SPECIFIC TREATMENT PROGRAMS AND APPROACHES some new slides have been added

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• SPECIFIC TREATMENT PROGRAMS AND APPROACHES (some
  new slides have been added)

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I. INTRODUCTION

• Motor vs. linguistic-based approaches (cross out)
• Second edition said traditional and
  pattern-based approaches (. 395)
  (Test 3)
• Textbook philosophy all programs contain
  elements of both regardless of what we call an
  approach, we are teaching motor production of
  phonemes
• P. 396 Children learn to produce speech sounds,
  not rules.
• All approaches use behavioral tx techniques

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II. TRADITIONAL APPROACH

• A. Background
• Began in early 1900s
• Associated with Charles Van Riper
• Commonly used today with minor modifications

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B. Part One Ear Training

• Phase 1 identification
• Phase 2 isolation
• Phase 3 stimulation
• Phase 4 discrimination

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(new slide) (p. 400)

• The 2nd edition discusses two forms of
  discrimination
• In error detection, the child has to tell when
  the SLP produces the sound in error
• In error correction, the child must explain why
  the sound was in error and how it can be corrected

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• C. Part 2 Production TrainingSound
  Establishment
• D. Part 3 Production TrainingSound
  Stabilization
• (begin at the most complex level possible)
• Stage 1 Isolation
• Stage 2 Nonsense syllables
• Stage 3 Words
• Stage 4 phrases (2-4 word phrases)
• Stage 5 sentences
• Stage 6 conversation

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(new slide p.404)

• To help establish the production of sentences
• 1. Slow-motion speech the SLP and child say the
  target at the same time, using a very slow rate
  of speech
• 2. Shadowing the SLP says the sentence first,
  then the child says it immediately

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E. Part 4 Transfer/Carryover

• (dont worry about definitionsuse them
  interchangeably)
• Vary settings, interlocutors/audience, stimuli
• Speech assignments
• Follow-up (maintenance) sessions

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III. MULTIPLE PHONEME APPROACH (test 3 just
lecture notes and summary on pp. 416-417)

• A. Introduction
• B. Phase 1 Establishment
• Step 1 Establishment of sound production
• Step 2 Holding procedure (all sounds in
  isolation in each tx session)
• C. Phase 2 Transfer
• Syllables?Words ?Phrases and sentences
  ?reading/story/conversation
• D. Phase 3 Maintenance

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IV. MCDONALDS SENSORIMOTOR APPROACH

• A. Introduction
• B. Part 1 Heighten Childs Responsiveness
• C. Part 2 Reinforce Correct Articulation of
  Error Sound

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(New Slide)

• Use facilitative contexts e.g. watch-sun
• 1. Slo-mo
• 2. Equal stress on both syllables
• 3. Primary stress on first syllable
• 4. Primary stress on second syllable
• 5. Child prolongs target until clinician signals
  to go on (e.g., watchsssssssssun)
• 6. Practice in short sentences

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• D. Part 3 Facilitate Correct Articulation of
  the Target Sound in Various Contexts
• V. Shine Prousts Sensorimotor Approach
• Based on McDonald, but more structured
• Emphasizes orientation to the speech helpers

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V. DISTINCTIVE FEATURE APPROACH (lecture only!)

• Based on distinctive feature analysis
• Teach a relevant sound that is missing the
  feature, hope for generalization
• E.g., for feature of stridency, teach /f/ and
  hope it will generalize to /s, z, sh/

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VI. PAIRED-STIMULI APPROACH

• A. Introduction
• Developed by Irwin Weston, 1971
• Good for children with a few sound errors
• Capitalizes on a key word

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B. Step 1 Word Level

• Select a target sound for tx
• Identify 4 key words 2 with target in
  word-initial position and 2 with target in
  word-final position

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C. Step 2 Sentence Level

• Use Key Word 1 with 10 training words, only
  evoke the target in a sentence
• FR3 schedule of reinforcement (3 responses for 1
  token)
• Do 2nd, 3rd, 4th key words and then do some
  alternations

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D. Step 3 Conversational Level

• Clinician and child converse
• Clinician stops the conversation immediately if
  the child produces a sound incorrectly

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VII. CONTRAST THERAPY APPROACH/PHONOLOGICAL
CONTRAST APPROACHES (pp. 432 on)

• Minimal contrast training use minimal pairs
  which only differ by one feature (tea-key)
• Maximal pair training sounds differ by at least
  2 features (cane-lane ten-men)

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(New slide pp. 436-437)

• Multiple oppositions/multiple contrasts approach
• Not on exam

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• Begin with perceptual training
• Then, go to production training where the child
  has to produce minimal pairs
• Good for use with adults also

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VIII. HODSONS CYCLES APPROACH (on exam!)

• A. Introduction
• General Procedures
• 1. Stimulation (multimodal cues)
• 2. Production training
• 3. Semantic awareness contrasts

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(new slide p. 428)

• Remediation programme is planned around a cycle
• A cycle is the time period required for a child
  to focus on each deficient phonological pattern
  for 2-6 hours
• A pattern is a phonological process

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B. Selection of Target Patterns and Phonemes

• Top Priority
• 1. Early-developing phonological patterns
• Initial and final consonant deletion of stops,
  nasals, and glides
• CVC and VCV word structures
• Posterior-anterior contrasts (k-g, t-d, h)
• /s/ clusters--word initial clusters /sp, st, sm,
  sn, sk/ and word-final clustes /ts, ps, ks/
• Liquids /r/ and /l/ and clusters containing these
  liquids

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2. Secondary Patterns

• A. Voicing contrasts, vowel contrasts
• B. Singleton stridents
• C. Other consonant clusters
• D. Other (metathesis, reduplication,
  multisyllabic words, complex consonant sequences)

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C. Structure of Remediation Cycles

• 1. Train each phoneme exemplar within a target
  pattern for 60 min per cycle before going to the
  next phoneme
• 2. Train 2 or more target phonemes in
  successive weeks within a pattern before
  changing to the next target pattern
• (2 hours on each pattern within a cycle)

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• 3. Target only one phonological pattern per
  session
• 4. When all target patterns have been taught, a
  cycle is complete
• 5. Initiate the second cycle. Review patterns
  not yet corrected, introduce new ones as
  necessary
• to become intelligible, most children need 3- 6
  cycles therapy (this involves 30-40 hours of
  instruction)

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D. Structure of Therapy Sessions

• 1. Review word cards from previous session
• 2. Auditory bombardment (use amplification!)
• 3. Target word cards3-5 new target words
• 4. Production practice
• 5. Stimulability probing
• 6. Repeat auditory bombardment

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E. Home Program

• Caretakers are asked to read the 12-item word
  list once a day.
• Child is asked to name the 3-5 pictures once a
  day (may also produce other target words)

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IX. (new slide) Oral-Motor Exercises

• Pena-Brooks and Hegde do not believe that oral
  motor exercises are beneficial for anybody
• They state that research has not proven that oral
  motor exercises help
• Roseberrys position I think that these
  exercises are very helpful for children with oral
  motor problems

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X. (New Slide) Language Treatment for
Phonological Disorders

• PBH said that research is inconclusive re the
  question Can language therapy improve childrens
  artic/phonological skills?
• Bottom line If the child has a language and
  phonological disorder, best to do both language
  and artic/phonology therapy simultaneously.
• In other words, dont just do language therapy
  and hope that somehow artic/phonological skills
  will magically improve too ?

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(new slide) Combining Therapy for Language and
Articulatory-Phonological Disorders

• We can connect phonology to childrens
  morphosyntactic skills
• If children have final consonant deletion or
  cluster reduction, they will have problems with
  some of the morphemes

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(new slide) These morphemes include

• Past tense ed (jumped, scared)
• Plural s (pots, sidewalks)
• Regular 3rd person s (eats, runs)
• Possessive s (Grants, Bobs)

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(new slide) Therapy suggestions

• If the child has final consonant deletion, use
  minimal pairs which include grammatical morphemes

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For example

• Plurals toe-toes key-keys
• Possessives Joe-Joes Ray-Rays
• Regular past tense ed show- showed

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If the child uses cluster reduction

• Plurals boat-boats cup-cups
• Possessives cat-cats Dad-Dads
• Regular past walk-walked dry-dried
• Irregular past drink-drank hold-held

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We can also connect phonology to semantics

• Children with language impairments often have
  difficulty with verbs
• For velar fronting tame-came taught-caught
• Stopping of fricatives tee-see, toe-sew,
  tip-ship
• Final consonant deletion shoe-shoot, ray-rake
  say-sail

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XI. Developing a Lexicon for Young Highly
Unintelligible Children with Accompanying
Language Disorders

• Use early-developing consonants with words that
  are key in childrens environments
• For example, we can teach
• No, puppy, baby, bye-bye, yes, happy

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If the child only says a few words

• We begin by imitating the childs vocalizations
  while she is playing
• When reciprocal vocalization is established, we
  introduce new consonant into the babbling
  activity and hope the child will imitate it.