions, ____ (#) of clients is ideal. (age and goal matched)
3-5
___ sessions are best in the late stages of therapy. Helps with working on generalization.
Group
____ (frequency) is customary for speech intervention (ITPS).
one or more times per week
In terms of duration, ___ to ____ is common, but the time in therapy (____) is individualized.
brief (15m); longer (1hr); months
___ is when the clnician presents the material for mass practice (stage 4).
drill
____ is the usage of a drill in the context of a game (get a shot at the hoop w/ a certain # of productions). (Stages 3-4)
Drill play
_____ is drill play in child centered activities (load the activity with the target sound) (e.g. scavenger hunt). (Stage 2-3)
structured play
___ is a very child oriented activity working on targets as they naturally happen (using a toy kitchen set) (Stages 1-2)
play
____ is an example of a complete intervention program, which are better suited for younger children and those w/ error patterns rather than articulation problems. They address both distinctive features and phonological processes.
Phonological programs
____ address the individual errors rather than patterns.
Articulation patterns
____ or ____ tell you exactly what to do for your intervention.
Complete Intervention or Comprehensive Intervention programs
___ is a threapy based comprehensive program on a specific timed cycle of activity with each error pattern addressed individually.
cycles program
Technically ____ are where complete programs are packaged and bought.
comprehensive programs
In ___, included is auditory bombardment, therapeutic play (drill structured), and drill. It ends w/ stimulability testing for the next sounds.
Cycles program
_____ combines multiple procedures from many phonological programs in 4 steps.
Easy Does It for Phonology
In Easy Does it for Phonology, the child is
1. ___ to bring attention to their error
2. Made aware of ____ an how that can change the meaning (hop v. hot)
3 Produce target in _____.
4. produce target correctly and ____.
1 bombardment
2 distinctive features
3 various activities
4 contrast with their incorrect production
____ assume that speech problems are largely motoric (stage 4).
Articulation programs
Articulation problems assume that speech problems are largely ___.
motoric
____ or ____ attacks isolated sounds, then syllables, then words (one word per session)
Traditional Approach/VanRiper Approach
_______ or ____ is when you put a key word (one they can do like their name) next to a target word.
Paired Stimuli; Key Word
_____ uses syllable structures with target words.
Sensory-motor program
____ is the same as Van Riper, but with multiple phonemes per session.
Multiple Phoneme Program
In all intervention techniques, if the child produces the sound incorrectly, the SLP will ___ the sound.
stop and teach
____ is using the contrastive nature of the sounds to reach a target (used later in stage 3 and stage 4)
word pairs
___ are two words which different by only 1 distinctive feature. tap/tab; ding/zing
minimal pairs
____ are two words which differ by multiple distinguishing features. set/bet; ham/hat
maximal pairs
Depending on the context, clinician may use ___ pairs first and ___ pairs at the end.
maximal; minimal
With school-age children language intervention, the purpose is to maximize ___ and __ competence in academic and social situations.
expressive; receptive
What are the 4 parts of intervention with school aged kids? Which one is emphasized?
1 eliminate the underlying problem
2 change the specific disordered beh
3 teach compensatory strategies (emphasis!)
4 change the environment
Young children often benefit from working on specific developmental skills, but older children often benefit from working on ____.
pragmatic skills
An example of pragmatic skills, is ____, which works on discourse skills.
scripts
What are the delivery model (size setting) options for school aged interactions (administrative decisions)? 6
1 individualized intervention 2 group intervention (2-3 ch of like age and disorder) 3 pull-out (taking the ch out of the classroom & going to the therapy room) 4 classroom 5 consultation (a type of indirect therapy) 6 collaborative/team (working w/ teachers and parents)
What are the benefits and drawbacks of the pull-out approach?
\+ child less distracted, low threat environment; - decontextualized setting; missing class time; stigmatizing
What are the benefits and drawbacks of the classroom approach?
+ see difficulties as they happen
- distracting to other students/teacher; stigmatizing
What are the benefits and drawbacks of the consultation approach?
+ intervention strategies taught to teacher or parent (primary intervention agent)
- teacher or parent may perceive SLP as language expert to deliver intervention services; teacher may be too busy
What are the benefits and drawbacks of the collaborative approach?
+ teacher or parent and SLP share mutual responsibility for child’s program
- teacher or parent may perceive SLP as language expert to deliver intervention services; teacher may be too busy
___ is an efficient and structured to elicit maximal response which target specific goals.
drill
____ is a structured intervention to elicit maximal response to target sounds w/ a greater student motivation compentent to target specific goals.
drill-play
What are the most important techniques and strategies for implenting intervention? 6
1 reinforcers 2 expansion 3 extension 4 recasting 5 mand-model/elicited imitation 6 modify linguistic input
___ is syntactic expansion of child’s production to reflect an adult version (does not go beyond semantic boundaries of ch’s utterance, e.g. “baby drink” -> “the baby drinks”)
Expansion
“Baby drink” -> “the baby drinks milk” is an example of ____
recast
___ is a semantically related utterance that goes beyond the ch’s utterance’s boundaries (e.g. “baby drink” -> “the baby is thirsty”)
Extension
____ is a response to ch’s utterances in a new linguistic structure produced immediately after ch’s production as it would naturally occur (not too much emphasis) (e.g.”the cat eat that food” -> “what kind of food is she eating?”)
recasting
____ is not a imitation of the child’s utterance, but a clarifying statement or question with new linguistic structure not an imitation of the child’s utterance. It can facilitate the development of new language structures.
recasting
_____ is making statements that require the child to respond. The adult models the language for the child and the child is expected to imitate.
mand-model/elicited imitation
____ is a statement that specifies a reinforcer.
Mand
____ is a technique that we do automatically based on what the client needs.
Modifying Language Input
What are examples of modifying language input? 8
1 slower speaking rate w/ longer pauses 2 repetition 3 rephrase information (not the best w/ all disabilities) 4 present info multi-modally 5 Produce shorter sentences 6 emphasize words w/ stress and loudness 7 enunciate 8 create favorable listening conditions
Older children who are in therapy in ____ speech stages. Those with more limited skills and those with better skills.
different
Older children with more limited skills will be treated ___.
with techniques from levels 1-3 like traditional or cycles approach or minimal pairs
What is the purpose of stage 4 speech treatment?
facilitate dev of literacy and eliminate errors affecting late acquiring speech sounds
What is the long-term goals of stage 4 speech treatment?
1 artic and phono dev appropriate compared to chronological development age
2 artic and phono skills satisfactory for personal satisfaction and educational development (child’s satisfaction)
Odler children w/ better skills will be treated __.
with mroe advanced techniques that require higher cognitive levels and treat specific needs rather than global error patterns
Children in stage 4, can begin with sounds with some knowledge like ___ , ___ or ___.
stimulable, emerging, or key words
Because the child is older in stage 4, you can target harder sounds because ____.
clients have more delayed gratification and understanding
___ approach is targeting isolated sounds with most knowledge (older children used rarely)
Traditional/Van Riper
____ puts a key word (that they can do) next to a target.
Paired stimuli/ Key Word
____ program starts with sounds in syllables then increases in complexity. Uses nonsense words.
sensory-motor
___ program is similar to traditional but w/ multiple phonemes.
multiple phoneme
____ increases speech movement with imitation and rehearsal with increasing compleity.
Motoric Automatization of Articulatory Performance
In Stage 4, the most important part of any speech program is choosing targets based on ____ (target words from academic textbooks or social situations).
function
____ is using the contrastive nature of the sounds to reach a target (relevant words academically and socially). This is effective in cognitively advanced stage 3 and into stage 4.
word pairs
tab/tap is an example of ___.
minimal pair
wet/set is an example of ___.
maximal pair
A technique for ____ is is to teach rhyming, beginning with rhyming vowel endings and move to consonants eventually.
Final consonants
A technique for remediating ___ is to place the problem in a position where it may migrate from the end to the beginning of a the next word (desk up -> de skup)
consonant cluster
A technique to deal with ___ is to practice with multiple syllabic words and w/ equal stress (supper -> sup per). Teach stress patterns for target words.
syllable deletion
A technique to address ___ is to tell the child where to produce a target. This is commonly used.
phonetic placement
A technique for ___ is to use a sound the child can produce and moving it into a sound that the child cannot produce.
shaping
Older children who are in therapy in ____ speech stages. Those with more limited skills and those with better skills.
different
Older children with more limited skills will be treated ___.
with techniques from levels 1-3 like traditional or cycles approach or minimal pairs
What is the purpose of stage 4 speech treatment?
facilitate dev of literacy and eliminate errors affecting late acquiring speech sounds
What is the long-term goals of stage 4 speech treatment?
1 artic and phono dev appropriate compared to chronological development age
2 artic and phono skills satisfactory for personal satisfaction and educational development (child’s satisfaction)
Odler children w/ better skills will be treated __.
with mroe advanced techniques that require higher cognitive levels and treat specific needs rather than global error patterns
Children in stage 4, can begin with sounds with some knowledge like ___ , ___ or ___.
stimulable, emerging, or key words
Because the child is older in stage 4, you can target harder sounds because ____.
clients have more delayed gratification and understanding
___ approach is targeting isolated sounds with most knowledge (older children used rarely)
Traditional/Van Riper
____ puts a key word (that they can do) next to a target.
Paired stimuli/ Key Word
____ program starts with sounds in syllables then increases in complexity. Uses nonsense words.
sensory-motor
___ program is similar to traditional but w/ multiple phonemes.
multiple phoneme
____ increases speech movement with imitation and rehearsal with increasing compleity.
Motoric Automatization of Articulatory Performance
In Stage 4, the most important part of any speech program is choosing targets based on ____ (target words from academic textbooks or social situations).
function
____ is using the contrastive nature of the sounds to reach a target (relevant words academically and socially). This is effective in cognitively advanced stage 3 and into stage 4.
word pairs
tab/tap is an example of ___.
minimal pair
wet/set is an example of ___.
maximal pair
A technique for ____ is is to teach rhyming, beginning with rhyming vowel endings and move to consonants eventually.
Final consonants
A technique for remediating ___ is to place the problem in a position where it may migrate from the end to the beginning of a the next word (desk up -> de skup)
consonant cluster
A technique to deal with ___ is to practice with multiple syllabic words and w/ equal stress (supper -> sup per). Teach stress patterns for target words.
syllable deletion
A technique to address ___ is to tell the child where to produce a target. This is commonly used.
phonetic placement
A technique for ___ is to use a sound the child can produce and moving it into a sound that the child cannot produce.
shaping
What are the 4 steps for Easy Does It for Phonology?
1 Bombardment
2 Awareness of the semantics differences
3 Producing targets in various activities
4 Contrast production with their incorrect production
_____ is based on research done on a certain technique.
External evidence
___ is considering how a certain technique may impact an individual child.
Internal evidence
____ is impaired comprehension and/or use of spoke and/or written and/or other system. And individual with this may have problems with form and/or content and/or use.
Language disorders
What are criteria for a language disorder? 3
1 impaired comprehension and/or use of spoke an/or written and/or other systems
2 can involve problems w/ form, content and/or use
3 occurs if different from age-matched peers of similar culture
Classifying a child as having a ____ implies te child will catch up.
language delay
About ____ of late talker will eventually catch up
50%
Classifying a child as having a ____ implies the child is significantly different from their peers in comprehension and/or use of language systems.
language disorder/impairment
_____ is a significant impairment in expression and/or comprehension of language (Can’t be attributed to any other causal condition) and diagnosed preschool or later (>3).
Specific language impairment (SLI)
Why is SLI usually diagnosed after 3?
to rule out late talkers
What are the 6 characteristics of SLI?
1 inconsistent skills across different domains
2 verb use problems
3 social skills, behavior and attention problems
4 slow vocab growth
5 word-finding troubles (“thing” & “stuff”)
6 persistent problems over course of lifetime
_____ is a term that refers to a range of four to five specifc neurodevelopmental disorders.
Autism Spectrum Disorders (ASD)
What is another name for ASD?
pervasive developmental disorders (PDD)
What are the 5 disorders included for ASD in the DSM-IV?
1 CDD 2 Rett 3 PDD-NOS 4 Autism 5 Aspergers
The ASD disorder CDD stands for ___.
childhood disintegrative disorder
What are the characteristics of CDD?
it is fairly rare disorder affecting only boys, with a regression beginning at 2 years of age (motor, social, language regress for a while and then plateau) - once they plateau, they look and behave like a child w/ Autism, SLPs not brought in until plateau
What are the characteristics of Rett Syndrome?
a rare regressive syndrome, which regresses in 4 distinct stages; only occurs in girls, microcephaly, teeth-grinding, hand-wringing; onset btw 6-18 months
The ASD disorder PDD-NOS stands for ___.
pervasive developmental disorders-not otherwise specified
What are the 3 characteristics that put a child on ASD?
1 Problems with social interaction (at least 2)
2 Problem w/ communication (Verbal and nonverbal) (at least 1)
3 Restricted pattern of interest (at least 2)
____ is a form of motoric verbal stimulation, where an individual with ASD, may repeat a phrase or make a sound loudly.
Stimming
The ASD have 3 basic characteristics in common and to confirm diagnosis, the clinician must identify at least ___ problems with social interraction, ____ problems with communication, and ___ restrictions in their pattern of interest.
2; 1; 2
____ is a form of motoric verbal stimulation, where an individual with ASD, may repeat a phrase or make a sound loudly.
Stimming
The ASD have 3 basic characteristics in common and to confirm diagnosis, the clinician must identify at least ___ problems with social interraction, ____ problems with communication, and ___ restrictions in their pattern of interest.
2; 1; 2
Characteristics of social interaction w/r/t ASD are 3
1 proximity
2 eye contact
3 conversational turn-taking
Characteristics of communication (verbal/nonverbal) w/r/t ASD are 2
1 echolalia
2 nonverbal/body language
Characteristics of restricted pattern of interest w/r/t ASD are 3
1 strange repeated motions
2 trouble transitioning
3 only eat one thing
How is ASD ID’d?
through behavioral means unless biological marker
How do children who don’t have ASD get misdiagnosed? 3
1 clinician error
2 child having a bad day
3 child has deficits in the 3 core ares
What has the ASD changed into for DSM V?
all disorders will now collapse into one disorder (Austistic Disorder) and Rett’s is no longer associated w/ Austism
The criteria for ASD has changed into what?
from 3 to 2:
1 social/communication deficits
2 fixed interests and repetitive behaviors
_____ is a new disorder which will be in the DSM V.
Social Communication Disorder (SCD)
What severity scale exists for Autistic Disorder?
3 level; 3 minimal support needed
2 moderate support needed
1 amount support needed
____ is often the first sign of language disorder.
Language delay
Autistic Disorder is also marked by atypical language, including ____, ____, ___,___, ___, ____, & ____ 7
1 echolalia (repeating a word or phrase previously heard);
2 pronomial confusions (incorrect use of pronouns);
3 dysprosody (unusual pitch rhythm, or pace in suprasegmentals);
4 paralinguistic difficulties,
5 non-literal language difficulties;
6 nonverbal communication (gestures, eye contact, etc.)
7 context bound usage (only concrete subjects, rather than abstract)
Autism onset is ____.
before 3 years old
Autism prevalence in school-aged children is ___ and in overall population is ___.
1:50; 1:88
___ is the overall number of cases.
Prevalence
___ is the number of new cases in a specific time frame.
Incidence
What is the cause of Autism?
no known cause; suspects are 1 Biological (brain function, pathways, non-neurotypical), 2 Genetic (twin studies, increased sibling risk) 3 Environmental (vaccines, pollution diet)
What is an option for non-verbal Autistic children?
augmented alternative communication (like Max, who had a lot to say)
What did the story of J Mac the basketball player teach us about Autism?
early intervention helps the child to function and even lose some of the criteria
What is the prevalence of Asperger’s Syndrome?
some say 2:10,000 and others say 1:500; Ross says maybe even less
What are the hallmarks of Asperger Syndrome? 3
1 IQ scores usually average or above average (may use atypical or advanced vocab)
2 Social communication problems (Have difficulty keeping up with the subtle cues and dynamics of conversation/poor social language or pragmatics, very literal)
3 Restricted pattern of interest (usually expressed in terms of topics of interest- little to no interest in other topics)
_____ is marked by limited topics of interest and often do really well in one on one, but poorly in small groups.
Asperger Syndrome
“Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or who are participants in research and scholarly activities, and they shall treat animals involved in research in a humane manner” is ASHA ethic number ____
I
“Individuals shall honor their responsibility to the public by promoting public understanding of the professions, by supporting the development of services designed to fulfill the unmet needs of the public, and by providing accurate information in all communications involving any aspect of the professions, including the dissemination of research findings and scholarly activities, and the promotion, marketing, and advertising of products and services.” is ASHA ethic number ___
III
“Individuals shall honor their responsibilities to the professions and their relationships with colleagues, students, and members of other professions and disciplines.” is ASHA ethic number ____.
IV
“Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence and performance.” is ASHA ethic number ___.
II
Code of Ethics offenders are printed in the ___ (frequency) newsletter called ___.
quarterly; ASHA Leader
The primary idea of ASHA ethic # 1 is what?
welfare of patients or research subjects including animals
The primary idea of ASHA ethic #2 is what?
maintain professional competence and performance
The primary idea of ASHA ethic #3 is what?
provide accurate information in research as well as marketing
The primary idea of ASHA ethic #4 is what?
honor/respect colleagues and students