CDO 338 12

  1. By 2020 50% of our children attending
    public schools will come from culturally and linguistically different (CLD)
    backgrounds.

    By 2050 50% of the total population will
    be from culturally and linguistically different (CLD) backgrounds.
  2. TREATMENT STRATEGIES for clients with a sound system disorder concomitant with a language, fluency or voice impairment
    • Simultaneous
    • Concurrent
    • Cyclic
    • Sequential
  3. Question:  How do we treat children with an artic/phono disorder concomitant (at the same time) with one or more other speech and/or language disorders?
    If the goal is to improve in both domains, the cyclic and concurrent approaches seem to be the most appropriate. 
  4. Should I use a  phonetic or phonological treatment approach ?
    Select the approach that best matches the client’s diagnosis: phonetic, phonological, mixed or apraxia. 
  5. Use Phonetic (motor) Approaches if...
    • If the individual does not articulate sounds correctly because of:
    • 1.Inappropriate placement of the articulators
    •    —Interdentalized /s/
    • 2.Inappropriate modification of the airstream
    •    —lateralized /tS/
    • The client is intelligible, uses a few misarticulated sounds, or distorts speech sounds.
  6. Phonological Approaches
    These approaches are for clients who are unintelligible and have multiple misarticulated sounds.
  7. Treatment Approaches for Phonetic Disorders
    • Emphasis is on motor or movement components of sounds in terms of visual, auditory, and kinesthetic changes.
    • Major approaches:
    • —Phonetic
    • placement 
    • Moto-Kinesthetic 
    • Stimulus
    • Sensory-Motor
  8. Treatment Approaches for Phonetic Disorders
    Criteria for Target Selection
    Most People agree--begin with a misarticulated phoneme(s) that are relatively easy for clients to produce.

    • Variables to Consider:
    • Earlier  vs. Later developing phoneme
    • Stimulable vs. nonstimulable phoneme
    • Phoneme produced correctly in Key word
    • —Frequently Occurring Phoneme
    • —Visible Phoneme
    • —Consistently misarticulated phoneme
    • —Phoneme that the Client/others desire to target
    • —Phoneme for which a Client has been criticized or penalized
    • Phoneme that is omitted or an atypical substitution
    • —Phoneme least affected by physical limitations
    • —Same phoneme for client group

    Probably 80% of the time we will choose the stimuable sound over the nonstimulable.
  9. Evidence Based Triangle – Evidence Based Practice – Research, Experience, and Client Values
  10. Treatment Approaches for Phonetic Errors
    Phonetic Placement Approach emphasizes:
    • 1.Placement of the articulators
    • 2.Modification of the airstream

    Premise is that an individual does not articulate sounds because of faulty articulatory placement or modification of the airstream.

    • You may choose this approach because you
    • know that the articulator needs to be in a specific place and it isn’t,

    • The Late Eight by Ken Bleile.
    • Working on things when they are destabilized because we aren’t stable on a regular basis. So that they generalize.
  11. Treatment Approaches for Phonetic Errors
    Phonetic Placement Approach-placement of articulators
    Intervention: 
    Teach appropriate placement by physically assisting placement

    • —Tongue: touching the alveolar ridge with a tongue depressor
    • —Teaching appropriate modification of the airstream by using a straw.
    • —Diagrams
    • —Demonstrations
    • —Use considerable repetitive practice.
  12. Treatment Approaches for Phonetic Disorders
    —Phonetic Placement is still used:
     particularly in early phases of articulation intervention to demonstrate how a phoneme is produced.
  13. Treatment Approaches for Phonetic Errors
    Moto-Kinesthetic Approach
    • —Premise:  speech is not a series of static positions, but a dynamic event.
    • —Sound productions rely on a motor process of shaping or obstructing exhaled air
    • This approach involves external manipulation of the articulators.
    • —Movement must be “felt” and developed as a muscle sense of kinesthetic image
  14. PROMPT – Prompts for Restructuring Oral Muscular Phonetic Targets
    • most widely used moto-kinesthetic approach. These teaches clients for positions for the sounds and how to move from one sound to another.
    • Speech isn’t static (stationary, non-moving) it is dynamic (moving).
  15. Moto-Kinesthetic  Approach continued
    • —Focus on the feelings of where sounds occur and the movement between sounds.
    • Association is made between the feeling of the movement and the simultaneously produced
    • auditory model.
    • —Feel movement as sound is produced first in syllables with schwa) then
    • -—Reduplicated syllables
    • -—Multisyllablc words,
    • -—Phrases,
    • -—Sentences.
    • Tactile cuing is part of M-K approach
  16. Sometimes we get caught up on having them watch how we pronounce it when we should be helping them to make the sound and see/know the sound themselves.
  17. Treatment Approaches for Phonetic Disorders
    Stimulus Approach
    • Van Riper’s—referred to as the traditional approach. 
    • Van Riper viewed misarticulations as more than placement or Production errors.
    • -—He viewed poor auditory sensory perception as a contributing factor in misarticulations.
    • —-Advocated auditory or ear training prior to production practice of individual sounds to stimulate the sensory perception of the phoneme.
    • —-Targeted 1 phoneme at a time
    • Speech Correctionists used this in the 1970s.
    • This is the correct approach for some kids with articulation disorders, but not for kids with phonological disorders.
  18. Stimulus Approach (Traditional)
    3 Phases:
    • Phase 1: Auditory Training
    • Phase 2:  Production 
    • Phase 3: Transfer of the sound production to other settings and Carryover and Maintenance of the sound in conversational speaking
  19. Phase 1: Auditory Training
    • 1.Identification: Naming of the target sound using a descriptive cue
    • /s/=snake sound     /f/=mad kitty sound
    • 2. Isolation- identifying the sound of the position of the sound in a word phrase or sentence (beginning middle or end).
    • 3.Auditory stimulation using the target sound in a variety of activities, tongue twisters and sound-loaded sentences.
    •    She sells sea shells by the seashore
    • 4.Discrimination of the “new” target sound from the client’s errors.
    • 5.Self-hearing where the client identifies own errors.
  20. There is lots of evidence to support using literature for language therapy.
    Book: Books are for Talking Too.
  21. Phase 2:  Production
    • Sound elicitation established by:
    • —  isolation
    • —  stabilization in isolation
    • —  nonsense syllable
    • —  words
    •   sentences
    • Very methodical and you must meet your 80% accuracy until you move to the next thing.
  22. Phase 3: Transfer of the sound production to other settings and Carryover and Maintenance of the sound in conversational speaking:
    • Facilitated through speech assignments at home, school, or in the community
    • —Self monitoring
    • Practice with various conversational partners in various settings.
  23. Treatment Approaches for Phonetic Disorders
    Sensory Motor Approach (McDonald, 1964)
    • Follows this sequence:
    • Heightened awareness of the speech movement patterns through bi-syllable and tri-syllable productions
    • —Correct production of sound sequences in syllables
    • —Correct production in varied phonetic contexts
    • Primary goal of the program is to increase the child’s auditory, tactile, and proprioceptive awareness of the motor patterns involved in speech sound production through motor tasks.
    • This is an old approach. It starts in syllables, teaching client how to move from sound to sound.
Author
shanamd2011
ID
187764
Card Set
CDO 338 12
Description
Intervention of Articulation / Phono Disorders
Updated