The Essentials of Good Therapy: Basic Skills

Week 1-2

general principles of therapy

• therapy is dynamic

• therapy is designed w/ client’s abilities in mind

• teaches strategies for facilitating the communication process rather than teaching isolated behaviors (to the extent possible)

general principles of therapy (continued)

• speech & language skills taught in communicative context

• individualized

• designed to show consistent success throughout all stages of therapy

• goals tailored to promote Ct knowledge one step above current level

5 parameters of facilitating successful treatment

1. programming

2. behavior modification

3. key teaching strategies

4. session design

5. data collection

Facilitating success: Programming

• selection of therapy targets

  • long term goals vs short term

  • pre-treatment baselines vs post-treatment results

Strategies in Programming

• normative strategy

• client-specific strategy

Normative strategy

• based on known developmental sequences of communicative behaviors in normally achieving individuals

• Short-term goals that will help to get to long-term goals

  • e.g. starting at the single syllable lvl, then going up

Client-specific strategy

focuses on what the parent/client wants instead of focusing on their developmental norms/things that will help them more in the long-run

Relevant factors in client-specific strategy and examples

• frequency

  • How much practice? How much Tx?

• importance

  • If Pt doesn’t see importance, they’re not going to practice

• potential

  • Age of onset

  • Do they have support at home?

Programming: Stimulability

Degree to which Ct can approximate the correct production of an error pattern on imitation

3 major factors determine the progression of the therapy sequence:

• stimulus type

• task mode

• response lvl

Programming: Stimulus type (and examples)

• direct physical manipulation

  • irl objects/things Ct can touch

• concrete symbols

  • objects

  • photos/colored images

  • black-and-white line drawings

• abstract symbols

  • oral & written lang.

Programming: Task mode

• imitation

• cue/prompt

• spontaneous

Programming: Response level

• increase length & complexity of desired response

• decrease latency b/w stimulus presentation and Ct response

Ways to increase length & complexity of desired response:

• isolation

• syllable length

• carrier phrases

• sentence

• text

How is branching achieved?

by increasing/decreasing the difficulty lvl by one step

Factors that can influence the degree to which successful generalization occurs:

• stimuli

• physical environment

• audience

Three main components of behavioral objectives:

• “do” (action) statement

• condition/context

• criterion (e.g. with 80% accuracy, in 8/10 trials…)

Fundamental purpose of intervention is to…

increase desired behavior or decrease unwanted behavior

Stimulus definition

An event that precedes and elicits a response

Response definition

The behavior exhibited by an individual on presentation of the stimulus

Consequence definition

An event that is dependent on and immediately follows the response

Reinforcement definition

Consequences that increase the probability that a behavior will recur

Punishment definition

Designed to decrease the frequency of a behavior