Approach to Treatment of Phonological Disorders

1
Approach to Treatment of Phonological Disorders

• Distinctive Features
• Phonological Processes
• Oral Motor Therapy

2
Distinctive Feature Approach

• McReynolds, et.al. (1975)
• Two phases of treatment
• Nonsense syllables initial position
• Nonsense syllables final position
• Authors report that this approach yields
  generalization of a feature to untrained sounds

3
Phase 1 Nonsense Syllables (I)

• Step 1
• Child is instructed to produce a consonant in
  which the feature is lacking
• For example, if the feature that the child is
  lacking is voice, then the child is told to
  produce a consonant that is voice (pie).
• Step 2
• Child is instructed to produce a minimal pair
  (pie-bye)

4
Phase 2 Nonsense Syllables (F)

• Step 1 Child is instructed to produce a
  consonant in which the feature is lacking (for
  example, ape, if the feature is voice)
• Step 2 Child is instructed to produce minimal
  pair containing both /- feature (ape-Abe)

5
Phonological Process Approach

• Cycles Approach
• Author is Hodson and Paden, (1983/1991)
• Textbook is Targeting Intelligible Speech A
  Phonological Approach
• Designed to be used with preschool children who
  are highly unintelligible and exhibit numerous
  phonological process errors

6
Cycles Approach

• Program is planned around cycles
• Cycle is a period of time in which all of the
  process errors are facilitated
• A cycle of treatment can last from 5 weeks up to
  16 weeks

7
Targeted Patterns

• Early developing phonological patterns
• ICD, FCD, WSD
• Posterior/anterior contrasts
• t/k, d/g
• /s/ clusters
• liquids

8
Structure of the Cycle

• Each phoneme within a pattern should be trained
  for 60 minutes per cycle, before shifting to the
  next phoneme in that pattern
• Each pattern should be worked on at least 2 hours
  each cycle
• Only one pattern should be worked on during any
  single session
• 3-6 cycles are necessary for a child to become
  intelligible

9
Sequence in a Session

• Review of previous sessions words
• Auditory bombardment
• Target word cards made
• Production practice
• Different play activity every 5-7 minutes
• Stimulability probing
• Auditory bombardment
• Home program (auditory bombardment daily naming
  picture cards daily)

10
Phonological Contrast Approaches

• Minimal pair contrast therapy
• Perceptual training (optional)
• Production training
• Present minimal pair, model, imitation
• Multiple productions operant conditioning
• Spontaneous productions

11
Phonological Contrast Approaches (continued)

• Maximal pair contrast therapy
• Procedures are similar to minimal pairs, but the
  error feature is not used, a phoneme that is
  maximally different (numerous features differ)
  from the target is used

12
Multiple Opposition Method

• Useful for children who substitute a specific
  sound for multiple sounds
• t/s t/k t/sh t/th
• In a single therapy session, all substitutions
  are treated simultaneously, using minimal pairs
• bat-bass
• bat-back
• bat-bash
• bat-bath

13
Oral-Motor Therapy

• Controversy over its effectiveness and the
  underlying principle that oral motor exercises do
  not involve speech production, and the time spent
  on oral motor exercises may be better spent on
  teaching articulation directly

14
Oral Motor Exercises

• Oral awareness
• Brushing exercises
• Strengthening
• Tongue elevation
• Tongue protrusion against resistance
• ROM
• Touch tip of tongue to nose, then chin

15
Review of the Literature

• No credible studies that indicate that oral motor
  exercises are of benefit to speech production
• Lots of studies that indicate articulation and
  phonology treatments discusses previously are of
  benefit to speech production