Structure of Treatment Sessions
- 4 structural modes of intervention: (Shriberg 1982)
- Drill play
- Structured play
Drill: stimuli are presented rapidly
- Treatment is a structured by a stimulus-response paradigm
- Positive reinforcement is given for correct responses
- Correctivefeedback is given for incorrect responses
- -when the response is incorrect the clinician gives the client a second trial by repeating the stimulus
- Last step is to modify the stimulus form by exaggerating the target in duration and intensity.
- Ex) flashcards for sounds, use repeatedly
Drill Play: a “fun” element is added
- Same as drill except a motivational event is incorporated before, during, or after the stimulus is presented.
- Ex) use Jinga and every time that you say this correctly you can pull a Jinga piece out.
- Similar to drill play, but the stimuli are presented as part of play activities.
- Clinician may opt to NOT provide instructional feedback about incorrect responses.
- The clinician arranges activities so that the target
- responses occurs naturally.
Which treatment style is the best?
- Drill and drill play treatment modes were shown to more effective for artic/phono therapy.
- Clinicians perceived drill play as the most effective, most efficient, and most preferred of the 4 modes
- (Shriberg&Kwiatkowski, 1982)
- You have to find out what makes the kid tick and use it. Do they like Barney, Lord of the Rings, etc. USE IT.
Elicitation of Speech Sounds
- Auditory-Visual Model
- Use a Mirror
- Use Tactile-Kinesthetic Cues
- Modification of nontarget sounds
- Visual illustration of placement of articulators
- Provision of visual cues
- Facilitating phonetic contexts
- Verbal instructions
- Successive approximation (shaping)
Transfer or Generalization
- Phonemic contexts – exact sounds
- Situational contexts – saying it in the classroom, making calls, etc.
- The habitual use of target sounds in all speaking situations, including conversational speech in and out of the clinic.
- When a child gets to carryover then we discharge the client.
- Carryover also involves articulation of the target sound without deliberate or conscious effort.
Carryover: In-clinic strategies
- Nonsense materials
- Timed productions
- Comparison of error and correct sounds
- Paired-stimuli approach
- Programmed approach
- Creative drama
- Group intervention
- Proprioceptive feedback
Carryover: Out-of-clinic strategies
- Extra-clinic environments
- Last phase of artic/phono intervention is maintenance or retention.
- Maintenance: continued use of the target sound/pattern in all speaking situations over time.