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222 Cards in this Set

  • Front
  • Back
Apraxia of Speech - What is it?
-motor planning disorder resulting from neurological damage
Characterazation of Apraxia
difficulty in execution of volitional movements inthe absence of muscle weakness, paralysis or incoordination
Simple Test for Apraxia
Stick tongue out - will not work if client has to think about it, but if you place ice cream in front of them, the tongue would automatically work.
Three Types of Apraxia
Oral
Limb
Verbal
What is oral apraxia?
problems with executing volitional nonspeech movements of the oral muscles (stick tongue out)
What is limb apraxia?
volitional movement difficulties of the arms and legs,

(wide based gait, off balanced look)
What is verbal apraxia?
impaired ability to program and execute volitional movements for the production of phonemes and words.
General Characteristics of Apraxia in Adults
-They know they have it
-volitional sequencing of movements required for speech are notably effected
-automatic speech is less noted (counting, singing familiar tune, etc)
-highly variable speech errors (different kinds of erros on repeated attempts)
Apraxia in Adults Artic. Errors
-Substitutions, distortions, and omissions
Anticipatory Substitution noted in Apraxia patients
pospital for hospital
phoneme that occurs later in the word affects one that occurs earlier
Regressive Substitution noted in Apraxia patients
tatle for table
phoneme that occurs earlier in the word affects one that occurs later
Metathetic Errors
switching position of phonemes in words
tephelone for telephone
Assessment of Apaxia in Adults (9)
1) automatic speech tasks
2) Imitative production of single speech sound
3)DDK rates
4) Imitation of single words
5) Imitation of multisyllable words
6) imitation of words increasing in size (zip, zipper, zippering)
7) repeated imitative production of words
8)imitatation of sentences
9)standardized measures
Childhood/Developmental Apraxia aka Developemental Verbal Apraxia
childhood disorder of unknown etiology; errors are similar to adults
Childhood/Developmental Apraxia Characterisitics
-Moderate to severe speech intelligibilty
-inconsistent or variable sound errors
-unusual articulation errors
-slow ddks
-gap in receptive (higher)/expressive (lower) lang.
Childhood/Developmental Apraxia Assessment
Nonimitative Speech Prod Skills (GFTA)
Imitative Speech Prod
DDKs
Intelligibility
resonance problems
-formal (screening Kaufman Speech Praxis Test)
What is Dysarthia?
neuromotor speech disorder effection one, various or all parameters of speech prod: respiration, phonation, resonance, articulatioin, and prosody (stress rate patterns)
(mumble quickly or speak slowly)
Muscle is damamged, drooping, muscle weakness
Names the 7 types of Dysarthia
1) Flaccid
2) Spastic
3) Ataxic
4) Hypokinetic
5) Hyperkinetic
6) Mixed
7) Unilateral Uppoer Motor neuron Dysarthia
What is Flaccid Dysarthia
lower motor neuron damage
(bublar palsy)
What is Spastic Dysarthia
bilateral upper motor neuron damage (hyperfunctional voice/strained)
What is Ataxic Dysarthia
damage to cerebellum resulting in coordination problems
What is Hypokinetic Dysarthia
basal ganglia damage (Parkinson's)
client has a 'rest tremor'
twitching/masked face
What is Hyperkinetic Dysarthia
basal ganglia damage (Huntington's Korea)
too much movement, facial ticks, excessive blinking
What is Mixed Dysarthia
combo of 2 or more, normally
Flaccid and Spastic is hte most common
MS ->spastic and ataxic
Lou Gehrig's
Ataxic and Wilson's
Assessment of Dysarthia (8)
connected speech production (over conversation time artic. decreases)
speech production mechanism (oral exam)
DDKs - slow
Respiratory Problems
Phonatory Problems
Resonance Problems (Hypernasality)
Artic.Problems
Prosodic Problems
Standard Measures for Dyarthia
-Frenchay Dys. Assessment
-Assessment of Intelligibility of Dysarthic Speakers
-Dysarthic Examination Battery
What is cerebral palsy?
non progressive, neuromotor disorder resulting from brain damage before, during, or shortly after birth
-not inherited
-does not get worse
Etiologies of Cerebral Palsy
-Prenatal
-Perinatal (trauma during birth)
-Postnatal - sepsis, premie, head trauma
5 Classifications of CP for paralysis
1) quadriplegia
2) diplegia
3) paraplegia
4) hemiplegia
5) monoplegia
What is quadplegia
paralysis involving trunk AND all four extremities (chest up and arms)
What is diplegia
paralysis involving corresponding extremities on both sides of the body (arms or legs)
What is paraplegia
paralysis involving lower trunk and legs (chest and down)
What is hemiplegia
paralysis involving one SIDE of the body
What is monoplegia
paralysis involving a single extremity (uncommon)
Classifying CP (5)
Spastic (50%, exaggerated stretch reflex (rigid and relaxed), slow and effortful, jerky voluntarty movements)
Athethoid (10%) slow writhing movement (involuntary)
Ataxic (5-10%)- balance issues
Rigid (1%) - simulataneous contraction and release of all muscles at once - worse kind, exhausting
Mixed (30%) Combination of one or more than one type (Spastic and Athetoid)
Cerbral Palsy Speech Problems (6)
Artic Problems
Resonatory
Phonatory
Respiratory
Prosidic
Associated - tight heel cords
CP - Assessment (8)
1) Neuromotor Functions
2) Motor Development
3) Mental Dev
4) Speech Disorders and Intelligibility
5) Prosodic Problems
6) Voice and Respiratory Problems
7) Oromotor Dysfunction (tongue thrust)
8) Augmentative/Alternative Communication (need another way to communicate needs)
Cleft Lip and Palate - Describe
Incidence
2 Causes
-1 in 600-750 births
-usually associate with an autosomal dominant syndrome
-environment teratogens (alcohol, drugs, etc.)
Cleft Lip and Palate Artic Characterisics (6)
More difficulty with voiced sounds
decreased intraoral pressure
velopharyngeal inadequacy
nasal emissions
vowel distortions
compensatory errors (glottals, laryngeal stops and fricatives)
Cleft Lip and Palate Assessment
Feeding Problems
connected speech production
speech production mechanism (oral exam)
artic and phonological problems
phonatory problems
resonance problems
Hearing Impairment Types
Conductive (can be fixed)
Sensorineural (perm)
Mixed
Hearing Impairment Articulation Problems
(Hint: 3 out of 6 are Os)
Omissions of final consonants and consonant clusters
omissions of /s/ across word positions
omission of inital consonants
imprecise articulation
epenthesis
inappropriate release of final stops
Hearing Impairment Voice and Resonant Problems
high pitched voice, harsh, hoarse, normal lack of intonation
Hearing Impairment Prosodic Distrubances
limited fluency
increased rate of dysfluency
slow rate of speech
inapproriate pauses
Hearing Impairment Associated Problems with language
limited vocab
poor comprehension of words
shorter sentences
pragmatic problems
poor reading comprehension
omission of several grammatical morphemes
Hearing Impairment Assessment
consult audiologist
auditory preception/speech discrimination
speech prod mech.
artic. and phonological assessment
connected speech sample
voice and resonance problems
How to select a treatment target (4)
what method is going to be used for target selected?
1) Stimulability
2) Emerging Sound
3) Key Word
4) Phonetic Placement/Shaping
Stimulability as a treatment target, explain
-is where the client is able to physically produce the sound.
-the therapist uses
max visual and kinetic clues
Emerging sound as a treatment target:
one produced correctly on 10 to 49% of all occassions in one or more phonetic environments.
-easier to generate
When would you want to use Key word as a treatment target
-client successfully produceds treatment target in one word, but not other words.
Ex: Kyle, kite, kick (paired stimuli)
Phonetic Placement and Shaping should be used when?
use this when the client has the ability to respond to these methods of manual guidance
How should you determine the number of treatment targets?
Traditional Approach: 1 per session
Phonological Approach: More than one (ex all fricatives or all stops)
BUT alter the environment, activity or method
When to change the treatment targets? (switch from one sound to another)
3 criteria
1) Flexibility Criterion
2) Time Criterion
3) Percentage Criterion
How is time criterion different than percentage criterion?
Time is when you work on a target for certain period of time each session, works well for both Traditional and Ph. Approaches
Percentage is where you work on a sound until a certain percentage is obtained (90% mastery).
Which is used most (Flexibility, Time or Percentage) for when to change a treatment target?
Percentage
What is Flexible Criterion for knowing when to switch treatment targets?
When the client is disinterested...switch, therapy should be FUN!
Name all the Linguistic Levels (6)
Isolation
Nonsense Syllables
Words
Phrases
Sentence
Spontaneous Speech
How do you know which Linguistic level does a child work best at?
GFTA will help
When client is 70-75% then move up or perhaps need to switch back down if need to
Generally you work at ___ linguistic level until criteria is met, then move ___ a level
ONE, UP
Criteria for moving up a Linguistic Level
Bingham - 70-75%
Others - 85-90%
Phonetic Environment - Word Position? Name 3
Initial, Medial and Final
Phonetic Environment - Syllable Position? Name 5
Initial
Final
Intervocalic
Stressed
Unstressed
Adminiatrative Decisions - Types of Sessions? and determined?
Group or Individual
Determined by setting and number of clients needing treatment
Group Therapy is better for ____ stages
later
Group Therapy is great for (2 things)
Generalization
Conversational Dialogue
Individual Therapy is ideal in the _____ stages of therapy
EARLY
Besides Group or Individual Therapy, what is an alternative?
Overlap Sessions
Group therapy is most likely in this setting:
schools
Individual or Group best for sounds in words at word level?
Individual
Frequency of Rx Sessions is determined by?
Severity, Time avail, client avail, and MONEY
(remember teachers times as well, you do not want to pull a kid away from recess or art)
Length of Rx ACTIVITIES is deteremined by?
Age
Interest
Attention
Behavior
Group/Ind Rx
Length of Rx SESSIONS is determined for Individual?
and ideally? but realistically?
From 10 - 60 min
Ideal is 20 min
Realistically, in a school it will be 15-25 minutes
Length of Rx SESSIONS is typically ___ for Group, but ideal is ____?
From 30-45 min, ideal is 45
Format of Activities during Rx?
Drill
What does drilling do for therapy? and what is it best used for?
Presents materials for mass practice
VERY important
More drill, more progress
GREAT for ARTIC problems
Drill Play - during therapy?
game boards, cards, checkers, action games (hungry hippo (20 prods for each marble), lucky ducks, frog on a lily pad)
Drill - Structured Play during therapy
Shopping (grocery store for /l/ phoneme - lima bean, lemons, lemonade, limes, lollipops, etc.)
Basketball
doll house
car racing
alligator golf
Play during therapy should be:
child oriented activities that are spontaneous:
-what does the child want to play/discuss
Where can play therapy occur?
Rx. room, home, grocery store, soccer field, wal-mart, anywhere)
Maintaining in Therapy - making sure the new skill does not get lost by
working with family
How to Assess the Treatment Chosen, is it working?
Pre and Post Tests
Intelligibility and Severity Tests
Assessing the Treatment using Pre and Post Tests are (2) and give examples of tests
quick and easy, demonstrates progress
what kinds? CPAC Probes, Homemade, etc.
Assessing the Treatment using Intelligibility and Severity Tests - describe
What does the book suggest?
Why is negative/positive about it?
What are other options?
books suggest using 3 different clinicians, not enough time for this
-time consuming
BUT
-effective for intelligibility clients
in clinic, you can use lang. sample to compute intelligibility (evidence based practice)
Assessing the Treatment - how often and why?
ONgoing!
Keep running data to know:
where client is
when to move to next step
IS REQUIRED by schools and most insurance co.
Elicitation and Facilitation - 4 stages of Articulation and Phonological Development (age ranges)
Stage 1 (0-12 Months)
Stage 2 (12-24 Months)
Stage 3 (2-5 years)
Stage 4 (5 and up)
What do the Articulation and Phonological stages refer to?
a level that corresponds to client's articulation and phono. development
-may or may NOT be client's age
Therapy during Articulation and Phonological Stage 1 does what
facilitate practice of vocal skills that serve as a basis for later speech development.
Ex - encourage phonation babbling
Therapy during Articulation and Phonological Stage 2 does what
Facilitage the acquisition of sounds and syllables in specific words
Ex: 1st word syllables
Therapy during Articulation and Phonological Stage 3 does what
Facilitate the elimination of errors affecting classes of sounds
(Focus on reducing the errors)
Therapy during Articulation and Phonological Stage 4 does what?
Facilitate the elimination of errors effecting late-acquired consonants, consonant clusters, and unstressed syllables in more difficult syllablic words
What are the later acquired consonants?
r, l, z, th, s, blends
What is a therapy technique for Articulation and Phonological Stage 1
Motherese
What are some techniques Therapy during Articulation and Phonological Stage 2
Expansion
Requests for more info/clarification
Modeling
Parallel Talk
What are some techniques Therapy during Articulation and Phonological Stage 3
Expansion and Parallel Talk
STRATEGIC ERRORS
Modeling
Requests for more info/clarification
What is a therapy technique for Articulation and Phonological Stage 4
Direct Instruction
What is motherese?
baby talk
serve to capture and keep infant's attention
What is expansion (during therapy)
fill in the incorrect or missing speech
Child says: Kitty
You say: Yes, a furry, little, white Kitty
What is strategic error during therapy?
speech errors that mimic aspects of the cleint's artic disorder
ex: fronting - tar for car
see if child will correct you
What is modeling during therapy?
use of clinician, another person, or toy as speech example (extra person serves as a role model)
Parallel Talk - what is it?
clinician narrates client's actions and interaction with objects
How do you use the request for confirmation/clarificatio technique?
used to focus the client on communicative inadequacy of speech...sometimes can irritate child
Other techniques used during therapy?
Bombardment
Metaphors
Descriptions
Demonstrations
Touch Cues
Word Pairs
Shaping
What is bombardment technique?
few min to 10 minutes -read practice words at elevated volume while client listens
What is the metaphor technique? and when is it effective?
compare some aspect od speech to something with which the client is familiar.
/s/ is the snake sound
not effective for stage 1 or 2
What is the description technique? and when is it effective?
describe what is happening to client's articulators..for /p/ you could say the /p/ sound is where you close your lips and build up air and release it quickly, not effective for stage 1 or 2
What is the demonstration technique? and when is it effective?
using tissue or puff balls to illustrate air puff in /p/ sound
good for stage 3 and 4
What is the touch cue technique? and when is it effective?
designed for clients with oral-motor dysfunctions...purpose is to draw attention to place of production. For example - /k/, place finger on upper most part of the neck to show it is a back sound. good for stage 3 and 4, some 2, but also hearing impaired.
/s/ sound point to lips.
What is the word pairs technique? and when is it effective?
words that differ from eachother by one sound or distinctive feature:
car/tar
bee/pea
using meaning of words to facilitate perception and production of correct sound.
good for stage 3 and 4. (bingo game is good)
What is the shaping technique? and when is it effective?
use a sound client can already produce to learn a new sound.
/s/ -> /th/ by opening mouth and moving tongue forward.
good for stage 4 and possibly advanced stage 3.
What is the phonetic placement technique?
/l/ example
using tongue depressor touch aveolar ridge
clinician is TOUCHING WHERE TONGUE SHOULD GO.
What is the manual guidance technique?
put gloved hands or depressor on child's articulators and physically move the articulator to where it should go
ex: /k/
push back tongue with depressor
what is the verbal or physical prompt technique? (touch cue)
vocalic /r/ example: demonstration with hand
(hold out hand to demonstrate how tongue is bunched when producing /r/)
/k/ - touch back of upper throat
Physical Prompts are the same as Manual guidance. (T/F)
FALSE
What is different about Physical prompting and manual guidance technique?
manual - move the articulators
physical prompt - demonstration of artic or touching placement outside artic (upper throat)
Ex /k/
-pushing tongue back with depressor is manual guidance
-touching back of throat is physical prompt
Traditional Articulation Approach Guiding Principles (3)
Usually treat ONE or a FEW sounds at a time
Comprised of a series of steps
Progressivley train sound (from simple isolation to conversational stage)
Name the Steps in Traditional Artic. Therapy Approach
1) Discrimination Training
2) Stimulability (Sound Establishment)
3) Sound Stablization
4) Generalization (Transfer and Carry Over)
5) Maintenance
Discrimination Training is
and what are the 2 types?
ability to listen and discriminate between error and correct production
2 Types:
Clinician Client (Clinician provides sounds)
Client-Client - Client listens to recording of themselves
Stimulability Training is:
Sound Establishment
Teach correct placement and production
Use these items as aids:
mirrors, tongue depressor
Personal Amplifier
Tube from mouth to ear
See-Scape (oral and nasal flow)
Palatometer (palate with tongue sensor)
straw
Spectrograph - hard to use, don't use under stage 4
What are the hardest sounds to work on:
s, r, and l
Stimulability Approaches
Auditory Stimulation/Imitation-listen and imitate
Use of context - coartic. effects sometimes help produce a sound, sometimes don't - avoid those
Moto-Kinesthetic-gloved hands, tongue depressor - godd for k and g
sound approximations (shaping)- shape s from t
Traditional Artic Therapy - Sound Stabilization Tech:
expanding the productions in which it occurs:
Linguistive Levels-
Isolation
Syllables
Words (Imitated/Spontaneous)
Phrases (Imitated/Spontaneous)
Sentences (Imitated/Spontaneous)

Conversation (Imitated/Spontaneous)

(Imitated is easier for clients)
Traditional Artic Therapy - Generalization Step:
No more errors!! (Transfer and Carry Over)
ability to generate more natural practice situations to make production more natural and automatic
-often the OTHER toughest part of therapy (use it outstide of therapy: visit and listen to the child in class, recess, or lunch)
Traditional Artic Therapy - Generalization Techniques
Speech Assignments - book report
Speech Buddy - listens and gives feedback
-'Clear' speech time periods (10-15 min of practice)
Involve Parents - have them keep data at home, have them report back to you, keep them informed, involve them in therapy
Traditional Artic Therapy - Maintenance Stage
Progressive Check up
-1,3 or 6 month
Traditional Artic Therapy - How to select Target BEHAVIORS (4)
those that have immediate and socially significant difference in the communicative skills of the client
-produced and reinforced at home
-help expand communicative settings (plurals could be problem, final d could be a problem - past tense)
-are linguistically and culturally appropriate for child

hisscel he is so cocky ethel lamented
Traditional Artic Therapy - Choosing SOUNDS: (10)
-are functional
-stimulable (90% of the time clinician choose this)
-occur in key words
-are visible
-occur mroe frequently (L,E,S,T,E,R)
-affect intelligibility
-are inconsistently mispronunced
-are acquired earlier
-are part of the child's phonetic inventory
-may generalize to others (cognates)
Traditional Artic Therapy - How many sounds should you target/train?
Training Deep: select number of sounds is taught intensively
Phonological Artic Therapy: How many sounds should you target?
Training Broad: Simultaneous teaching of multiple targets
Therapy Session - Baseline definition:
measured rates of behavior in the absence of treatment
Baselines in Therapy Sessions are used to: (3)
Evaluate child's progress over time
Establish treatment effectiveness (or ineffectiveness)
Establish clinician accountability
Baselines - 4 Steps
1) Specify Treatment Targets
2) Prepare the Stimulus Items
3) Prepare recording sheet
4) Administer Baseline trials
Baseline - when you prepare the stimulus items what should it be based on? and how many opportunites should be provided for each item?
client's age, cultural background, linguistic abilities, at least 20 chances for items/target behavior
Goals 3 types:
Long term
Short term
daily
For each goal you need (7)
criteria for each daily goal
reinforcement plan
activities for each goal
courage
enthusiasm (during contact time)
planning time
materials to use
Baselines should be done when?
prior to treatment and then post treatment to see if treatment is working
goals provide a ________ to move in
allows you to _______ progress and helps _______ see progress
direction, document, parents/clients
Articulation Goals - how to select?
Normative Data
Developmental Charts
Intelligibility
Stimulability
Family Concerns
Personal 'Gut' Feelings (not normally used)

FINDS
Long term goals are
what the client will accomplish when therapy is completed
Provide an example of a Long Term Goal
Johnny will be 100% inteeligible in conversation al speech during 3 consecutive 3-minute language samples.
or
Johnny will correctly produce all age-appropriate phonemes with 95% accuracy duing cnversational speech
Short Term Goals are typically where the client will be _______
at the end of the semester/school year
Short term goals must be (2)
justified by test results and
criteria should be ATTAINABLE
A short term goal statement should have these 4 things:
Phoneme
Position
level of complexity
criteria
In a short term goal the level of complexity is:
examples: isolation, syllables, words, sentences, conversation
In a short term goal the criteria is:
example - 80-90% of the time (whatever phoneme and complexity chosen)
Short Term Goal Example:
Mary will correctly produce the /s/ phoneme in isolation following clinician model with 95% accuracy.
Identify 4 items of goal
/s/- phoneme
isolation - level of complexity position is understood to be initial given phoneme in isolation (initial)
95% accuracy -criteria.
Short Term Goal Example:
Mary will correctly produce the /s/ phoneme in the initial position of ten one syllable words following clinician model with 95% accuracy.
Identify 4 items of goal
phoneme - /s/
position - initial
complexity - word
95% - critieria
How to write progress on a goal -
use baseline data, therapy approcah and post-data
may want to include specific material, reinforcers, family participation
Before a session 3 things to prepare:
plan goals/activities
plan criteria for advancement
use daily therapy plan log
During therapy - 3 things
Try to follow plan but
Be flexible
remember that sometimes children finish an activity before the clinician is done
After a session: (3)
determine daily performance
figure # of responses and correct
fill out daily therapy plan log
(goals, criteria achieved, activities, future plan)
review lecture 6 B Holding a Therapy Session for document examples
Primary and secondary language and phonological characteristics, rules, and properties can be very _______
diverse
In order to correctly assess a child with more than one language spoken, a clinician must assess the ______ language to determine if there is a disorder
primary (and it may not be English)
AAVE - how did it develop
first by a pidgin, which eventually turned into a creole
What is a pidgin?
a simplified and limited system of communication that develops out of NECESSITY when two communities with no common language are forced to communicate. (slavery example)
What is a creole?
more complex system of primary communication with its own phonological, semantic, syntactic and pragmatic rules.
-stems from a pidgin
AAVE Phonological Characteristics? (8)
/l/ lessoning or omission
/r/ lessoning or omission
f/voiceless /th/ in word-final postion or medial position (baf vs. bath)
d/voiced th in initial and final medial position (dis or dat)
v/voiced th in word final position (bav vs. bathe)
different stress syllable pattern - POlice
metathetic productions (aks vs ask)
devoicing/deletion of final consonants
Selecting treatment targets of AAVE
1) Choose phonemes whose pattern of usage is the same as SAE and AAVE
2) Then choose phonemes that the child does no sue or misues in patterns of AAVE
Remember what about treatment targets for AAVE:
respect the parents' wishes. SAE could be a goal or not.
Native American Languages
nearly a ___ are under 21
and
many of the languages are becoming _____
1/4, extinct
Native Americal Phonological Characteristics?
too many to list except:
glottal stop is common
in Cheyenne, the /p/, /t/. and /k/ are always unaspirated
of 3 vowels they may be voiced or voiceless
Native American communication style: (6)
-respect - no eye contact from children
-mothers may be silent with infant
-one learns from listening rather than by talking
-speech, lang. and hearing dififculties occur 5x more (ear infections)
-children are discouraged from speaking tribal language until articulation is 100% correct
-etiquette requires a lapse of time before answer is given to question
Spanish - how many dialects and what are they?
6
mexican/southwest
central american
caribbean
highlandian
chilean
south paraguay, urugray, and argentina
Spain (not listed)
Spanish - phonological system easier than English - how?
only 5 vowels all pronounced the same
19 consonants (no v,th, z, zh, dz)
Spanish Articulation Characteristics
Hint: Lots of subs
/t,d, n/ may be dentalized
final consonants may be devoiced
b/v substitution
sh/ch substitution
d/voiced /th/
t/voiceless /th/
Schwa inserted before word inital consonant clusters (uhsky - like Antonio Banderas talks)
Initial /h/ is silent
Frontal /s/ is produceed more frontally
vowel substitutions (beet for bit)
Spanish Assessment tests
Spanish Articulation Measures
Austin Spanisth Artic Test
Assessment of Phonological Process-Spanish
PLS-4 Spanish Artic Screener
or
Use interpreter
Asian and Pacific Islander
China, India, Southeast Asia, Pacific Islands
Asian Articulation Characteristics (8)
final consonant deletion
truncate ploy syllabic words or emphasize wrong syllable
devoicing of voiced cognates
r/l confusion -rice/lice
/r/ omitted
no voiced or voiceless /th/
epenthesis (emphasis of
schwa)
b/v substitions
What is bidalectal
speak 2 dialects of the SAME language
what is bilingual and what types are there?
speak 2 different languages
-simultaneously learned
OR
-successively learned
code switching
switching between two languages OR dialects depending on audience
3 Therapy Approaches
Paired Stimuli
Minimal Contrast
Deliberate Speech
Paired Stimuli was developed by
Irwin and Weston 1971-1975
Paired Stimuli assumes
an acceptable produced target phoneme can be generalized from selected phonetic contexts to a variety of phonetice contexts through a program of BEHAVIOR MODIFICATION
Paired Stimuli is used to teach _____ ____ ____ ____ ___ _____ through the use of a ____ ______
one speech sound at a time through the use of KEY word
Paired Stimuli has 3 Levels
Word Level (note no isolation level)
Sentence Level
Conversation Level
For Paired Stimuli word level, a ____ is chosen
target
For Paired Stimuli, after a target is chosen then _____ ____ ______ are chosen
4 key words
(2 initial, 2 final)
For Paired Stimuli what is a key word
word in which sound is produced correctly at least 90% of the time
Paired Stimuli also uses ______ words with the key word
training words
for Paired Stimuli what are the training words?
10 words that have the same error in the same word position and are produced in error 2/3 of the time
For the Paired Stimuli, what is the criterion for word level success
when client moves though all four key words:
80% of target sounds in words over two successive probes
for Paired Stimuli sentence level - what does clinician do?
same key words used at word level with 10 training words as before, however, clinicial points to training word and asks a question that evokes a target response in the form of a sentence.
client moves through all 4 key words
Example of Paired Stimuli at Sentence level:
Picture of SUN
Clinician says: What do you see here?
Client responds: I see a sun.
for Paired Stimuli at Conversation Level - describe when clinician stops the child
Engage child in conversation
clinician STOPS client whenever client CORRECTLY produces a target sound in four words or
child INCORRECTLY produces a target sound in any word
for Paired Stimuli at Conversation Level - when is training finished
when client produces target successfully on 15 CONSECUTIVE opportunities in CONVERSATION held on TWO successive treatments that are separated by at least ONE day
for Paired Stimuli - teaching key word criteria for success is
9/10 correct productions with no reinforcement
Minimal Contrast Approach is similar to _______ but more appropriate when child has confusion between 2 phonemes - provide example
paired stimuli approach,
ex: f/th - frill vs. thrill
Minimal Contrast Approach definition
attach meaning to error productions as well as target productions, contrast in meaning NOT production
in the Minimal Contrast Approach clinician models ____ words
both
Minimal Contrast Approach assumes
child will soon realize the importance of correct articulation to get the desired outcome
Minimal Contrast Approach - once sound is developed, it can be _____to others and can be ______ in conversation
transferred, generalized
Examples:
w/r
k/t
Deliberate Speech approach -
as client produces SLOWER speech, he becomes more aware of errors produced in his own speech and how they are produced correctly by clinician
IN Deliberate Speech approach, the clinician models slow or fast speech
SLOW
Deliberate Speech approach Steps (4)
Describe
Demonstrate
Discrimination
Production
Deliberate Speech - Discrimination
have client tell you when turtle talk vs. bunny talk is used
Deliberate Speech - Demonstrate
use turtle and talk slow
Deliberate Speech - Describe
concept of rate reduction and accurate production (Turtle Talk)
Deliberate Speech - Production
single words, imitated phrases or short sentences, spontaneous sentences, short periods (5 min), or longer periods
Interpretation vs. Translation
Conveying Oral vs. written information on one language to another
Methods of Interpretation/Translation
Consecutive Interpretation
Simultaneous Interpretation
Prepared Translation
Sight Translation
Consecutive Interpretation
message is transalted AFTER it has been SPOKEN
Simultaneous Interpretation
message is conveyed at the SAME TIME as it is being produced
Prepared Translation
written docs prepared beforehand (IEP)
Sight Translation
written docs are translated orally at the time they are being read
Code Switching - within terms of 2 languages
alternate use of two languages (Spanglish)
Code Mixing
a word from an alternative language is used within a given sentence:
Dame el fork.
Using an Interpreter 3 Important Steps
Briefing
Interaction
Debreifing
Using an Interpreter - Briefing
SLP meets with interpreter to formulate an agenda for meeting
Using an Interpreter - Interaction
actual time that SLP and interpreter work together in the session.
IMPORTANT to address client and parent directly NOT the interpreter
Using an Interpreter - Debriefing
interpreter and SLP review the outcomes of the session
Phonological Awareness?
refers to childs underlying knowledge that words are created from sounds and sound combinations
With good Phonological Awareness a child can
break down the word and analyze the individual components
Skills associated with good Phonological Awareness
rhyming
alliteration
phonemic isolation
sound blending
syllable identification
sound segmentation
invented spellings
phoneme manipulation
Phonological Awareness - invented spellings
ability to spell words phonetically
Phonological Awareness - sound segmentation
ability to breakdown into individual sound components (identify number of phonemes in word)
Phonological Awareness - syllable identification
the ability to identify the number of syllables in a word through clapping, finger tapping, etc.
Phonological Awareness - rhyming
ability to identify words that sound alike, provide words that rhyme with another, and sort rhyming words vs. non-rhyming words
Phonological Awareness - alliteration
the ability to identify words that begin or end with a certain sound
Phonological Awareness - phoneme isolation -
the ability to identify whether a specific sound occurs in the beginning, end, or middle of a word
Phonological Awareness - sound blending
the ability to blend two or more sounds that are temporally separated by a few seconds into a word (what does tea.......cher say?)
Phonological Awareness - phoneme manipulation
ability to delete, add or substitute a sound in a word to create other words
(What do you get when you take h from hat?)
What are phases for Stage 1 Traditional Therapy?
Stage 1 Sensory Perceptual Training (Discrimination)
Phase 1: Identification
Phase 2: Isolation
Phase 3: Stimulation
Phase 4: Discriminiation