New SHS 402 Exam 1

What is the main idea behind therapy in Speech-Language Pathology?

There is no one-size-fits-all therapy. Every client and disorder is unique, so therapy must be flexible and individualized.

Why are flexibility and critical thinking important in therapy?

Therapy adapts as you go—clinicians must adjust techniques based on client response, progress, and needs.

How does clinical skill improve over time?

Through experience, observation, reflection, and lifelong learning.

What are the three components of Evidence Based Practice (EBP)?

1. Research evidence (best current scientific findings),
2. Clinical expertise (your own professional judgment/experience),
3. Client values (culture, preferences, goals).

What does EBP mean in practice?v

Continuously updating methods based on new research and self-reflection to ensure therapy effectiveness.

What are the main steps in the therapy process?

1. Diagnosis/Assessment
2. Target Selection
3. Baseline Data
4. Intervention
5. Progress Monitoring
6. Dismissal/Follow-up

What happens during Diagnosis/Assessment?

The clinician identifies the disorder and assesses the client’s strengths and needs.

What is Target Selection in therapy?

Choosing functional, real-world relevant goals for the client.

What is baseline data used for?

Measuring the client’s current performance so progress can be compared later.

What happens during intervention?

Evidence-based techniques are applied to address therapy goals.

What is progress monitoring?

Data is collected regularly to evaluate improvement and adjust methods as needed.

When is Dismissal/Follow-up appropriate?

When goals are met or when progress plateaus.

What are SMART goals?

Specific, Measurable, Attainable, Relevant, and Time-bound.

Give an example of a SMART goal in articulation therapy.

“In 8 weeks, the client will produce /s/ in the initial position of words with 80% accuracy across 3 sessions.”

What is Direct Modeling?

The clinician demonstrates the target behavior, and the client imitates it.

What is Indirect Modeling?

The clinician provides repeated examples of the target behavior for the client to hear and learn from.

What is Shaping?

Reinforcing small, gradual steps toward the correct production or behavior.

What are prompts and cues?

Verbal, visual, or tactile hints to help the client produce the correct response.

What is Expansion or Recasting?

The clinician naturally corrects or expands the client’s response during conversation.

What is positive reinforcement?

Giving a pleasant reward (like praise or a token) to encourage correct behavior.

What is negative reinforcement?

Removing something unpleasant when behavior improves (not punishment).

What is Continuous Reinforcement?

Rewarding every correct response—best for learning new behaviors.

What is Intermittent Reinforcement?

Rewarding occasionally—best for maintaining learned behaviors.

What is the difference between Fixed and Variable schedules?

Fixed = predictable reward timing (e.g., every 3 responses).
Variable = unpredictable reward timing (stronger habit formation).

What are the key characteristics of good feedback?

Feedback should be specific, immediate, and constructive.

What is the goal of generalization in therapy?

To transfer skills learned in therapy to other settings (home, school, community).

How can generalization be promoted?

Use varied contexts, involve caregivers, and assign home practice.

What are the core aspects of professionalism for SLPs?

Follow ASHA’s Code of Ethics, maintain confidentiality, commit to lifelong learning, and provide accurate documentation.

What are behavioral goals?

Goals that describe observable, measurable actions a client can perform.

What are the three components of a behavioral goal?

1. Do statement – what the client will do
2. Condition – under what circumstances
3. Criterion – level of accuracy required

Example of a behavioral goal?

“James will produce /f/, /v/, and /s/ in CV syllables when shown a picture and given a model with 90% accuracy across two sessions.”

What is the Innateness theory of learning?

Language ability is biologically programmed; the environment triggers it (Chomsky, Piaget).

What is the Behavioral theory of learning?

Behavior is learned through reinforcement and repetition (Skinner).

What is the Constructivist/Interactionist theory of learning?

Learning is an active process shaped by experience and social interaction (Vygotsky, Bruner).

What is Operant Conditioning?

Learning model where behavior is shaped by:

• Antecedent – what happens before behavior

• Behavior – the response

• Consequence – reward or correction

Goal of Operant Conditioning in therapy?

Increase desirable behaviors and reduce undesirable ones.

What is Punishment in behavior modification?

Adding an aversive stimulus or removing a privilege to discourage behavior.

Why are intermittent schedules effective?

They build long-term habits because the client doesn’t know when the reward will come.

What is a stimulus hierarchy?

Gradually increasing stimulus difficulty:
Physical manipulation → Objects → Pictures → Drawings → Symbols → Spoken → Written

What is a response hierarchy?

Gradually increasing response difficulty:
Isolation → Syllable → Word → Phrase → Sentence → Conversation

Examples of target communication behaviors in therapy?

• Language: vocabulary, phrases, turn-taking

• Articulation: correct phoneme production

• Voice: pitch/loudness control

• Fluency: reduce tension, improve flow

• Swallowing: safer bolus prep

• Cognitive-communication: attention, memory, social skills

What are core teaching techniques in speech therapy?

• Direct/Indirect Modeling – Demonstrate with or without imitation

• Shaping – Build skill gradually

• Prompts/Cues – Verbal, visual, tactile hints

• Expansion/Recast – Correct naturally within conversation

• Negative Practice – Contrast errors vs. correct forms

• Fading – Gradually reduce support

What are attentional vs. instructional prompts?

• Attentional: “Look at my mouth”

• Instructional: “Put your tongue behind your teeth”

What is target-specific feedback?

Feedback that highlights the exact behavior to reinforce, e.g., “Good job keeping your tongue up on that /s/!”

What is the purpose of homework in therapy?

Used for carryover of learned skills, must be short, clear, and monitored.

What is the basic therapy session structure?

1. Present stimulus
2. Wait for response
3. Give consequence (feedback/reinforcement)
4. Record response
→ Start easy, increase difficulty as client succeeds

Pros and cons of group therapy?

✅ Natural conversation, motivation, peer feedback
❌ Less individual attention, uneven participation

Clinician’s role in group therapy?

Model behaviors, manage behavior, encourage interaction

Why is data collection important?

Tracks progress and guides therapy changes; use prepared data sheets and record every response type.

What is the purpose of probes?

Test generalization of skills without cues.

What are collaboration models in speech therapy?

• Consultative: SLP advises others

• Team teaching: Shared instruction

• Interprofessional (ICP): Collaboration with other professionals

• RTI/PBIS: Multi-tiered systems for early intervention and positive behavior

What is treatment intensity?

• Dose: Number of practice opportunities per session

• Dose frequency: Sessions per week

• Duration: Total time in therapy

• Cumulative intensity: Total intervention load → More practice = faster mastery (within reason)

What are the main types of reports?

• Diagnostic Report: Summarizes assessment findings & recommendations

• Therapy Plan: Lists goals, reinforcements, generalization plans

• Progress / SOAP Notes: Records short-term progress per session

• Therapy/Discharge Summary: Documents overall progress & outcomes

What does SOAP stand for in progress notes?

• S: Subjective – Observations/reports

• O: Objective – Measurable data

• A: Assessment – Interpretation of progress

• P: Plan – Next steps

What federal reports are relevant in speech therapy?

• IEP: Individualized Education Program, ages 3–21 under IDEA

• IFSP: Individualized Family Service Plan, birth–3 years, focuses on family involvement

• ISP: Adults/disabled receiving community services

• 504 Plan: Accommodations for non-IEP students

What is HIPAA and why is it important?

Health Insurance Portability and Accountability Act; protects privacy of health information (PHI).

What are key writing guidelines for documentation?

• Professional, third-person, chronological, factual

• Avoid exaggeration and contractions

• Explain test results and examples clearly

What is articulation?

The motor act of producing speech sounds. Disorders involve problems with physical sound production (substitution, omission, distortion, addition).

What are the main types of articulation disorders?

• Organic: Identifiable cause (hearing loss, cleft palate, neurological issue)

• Functional: No known cause (motor pattern issue)

• Cultural/Linguistic: Normal variations due to dialect/language

What assessments are used for articulation disorders?

Standardized tests: GFTA-3, CAAP, PAT, LAT, Arizona-4

• Other tools: Spontaneous speech sample, intelligibility rating, stimulability testing

How are therapy targets selected?

• Developmental: Start with earlier-acquired sounds

• Non-developmental: Based on importance for communication, stimulability, visibility/ease of correction, degree of error

What is the purpose of documentation in speech therapy?

Track and communicate progress, ensure accountability and professionalism.

What are characteristics of organic disorders?

• Cleft Palate: Hypernasality, nasal air emission; focus on VP closure, early intervention, biofeedback

• Hearing Impairment: Omits final sounds, distorts fricatives, misvoices; use amplification, visual cues, tactile feedback

• Childhood Apraxia of Speech: Difficulty planning/sequencing movements, inconsistent errors, vowel distortions, groping; therapy = frequent, repetitive practice focusing on movement accuracy, rhythm, prosody

What is the difference between phonology and articulation?

• Phonology: Rule-based patterns of sound system

• Articulation: Motor-based, how sounds are made

How are phonological processes treated?

Target processes used ≥40% of the time, starting with those that affect intelligibility

• Approaches: Traditional & Motor-Kinesthetic, Distinctive Features, Oppositional Pairs, Cycles, Metaphon, Core Vocabulary

What is OMT?

Therapy to correct tongue, lip, and facial muscle dysfunctions, often caused by habits or restricted airway.

What are common causes of OMT needs?

Mouth breathing, tongue tie (ankyloglossia), thumb sucking, pacifiers, sippy cups

What are consequences of untreated OMT issues?

Facial growth changes (long face, receded chin), orthodontic issues, sleep apnea, mouth breathing, bad breath

What are OMT therapy goals?

• Establish nasal breathing & closed-mouth posture

• Train correct tongue rest position (tip on alveolar ridge)

• Teach efficient chewing & swallowing patterns

• Eliminate negative oral habits

How long does typical OMT therapy last?

8–16 weeks with follow-up for a year

What is the Traditional / Motor Practice approach in phonological therapy?

Focuses on motor practice and drill. Often used with children to correct specific speech sound errors.

What is the Motor-Kinesthetic approach?

Uses tactile/physical cues (like PROMPT) to shape articulatory movements and correct speech patterns.

What is the Distinctive Features approach?

Teaches missing sound features (place, manner, voicing) to help children produce correct phonemes.

What is the Oppositional Pairs / Minimal-Maximal Pairs approach?

Uses word pairs that differ by one (minimal) or multiple (maximal) features to teach contrast and correct production.

What is the Phonological Process Cycles approach?

Time-based cycles target multiple phonological error patterns gradually. Includes auditory bombardment, production practice, and home practice.

What is the Metaphon approach?

Teaches abstract sound properties (e.g., “long vs. short,” “noisy vs. quiet”) to increase phonological awareness and improve intelligibility.

What is the Core Vocabulary approach?

 Focuses on consistent production of key functional words selected by parents, using repeated practice and feedback to improve intelligibility.

What is Final Consonant Deletion?

Omitting the final consonant of a word. Example: “da” for “dog.”

What is Cluster Reduction?

Simplifying consonant clusters by deleting one or more consonants. Example: “tuck” for “truck.”

What is Gliding?

Replacing /l/ or /r/ sounds with /w/ or /y/. Example: “wabbit” for “rabbit.”

What is Stopping?

Replacing fricative or affricate sounds with stop consonants. Example: “top” for “soap.”

What is Fronting?

Producing sounds that should be made in the back of the mouth at the front. Example: “tar” for “car.”