Behavior Modification

Front 1

What is behavior modification? How can it be applied to physics?

Back 1

Behavior modification is a set of principles that can be applied to any treatment. When applied to physics, it can predict the occurrence of events.

Front 2

A behavior is increased if a _____ consequence follows. A behavior is decreased if a _____ consequence follows.

Back 2

desired
undesired

Front 3

What is the goal of behavior modification? What are the procedural steps?

Back 3

To habitually and spontaneously produce a behavior in everyday speaking and listening situations.
1. establish behavior
2. stabilize/strengthen behavior
3. generalize behavior
4. maintain behavior

Front 4

What is fading?

Back 4

Gradually reducing a stimulus or consequence while maintaining the target response.

Front 5

What is an antecedent?

Back 5

Any type of stimuli used to evoke a response from a client.

Front 6

What are the stimuli types? What are teaching strategies used for?

Back 6

1. Clinician support
-direct physical manipulation
-imitation or modeling
-cues and prompts
-indirect modeling
-spontaneous
2. input (material used to evoke response)
-abstract symbols
-concrete symbols

Front 7

What is successive approximation? What is phonetic placement?

Back 7

Successive approximation are step by step instructions to teach the child to produce a sound. Usually used when direct modeling and prompts don't work.
Phonetic placement is use of direct methods to teach where the client should position the articulators for appropriate manner.
done by:
-direct manipulation
-kinesthetic cues (peanutbutter)
-verbal instructions
-modeling

Front 8

What is a consequence? What is its goal?

Back 8

A consequence is an even that is contingent on and immediately following a response. It's goal is to increase a desired behavior or decrease an undesired one.

Front 9

What type of consequence increases desired behavior? What type decreases unwanted behavior?

Back 9

Reinforcement increased desired behavior and punishment decreased undesired behavior.

Front 10

What is positive reinforcement & it's types.

Back 10

Positive reinforcement is a rewarding event presented upon desired behavior. 3 TYPES:
1. primary: biological in nature; powerful & resistant to fading, susceptible to satiation. (food)
2. secondary: must be learned to be a good thing. Can be praise, token, or feedback (verbal, visual, biofeedback)
3. self-reinforcer: the client's knowledge of producing correct sound. More effective than outside feedback.

Front 11

What is Negative Reinforcement and it's types?

Back 11

Negative reinforcement is the removal of an undesired condition upon presentation of a desired behavior.
Escape: performing a desired behavior to terminate an unwanted condition.
Avoidance: performing a desired behavior to prevent an unwanted condition from occurring.

Front 12

What is punishment? What are the types?

Back 12

Punishment is an unpleasant event presented due to the performance of an unwanted behavior. Used to DECREASE UNWANTED behavior.

TYPE 1: prompt unwanted event upon presentation of undesired behavior.
TYPE 2: removal of a pleasant condition upon presentation of unwanted behavior.

Front 13

What is extinction?
What is schedule of reinforcement?

Back 13

Extinction is the decrease and disappearance of a target behavior behavior due the lack of consequence.
Schedule of reinforcement is the frequency upon which a reinforcer is presented upon correct response.

Front 14

What are the two schedules of reinforcement & their characteristics?

Back 14

Continuous SoR: The reinforcer is presented every time a correct production is made. *initially generates high rate of response *good for establishing or transitioning to new level of complexity *susceptible to extinction

Intermittent SoR: reinforcers only follow some correct responses.
*good for stablizing a behavior
*resistant to extinction

Front 15

Describe FR & VR.

Back 15

Two types of Intermittent SoRs.

FR: Every 2 correct, every 5 correct, etc.

VR: predetermined pattern of reinforcing set by the clinician and repeated. (3, 5, 8, 10, repeat)
*more effective than FR

Front 16

How does the degree of difficulty of the target response progress?

Back 16

increase in length and complexity.
isolation-->syllables-->word-->
phrases-->sentence-->
conversation

decrease of latency between stimulus and response.

Front 17

What is conditioning? How do you avoid it?

Back 17

Conditioning is a learned process by which a behavior becomes dependent on an event occurring in it's environment. To avoid it, vary the setting, environment, audience, situation, and stimuli when teaching a behavior.

Front 18

What are the three crucial aspects of behavior modification?

Back 18

immediacy of consequences
consistency
relevant and appropriate feedback

Front 19

What is the hallmark of the traditional approach?

Back 19

The hallmark is a progression from sensory-perceptual training the the maintenance of the newly acquired sound.

Front 20

What are the phases of the traditional approach?

Back 20

1. Sensory-perceptual/ ear training
2. Production training: sound establishment
3. Production training: sound stabilization
4. Transfer/carry-over training
5. Maintenance of behavior across time

Front 21

Describe the staircase of the traditional approach, beginning at the first step.

Back 21

1. Identifying the sound
-auditorily, visually, tactily
-isolating the sound from others
2. Knowing the sound
-sound properties
-familiar with the sounds in different contexts
3. Discriminating the sound
-detecting errors in others
-recall, perceive, and predict errors
4. Producing the sound (with help)
-imitating sound correctly
-correct placement of articulators
-shaping sound to correct production
5. Producing the sound with ease
-sound in isolation or syllables
-in words, phrases, sentences
-in reading
-in conversation
6. Transfer & carry-over
-generalize to other environments: school, home
-use in different situations
7. Maintenance over time.
-repeating any of the steps below if necessary

Front 22

Name/describe the first phase. What are the 4 phases of it?

Back 22

1. sensory-perceptual/ear training
-teaching auditory discrimination of the sound; make child aware of production errors. thought to be foundation of production training
4 PHASES:
1. isolation-teach auditory/visual/kinesthetic properties of sound; goal is to recognize sound in isolation
2. identification-teach how to isolate sound when in words, phrases, or sentences
3. stimulation-increase sensitivity to the occurrence of the sound and to develop an internalized auditory model. "Auditory bombardment"
4. discrimination
-discriminate correct/incorrect production of the sound in others.
1. error detection
2. error correction

Front 23

Name/describe the second phase.

Back 23

Production training: sound establishment
-evoke and establish new sound to replace child's errored production.
-can use combination of stimuli techniques (direct physical manipulation, phonetic placement, contextual cues, successive approximation)

Front 24

Name/describe the third phase.

Back 24

Production training: sound stabilization
-correct production of established sound is stabilized at various levels of complexity.
isolation-->nonsense syllables --> phrases-->sentences--> conversation

Front 25

Name/describe the fourth phase.

Back 25

Transfer and Carry-over phase
-stabilized sound is produced correctly in extra-clinical situations and everyday settings.
-related to conditioning
-transfer= generalization
-carry-over= correct production in everyday conversation
RULE: DO NOT START PHASE 4 UNTIL CHILD HAS MASTERED IT IN TX

giving child speech assignments-make sure it is practical, realistic, and individualized. consider accuracy of peer/parent judgment and keep in mind family lifestyle.

*one of the most important and most difficult aspects of tx.

Front 26

Name/describe the fifth phase.

Back 26

Maintenance across time-ultimate goal* maintenance of new learned skill in various natural environments across time.

Front 27

Give an evaluation of the traditional approach.

Back 27

-teaches individual sounds, not processes
-establishment, stabilization, and transfer/carry-over are essential to ANY tx

limitation: some steps may be unnecessary for client

Front 28

What are the advantages of the traditional approach?

Back 28

-use of modeling
-positive reinforcement
-corrective feedback
-repeated practice
-varied linguistic/phonetic contexts
-extensive efforts for carryover
-teaching self monitoring skills

Front 29

What is the sensorimotor approach? What test is used? What is the theory of it?

Back 29

The sensorimotor approach uses facilitative phonetic contexts/coarticulation to evoke the correct phonetic production. McDonald's Deep Test of Articulation is used. The theory is that each phoneme can be produced in at least one phonetic context.

Front 30

What are the steps for the sensorimotor approach?

Back 30

1. Watchsssssssss-sun.
2. Watch, sun will burn you.
3. Watch-sea, watch-sit, watch-send
4. Reach-sea, teach-sit, which-sale
5. book-sun, cat-sun, mop-sun

Front 31

What are Shine & Proust's modifications to the sensorimotor approach?

Back 31

Shine and Proust added behavior modifications to it and added token reinforcement & verbal feedback.

Front 32

What is the multiple phoneme approach? Who is it best for? How is it similar to the traditional approach?

Back 32

MPA teaches multiple phonemes simultaneously & analyzes sound production in conversation. Best for children with 6+ articulation disorders. Similar to TA in regards to establishment, transfer, and maintenance phases, progression of complexity, and criteria for mastery at each level.

Front 33

How is assessment done for the Multiple Phoneme Approach?

Back 33

Whole Word Accuracy taken of a sample of 150 conversational speech words. 90 errored words/150= 60WWA.

Front 34

Describe the stages of the multiple phoneme approach.

Back 34

ESTABLISHMENT:
Level A#1: Visual cueing only
(if client cannot produce target, move to level C)
Level C: auditory + visual +
Level B: auditory + visual
Level A #2: Visual cueing only.
TRANSFER:
sound from syllable-->words--> phrase/sentence--> reading/story -->conversation
*picture books for preliterate children w/ make up stories

MAINTENANCE:
90% WWA
Client skills monitored for 3 months

Front 35

What is the Paired-Stimuli Approach? Who is it best for? What is a key word?

Back 35

Best for few misarticulations and sound distortions. PSA identifies a keywords to teach target sounds in other contexts. A keyword is a word that a target sound occurs in only once and is produced correctly 9/10 times.

Front 36

Describe the first level of the paired stimuli approach.

Back 36

Word level:
identify 4 key words (2 initial, 1 medial, and 1 final) and 10 training words (words where the target sound occurs only once in initial or final position and is misarticulated 2/3 times)
kw-tw-kw-tw-kw-tw etc.

training string: a successful pairing of the keyword with 10 training words.

Front 37

Describe the second level of the paired stimuli approach.

Back 37

SENTENCE LEVEL:
Ask questions to client include the keyword and training word.
Q:"Did the FAN blow the FLOWERS?"
A: "yes, the FAN blew the FLOWERS."

Front 38

Describe the third level of the paired stimuli approach.

Back 38

CONVERSATION LEVEL:
Ask open ended questions, only stop for two things:

1. To give child a reinforcer for every 4 correct responses
2. To provide modeled correction production for all incorrect productions.

Front 39

What is the Distinctive Feature Approach? What is its theory?
What is its goal?

Back 39

The distinctive feature approach is the first patterned based approach that finds and targets patterns in errors. It is a method of error analysis before&after tx. The theory is that if a child is missing (a) distinctive features, that leads to patterned errors of articulation. The goal is to establish the missing DF features which will lead to generalization.

Front 40

Step 1 of the DFA

Back 40

**Use nonsense syllables for both step 1 and step 2

1. Ask client to produce a consonant in which the feature is lacking

Front 41

Step 2 of the DFA

Back 41

2. Ask child to produce a minimal pair of the phoneme.

Front 42

Who is the Cycles Approach for? What does it combine? What is a cycle?

Back 42

CA is best for severely unintelligible children with several phonological processes. It combines auditory bombardment and production practice. A cycle is a period of time during which phonological patterns in need of remediation are successively facilitated. Cycles may last 5-16 weeks.

Front 43

What is the main concern for selection in the CA? What are the 2 main steps in selection of target patterns?

Back 43

Main concern for selection is intelligibility.
1. Create a hierarchy pf phonological patterns present at least 40% of the time during assessment
2. consider the most stimulable patterns as most optimal and first so the child can achieve immediate success.

Front 44

What are the potential primary target patterns and phonemes in the CA? What are the potential secondary target patterns? Advanced targets?

Back 44

Potential Primary Target Patterns FIRST CYCLE:
1. early developing patterns (word initial/final, nasals, stops, glides, cvc/vcv structures)
2. posterior/anterior contrasts (k/g, d/t, p/b)
3. /s/ clusters
4. liquids

POTENTIAL SECONDARY TARGET PATTERNS CYCLE 2
1. voicing
2. vowel contrasts
3. singleton stridents
4. other consonant clusters

ADVANCED TARGETS
1. multisyllabic words
2. complex consonant sequences

Front 45

How is the structure of cycles in the CA?

Back 45

1. 1 pattern per session
2. each phoneme within a target pattern should be trained for approx. 60 minutes
3. 2+ targets per pattern for voicing errors (so at least 2 hours per pattern)
4. the cycle is complete when all patterns have been taught
5. at least 3-6 cycles for gained intelligibility

Front 46

How are the sessions structured in the CA?

Back 46

1. review of previous session
2. auditory bombardment
3. word cards
4. productions practice
5. stimulability probing for next session
6. auditory bombardment
7. home program
*shift activities every 5-10 minutes so child doesn't lose interest

Front 47

Describe the Phoneme Contrast Approaches

Back 47

-"cognitive linguistic" approaches
-The target selection is different for each
-significant in generalization
-2 or more target sounds with contrasting features are taught at the word, phrase, and sentence level.

Front 48

What are the 3 ways contrasting features are taught? Describe.

Back 48

MINIMAL PAIRS: most common approach. Only 1 phoneme contrast; productions must be semantically meaningful.

MAXIMAL CONTRAST: multiple or all features contrasted. It's different from MP in that we must pair an already mastered sound with an incorrect sound.

MULTIPLE CONTRASTS:
*used for children who substitute different sounds for one sound.
-several multiple pairs used to contrast all errors
-multiple sets may be used.

Front 49

What is assessment? What are the three diagnostic purposes of assessment? What is dynamic assessment?

Back 49

Assessment is the process and procedures used to attain a clear description of articulatory and phonological skills of a child with a view in determining the presence or absence of a disorder.

The three diagnostic purposes of assessment:
1. Is there a phonological or articulation disorder?
2. If so, what is the nature and severity?
3. State prognosis and recommendations for management.

Dynamic assessment is a clinical activity that precedes treatment, often continues through treatment, and is repeated before dismissal and during follow-up.

Front 50

What things must we understand about the nature of the disorder?

Back 50

-understand the characteristics of the disorder and any contributing (causal/correlation, communication style of the family, exposure, interaction, culture, etc) factors.

Description of what the child DOES and DOES NOT do (existent and nonexistent behaviors) and CAN DO (i.e with prompting) vs DOES DO (habitually)

Know strengths, limitations, and needs of the child/family.

Front 51

What is the purpose of screening? How long should it take?

Back 51

Screening quickly identifies people who communicate within normal limits and those who may have a communication disorder and need further assessment. It should not take more than a few minutes.

(does not have to be formal, but some formal tests are The Denver Articulation Screening Test & The Preschool Language Scale)

Front 52

What are the overview steps of assessment? (8 steps)

Back 52

1. Review client background
2. Plan the diagnostic session
3. Select appropriate tests
4. Prepare testing area
5. Conduct an intake interview
6. Assess the child (observation, nonstandardized/standardized measures, assess related areas)
7. Write a diagnostic report
8. Discuss findings and make recommendations

(Reverend P Selected Prep Classes After Wrong Doing)

Front 53

Define the characteristics of standardized assessment. What are the two types of standardized tests?

Back 53

Standardized assessment yields results that are pass or fail and often include normative data. Two types are norm-referenced score interpretations and criterion-referenced score interpretations.

Norm referenced score interpretations take the client's score and compare it to others' scores. Criterion referenced takes the client's scores and solely relates it back to the subject matter being tested, not the scores of others.

Front 54

Describe the characteristics of nonstandardized assessment measures. When does it start?

Back 54

Nonstandardized assessment yields information about the child's articulation and phonology. May include any SLP-designed measure. It starts from the moment you meet the client/family.

Front 55

What does a connected speech sample help us obtain? How many utterances should it contain? How can we engage the child to speak?

Back 55

A connected speech sample will help us obtain:
1. omissions, substitutions, distortions, and additions
2. A phonological pattern analysis
3.Phonetic inventory or repertoire
4. Syllable structure analysis
5. Level of speech intelligibility.

It contains 50-150 utterances.

To engage a child, we must first learn of the child's interests and prepare the clinic with age-appropriate and interesting toys. (consider placing them in hard to reach places) Make sure atmosphere is relaxed and non intimidating. Take advantage of the presence of family members.

Front 56

When transcribing the speech sample, do we use broad or narrow transcription for sound substitutions? What about sound distortions?

Back 56

Sound substitutions-broad transcription

Sound distortions- narrow transcription

Front 57

What is stimulability? What are the two main reasons for stimulating?

Back 57

Stimulability is a child's tendency to produce a correct or improved production of a misarticulated sound when given a model or additional stimulation by the clinician.

2 main reasons:
1. prognosis (this is controversial)
2. target selection during treatment.

Front 58

What is contextual testing? What are key words? What is the test associated with this? Is it formal or informal assessment?

Back 58

Contextual testing is a special procedure that can help identify facilitative phonetic contexts for correct production of a particular phoneme.
--facilitative context is a surround sound/group of sounds that has a positive influence on the production of a misarticulated phoneme.

Key words are certain phonetic environments that facilitate correct production of a phoneme.

Associated with McDonald's Deep Test for Articulation (1964)

It is informal assessment.

Front 59

Children with artic/phonological disorders can ___a____ their own sound errors when made by the clinician even if they cannot __b___ the sounds.

What is this called? Inaccuracy of it is related to what?

Back 59

a. discriminate
b. produce

Called speech discrimination. Inaccuracy is related to second language acquisition.

Front 60

Research suggests that treating ___a___ alone does not lead to better production while _____b_____ leads to both benefits in _c___ and __d__ skills.

Back 60

a. speech discrimination
b. production training
c. production
d. discrimination

Front 61

What is the difference between intra-auditory discrimination and inter-auditory discrimination?

Back 61

intra-auditory discrimination-discriminating errors in one's own speech

inter-auditory discrimination- discriminating errors in someone else's speech

Front 62

What is independent analysis and what is relational analysis? What does a thorough examination include?

Back 62

Independent analysis describes the child's speech productions without reference to the adult model. (The child's repertoire and syllable structures)

Relational analysis describes the child's speech with reference to the adult model. (phonological patterns; omissions, substitutions, additions, distortions)

A thorough exam includes both independent and relational analysis.

Front 63

Define severity. What are its ranges? What is it based on? (4 things) How do you find the Percentage of Consonants Correct & what is the scale?

Back 63

Severity is the degree of impairment in a particular client. It ranges from slight to profound.

Based on:
1. intelligibility
2. number of sounds in error or phonological processes present
3. consistency of the errors
4. age: consider the norms.

To find the PCC, divide the number of correct consonants over the total number of consonants and multiply by 100.

PCC SCALE:
<50=severe
60-65= mod-severe
65-85= mild-mod
85-100= mild

Front 64

When making a diagnosis, what are the 3 situations in which the child's speech is considered normal? What must be considered?

Back 64

1. The errors are related to second language interference, bilingualism, or dialect.
2. The errors fall within normal development range of mastery for a particular age group.
3. The errors are so slight or subtle they would not call undue attention to the speaker or be perceived as disordered to the average layperson.

Must consider family/client's perception of the problem.

Front 65

A prognostic statement specifies what? What is it based on, and what are the various prognostic variables?

Back 65

A prognostic statement specifies the course of improvement under treatment. It is based upon the available information at the time of assessment.

Variables:
-age
-intelligibility
-motivation
-inconsistency of errors
-associated conditions
-treatment history
-family support

Front 66

What 3 main components make up a well-written prognostic statement?

Back 66

1. A goal statement
2. A judgment of success (poor, fair, good, excellent)
3. The prognostic variables that justify the judgment.

Front 67

"Is speech and language tx appropriate for this particular client?"

What are the 4 possible answers?

Back 67

1. Normal articulation and phonological skills--> tx is not recommended
2. Within normal limits but tx is not recommended and re-evaluation is.
3. Articulation or phonological disorder but immediate tx is not recommended
4. Articulation or phonological disorder and tx is recommended. (along with frequency/length of sessions, specific therapy goals and objectives)