Comprehensive and Evidencebased Treatment Program

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Comprehensive and Evidence-based Treatment Program
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Structuring Treatment Sessions

• Client-centered vs. clinician-directed
• Client-centered
• Loose structure
• Clinician follows the clients lead
• For young or cognitively impaired clients
• Clinician-directed
• Highly structured
• Clinician leads the session
• For older or less severe clients

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Techniques

• Clinician-directed
• Drill
• Drill-play
• Structured play
• Client-centered
• Play

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Drill and drill-play

• Yield lots of responses from the client
• Best in the initial stages of treatment
• Establishes sound or pattern
• Does not promote generalization

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Structured play and play

• Does not yield many target responses
• Best after a sound or pattern
• is established
• Promotes generalization
• Videotape Articulation and Phonological
  Disorders

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Administering trials

• Present stimuli
• Provide cues/prompts
• Consequate response
• Response record
• Pause, and repeat

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Example Activities(can be used at any response
level)

• Buried treasure production practice cards are
  buried in sand or styrofoam pellets
• Tic-tac-toe for every correct production, a mark
  is made in
• grid
• Road. Child lines cards up to make a road and
  drives a truck over the cards saying each word as
  he drives over it.
• Bean Bag. Place cards on the floor child throws
  bean bag on cards
• and names the card he hit. He can also tell
  you
• which card he will try to hit before throwing
  the beanbag.
• Feed Clown. Child says words to clown (large
• cardboard clown face with large hole for
  mouth) and
• then puts the cards in the clowns mouth.
  May be adapted
• to feeding cookies (cards) to Cookie Monster
  puppet.
• Store. Child buys the cards from the store clerk
  (you).
• Child tells you what he wants to buy.
• Hide n Seek. Hide the cards in obvious places
  around the room.
• Child says words as he hides them.

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Promote generalization from day one

• Choose an activity that will naturally elicit the
  target phoneme or pattern
• Go Fish if working on /f/ or the elimination of
  stopping process
• Feed the Animal if working on
• weak syllable deletion

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Probing for Generalized Responses

• Generalization to untrained stimulus items
• Generalization across word positions
• Generalization across response topographies
  (levels of response)
• Generalization within sound classes
• Generalization across sound classes
• Generalization across situations

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Promoting generalization and maintenance through
stimuli

• Select stimuli from natural environment
• Use common verbal antecedents
• Vary the audience
• Vary the physical setting

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Promoting generalization and maintenance through
responses

• Choose functional objectives
• Teach multiple exemplars
• Use complex response topographies
• Move from continuous to intermittent schedule of
  reinforcement
• Use naturally occurring reinforcers
• Delay reinforcement
• Train others to reinforce
• Reinforce generalized responses
• Teach self-monitoring
• Involve family and others in treatment program

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Phonological Awareness

• The knowledge of sounds, and how those sounds
  blend together to form words
• Correlation between severe phonological disorders
  and
• poor phonological awareness
• Poor phonological awareness has
• been linked to poor reading

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Role of the Speech-Language Pathologist

• Assess and train foundation skills necessary to
  literacy development
• Rhyming
• Alliteration
• Phoneme isolation
• Sound blending
• Syllable identification
• Sound segmentation