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SPAA 210 > Unit 3 > Flashcards

Unit 3 Flashcards

1
Q

Traditional or Phonetic Approach to therapy

A

a.k.a. motor approach
Client is instructed on how to position articulators to produce the misarticulated speech sound correctly
Each error sound is treated individually Therapy progresses from 1 error sound to the next
Approach is best for clients with articulation disorders

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2
Q

Sensory Perceptual Training

A

Historically, one of the hallmarks of this technique, but not as widely used presently
Basically, auditory speech discrimination training to improve auditory recognition of the targeted sound
PRECEEDS initiation of production of the error sound
Levels:
Recognition of the target sound in isolation when
contrasted with first dissimilar and later similar sounds Identification of the word position placement of the target
sound (initial, medial, final)
Discrimination of the target vs. error sound when produced by the clinician

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3
Q

Traditional Approach – Typical Therapy Sequence

A

Treatment for each sound targeted in therapy begins at the stage in which the client demonstrates minimalcompetency and progresses to the next stage once a certain level of accuracy has been achieved

  1. Isolation
  2. Syllables
  3. Words
  4. Phrases
  5. Sentences
  6. Connected Speech
  7. Conversation
  8. Generalization
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4
Q

Traditional Approach - Therapy Sequence for Target Sound Production (criteria)

A

Criteria for level of accuracy is typically set at 80- 90% for more structured contexts
Criteria for level of accuracy can sometimes be slightly lower for more spontaneous, natural contexts (based on the assumption that once the child is using the targeted sound correctly in spontaneous speech the majority of the time, it will probably progress to more consistent usage over time)

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5
Q

Isolation

A

Goal of this phase is to elicit a normal production of the target sound alone
Not all sounds can be produced in isolation Fricatives and voiceless stops – isolation possible Voiced stops, glides and liquids – not possible
May need to use various techniques to elicit correct production of the sound
If techniques are not successful within first 5-10 minutes, try a different approach

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6
Q

Techniques to Elicit Correct Sound Production

A

Verbal model/imitation
Try this method first
If successful, this can be easiest and quickest way
to achieve correct production
”WATCH ME AND DO WHAT I DO.”
Often not successful for /s/ distortions and /r/
errors
Provides client with both visual & verbal model of production

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7
Q

more Techniques to Elicit Correct Sound Production

A

Phonetic placement cues (p.p.c)
-Clinician instructs client to position articulators to produce
sound correctly
-Clinician must first analyze error production and determine
what needs to be changed (place, voice, manner)
-Example: “bite your lip and blow”
Sound modification
-Using a phonetically similar sound that client can say
correctly to shape production of the misarticulated sound
-Example: shaping /s/ from /t/ prolongation

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8
Q

Syllables

A

Goal is to maintain accuracy of production of target sound when paired with vowels
For sounds which can’t be produced in isolation, this is the smallest phonetic context
Some clinicians skip syllables, finding words more meaningful and interesting
However, syllables may help stabilize consistency of sound production before introducing words (if child is familiar with the word, he may resort back to error production out of habit)
Can skip syllables if client can produce target sounds in words with at least 50% accuracy
Typical sequence is:
 VC (vowel-consonant)
 CV (consonant-vowel)
 VCV (vowel-consonant-vowel)
Example: /f/ [fi], [fai], [fo], [ɪf], [ɑf], [of] [ifi], [ofo], [ɑfɑ]

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9
Q

Factors influencing articulatory complexity of words

A 
Length of the word
Position of the sound within the word
Syllable structure of the word
Syllable stress of the word
Coarticulation factors of surrounding sounds
Word familiarity
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10
Q

Length of the word

A

Fewer syllables are typically easier

Begin with 1 syllable words

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11
Q

Position of the sound within the word

A

Initial, medial, final position

Initial position typically easiest (but not always!)

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12
Q

Syllable structure of the word

A

Open syllables (CV) typically easier than closed syllables

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13
Q

Syllable stress of the word

A

Easier to produce the sound in a stressed syllable
When adding 2 syllable words, target sound should be in
stressed syllable

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14
Q

word

A

Goal of this phase is to maintain accuracy of target sound production within the context of words
Large variation in level of difficulty of individual words within this category
Recommended to organize words from relatively easy to more difficulty, introducing easier words first and more difficult words later
Multiple factors influence the articulatory complexity of words

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15
Q

Coarticulation factors of surrounding sounds

A

Usually easier to produce word when target sound only
occurs once in word
 Easier to produce target sound as consonant singleton
than in cluster
 Vowels may influence production, esp. with glides

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16
Q

Word familiarity

A

Typically begin therapy with high-frequency words that
child knows
Children who are not reading at a 3rd grade level will need
pictures to represent the target word
Words important to the child (family names, favorite characters, animals, etc…)

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17
Q

Phrases

A

Goal is to maintain accuracy of target sound in short phrases
Start with carrier phrases + target word “I like ____________________”
Can also try target sound in carrier phrase
If target was /ʃ/ initial, what could you use for phrase?
Listen carefully to final consonants in carrier phrase – child may put target sound at end of phrase, rather than end of word

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18
Q

Sentences

A
  • Goal is to maintain accurate production of target sound in connected speech in a structured situation
  • For children reading at 3rd grade level or above, reading aloud sentences may be possible
  • For younger children, try to have the child make up a sentence about the pictured word (tell me about the picture, make up a silly story)
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19
Q

Connected Speech

A

This level can be a bridge from more structured speech drills using (now) familiar target words and pictures to more spontaneous conversation
Readers can read aloud a paragraph which features the target sound
Potential activities for non-readers include:
-Story retelling
-Picture scene

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20
Q

Conversation

A

Goal: maintain accurate production in spontaneous speech Start with conversing in the speech room with the clinician Progress to conversations with others and in other settings May need conversation topics that help elicit target sound Younger children benefit from a more play-based approach Watch for self-correction of errors
Ask parents to monitor target sound at home for carryover (regular use of newly learned speech skill in everyday situations)

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21
Q

Generalization

A

Correct production of target sound in untreated words
Production of recently learned target sounds in different word positions
E.g. correct word medial productions of /f/ heard in conversational speech (client says muffin & coffee correctly) after targeting word initial position /f/
Production of new (untrained) sounds based on recent learning
E.g. correct production of [ʧ] is heard in conversation after targeting [ʤ] in therapy

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22
Q

Training Deep

A

Traditional approach to articulation therapy focused on 1-2 sounds at a time, moving each sound through all phases of the continuum before going on to a new sound
“5-minute kid” approach

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23
Q

Training Broad

A

Current practice with articulation therapy is to focus on several sounds at the same time, moving all of them along the continuum simultaneously
Each targeted sound may enter the treatment continuum at a different point. The clinician needs to evaluate where treatment should begin for each target.

24
Q

Phonological Based Treatment Approaches

A

a.k.a. phonemic approach
Target groups of sounds with similar patterns of errors (rather than individual sounds)
Establish phonological contrasts that were previously neutralized (such as minimal pairs approach)
Emphasize a naturalistic communicative context (not likely to be isolation or syllable level work)

25
Q

Phonological Based Treatment Approaches

A

“Although phonologically based approaches emphasize the function of phonemes, both the production of speech sounds and the relationship of phonology to other areas of language should not be overlooked.” (textbook, page 326)

26
Q

Phonological Treatment Principles

A

Intervention begins at the word level
-Contrasts in word meaning are often taught
through minimal pairs approach
Focus is on the child’s phonological system, with thorough analysis of the child’s:
-Inventory and distribution of speech sounds
-Syllable shapes and phonemic contrasts used
-Error patterns used
-Sound groups or classes are targeted
-Some target all sounds in a class
-Others target select sounds within a class
and probe for generalization to others

27
Q

Minimal Pair Contrast Therapy

A

Oldest, best known and used phonemic approach
Children learn to produce the contrast between words through use of minimal pairs (words that differ by only 1 phoneme, whereby that difference is enough to signal a change in meaning)
The pair of phonemes used typically differ by only 1 or 2 features (e.g. bat-pat, four-pour, tea-key)
Used to establish contrasts not present in the child’s phonological system
Children with primarily phonemic substitutions (as opposed to distortions) are most likely to benefit
Children with mild-moderate phonological disorders with only a few active processes are more likely to succeed with this technique
Technique is most appropriate for clients who are stimulable for the target sound
Because technique is linguistic in nature, it is important to use productions that are semantically meaningful

28
Q

Selecting Target Sounds for Minimal Pairs Contrast Therapy

A

Typically, contrast the target and error production
Place-voice-manner features for both the target
sound and the error sounds should be considered
Sounds substitutions chosen should reflect the least number of differences in production features
Sound substitutions reflecting the child’s intelligibility should have priority over those with minimal impact
Stimulable sounds have priority over nonstimulable sounds

29
Q

Minimal Pairs Step-by-Step

A

Discussion of words
Discrimination testing and training
Production training
Carryover training

30
Q

Discussion of words

A

show child pictures and discuss each one to familiarize child with the pictures and target words
“This is a ring. We wear it on our finger.”
“This is a wing on a bird.”
“Which one is jewelry?”
“Which one is found on a bird?”

31
Q

Discrimination testing and training

A

clinician instructs child to pick up the picture named by the clinician
“Pick up the ring.” “Pick up the wing.”
Words are named in random order
Textbook author suggests criteria of 7
correct responses in a row.
If child selects wrong picture, clinician corrects client & repeats word

32
Q

Production training

A

child is instructed to tell the clinician which picture to pick up
Use traditional therapy techniques to elicit the targeted sound if child produces it incorrectly
Clinician indicates when there is confusion over
which picture to select (“I’m not sure what you mean. Do you mean wing or ring? Tell me again.”)

33
Q

Carryover training

A

use of the target words in short phrases (“a ___”, “point to the _____”)

34
Q

Maximal Oppositions Approach

A

a.k.a. Maximal Contrasts Approach
Word pairs have multiple phoneme feature contrasts
If possible, sounds which do not share place, voice or manner features are selected
Research suggests those children with moderate- severe phonological disorders would benefit most from this approach
Generalization may be greater with this approach than using minimal pairs

35
Q

Maximal Oppositions Step-by Step

A

2 sounds are selected for contrast and minimal pair words are selected
Discrimination training is not done
Imitation phase – uses minimal pair pictures. Client repeats clinician’s model
Spontaneous phase – child names minimal pair words without clinician’s verbal model
/f/->/g/ or /n/

36
Q

Multiple Oppositions Approach

A

Variation of the minimal pair contrast approach
Appropriate for children with moderate to severe phonological disorders that collapse several phonemes to a single sound
These children often have limited speech intelligibility This approach contrasts several target sounds
simultaneously to the child’s error sound
Example: if child produces /t/ for /ʧ, k, s, ʃ/, target words might be “tip”, “chip”, “kip”, “sip”, and “ship”

37
Q

Steps to a Treatment Plan

A
  1. Identify treatment targets
  2. Determine starting point for each target
  3. Identify and use successful sound-elicitation techniques
  4. Incorporate strategies that strengthen the child’s correct production of the targets
  5. Address carryover for connected speech both within and beyond therapy
  6. Evaluate for generalization to other environments, untreated word positions, and other untreated sounds
38
Q

Analyzing Assessment Results for Potential Therapy Targets

A

Patterns of misarticulations, including distortions, omissions and substitutions
Active phonological processes
Results of stimulability and deep testing
Age and overall development of the child

39
Q

Child-Specific Considerations in Target Selection

A
  1. Which targets will make an immediate and socially significant difference in the child’s communicative skills?
    1. Sounds frequently used in conversation
    2. Sounds that will improve speech intelligibility the
      most
  2. Which targets will be produced and reinforced at home and other natural settings?
    1. Targets that fill a need at home
    2. Targets that will be reinforced by parents and other
      adults
    3. Targets that help child in the context of his/her cultural background
40
Q

Criteria for Selecting Target Phonemes for Training

Edwards, 1983

A 
Choose Target Sounds:
In the child’s phonetic repertoire
For which the child is stimulable
Should improve speech intelligibility
Occur frequently
Acquired early
High value sounds – sounds that will have an impact for
the child
Relatively easy to produce
41
Q

Factors that Influence Selection of Sounds for Training

Weiss, Gordon & Lillywhite, 1987

A 
Earliest to develop
Most stimulable
Produced correctly in a key word
Occurs most frequently in speech
Most consistent (wrong)
Visible
For which the child has been criticized or penalized
That child most desires to correct
Whose production is least affected by physical deviations
42
Q

Predictions for Generalization

A

Teaching 1 member of a cognate pair will result in improvement in the other sound in the pair
Teaching 1 allophone will result in the improvement in other allophones (l and r)
Teaching a distinctive feature in the context of 1 sound will result in use of that feature in other untreated sounds
Teaching sounds in the final position of words will result in more accurate production of the sounds in intervocalic contexts
Teaching stops in the word final position will lead to more accurate production in the word initial position
Teaching fricatives in the word initial position will result in more accurate production of fricatives in the word final position
Teaching fricatives will result in more accurate production of stops
Teaching voiced obstruents (stops, fricatives, affricates) will result in more accurate production of voiceless obstruents
Teaching sounds that are stimulable results in more accurate production than teaching sounds that are not stimulable
Sounds that are phonologically “known” will be produced more accurately than “unknown”
Teaching sounds of which a child has least phonological knowledge (most “unknown”) will result in changes across untreated aspects of the sound system

43
Q

Determining Starting Point for Targets

A

Was child stimulable for sound in isolation? Words? Does child produce sounds correctly with a verbal
model?
What word position(s) can child produce the sound correctly?
In what context (surrounding vowels, consonants) is sound correct?
Is there a key word that is consistently correct?
What is the highest level in which the child doesn’t produce the sound correctly?

44
Q

Use of Mobile Devices and Apps by SLP

A

Most SLPs and Audiologists use mobile devices, including laptops, in their practice
21-25% of SLPs use apps for professional purposes, while 55-61% expressed an interest in them

45
Q

Advantages to Using Apps

A
  • Replace outdated picture stimuli
  • Contain lots of resources and material in a small space
  • Portable to use for therapy in variety of locations
  • Motivating to children
  • Many apps offer scoring and data collection features
  • Many schools are supplying iPads to teachers and students
  • Potential to use for homework/carryover outside of speech therapy
46
Q

Disadvantages to Using Apps

A

-Financial investment in device and apps
-Children may be distracted by iPad
-iPads can break, especially in the hands of kids!
-Not all apps are created equal – important for the SLP to still have control in selecting and using apps for each individual on the caseload
-SLP still needs to provide the intervention – apps are merely another tool to use in therapy
-Families may choose to use apps to self-treat their child’s communication disorder
-Apps should support, not replace the teacher
-Important for the SLP to assess the child prior to
starting therapy (and app selection should be based on the child’s individual treatment plan)

47
Q

phonological awareness

A

“ Phonological awareness refers to the ability to recognize that speech is made up of sentences that can be broken down into words, syllables, intrasyllabic units and phonemes, as well as the ability to talk about, reflect upon, and manipulate these components. Phonological awareness occurs when children recognize that there are sounds in words and that these sounds can be talked about, reflected upon and manipulated.”

48
Q

why is phonological awareness important (research says)

A

Children with speech sound disorders are at an increased risk of having difficulties learning to read
30-77% of children with speech sound disorders struggle with reading
Phonological awareness tends to be less well developed in children with poor expressive phonology
Strong phonological awareness skills are characteristics of good readers, whereas children with poor phonological awareness skills in kindergarten and early school years are far more likely to become poor readers

49
Q

how does phonological awareness develop?

A

Phonological awareness skills develop in a predictable progression from whole to part
Acquisition progresses from larger units to smaller ones (word – syllable – phoneme)
Within each level, skills develop from blending to segmenting to counting to deleting

50
Q

segmenting Words Into Syllables

A 
Counting or clapping syllables in words 
Skill acquired by age 5 years old
Clap the syllables in these words:
-Truck
-Airplane
-Motorcycle
51
Q

Rhyme Awareness & Production

A

By age 4, children can imitate and enjoy rhymes
-Hickory, Dickory Dock, the mouse ran up the __
By age 4, children can also identify which word doesn’t rhyme when 3 words are spoken
-Cake – Cat - Snake
By age 5 1⁄2, children can produce a rhyming word:
-Tell me a word that rhymes with car

52
Q

alliteration

A

By age 5 1⁄2, children can identify words that begin or end with a certain sounds

  • Which words start with the [ʃ] sound?
  • Which words end with the [s] sound?
  • Tell me 3 words that start with [p]
53
Q

phoneme isolation

A

By age 5 1/2, children can isolate the initial and final sounds of words (segment initial and final sounds)

  • What’s the first sound in the word bus?
  • What’s the last sound in the word pan?
54
Q

blending sounds into words

A

Considered one of the two most critical skills for learning to read and spell

  • By age 5, children can blend onset + rime to form a word • What is the word? th-umb, qu-een, h-ope
  • By age 6, children can blend 2-3 phonemes to form a word
  • What is the word? [z] - [u], [ʃ]- [ɑ]-[p], [æ]-[n]-[t]
55
Q

segmenting words into sounds

A

Considered one of the two most critical skills for learning to read and spell
By age 6, children can segment 2-3 phoneme words into individual phonemes (Say the word slowly while you tap the sounds) [b]-[æ]-[k]; [ʧ]-[i]-[z]
By age 6 1⁄2, children can segment words of 3-4 phonemes into individual sounds, including blends
-[f]-[l]-[o]-[t]; [s]-[t]-[ɪ]-[k]

56
Q

delete and manipulate phonemes

A

By age 6 1⁄2, children can substitute phonemes in words to build new words

  • Say cane. Now change the /e/ to /o/.
  • By age 7-9, children can delete phonemes in words (initial & final phonemes easiest, medial & consonant clusters hardest)
  • Say meat. Say it again without the /m/
  • Say snail. Say it again without the /n/
57
Q

what is our role as an SLP with phonemic awareness

A
  • Be aware that children with speech sound disorders, especially phonological disorders, are at increased risk for phonological awareness delays & recognize the impact of phonological awareness on developing reading skills
  • Screen or assess phonological awareness skills in children with speech sounds as part of the assessment process
  • Systematically address areas in which the child is delayed, beginning with earliest developing skills that are not present
  • Incorporate literacy into therapy – use children’s literature!

SPAA 210 (3 decks)

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