Phonological and Articulation Disorders Final

study ASHA chart

early 8 phonemes

suppressed by age 3

d, p, b, w, m, n, j, h

mid 8 phonemes

ng, k, g, t, ch, dj, f, v

late 8 phonemes

sh, jjj, th, th, s, z, l, r

subsystems of speech

respiratory, phonation, articulation, resonation

4 types of speech errors

Substitution

Omission

Distortion

Addition

how to write an objective

Audience

Behavior

Context

Degree

3 types of phonological processes

substitution, syllable structure, assimilation

substitution processes

stopping, fronting, backing, gliding, deaffrication, vowelization

syllable structure processes

reduplication, final/initial consonant deletion, weak syllable deletion, cluster reduction/deletion/substitution, epenthesis, diminutization

assimilation processes

prevocalic voicing, postvocalic devoicing

backing

idiosyncratic

gliding

late

vowelization

late

stopping

early/mid

deaffrication

early/mid

fronting

early/mid

syllable deletion

early

diminutization

early/mid

epenthesis

late

final consonant deletion

early/mid

initial consonant deletion

idiosyncratic

cluster deletion

early/mid in final

cluster reduction

early/mid in final

cluster substitution

later

reduplication

early

screening

consists of activities or tests that
identify individuals who merit further
evaluation

often used in school setting

independent phonological analysis

Looks at the child’s own unique phonological system
independent from the adult target system

relational phonological analysis

looks at the child’s productions compared to adult model

ideal candidate for independent phonological analysis

For children in the prelinguistic stage or younger than 2-3 years, and does not attempt to use the adult target

shaping

moving from sound in isolation to more
complex linguistic levels

involves breaking down a target behavior into smaller, more manageable steps, and then reinforcing each step as it's mastered

differences between phonetic vs. phonemic therapy approaches

phonetic - each sound is treated individually, in a sequence with one sound following the next.

phonemic - groups of sounds or sound classes rather than individual sounds are treated.

principles of distinctive features approach

Carryover will occur to untrained sounds

work on establishing the missing distinctive features rather than treating sounds

good candidates for the distinctive features approach

For clients with multiple errors (not for distortions)

principles of the conventional minimal pairs approach

Therapy that uses pairs of words that differ by one
phoneme only.

Highlights the need for a contrast between word pairs

minimal pairs

pairs of words that differ by one
phoneme only

principles of the minimal oppositions contrast approach

Selection of two sounds with as many articulatory similarities as possible

ideal candidates for the minimal oppositions contrast approach

stimulable for the sound

demonstrate some knowledge of the
error phoneme

one particularly pervasive process or only a few age-inappropriate phonological processes

consistent phonemic substitutions

moderate-to-severe sensorineural hearing impairment who are being trained orally.

cleft palate

Selection of Target Sounds for Minimal
Contrast Therapy

Choose the pair that has the fewest differences in the
production.

what they are producing (error) and what you want them to produce

principles of maximal oppositions approach

minimal pairs that are maximally different on the most distinctive features

Based on research that if we target first on sounds
that the child could not produce then more
generalization occurred

ideal client for maximal oppositions approach

Used with clients who demonstrate moderate to
severe phonological impairments

Selection of Target Words for Maximal Oppositions Approach

Choose two sounds that are NOT in the client’s
inventory they should be maximally different in
their distinctive features

principles of multiple oppositions approach

It is thought that by treating a larger number of
contrasts then a greater improvement in their
phonological system will take place

ideal client for multiple oppositions approach

Appropriate for client’s with severe to profound speech
disorders

Selection of Target Sounds for Multiple
Oppositions Approach

Maximal distinctions are used

ideal candidate for phonological process therapy

Appropriate for a young client with a phonological
system that has limited number of phonological
processes

Targets for phonological process therapy are chosen based on:

 Frequency of occurrence
 Effect on intelligibility
 Phonological development

principles of cycles approach

No predetermined level of mastery for phoneme
 Only looking for emergence not mastery
 Approximates the way phonological development
normally occurs (gradual)

structured sessions

ideal candidates for cycles approach

Highly unintelligible children

cycles training

Cycle – time period (about 2-3 months) during
which all primary deficient phonological patterns
are targeted in succession.
 Each stimulable phoneme should be targeted for
about 60 minutes per(1 60 minute cycle or 2 30
minute sessions) cycle before progressing to the
next target phoneme within a pattern.
 Only enough phonemes are targeted that will allow
for generalization. Two hours (more if there are
other stimulable phonemes) on average spent on
each pattern the next most stimulable pattern is
targeted.

typical cycles approach training

1. Review of preceding session’s production-
practice words.
 2. Auditory bombardment of this week’s target.
 3. Potential word list for production practice.
 4. Therapy activity using new target words.
 5. Probe for next session’s target phoneme
 6. Home program

principles of the traditional approach

Goal is to change errored patterns

phonemes are treated individually

Correct phonemes for misarticulations are normally taught in isolation, then in nonsense syllables, then words, then phrases, then sentences, and finally, in conversation

Child must first differentiate between correct pronunciations and sound errors of the
targeted phoneme, and learn to imitate clinician

principles of the complexity approach

The complexity approach proposes that children who are missing multiple sounds in their speech should contrast two words with unknown sounds or later produced sounds (such as an “empty set”)

If language includes a complex form, it has related simpler forms

later developing, more complex sounds that are not in vocab and not stimulable are chosen first.

elicitation techniques

shaping, prompting, modeling, repetition, imitation, auditory discrimination, engage in conversational speech, etc.

antecedent events

the stimulus events presented during or just prior to a response, such as a verbal model, instructions, picture, etc. designed to elicit responses

2 types of feedback

knowledge of performance and knowledge of results

knowledge of performance

feedback about what the client is doing correctly or incorrectly (“don’t forget to do this”)

knowledge of results

focus on whether it was produced correctly "(“that was good” or “no, not quite”)

modeling

demonstrating how to produce a specific word, sentence, or speech sound

prompting

providing a cue or signal to guide a client towards producing a specific speech sound or movement (more direct than cueing - like giving instructions or part of an answer)

raw score

number of correct phonemes

3 considerations for choosing target phonemes

 Consider the age of the client and the developmental
level of the client’s phonemic system.
 Consider which sounds have the greatest impact on the client’s intelligibility.
 Consider which sounds are more stimulable.