m.t Introduction to Communication Treatment and Core Procedures

Treatment

Intervention, teaching, habilitation, or rehabilitation used to improve communication skills or functioning.

Intervention

A planned process used to address a communication difficulty and help a client improve functioning.

Teaching

Helping a client learn a new skill or change behavior through planned instruction and practice.

Habilitation

Developing a skill that has not been established or previously acquired.

Rehabilitation

Restoring or improving a skill that was previously developed and then lost or impaired.

Treatment target

The specific communication skill or behavior that the client needs to learn or improve.

Treatment procedure

The method used by the clinician to teach, strengthen, or change a treatment target.

Target vs. procedure

A target is the skill being taught; a procedure is how the clinician teaches it.

Why are treatment procedures considered behavioral?

They change behavior by arranging stimuli, responses, consequences, and interactions with others.

Five ways to change communication behavior

Rearrange skills/stimuli, increase/decrease behaviors through interactions, and change interactions between client and others.

Core treatment procedure 1

Gather, present, and manipulate stimulus items to evoke specific target behaviors.

Core treatment procedure 1: examples

Presenting objects, giving verbal directions, modeling, providing prompts, and using manual assistance.

Stimulus item

An object, picture, word, question, or other material used to elicit a target response.

Prompt

A cue or assistance provided to increase the likelihood of a desired response.

Model

A demonstration of the desired response that the client can imitate.

Manual assistance

Physical assistance, such as hand-over-hand guidance, used to help a client complete a response.

Core treatment procedure 2

Shape and strengthen target behaviors through positive reinforcement.

Shaping

Teaching a complex behavior by reinforcing successive approximations toward the final target.

Positive reinforcement

A consequence that increases the likelihood that a behavior will occur again.

Reinforcement examples

Verbal praise, positive facial expressions, access to a preferred activity, or other meaningful consequences.

Continuous reinforcement

Reinforcing every correct response; highly useful when first teaching a skill.

Variable reinforcement schedule

Reinforcing some responses rather than every response to help maintain a learned behavior.

Core treatment procedure 3

Decrease undesirable verbal and nonverbal behaviors through specific response consequences.

Verbal corrective feedback

Spoken feedback indicating that a response was incorrect or needs to change.

Nonverbal corrective feedback

Gestures, facial expressions, or other nonverbal signals showing that a response needs to change.

Response cost

A procedure where a specified reinforcer or privilege is removed following a behavior.

Time-out

A procedure that briefly removes access to reinforcement following an undesirable behavior.

Generalization

Using a learned skill beyond the original treatment situation.

Carryover

Continued use of a learned skill outside the therapy activity or session.

Functional communication

Communication that meets meaningful needs and supports participation in everyday life.

Final treatment target

Effective communication in natural settings.

Target selection

Deciding which communication behaviors to address in treatment.

Target sequencing

Arranging treatment targets in an order suited to learning and skill development.

Prerequisite behavior

A skill that may be needed before teaching a more advanced skill.

Normative target selection

Choosing targets using the client's age and developmental expectations.

Client-specific target selection

Choosing targets based on their immediate, meaningful impact on the individual's communication.

Functional target

A behavior that improves communication or participation in meaningful everyday activities.

Linguistic and cultural appropriateness

A consideration when selecting treatment targets.

Starting point for target selection

Depends partly on prior assessment or treatment at the clinic or another facility.

Speech sound disorder targets

Individual speech sounds and sound patterns.

Individual-sound target

A particular speech sound taught in a specified context or position.

Sound-pattern target

A pattern of sound errors addressed rather than one isolated sound.

Child vocabulary targets

Useful words the child understands or uses.

Child phrase targets

Combining words into meaningful phrases.

Child morphology and syntax targets

Grammatical forms and sentence structures.

Child social communication targets

Language used for meaningful purposes and interaction with others.

Child literacy targets

Language-related reading and writing skills appropriate to the client's needs.

Voice disorder targets

Selected according to the client's specific voice difficulty.

Aphonia

Absence of voice.

Dysphonia

An abnormal or impaired aspect of voice production.

Resonance target

How sound resonates through the vocal tract and related structures.

Fluency shaping

Teaching speech patterns or strategies intended to increase fluency.

Direct stuttering reduction

Intervention directly addressing stuttering behaviors or moments of stuttering.

Fluency reinforcement

Using reinforcement to encourage more fluent speech behaviors.

Target selection

The process of deciding which communication behaviors should be addressed in treatment.

Why must targets be selected carefully?

Clients cannot learn every skill at once; targets must be prioritized and sequenced.

Target sequencing

Arranging treatment targets in an order that makes sense for learning and skill development.

Prerequisite behavior

A skill that may need to be learned before a more advanced skill can be taught.

Normative approach to target selection

Choosing targets by considering the client's age and age-based developmental expectations.

Client-specific approach to target selection

Choosing targets that make an immediate, meaningful difference in daily life, regardless of norms.

Functional target

A target that improves the client's ability to communicate or participate in everyday activities.

Guidelines for selecting targets

Choose functional, culturally appropriate behaviors that expand communication and are reasonable to teach first.

Factors affecting the starting point for target selection

Whether the client has prior assessment/treatment at the clinic or received services elsewhere.

Individual-sound target

Teaching a particular speech sound, such as /s/, in a specified context or position.

Sound-pattern target

Addressing a pattern of sound errors rather than teaching only one sound in isolation.

Child language targets: basic vocabulary

Teaching useful words and expanding the words a child understands or uses.

Child language targets: phrases

Teaching the child to combine words into meaningful phrases.

Child language targets: morphology and syntax

Teaching grammatical forms, word endings, and appropriate sentence structures.

Child language targets: functional units and social communication

Teaching language used for meaningful purposes and interaction with other people.

Child language targets: literacy skills

Addressing language-related reading and writing skills when appropriate to the client's needs.

Voice disorder targets

Targets addressing aphonia, dysphonia, loudness, pitch, or resonance, depending on the client's difficulty.

Aphonia

The complete absence of voice.

Dysphonia

An abnormal or impaired voice quality, pitch, loudness, or other aspect of voice production.

Resonance target

An intervention target addressing how sound resonates through the vocal tract and related structures.

Fluency disorder targets

Targets involving fluency shaping, direct stuttering reduction, fluency reinforcement, or cluttering.

Fluency shaping

Teaching speech patterns or strategies intended to increase speech fluency.

Direct stuttering reduction

Intervention that directly addresses stuttering behaviors or moments of stuttering.

Cluttering

A fluency-related disorder associated with an unusually rapid, irregular speaking rate and reduced clarity.

Normative vs. client-specific approach

The normative approach uses age-based developmental expectations; the client-specific approach prioritizes individual functional needs.

Developmental dysarthria

Dysarthria associated with prenatal or perinatal brain injury; the slides connect it with cerebral palsy.

Hearing loss

Reduced auditory acuity ranging from mild to severe.

Hearing loss intervention factors

Age of onset, type and degree of loss, and quality and timing of early intervention.

Oral communication targets in hearing loss

According to the slides, targeted only at a parent's or adult client's request.

Unaided AAC

Communication produced by the body without equipment, such as gestures or signs.

Aided AAC

Communication using external devices or objects.

No-tech AAC

Communication supports without a device, such as physical symbols or communication objects.

Low-tech AAC

Communication supports using simple external materials, such as picture boards.

High-tech AAC

Communication supports using electronic devices or advanced technology.

Purpose of AAC

Supports meaningful communication when a person needs another way to communicate.

Baseline data

Measures of target communication behavior collected before planned intervention begins.

Purpose of a baseline

Establish starting performance and provide a comparison for evaluating progress.

Timing of baseline collection

At the beginning of treatment, before intervention for the target behavior.

Baseline stimulus rule of thumb

Use 20 stimuli or opportunities for each pretreatment target.

Conversational baseline

A measure of target behavior during conversational speech before treatment.

Conversational baseline collection

Use play, an interesting topic, or an interview suited to the client and target.

Conversational baseline measurement

Identify correct and incorrect target examples and calculate the percentage correct.

Evoked discrete-trial baseline

The client attempts the target across discrete trials without a model.

Modeled discrete-trial baseline

The client attempts the target after the clinician provides a model for imitation.

Discrete-trial baseline preparation

Define the target measurably and prepare stimulus items and eliciting questions or models.

Measurable speech baseline example

Production of /ʃ/ in the initial position of words.