Speech Practicum: Programming & Behavior Modification

Study Notes

Involves the selection and sequencing of specific communicative behaviors
New behaviors are introduced and taught in highly structured situations with multiple prompts and maximal support
Subsequent activities progress through a hierarchy of difficulty and complexity, with decreasing support from the clinician
The client demonstrates generalization of each newly learned behavior by using it in novel situations or contexts

The first step in programming is identification of the communication behaviors to be acquired over the course of the treatment program
These therapy targets are often referred to as long-term goals
Initial information about potential therapy targets should be obtained by reviewing the results of previous diagnostic findings
Baseline measures that fall below the 75% accuracy level represent potential intervention targets
Clinicians typically employ one of two basic approaches for choosing among potential targets:
- Developmental/Normative Strategy: based on known normative sequences of communicative behaviors in typically achieving individuals
- Client-Specific Strategy: based on an individual’s specific needs rather than according to developmental norms

Three major factors determine the progression of the therapy sequence:
- Stimulus type (nature of input used to elicit target responses)
- Task mode (type of clinician support/scaffolding provided to obtain desired responses)
- Response level (degree of difficulty of target responses)
The sequencing process starts with a decision regarding the most appropriate level to begin training on each target behavior
Pretreatment baseline data for a given target are analyzed to determine the entry training level
A rule of thumb is to start training at a level just below the difficulty of the baseline stimulus items if the client obtained a baseline score lower than 50% accuracy

A crucial consideration in programming involves a client’s ability to transfer newly mastered communicative behaviors from the clinical setting to the everyday environment
Three main factors can influence the degree to which successful generalization occurs:
- Variety of stimuli used during therapy activities
- Variation in the physical environment in which therapy occurs
- Variation in the audience with whom therapy targets are practiced

Based on the theory of operant conditioning and involves the relationship among a stimulus, a response, and a consequent event
A stimulus (or antecedent event) is an event that precedes and elicits a response
A response is the behavior exhibited by an individual on presentation of the stimulus
A consequence is an event that is contingent on and immediately follows the response
Types of reinforcement:
- Positive reinforcement: a rewarding event or condition that is presented contingent on the performance of a desired behavior
- Negative reinforcement: an unpleasant event/condition is removed contingent on the performance of a desired behavior
Types of punishment:
- Type I: prompt presentation of an aversive consequence after each demonstration of an unwanted behavior
- Type II: withdrawal of a pleasant condition contingent on the demonstration of an unwanted behavior
Schedules of reinforcement:
- Continuous reinforcement: a reinforcer is presented after every correct performance of a target behavior
- Intermittent reinforcement: only some occurrences of a correct response are followed by a reinforcer