SLP 522 Speech Sound Disorders Chapter Ten PDF

SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders Comparison of Therapies o Articulation Therapy ▪ Begins with sounds in isolation ▪ Focuses on speech form ▪ One sound targeted at a time o...

SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders Comparison of Therapies o Articulation Therapy ▪ Begins with sounds in isolation ▪ Focuses on speech form ▪ One sound targeted at a time o Phonological Therapy ▪ Begins with word level ▪ Targets multiple sounds ▪ Focuses on phonemic function Interaction between Form and Function o Form (speech sounds) and function (phonemes) constitute a dynamic interaction o Almost impossible to separate the two o In therapy sessions, impossible to target one and not the other Principles Underlying Approaches o Groups of sounds with similar patterns targeted o Phonological contrasts that were neutralized are established o A naturalistic communicative context is emphasized Principles Underlying Treatment o Phoneme as a basic unit differentiating between word meanings ▪ Intervention begins at the word level ▪ Phonemes arranged contrastively o Treatment focuses on child’s phonological system ▪ Knowledge of inventory ▪ Syllable shapes and phonemic contrasts used ▪ Error patterns displayed  SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders o Groups or classes of sounds targeted ▪ Assumption is generalization will occur to other sounds or sound classes ▪ Minimal Pair Contrast Therapy Use of Minimal Pairs o One sound from representing sound classes contrasted o Establishing a contrast causes generalization to occur to other stops and fricatives o Minimal pair contrast therapy o Use of pairs of words that differ by one phoneme o Used to establish contrasts not in child’s system o Target one sound from a group or class and will lead to generalization o http://www.youtube.com/watch?v=MQYXVzCnP0c Minimal Opposition Contrast Therapy o Minimal pairs used in the beginning o Sounds selected with as many articulation similarities as possible ▪ Sound differs in only one or two characteristics: manner, place, or voicing o Phonemic contrasts established using a phonetic approach, form, and function united o Use with children exhibit sound distortions and assimilations ▪ Substitution on sound ▪ Stimulable for target sound ▪ Effective for children with consistent phonological speech errors o Selecting target sounds ▪ Phonemic substitutions ▪ Place, manner, voicing considered for both sounds; choose contrasts with least number of differences ▪ Child’s age and developmental level  SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders ▪ Sound substitution that affects intelligibility the most ▪ Stimulable sounds preferred over nonstimulable sounds o Selecting minimal pairs ▪ If meaningful minimal pairs not available, use near minimal pairs Differ by more than one phoneme; vowel preceding or following target phoneme stays the same o Therapy protocol includes discrimination, imitation, and spontaneous production o Steps ▪ 1. discussion of words ▪ 2. Discrimination testing and training ▪ 3. production training ▪ https://www.youtube.com/watch?v=MzkNjdet9uM Maximal Oppositions Approach o Chooses sounds that are very different o Target sounds with least ph0onological knowledge and will generalize to other sounds in the sound system o When to use this approach: ▪ At least 6 sounds missing from phonetic and phonemic inventories ▪ Moderate to severe phonological disorders o Maximal oppositions approach o Selecting target sounds ▪ Two sounds not in the child’s inventory ▪ Sounds must be maximally different Number of unique distinctive features Nature of the feature o Major (p. 355) and nonmajor class features-BOX 10.1 o Ex: chop; pop  SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders o Maximal oppositions approach o Treatment ▪ Phonological contrast not trained ▪ Two phases: imitation and spontaneous production ▪ Imitation phase Continues until 75% accuracy met ▪ Spontaneous phase Word pairs produced until 90% accuracy level met in 3 to 12 sessions Complexity Approach o More complex linguistic input promotes greater changes in child’s phonological system o Focuses on what is targeted as opposed to how it is targeted o Complexity approach o Selecting target sounds ▪ Two sounds that differ in place, manner, voicing ▪ Markedness applied to the selection of targets ▪ Stimulability important ▪ Using nonwords as opposed to real words ▪ Ex: shat; gat o How used: ▪ Children 4;0 yrs ▪ 6 or more sounds in error across 3 manner categories ▪ Moderate to severe phonological impairment Multiple Oppositions Approach o Several sounds collapsed into one phoneme o Treat a larger number of contrasts o Contrast error sounds using minimal pair sets  SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders o When to use: ▪ Moderate to profound phonological impairments ▪ Demonstrate a collapse of multiple phonemic contrasts o How to select target sounds ▪ Use maximal distinctions, maximally different from child’s error o Multiple oppositions approach o How used: ▪ Imitative level at 70% in 2 consecutive tx sets ▪ Spontaneous phase at 90% across 2 consecutive sets ▪ Spontaneous contrasts or generalizations at 90% of target sound in untrained words ▪ Conversation based phase ▪ /d/ contrasted with /g, th, sh, dj) ▪ Phonological process therapy o Establish phonological process o Then use minimal contrasts o When to use this therapy: ▪ Young client with minimal number of phonological processes o How to select target sounds: ▪ Frequency of occurrence ▪ Effect process has on intelligibility ▪ Age and phonological development of the child Phonological Process Therapy o How Minimal Pairs are used ▪ Incorporate child’s interest and level of ability ▪ Communicative function should receive focus o Cycles training  SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders o Phonological patterns are remediated and trained successively during specific time periods (cycles) o No predetermined level of mastery for phonemes or patterns within cycles o Patterns used to stimulate emergence of a specific sound or pattern o Based on principle that acquisition is gradual o Several sounds targeted within a cycle o When to use: ▪ Highly unintelligible children; severe to profound on HAPP-R o How select target sounds in cycles: ▪ Early developing phonological patterns Deficiencies in syllableness, word initial singletons, word final singletons, other word structures ▪ Posterior/anterior contrasts ▪ /s/ clusters ▪ Liquids o How cycles training is used ▪ Each phoneme w/i pattern targeted 60 minutes per cycle ▪ Word cards: monosyllabic, facilitating contexts, avoid using substituted sound in words ▪ Structuring the session Review Auditory bombardment Target word cards Production practice through experiential play Stimulability probes Auditory bombardment Home program Metaphon Therapy  SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders o Based on metalinguistic awareness ▪ Ability to think about and reflect on the nature of language o Develops metaphonological skills o When to use: ▪ Preschool children ▪ Restricted phonetic inventories ▪ Idiosyncratic processes ▪ Moderate to severe phonological disorders o How select target sounds: ▪ Idiosyncratic processes ▪ Various use of simplifying process ▪ Effect on intelligibility ▪ Sounds available imitatively and spontaneously o How is metaphon tx used: ▪ Two phases ▪ Phase I Aim is to capture child’s interest in sounds and entire system Develop phonological awareness (word, syllable, rhyme, phonemic awareness, alliteration) Explore properties of sound and importance of making distinctions Four levels: concept, sound, phoneme, word o http://www.youtube.com/watch?v=T4YvWb0WMRQ o http://www.youtube.com/watch?v=BELlZKpi1Zs o http://www.youtube.com/watch?v=t99ULJjCsaM o http://www.youtube.com/watch?v=aluuyOtscnE ▪ Phase II Developing phonological and communicative awareness  SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders Client and clinician take turns producing minimal pair words Last phase is putting minimal pairs into sentences to facilitate communication and promote repairing communicative breakdowns o “I can pat the fat dog.” Phonemic and Language Problems Co-occurrence in preschoolers between 60 and 80% Interdependencies in subcomponents of language Phonological intervention does impact other language areas Morphosyntax intervention o Four grammatical morphemes are targeted in a cycle for a week; can be repeated o Singleton or final clusters can be targeted in past tense o Morphemic contrasts preserved but attention must be given to final consonants and clusters ▪ FCD-incorporate specific grammatical morphemes in contrasting word pairs ▪ CR/FCD-contrastive word pairs that incorporate grammatical morphemes ▪ Minimal pair words could be used to represent other grammatical morphemes ▪ Subject and object pronouns can be used in sentences ▪ Consider length and complexity of sentence ▪ “There 2 ________ playing outside. (fill in the blank) ▪ Incorporate written tasks as well Semantics and phonology Vocabulary intervention o Remediation suggestions ▪ Incorporate nouns and verbs  SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders ▪ When target sounds emerge, expand vocabulary with new words containing target Use with a child who has difficulty with vocabulary skills as well as a phonological disorder o Final consonant deletion o Sip, kick, dog, cup (Consider word shape and functionality when choosing vocabulary) o It, can, red o Can incorporate into play therapy. Create a story that includes vocabulary and act it out. Initially, you will tell the story but eventually build in moments in which the child can add in target word Whole Language Intervention Therapy takes place via conversational interactions and story contexts, incorporating cues, cloze sentences, rebus stories, story reading (to the child) and storytelling (to the child and by the child) with no picture or object-naming per se (http://speech-language- therapy.com/index.php?option=com_content&view=article&id=84:whole&catid=1 1:admin) http://www.magickeys.com/books/pirate/index.html Emerging Phonology Referred to as late talkers Develop a lexicon o Consider child’s consonant inventory o New word contains sounds in child’s inventory o Consider syllable shapes and use in target words o Expand the consonant inventory, consider normal sound developmental sequence o New words similar to those used by normally developing children o Use words from a variety of grammatical classes o http://www.youtube.com/watch?v=QzuDBB1yNVM o http://www.youtube.com/watch?v=Lv3s1-C_Xm8  SLP 522 Speech Sound Disorders Chapter Ten: Therapy for Phonemic-Based Speech Sound Disorders Treatment of vowel errors Extremely limited vowel inventories; similar to babbling period o Therapeutic suggestions ▪ Teach earlier learned vowels p. 383 and follow sequence ▪ Use one known and one unknown vowel in minimal pairs; ex: me, ma ▪ Introduce other early vowels in minimal contrasts with original vowel included ▪ Using 2 unknown vowel pairs Similar to maximal oppositions 2 different unknown vowels targeted Large vowel inventories but high incidence of vowel errors o Vowel substitutions ▪ Choose vowel with high inconsistent use ▪ Substitution chosen should be productionally different