Specific Treatment Approaches

1
Specific Treatment Approaches

• Articulation

2
Traditional Approach

• Been around forever!
• Early authors include S. Stinchfield and C. Van
  Riper
• 5 basic phases
• Ear training
• Production Training establishment
• Production Training stabilization
• Transfer Carryover
• Maintenance

3
Ear Training

• Phase 1
• Identification
• Teach properties of the sound and give it a name
• Ticking sound
• Angry kitty sound
• Phase 2
• Isolation
• Identify words that contain their sound
• Identify where in the word the sound is located
• Phase 3
• Stimulation
• Auditory bombardment of the sound
• Phase 4
• Discrimination
• Detection and correction
• No evidence suggesting this is a necessary step

4
Production Training - establishment

• Sound evoking techniques
• Wayne Secord and Ken Bleile books
• Imitation
• Phonetic placement
• Contextual cues
• Motor kinesthetic cues
• Sound approximation

5
Production training - stabilization

• Stage 1 isolation
• Stage 2 nonsense syllables
• Stage 3 words
• Stage 4 phrases
• Stage 5 sentences
• Stage 6 - conversation

6
Transfer Carryover

• Home assignments
• Self and peer monitoring
• Taking the speech teacher out of the speech room
• Proprioceptive awareness
• Masking noise during speech work
• Varying the audience and setting

7
Maintenance

• Gradual dismissal from services

8
Sensori-Motor Approach

• McDonalds Sensori-motor Approach
• Syllable is the basic unit of training
• Facilitative contexts should be used
• Three objectives
• Heighten childs awareness of motor patterns of
  non-error sounds (no effort to remediate error
  sounds at this point)
• Train error sound with facilitative context
• Systematically vary the context

9
Multiple Phoneme Approach

• McCabe and Bradley
• Designed for use with articulation disorders that
  have numerous errors
• 3 phases
• Phase 1
• Establishment (visual, auditory, tactile cues)
• Avisual only (grapheme)
• Bvisual auditory
• Cvisual auditory tactile
• Holding

10
Multiple Phoneme Approach (continued)

• Phase 2
• Transfer
• Get all errors sounds to correct use in
  conversation
• Progressively increase length of utterance
• Syllable, word, phrase, story, conversation
• Phase 3
• Maintenance
• 90 accuracy across speaking situations without
  monitoring
• Phone conversations
• Classroom visits
• Return visits to speech clinic

11
Paired Stimuli Approach

• Weston and Irwin (1971)
• Teaches one sound at a time
• Commercially available program, Paired Stimuli
  Kit
• Uses key words (words that can be produced
  correctly with the target sound)
• 2 initial position and 2 final position key
  words
• 3 levels of training Word, Sentence, Conversation

12
Programmed Conditioning

• Baker and Ryan (1971) Monterrey Program
• Numerous other behavioral programs in the 1970s
• Stimulus-response-consequence
• Utilizes models, pictures, graphemes, stories,
  etc.
• Schedule of reinforcement shifts from CR to and
  intermittent schedule
• 3 phases Establishment, Transfer, Maintenance
• Each phase has multiple substeps