WSU SLP 6460 week 12 phonological intervention

long term objectives (LTO)

to demonstrate correct production of age appropriate phonemes at conversational discourse level; child will be able to produce intelligible speech at conversational discourse level

short term objectives (STO)

‘given visual, auditory, and tactile cuing, the client will produce the /k/ phoneme in the initial position of words with 60% accuracy’

rationale: child is not yet producing velar sounds, according to formal and informal assessments completed; this should be mastered as indicated by developmental norms

linguistic-phonologically based approach

target phonological processes and the child’s underlying phonological system; trying to suppress the pattern of error that a child is producing

cycles approach (Hodson & Paden)

designed for the highly unintelligible child; focuses on suppression of phonological patterns that are not yet suppressed; not focused on mastering individual phonemes; patterns are targeted for intervention, not individual sounds; program is planned around ‘cycles’

cycle

a period of time in which all phonological patterns in need of remediation are facilitated in succession; can take 5-6 weeks or up to 16 weeks to get through one cycle

basic info of cycles approach

each errored phoneme within each pattern is “trained” for 60 minutes/cycle; stimulation should be provided for two or more target phonemes within a pattern before changing to the next pattern; 1 phonological pattern per session only; mastery is not required to move to the next pattern; cycle is completed when all phonological patterns in error have been taught; after 1 cycle you will repeat from the beginning using sound targets that haven’t emerged yet or need further instruction; typically 3-6 cycles of remediation are usually required to see an unintelligible child becomes intelligible

cycles vs traditional approach

cycles approach is horizontal (mastery not required before moving on); traditional is vertical (mastery required before moving on)

3-6 cycles

typical amount of remediation required to see an unintelligible child become intelligible

procedures for the cycles approach

1. review prior session

2. auditory bombardment

3. target word cards

4. production practice

5. stimulability probing (what to target next)

6. auditory bombardment

7. home program

1. review prior session (cycles approach)

start each session with a review of the sound and pattern that was targeted; use the same practice cards unless a new pattern is being initiated (don’t review old cards then)

2. auditory bombardment (cycles approach)

for about 2 minutes; slight amplification; child simply listens while therapist reads target words slowly, child is NOT allowed to repeat the words, listening only

3. target word cards

allow the child to draw, color, glue pictures of the target words (3-5) on index cards; write the name on the cards; elicit multiple trials of correct productions; do not practice incorrect productions instead model correct production

4. production practice (cycles approach)

practice targets through drill/play model; provide auditory, tactile, and visual stimulation assisting the client in producing the phoneme

5. stimulability probing (cycles approach)

do some baseline collection at the end of the session to determine what sound will be targeted next in the process pattern; check for stimulability, whatever is strongest target that next

6. auditory bombardment (cycles approach)

repeat the same sound list from the beginning of the session

phonological awareness activities

should be incorporated into every cycles approach session; for example rhyme activities, letter sound knowledge, etc; generally used in between stimulability and second auditory bombardment (turns into a modified cycles approach)

7. home program

very important to help facilitate generalization; caregiver is asked to read the auditory bombardment word list to the child every day; have child practice target word cards every day; takes only 2 mins

if the child is not stimulable for any target patterns?

go through a cycle of focused auditory stimulation

if the child demonstrates speech and language errors?

likely target both; may have to start with AAC depending on intelligibility