Speech Sound Disorders - TCU Prahl - Final Exam

Treatment Principles and Procedures | 3 more 8 am Mondays

Target Behavior

Any skills that we are teaching the client

Short Term goals

Reflect the skills or targets that we can train or teach them in a realivley short-period of time… baby steps to support long term goals

Long term goals

More broadly defined, things that we hope the client learns to help their overall goals, overall, for when they are done with treatment

Short-term or long-term?

Areas of concern: Improve their production of /r/

Increase intelligibility

Reduce cluster reduction

Short term: Improve production of /r/, Reduce cluster reduction

Long-term: Increase intelligibility

Common Long-term goals

Age-appropriate articulation, intelligibility, improve phonological skills, self correct, maintaining skills

Selecting Targets: General Considerations / Justifications

• Behaviors that make an immediate, meaningful, and social experience (e.g., sounds that help them get their message across)

• Most useful because they are produced and reinforced at home and other natural settings: Ex: lots of people in their life have names that start with /l/

• Behaviors that help expand their communication skills (ex, producing more age-appropriate sounds, or kiddos who have a language disorder and speech sound disorder, so focus on error patterns when it comes to language)

• Behaviors that are linguistically and culturally appropriate for the specific client

Selecting Targets: Phonological Impairment aka error patterns, more severe than an artic disorder…

1. Select error patterns that affect intelligibility (Kid is trying to say: The dog ran off with the leash… but instead they had liquid gliding and final consonant deletion: (liquid gliding):” The dog wan off with the weash."… (final consonant deletion): “The do ra o wi the lea” as we can see, final consonant deletion has a greater impact on intelligibility

2. Select error patterns that are less stable : maybe they have liquid gliding and they are getting /l/ right in intial position of words so start there because they are showing you they have inconsistency and lets build off of that foundation

3. Select error patterns that are most common for young children: error patterns that should disappear by age 3 and if they are persisting after, lets start there, ex: Five year old who still does final consonant deletion

Selecting Target: Individual Sounds (Artic Disorder)

1. Functional: Sounds and words that are most frequently used in the client’s language and dialect across their natural settings (More likely to be reinforced and sustained)

2. Occur more frequently: Starting with sounds that occur more frequently, errors or in conversation (see the connected speech sample)

3. age of acquisition/developmental norms: selecting sounds based on those that they really should have mastered because of their age, work on most early developing sounds

4. Phonetic inventory: sounds that the child is producing some of the time to build on the foundation they have

5. Stimulable: Incorporate words that are stimulable by giving them models, and see how much cueing they need

6. Visible: Sounds where the child can see the articulators involved because they can see how to produce them… ex: starting with bilabials instead of velar

7. Intelligibility: Starting with sounds that impact intelligibility the most, one may need to work on multiple sounds simultaneously

8. Inconsistent: 2 arguments: If they are inconsistent, it means there is less work because they already have a foundation, or I think, since they can do it some of the time, then they can figure out how to correct that sound spontaneously

9. Exemplars that may generalize: just focus on a few fricatives rather than all of them, positive changes on untreated sounds, saves us time and effort

10. Exemplars that are part of a phonological pattern: ex: /l/ and /r/ and they consistently demonstrate liquid gliding so lets start there because we know the pattern

How many sounds should be targeted?

Not a clear black and white answer, we have thought through…

What is unique about this individual client?

• Motivation: Work on all sounds

• Intellectual level: work on a few, so its not too taxing

• Language skills: Slower speech, 1-2 sounds

• Learning proficiency: quick learner than multiple sounds or slow to demonstrate progress, backtrack, and narrow the sounds down

Simultaneous treatment of multiple phonemes is recommended! If this seems difficult, then adjust accordingly and narrow the number of sounds.

Which best describes a short-term objective?

A skill learned quickly to support long-term goals

Simultaneous treatment of multiple phonemes is

Recommended depending on the client

List 3 variables you would consider when selecting therapy targets

Motivation

Intelligibility

Stimulability

Age of acquisition