Different Therapy Approaches – Test #2 – Flashcards

-linguistic based -employs pairs of words that differ only by a single phoneme -developing cognitive awareness of the difference between two sounds -most common type of contrast: subsituted or deleted sound versus target sound -ex. /t/ for /k/, pairs used might be tea and key or top and cop - select a sound based on sound pattern error, perceptual training where clinician says it and client picks the difference in pictures, have child imitate you with producing it, then have child say when picking pictures and then have them say it using carrier phrases -pairs based on what the client is saying and what the intended target is -words only differ in one sound feature

-minimal pairs are used, (according to place, manner, and voicing); sounds should differ in only one production features (tea - key) - can be used for individuals who primarily exhibit phonemic substitutions and who are stimulable for the target sound (not omissions or distortions) - not much research support; based on limited data, it appears that this approach may be useful if combined with a traditional approach - showing the client that saying a different word changes the meaning , used often in therapy - Caroline Bowen has a good website

- analyzing the individuals norm production and substitutions -considering place, manner, and voicing features and count differences -choosing sound substitutions reflecting the least number of differences in production features (f/v and d/v substitution - f/v differ in only one feature - voicing and d/v differ in two - manner and place) -considering intelligibility, stimulability and early vs. late developing sounds

-familiarize the client with the minimal pair words by showing pictures of each and describing them -show several examples of each word - client picks up or points to the picture named by the clinician -reverse roles: client must name a picture and clinician points to it or picks it up - sound substitutions will result in a communicative breakdown - oppurtunity is given for child to form communicative repair (self correct) - this attempt is reinforced by clinician pointing to, or picking up, the intended picture - use carrier phrase (i want, i found, i have)

Judy Gierut -for children with multiple errors, this training produces a greater overall change -"complexity approach" -enhance learnability and generalization -teach two new sounds that differed in place, manner and voicing -children with a restricted language should expand sonorants and obstruents

-similar to distinctive feature and minimal oppositions intervention approaches, except that this approach uses target sounds that are productionally very different -used with children who have moderate to severe phonological disorders -research shows better generalization when maximal oppositions are used as compared to minimal oppositions -clinically not used much

-imitation: minimal pair pictures are presented and the client is asked to repeat the clinicians model - several motivating activities are used (criterion =75% accuracy over 2-7 consecutive sessions) -spontaneous production: words produced by the client without a clinician model (criterion = 90% over three to 12 consecutive sessions) NOTEL protocol originated from a research project, practitioners may want to implement additional strategies -specific to the child, and later developing phonemes are used

-children with multiple sound errors, with severe to profound phonological impairments -phoneme collapse: one sound is used in place of two or more other sounds - systematic view instead of individual sound focus - help child reorganize their sound system by focusing on numerous contrasts at the same time -ex. if child subsitutes t in the final position for the k, ch and s then you would compare t with those three sounds (bat and back, bat and batch, bat and bass) this is a collapse - each collapse is a separate therapy target

-used with children who exhibit moderate to profound phonological disorders - designed to treat the collapse of multiple phonemic contrasts - example: (d >s, d>g,d>t,d>dz), word pairs that are /d/ with the rest of those - minimal pair words that go with this outline above - phoneme collapse: teach child nature of collapse (put on display) -Lynne Williams

- these sounds could be used to form minimal pairs such as: doe -show - go -though -joe (example from before) - treatment and phases include: +imitation phase +spontaneous phase +spontaneous contrasts/generalization phase (accuracy using untrained contrasts) -conversation-based phase

-Howell and Dean - SSDs who fail to respond to minimal pair therapy may need to be taught the characteristics of sounds as a way to facilitate development of sounds contrasts - this therapy helps to get the skills for minimal pairs therapy -teaching feature differences between sounds in order to develop awareness that sounds can be classified by characteristics -metaphonological skills: pay attention to the details of the phonological system -may start by showing the client long and short sounds and identifying features that belong with this (sorting long and short targets) and then having them apply this to communication

-based on metalinguistic awareness: the ability to think about and reflect on the nature on language and how it functions - structured to develop childrens metaphonological skills: the ability to pay attention to, and reflect upon, the phonological structure of language -explicitely tell the child how the sounds are made (ex. back of mouth) - rarely used

used for children with moderate to severe phonological disorders;typically have at least two or three processes predominating their speech patterns - selecting target sounds: +identify frequency of occurence of processes +implement more extensive probes of identified processes +consider childs phonetic inventory

developing phonological awareness - concept level -sound level -phoneme level - word level (using minimal pairs)

developing phonological and communicative awareness, the goals are: - transfer metaphonological knowledge from phase 1 to communicative situations - build awareness of communication breakdowns - develop phonological awareness to the level that the child will engage in communicative repair

use minimal pairs in relevant, motivating activities -positive feedback provided for correct production - for incorrect productions, SLP picks the word said

-minimal pair contrast intervention +distinctive feature intervention +minimal opposition intervention +maximal opposition intervention -phonological process intervention +cycles intervention +metaphon intervention - basic principles: +target groups of sounds +phonological contrasts are established +a naturalisitc communicative context is emphasized

if a childs phonological system is characterized by the persistence of only a few phonological processes, phonological process intervention/minimal pairs may be appropriate - if a childs phonological system is characterized by a wide variety of phonological processes and his/her speech is unintelligible, a cycles approach or metaphon intervention may be more appropriate

phonological processes should be chosen based on + their relative frequency of occurrence +their effect on intelligibility + the age and phonological development of the child -after phonological processes have been chosen, word pairs are chosen for minimal contrast training

-phonological acquisition is a gradual process (moving ahead and recycling), with mastery eventually occurring as sessions progress in accord with normal phonological acquisition - children with normal hearing typically acquire the adult sound system primarily by listening - as children acquire new speech patterns, they associate kinesthetic with auditory sensations, enabling later self-monitoring -phonetic environment can facilitate correct sound production -children are actively involved in their phonologic acquisition -children tend to generalize new speech production skills to other targets

-designed to assist children in acquisition of appropriate phonological patterns rather than eliminating patterns - a cycle is complete when all phonological patterns selected for remediation at a given point time have been treated - phonological patterns are recycled until target patterns emerge in spontaneous utterances - things are worked on based on time

-even if a process isn't suppressed, you can move on to another one and work on other ones - auditory bombardment: slightly amplified sounds

select phonological processes based on assessment (HAPP-3) -potential processes include those for which the child scored 40% or more errors (except for glides and non-strident anteriors) which requires 60% or more error

use stimulation to facilitate development of awareness of target patterns - auditory -visual -tactile -kinesthetic - production practice - developing semantic awareness (contrasts)

cycles - the period of time required for the child to successfully focus for 2-6 hours on each of his/her basic deficient patterns - select at least 2-6 target phonemes for each pattern; each phoneme is targeted for 1 hour per week (one 1 hour session;2 thirty minute sessions; or 3 twenty minute sessions

- final voiced obstruents (b,d,g,z,v) -weak syllables -interdental fricatives -velar nasal -postvocalic/syllabic /l/

-review prior sessions target -amplified auditory bombardment (because you yourself can distort) - child isnt suppose to know words, they are playing while doing this -production practice: begin with coloring target word cards (then experiential play activities) - working on /k/ then draw a picture of a key, pick 5 that are easiest and drill play for 5-7 minutes -selecting target for next session (stimulability probes) - imitate a new target -phonological awareness activities (rhyming, syllable segmentation) -amplified auditory stimulation (repeated) -home program (5 cards used in session should be used for 2 min. each day)

establishing priorities - primary targets to work on - secondary targets to work on (minimal pairs should be used whenever possible for these)

-based on concept of distinctive features as bundles of phonetic components that establish and distinguish between phonemes - when combined with minimal pairs, distinctive feature intervention uses minimal word pairs that exemplify the binary function (+ and -) of a certain distinctive feature - Chomsky and Hallee - example: consonantal vs. nonconsonatal features (whatever is a consonant would get a + and whatever isnt would get a -) - other examples: nasals, continuants, back, feature differentiation from /k/ to /g/ is voicing - you are teaching a feature to a child

-may be used when one phoneme is substituted for another - NOT appropriate for sound distortions or omissions

- list of all target phonemes and subsitutions -distinctive features representing the target phonemes - DF representating substitutions -summary of feature changes and the number of affected phonemes

-choose based on frequency of occurence -if several demonstrate high frequency, choose the distinctive feature that affects a whole class of sounds (fricatives) or groups of sounds (voiced stops)

- one sound has the feature, the other does not -priority is given to sound pairs that represent a change in the least number of features -early developing sounds have priority over later developing sounds - determine word pairs that contain the selected sounds (based on common usage)

1. discussion of words: name pictures, ask question about pictures 2. discrimination testing and training: clinician randomly repeats the two words and child points to picture (criterion=7 consecutive correct) 3.production training: child says the words while the clinician points to the pictures; if child cannot produce the word, then traditional approach may be used at the word level 4. carry-over: use progressively longer carrier phrases (a+word, the+word, touch the +word ... and get longer)