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130 Cards in this Set
- Front
- Back
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The importance of interviewing?
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-Medium of therapy
-means of establishing and sustaining a relationship -Tool for data collection |
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Interview vs. social conversation?
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Time/location formally set
-Questions are unilateral -Unpleasant topics brought up |
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Interview Considerations?
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-Ask for specific examples
-Use open-ended questions -Restate what client says -Minimize misinterpretations |
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General Goals of Interviewing?
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-Obtain information
-Give information -Provide counseling |
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Obtain information
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-Set the tone (role definitions)
-Rapport (involves trust, understanding, empathy) |
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Obtain Information (Ask the Questions)
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-Consequences
-Impact -Expectations |
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Obtain information
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-The presenting story: how client/parent preceive and look at their situation
-Nonverbal messages: body lang. -Things to avoid: multiple questions at once, leading questions, why questions |
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Give information
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-convey messages accurately and professionally
-inform client status of problem -use non-technical language |
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Questions clients may ask?
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-Content Questions: informative/factual
-Opinion Questions: client may feel strongly about a subject -Affect Questions: looking for emotional support |
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6 Basic principles
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1) Emotional confusion may inhibit ability to understand
2) refrain from being didactic/instructive 3)use simple language 4)provide action to the patient 5)be pleasant and truthful 6)understand the client may have strong reactions |
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An approach to interviewing
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-Provide release and support
-give advice -help sort out choices -empathy -support |
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Improving Interview Skills
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-Listen to people
-form student groups -role play to prepare -be knowledgeable |
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University Training Programs
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-Comprehensive reports
-Contain subheadings, conclusions, diagnosis |
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Medical Settings
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concise, textual writing
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Public Schools
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-Federally mandated reports
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S
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-provided by the parent, client, caregiver, teacher
-symptoms, explanations of contributing factors, observations |
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O
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-Data collection, including objective testing
-Symptoms, explanations of contributing factors, observatoins |
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A
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-Evaluation of the problem based on the subjective and objective findings
-physicians, other health-related professionals, and caregivers often will read this section only |
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P
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Consists of 3 Parts:
a)further diagnostic testing that should be done b)plan of treatment c)lesson plan |
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IEP
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-Individual Education Program
-Individualized document -TEAM must look at student's unique needs -Combine knowledge, experience commitment and design program |
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Identification
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-Child Find
-Referral/request for evaluation -Screenings |
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Evaluation
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-Assess areas of suspected disability
-Used to determine eligibility -If parent disagree with evaluation they can ask for an independent evaluation |
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Services are determined
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-If child is found eligible they are entitled to services
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IEP meeting
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-Must notify the parents
-TEAM members: parents, teachers, specialists |
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IEP written
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-Parents accept IEP and gives consent to receive services
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Services are Provided
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-IEP is carried out as written
-Parents/teachers/service providers have copy of IEP |
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Progress is Measured
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-Parents updated on progression toward goals
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IEP is reviewed
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-At least once a year
-TEAM attends meeting to update IEP Parents must agree for new IEP in order for new goals/accommodations etc to start |
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Child is reevaluated
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-Every 3 years child is assessed
-Determine if child continues to be a "child with a disability" |
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Grampheme
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" "
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Phonemes
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/ /
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Phonology
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Study of sound systems
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Articulation Disorders
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-Errors
-Functional/Organic |
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Phonological Disorder
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-Difficulty organizing speech sounds into a system
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Sounds
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Articulation
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Processes
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Phonology
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Articulation
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Errors are constant
-omissions substitutions -distortion -addition -biological -sensorimotor |
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Functional Disorders
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exist in the absence of any apparent cause
-Distortions of sounds |
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Organic Disorders
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result from condition/syndrome
-TBI -Cerebral Palsy |
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Phonological Disorders
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-cognitively/linguistically based
-impairments in phoneme organization -impairments in specific contexts -reduced phonemic inventory |
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Phonological Disorders
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-Predictable phonological development
-Impairments result when processes continue past an age when most children stop exhibiting them |
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Oral Motor Examination
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Look for structure and function differences
-Structural (physcial) -teeth, throat, hard/soft palate, jaw, tongue, cheeks, tonsil area -Functional features(movement, strength/weakness) |
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Distinctive Feature Theory
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-Aspects of sound production
-Acoustic signal and articulatory processes -Distinguish between: -vowels and consonants or voiced and voiceless sounds -External and Internal features |
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Phonological Development--3 Aspects
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-way sounds are stored
-way sounds are said -rules or processes that map the two above -usually eliminated by 5 years |
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Context Sensitive Voicing
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A VL sound is replaced by a voiced sound
-eliminated by age 3.0 |
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Word-final devoicing
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A final V consonant in a word is replaced by a VL consonant
-eliminated by age 3.0 |
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Final consonant deletion
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The final consonant in the word is omitted
-eliminated by age 3.3 |
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Velar Fronting
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-A velar consonant is replaced with consonant produced at the front of the mouth
-eliminated by age 3.6 |
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Palatal Fronting
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-the fricative consonants 'sh' and 'zh' are replaced by fricatives that are made further forward on the palate, towards the front teeth
-eliminated by age 3.6 |
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Consonant harmony
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The pronunciation of the whole word is influenced by the presence of a particular sound in the word
-eliminated by age 3.9 |
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Weak Syllable deletion
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weak syllables are omitted when the child says the word
-eliminated by age 4.0 |
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Cluster reduction
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part of the cluster is omitted in a word
-eliminated by age 4.0 |
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Gliding of Liquids
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The liquid consonants /l/ and /r/ are replaced by /w/ or /y/
-eliminated by age 5.0 |
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Stopping
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a fricative consonant (f,v,s,z, sh, zh, th, or h) or an affricate consonant (ch or j) is replaced by a stop consonant (p,b,t,d,k,g)
-eliminated by age 3.0-5.0 |
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Assimilation
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how a segment is modified by its neighbors
-L to R -R to L |
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Phonology is a component of language T/F
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True
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Increase misarticulations with an increase in_______complexity
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syntactic
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Increase misarticulations with an increase in_______complexity
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semantic
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Pragmatic value affects misarticulations. T/F
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True
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Language and Phonological Disorders typically co-occur. T/F
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True
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50-80% with phonological problems have language problems. T/F
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True
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Articulation/Phonology Assessment
Expected Outcomes: |
1) underlying structural/functional strengths and deficits
2)effects of articulation and phonology impairments on the individual's activities and participation 3)contextual factors that serve as barriers to or facilitators of successful communication and participation |
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Results for Articulation/Phonology Assessment
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-Diagnosis of a speech sound disorder
-prognosis for change |
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Assessment Process
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-Sensitive to cultural/linguistic diveristy
-May be static or dynamic -Includes: case history, review of auditory status, standard/nonstandard assessments -curriculum based assessments |
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Articulation/Phonology Assessment
(Setting) |
-Clinical/educational setting
-safety and health -equipment specifications |
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PreK/Early Elementary Children
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-Interview: parent+child, % intelligibility
-Free play: observed -conversational speech -rote counting, colors, picture naming -repetition/imitation |
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School Aged Children
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-reading passage
-formal articulation or phonology test |
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Phoneme Inventory
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list of all phonemes produced in the sample
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Response to stimulation
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impact that verbal, visual, tactile modeling has on the production of the target sound
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formal tests
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-inventory of substitutions, omissions, distortions, additions
- photo articulation test, goldman-fristoe |
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26-50% intelligible by...
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2.0 years
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51-70% intelligible by...
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2.6 years
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71-80% intelligible by...
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3.0 years
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By 18 months a child's speech is normally...
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25% intelligible
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By 24 months a child's speech is normally...
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50-75% intelligible
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By 36 months a child's speech is normally...
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75-100% intelligible
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Children above the age of ___, with speech intelligibility of less than ___%, should be considered for S/L intervention
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4.0 years, 66%
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Areas to Assess
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-Language assessment
-Audiometric screening -auditory discrimination -oral-peripheral examination -phonological awareness |
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Mild
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sound errors are intelligible but noticable
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Moderate
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-more numerous articulation errors
-intelligibility is difficult for an unfamiliar listener |
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Severe
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-many articulation disorders
-speech is frequently unintelligible to most listeners |
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Informal Assessments
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Mild- intelligible over 80% of the time in connected speech
Moderate-intelligible 50-80% of the time in connected speech Severe-intelligible <50% of the time is connected speech |
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Effect on Education
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Mild-acquisition of basic academic, social, and or vocational skills MAY be affected
Moderate- acquisition of basic academic, social, and or vocational skills is USUALLY affected -Severe- acquisition of basic academic, social, and or vocational skills is IMPAIRED |
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Students at risk academically
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-C grades or lower
-50% at risk for linguistic problems -currently not receiving tx -"low achievers"- borderline -1 and -2 SDs |
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PreKs with speech delay often encounter later academic difficulties. T/F
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True
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Functional
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no known pathology is causing the errors
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Organic
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result from a known physical cause
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Goal Attack Strategy
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Vertical Training-intense practice on a limited number of targets
Horizontal Training-simultaneous exposure to a wide variety of targets Cyclical Training- practice on a given target or a predetermined amount of time and then moves on to another target |
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Minimal Pair Treatment
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-Children who have a mild to moderate phonological impairment
-Linguistic treatment approach using word pairs that have minimal phonemic contrast -This contrast involves pairing two words that differ by only one phoneme -CX instructs the child that it is necessary to use two different sounds to signal a difference in meaning |
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Cycles Approach Treatment
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-Phonological process
-focus on key processes -each process is targeted for 2 to 4 weeks -re-assess (informally) after each cycle -repeat cycle if necessary, or start new cycle |
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Oral Motor Therapy
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-Weakness or incoordination or oral structures
-Incorporates understanding of tactile sensitivity, neurological development, and normal versus abnormal functioning -Associate the swallowing, feeding, and individual speech sounds with specific foundational oral motor skills -Little evidence to support it's effectiveness |
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Oral Motor Goals
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-Increase awareness, strength, and coordination of the oral mechanism
-increase or normalize oral-tactile sensitivity -increase more normal movement patterns -increase differentiation of oral movements -improve feeding skills and nutritional intake -Improve speech sound production to maximize intelligibility |
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Oral Motor Treatment Steps
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-Postural and positioning issues
-oral sensitivity -jaw control -lip movement -tongue control |
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Functional Speech Disorders
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-Cause is unknown
-intervention is based on ongoing assessment of c ommunication skills -use developmental/nondevelopmental intervention -therapy targets: placement of sound, production of sound therapy plans: evidence based and optimal for client |
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Organic Speech Disorders
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-Cause is known
-cleft palate -hearing impairment -developmental verbal dyspraxia -ongoing assessment |
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Oral Clefting
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susceptible to colds, hearing loss, and speech defects, dental problems, feeding complications
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Cleft Palate-Therapy Targets
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-correct articulatory contacts
-light articulatory contacts -greater mouth opening -decrease hyper nasal resonance qualities -promote more anterior placement of articulatory production |
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Conductive
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Sound is not normally conducted through the outer or middle ear or both
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Sensorineural
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Insensitivity of the inner ear, the cochlea, or to impairment of function in the auditory nervous system
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Mixed
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combination of conductive/sensorineural loss
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Causes for hearing Loss
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-long term exposure to environmental noise
-genetic -disease or illness -medications -physical trauma |
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Factors that Impact Speech
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-Age of onset
-Configuration of hearing loss -age of identification -degree of linguistic complexity |
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Mild
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for children: 20-40dbB
for adults: 25-40dB |
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Moderate
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41-55 dB
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Moderately severe
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56-70dB
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Severe
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71-90 dB
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Profound
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90 dB +
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Hearing Impairment-Treatment
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-Oral Programs
-Manual Programs -Total Communication -Cochlear Implants |
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Developmental Verbal Dyspraxia
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-Loss of ability to consistently position the articulators resulting in ability to correctly produce sounds syllables, words
-Cause: unknown -Main characteristics of DAS: *limited speech sound repertoire *inconsistency *spontaneous speech difficult *longer the utterance, the worse the speech accuracy |
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Signs that can indicate developmental apraxia of speech for very young children
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-does not coo or babble as an infant
-produces first words after some delay -produces relatively few different consonant sounds |
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Signs that can indicate developmental apraxia of speech for older children
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-Has greater difficulty saying longer phrases
-ability to speak appears to be affected by anxiety -listener has difficulty understanding the child |
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What other areas can be affected by Developmental Verbal Dyspraxia?
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-Accessing vocabulary
-behavior -flexibility with topics -written language -motor planning activities |
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Children with developmental apraxia of speech will not outgrow the problem of their own. T/F
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True
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Augmentative Communication
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Sign, notebook, electronic communication
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DVD treatment: multi-sensory
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-see how lips, tongue and jaw move when producing different speech sounds and words
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DVD treatment: tactile feedback
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-touch, rub or pat certain oral parts such as the lips, the tongue, or the roof of the mouth so the person becomes aware of these oral areas
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DVD treatment: auditory feedback
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-hear the sound, how to use their muscles to make the sound
-amplifers |
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Phonetic-level approach
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-motor deficit
-oral motor movements |
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Phonemic-level processing
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-poor representation and organization of sounds
-focus on changing the child's phonological rule |
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Phonological Disorders
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Involve a difficulty in learning and organizing all the sound needed for clear speech, reading and spelling
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Phonological development involves 3 aspects:
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a) the way the sound is stored in the child's mind
b)the way the wound is actually said by the child c)the rules or processes that map between the two above |
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Characteristics of Phonological Disorders?
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-immature grammar and syntax, stuttering or word-retrieval difficulties
-problem with speech clarity in the Prek years -difficulty learning to read -difficulties with reading comprehension -difficulty with spelling -difficulties with written expression in primary school |
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Phonological Therapy
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Based on the systematic nature of phonology
-characterized by conceptual activities -facilitations age-appropriate phonological patterns generalization is the ultimate goal |
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3.0 years
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h zh y w nh m n p k t b g d
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3.6 years
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f
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4.0 years
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l sh ch
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5.0 years
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r
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6.0 years
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v
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8.0 years
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th (voiced)
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8.6 years
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th (voiceless)
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