CDO 338 14

• These approaches are for clients who are unintelligible and have multiple misarticulated sounds.
• Phonological awareness is an umbrella term. Phoneme awareness is specifically looking at being able to recognize specific sounds.

• 1. Suppression of processes through intervention
• of sounds affected by the process
• 2. Awareness of patterns that we use in our language

A goal basic to all phonological intervention is facilitating the reorganization of a child’s phonological system and enhancing the strategies for processing phonological information.

• Cycles approach
•    Hodson & Paden, 1991
• Phonological Awareness Approaches
•    Gillon, 2000
• Major Contrast Approaches
•   A. Lynn Williams, 2000

• Designed for intervention of highly unintelligible children
• —Focus on facilitating emergence of phonological patterns, contrasted with meeting a criterion for mastery of individual phonemes
• —A phoneme that represents a deficient pattern becomes the target
• Kids with phono impairment we work really hard with them with suppressing phonological processes and when they are mostly intelligible we then have to clean up their articulations.
• NEVER forget about input.
• Use a phonological approach for highly unintelligible individuals.

• 1.Stimulation/Auditory Bombardment
•    In every session you must do this 
• 2.Production Training/Semantic Awareness Contrasts
•    Teach the child the target (10 minutes)
• 3.Practice core words in target process
•    Using games you practice the target sound.
• 4.Probe
•    Get the stuff for next week and see how the child does with it.
• 5.Auditory Bombardment
•    Have child listen to the sound again.

• This is called cycles because you don’t wait until they have mastered anything. You just continually move to the next thing. Be systematic and keep moving because
• you are reorganizing the system not training on individual sounds.
• 3 full cycles for a highly unintelligible preschooler.
• An hour of therapy is recommended per session.

• —A cycle is a period of time during which all phonological patterns needing treatment are facilitated in succession. 
• —Major phonological deviations present in at least 40% of the possible occurrences are to be targeted.
• Each phonological pattern is targeted in for app 60 minutes per context before going on the next pattern. 
• —One pattern is targeted per session.
• —The length of a cycle varies from 5 to 16 weeks
• —Three or four cycles are usually required for an unintelligible child to become intelligible.

• Children with expressive phonological impairments (especially severe) have been shown to be at greater risk for later literacy problems 
• (Hodson & Strattman, 2004).
• —There is a relationship between expressive phono abilities & phono
• awareness.
• —What are Phonological Awareness Skills?
• —Awareness of the sound structure of a language and the ability to manipulate sounds in words
• They need more input.

• —Rhyming:do these words sound alike: cat-hat?
• Phoneme isolation: tell me if /b/ is in the beginning or at the end of the word “ball”?
• —Phoneme manipulation: Say the word “man” without the /m/ sound. 
• —Sound blending:  What does tea---------cher say?
• —Sound segmentation: What are the 3 sounds in the word dog?

• You might choose a phonological awareness (input) first and then focus on output.
• Good kindergarten teachers are working on rhyming every day and giving students lots of auditory input.

• Minimal Pairs
• Multiple Oppositions
• Maximal Oppositions

• —AKA – Contrast Therapy
• —Oldest—used since the 80s
• Most widely used
• —Contrasts child’s error with target sound
• —Eliminates common phonological processes
• —Fronting, Stopping, Gliding, Cluster reduction, & Final consonant deletion
• Useful with Mild to moderate errors
• —The task of treatment is to eliminate inappropriate rules or processes.
• —You change their system by using their meaning.
• —Change their inappropriate rules in their language center.
• Used for children that have one really bad phonological process. It can be mixed with cycles training.

• Compare and contrast two words.
•   Example: 
• bow/bone, me/meet –final consonant del.
• cake/take, game/dame- velar fronting
• soon/spoon, feet/fleet- cluster reduction

• Establish the meaning of words-teach meaning with pictures
• Receptive testing and training-point to pictures that you hear
• Production training-produces the word and clinician points
• Carryover activities- words in phrases and conversations

• Williams (2000)
• —This is also considered contrastive therapy.
• —The difference between multiple oppositions and minimal pairs involves the number of contrasts to be trained. Minimal pairs train a single contrast, multiple oppositions train several oppositions across an entire rule set.

• Child says “tip” for “sip", "kip”,
• “chip”, and “trip”.  They are using stopping, fronting, deaffrication, and cluster reduction. You use all these words to train affect learning across an entire rule set. 
• —The goal is to place additional demands on memory, attention and increase semantic load

• Maximal oppositions by Gierut (1989;1990)
• —The difference between this approach and minimal pairs is the comparison sound that will contrasted with the target sound. The comparison sound is not the child’s errored
• sound.  It must be a sound that produced correctly by the child and the comparison sound must be maximally distinct from the target sound.
• “me” and “she”
• “my” and “shy”
•  Minimal pairs is part of a contrasts approach. From that we derived multiple oppositions approach.
• The idea is that we work on targets that are beyond what the child should be able to do in hopes that the stuff in between will fall into place. – We often use this when we have run out of options.
• If it isn’t working after 16 months then we need to change it up.

Developed to facilitate cognitive reorganization of children’s speech sound systems.

• children can change their sound productions through developing an awareness of the similarities and differences in duration, placement and manner of production for speech sounds.
•    —Demonstrated through classification sorting
•    —2 phases

• Phase 1:Properties of Sound
• Phonological production concepts &
• terminology are enhanced through classification (sorting) of non speech sounds noisy/whispered;  front/back
• Phase 2:Sound Production
• Clients become aware of communication
• breakdown which are facilitated by applying their
• knowledge of the phonological system.

• Children learn to monitor themselves in sentence production & modify what they say for more effective communication.
• Assists cognitive-linguistic reorganization.  Results of a study of Scottish preschoolers demonstrated that children using this approach improved expressive phonological productions.

• “…,virtually everything works (including maturation). The critical concern pertains to the overall expenditure of time, along with potential impact of disordered phonologies on academic achievement.”
•   -B. Hodson (1992)
• THE GOAL IS EFFECTIVE AND EFFICIENT TREATMENT

• There are many different approaches to phonological intervention.
• —No single approach is correct for all children.
• —We must choose the right approach based on the child’s individual profile.