slhs 5370 intervention for articulation disorders

traditional approach

articulation approach to therapy that focuses on the phonetic placement of the sound in error and teaching the motor skills to correctly produce that sound

individually

in the traditional approach, sounds are typically treated ________

limited

the traditional approach works for clients of all ages who usually produce a limited number of errors

perceptual training

step 1 of articulation therapy progression

- improving the child's ability to auditorily discriminate between target and error sounds

isolation

step 2 of articulation therapy progression

- goal is to elicit and stabilize the sound in isolation consistently

- the SLP should be able to prompt the client to produce a sound accurately within 5-10 minutes

auditory stimulation/imitation

clinician provides examples of the target sound and the client is asked to imitate the sound

- "I say it, then you say it"

phonetic placement method

clinician instructs the client how to position the articulators in order to produce a typical production

sound modification method

deriving the target sound from a phonetically similar sound that the client can accurately produce

- should be a sound that they already have

syllable production

step 3 of articulation therapy

- usually starts with CV, VC, VCV syllables

- including nonsense words may help reduce interference of old errors

word production

step 4 of articulation therapy

- facilitating contexts make the word easier to produce

- coarticulatory factors should be considered

shorter, initial, open, stressed

facilitating contexts (make the sound easier to produce) include

- _____ words

- word-______ position

- ____ syllables

- ________ syllables

phrase production

step 5 of articulation therapy

- start structured and then move to spontaneous (after 80% accuracy benchmark)

controlled conversation

step 6 of articulation therapy

- verbal interaction between clinician and child that is more directed than spontaneous conversation

- start with 1-2 minutes, then increase

spontaneous speech

step 7 of articulation therapy

- start carryover in short conversations with teachers/parents

- observe the child in other contexts besides speech therapy

- dismissal criteria is usually around 50% accuracy

principles of motor learning

a set of processes associated with practice or experience leading to relatively permanent changes in the capability for movement

during, after

performance ______ acquisition of skill ≠ performance _____ acquisition of skill

pre-practice phase

variables that influence motor learning before the learner begins to practice the skill

- providing information about the sound to the child

practice phase

actual learning of skills

- composed of conditions of practice and conditions of feedback

conditions of practice

practice conditions that are implemented before and during training to enhance the effectiveness of active practice and maximize learning and retention

practice amount

condition of practice

- dose

- a large number of trials is better (100/session)

practice distribution

condition of practice

- the spacing of practice sessions

mass practice

type of practice distribution

- intensive treatment where sessions are close together

distributed practice

type of practice distribution

- sessions are more spread out

mass, distributed

start with ____ practice distribution and then decrease frequency to more ______ practice

practice variability

condition of practice

- refers to the amount of change and uncertainty in an environment or in the performance of a skill

constant practice

type of practice variability

- practice of a given task under a uniform condition

- /si, si, si, si/

variable practice

type of practice variability

- practice of a given task under differing conditions

- /si, so, se, su/

constant, variable

start with ______ practice variability and then move to ______ practice

target complexity

condition of practice

- simple, earlier-developing sounds and sound sequences vs. more complex, later-acquired sounds and sound sequences

practice accuracy

condition of practice

- whether or not the client should make mistakes during practice or not

errorless learning

type of practice accuracy

- structuring therapy so that errors are not likely to occur

errorful learning

type of practice accuracy

- structuring therapy to allow errors to refine motor skills and develop self-monitoring skills

errorless, errorful

start with _____ learning (to experience success and build off of something positive) and then transition to ______ learning

attentional focus

condition of practice

- the directing of attention to specific aspects of the client's performance or performance environment

internal focus

type of attentional focus

- the client focuses on how they are moving their mouth

- "is my tongue in the right spot?"

external focus

type of attentional focus

- the client focuses on whether or not the sound was perceptually accurate

- "was the sound produced correctly?"

internal, external

start with ______ focus and move to ______ focus to promote self-monitoring skills

conditions of feedback

conditions that help clients tell if a production was successful vs. unsuccessful and how to modify their production

feedback type

knowledge of results vs. knowledge of performance

knowledge of performance

type of feedback

- provides feedback about why a client wasn't accurate

- "this is not accurate because you did this"

knowledge of results

type of feedback

- provides feedback about if the production was accurate or not

- "that wasn't quite right"

performance, results

start with knowledge of ________, then move to knowledge of _______

feedback frequency

condition of feedback

- how often the learner receives feedback

high feedback frequency

type of feedback frequency

- feedback on every attempt

- better in pre-practice

low feedback frequency

type of feedback frequency

- feedback on less than 50% of trials

- better in practice to encourage self-monitoring

feedback timing

condition of feedback

- how soon after an attempt the learner receives feedback

immediate feedback

type of feedback timing

- feedback given right after performance

- better for pre-practice

delayed feedback

type of feedback timing

- feedback provided several seconds or minutes after performance

- better during practice to encourage self-monitoring

DTTC

intensive, motor-based, drill-type treatment for severe childhood AOS

- back-and-forth, adding and fading cues from one teaching moment to the next

- varying the amount of time between the clinician's stimulus and the child's imitative response

- use of tactile-phonetic cues, manual guidance, and gestural cues to achieve initial articulatory configurations/sequences

ReST

intervention for mild-moderate CAS that targets lexical stress, smooth articulatory transitions, and articulatory accuracy

- involves intensive practice of multisyllabic pseudowords with a variety of stress patterns

- emphasizes metalinguistics, visual aides

PROMPT

articulation intervention that uses facial touch cues to teach the articulators how and when to move in the correct sequence

- addresses timing and pressure

- could be useful for autistic children

systems approach

dysarthria intervention that focuses on physiological levels (supralaryngeal, laryngeal, respiratory)

- goal is to improve life participation and maximizing daily functioning

AAC

___ can be helpful for really severe motor impairments and/or low intelligibility

- ___ can encourage the use of verbal speech