Overview of Intervention Procedures This chapter discusses intervention procedures and goals, serving as a complementary resource to Chapter 11 o

Overview of Intervention Procedures

  • This chapter discusses intervention procedures and goals, serving as a complementary resource to Chapter 11 on principles and plans.

  • Emphasis on understanding different intervention approaches applicable to:

    • Chapter 13: Phonological impairment

    • Chapter 14: Motor speech disorders

  • Learning Objectives:

    • Prepare an intervention management plan and session plan for a child with a speech sound disorder (SSD).

    • Understand the importance of structured intervention.

Intervention Procedures

  • Definition: Intervention procedures comprise teaching cues such as verbal instructions, feedback, comments, corrections, stimuli, resources, and activities that clinicians use to facilitate children's learning.

  • Goals: Aim to assist children in achieving session, short-term, and long-term intervention goals.

  • Unique Combinations: These procedures are unique combinations that define the intervention approaches.

Teaching and Learning Moment

  • Concept: Based on Skinner's (1938) behavioral principles, learning moments are divided into three components:

    • Antecedent stimulus

    • Response

    • Consequence

  • Application in SSD: In therapy for children with SSD, an SLP (speech-language pathologist), teacher, parent, or computer provides:

    • Antecedent instruction (verbal or behavioral cue)

    • Child response

    • Consequent feedback (resulting guidance or reinforcement)

  • Example of Therapy Dialogue:

    • Clinician: "Tell me a picture to pick up."

    • Child: "Snow" (pronounced as "no")

    • Clinician: "Did you mean 'snow' with a 'sneaky s' sound?"

    • Child: "Snow" (pronounced correctly)

    • The dialogue illustrates how cues can merge and reinforce learning.

Types of Cues Used in Intervention

  • Cues can be classified into three main categories: auditory-based cues, production-based cues, and responses expected from children.

Auditory-Based Cues

  1. Focused Auditory Input:

    • Intentionally produced speech patterns for listening.

    • E.g., reading carefully selected words containing the target pattern.

  2. Auditory Detection:

    • Child indicates when they hear the target sound in various contexts (isolation, phrases, sentences).

    • E.g., Show happy face for correct sound, sad face for incorrect one.

  3. Auditory Discrimination:

    • Child listens to two words to judge if they are the same or different.

    • E.g., Identify if heard "bat" or "pat".

  4. Auditory Judgment Tasks:

    • Child evaluates correctness of own vs. others' speech.

    • E.g., Listen, then confirm whether correctly pronounced.

  5. Metaphonological Input Tasks:

    • Identify the phonological properties in words.

    • E.g., Recognizing initial consonant sounds in minimal pairs.

  6. Phonological Awareness Input Tasks:

    • Engage children in categorizing and manipulating phonological elements.

    • E.g., "Help munching monkey find pictures starting with 'm'."

Production-Based Cues

  1. Auditory Model for Imitation:

    • Clinician models target sounds for the child to repeat.

    • Hierarchy of imitation includes:

      • A: Simultaneous imitation

      • B: Delayed imitation

  2. Phonetic Cues:

    • Info about sound articulation via visual, verbal, tactile, or manual guidance.

    • E.g., Showing tongue placement through a mirror.

  3. Prosodic Cues:

    • Visual and verbal information about speech characteristics (stress, loudness).

    • E.g., Visual aids showing short and long sounds for rhythm.

  4. Orthographic Cues:

    • Use of written forms of sounds to elicit speech.

    • E.g., "Car starts with 'k', point to letter 'c'."

  5. Gestural Cues:

    • Incorporation of hand movements representing speech sounds.

    • E.g., Rocking motion to illustrate the sound 'b'.

Children's Responses

  • Responses during teaching moments are influenced by antecedent auditory and production cues:

  1. Passive Listening: Child listens to input without producing speech.

  2. Active Listening: Engagement with auditory detection and judgment tasks, such as identifying sounds or recognizing differences.

  3. Spontaneous Production: Children produce speech focusing on sounds or sound classes based on provided cues.

  4. Pragmatic Responses: Responding to requests for clarification, indicating a misunderstanding in communication.

  5. Metalinguistic Comments: Children make comments reflecting awareness of their phonemic productions based on feedback given.

  6. Self-Correction: Reflecting on speech errors and attempting revised productions.

Teaching Moments Dynamics

  • Describe the shifting nature of teaching and learning moments, where cues are adjusted based on child performance:

    • Stepping Up: Changing cues to increase task difficulty.

    • Stepping Down: Changing cues to simplify tasks when a child struggles.

  • Concept relates to Vygotsky's Zone of Proximal Development and Scaffolding strategies (Vygotsky, 1978).

  • Dynamic Temporal and Tactile Cueing (DTTC) method highlights this approach.

Stimuli, Resources, Materials, and Activities

  1. Stimuli: What is practiced during a learning moment (sounds, syllables, prosody).

  2. Resources: Objects or images used alongside stimuli (e.g., pictures for elicitation).

  3. Activities: Tasks designed to engage children, which can include crafts or games.

  4. Activity Genres: Include different session management modes:

    • Drill: High frequency of practice with minimal play.

    • Drill Play: High frequency within a game or structured activity.

    • Structured Play: Moderate practice rate with structured activities.

    • Unstructured Play: Child-directed activities with minimal directives.

Application of Techniques

  • Example of intervention for improving Michael's production of multisyllabic words:

    • Using stimuli ( pictures of polysyllabic words) during a drill play activity.

    • Adjusting cues when establishing the word "dinosaur" if initial attempts display weak syllable deletion:

      • Switch to simultaneous or mind imitation.

      • Use visual aids to represent syllable stress using blocks.

      • Implement backward chaining to help with syllable structure.

  • Each exemplified strategy emphasizes tailored approaches essential in intervention planning for children with SSD.

Conclusion

  • The integration of auditory and production cues throughout intervention procedures is vital in facilitating effective speech sound learning.

  • Importance of adjusting strategies according to real-time performance enhances the adaptive learning of children with SSD.

  • Clinicians should prepare for a variety of learning scenarios to adequately support diverse child responses and progress.

Overview of Intervention Procedures

This chapter discusses intervention procedures and goals, serving as a complementary resource to Chapter 11 on principles and plans. It places an emphasis on understanding different intervention approaches applicable to phonological impairment (Chapter 13) and motor speech disorders (Chapter 14). The primary learning objectives include preparing an intervention management plan and session plan for a child with a speech sound disorder (SSD) and understanding the importance of structured intervention.

Intervention Procedures

Intervention procedures comprise teaching cues such as verbal instructions, feedback, comments, corrections, stimuli, resources, and activities that clinicians use to facilitate children's learning. These procedures aim to assist children in achieving session, short-term, and long-term intervention goals. The unique combinations of these procedures define the specific intervention approaches used in clinical settings.

Teaching and Learning Moment

Based on Skinner's (1938) behavioral principles, learning moments are divided into three components: the antecedent stimulus, the response, and the consequence. In the context of SSD therapy, an SLP, teacher, parent, or computer provides an antecedent instruction, which is a verbal or behavioral cue. This is followed by the child's response and then consequent feedback, which offers resulting guidance or reinforcement. For instance, in a therapy dialogue, a clinician might guide a child who mispronounces 'snow' as 'no' by using a cue about a 'sneaky s' sound, illustrating how cues can merge and reinforce learning.

Types of Cues Used in Intervention

Cues used in intervention are classified into three main categories: auditory-based cues, production-based cues, and the responses expected from the children.

Auditory-Based Cues

Auditory-based cues include focused auditory input, where speech patterns are intentionally produced for listening, and auditory detection tasks, where children indicate when they hear a target sound. Children may also engage in auditory discrimination to judge if heard words are the same or different, or auditory judgment tasks to evaluate the correctness of speech. Furthermore, metaphonological and phonological awareness input tasks help children identify phonological properties and manipulate elements, such as categorizing images based on their initial consonant sounds.

Production-Based Cues

Production-based cues involve an auditory model for imitation, following a hierarchy from simultaneous to delayed repetition. Clinicians also utilize phonetic cues to provide information about sound articulation via visual or tactile guidance, prosodic cues for speech characteristics like rhythm and stress, and orthographic cues using written forms. Gestural cues incorporate hand movements to represent speech sounds, such as a rocking motion to illustrate the sound 'b'.

Children's Responses

Responses during teaching moments are influenced by antecedent auditory and production cues. These include passive listening, where the child listens without production, and active listening, where they engage in detection or judgment tasks. Children also engage in spontaneous production of sounds, pragmatic responses to clarify communication, and metalinguistic comments that reflect an awareness of their own phonemic productions. Self-correction is another key response where children reflect on errors and attempt revised productions based on provided feedback.

Teaching Moments Dynamics

The nature of teaching and learning moments is fluid, as cues are constantly adjusted based on a child's real-time performance. Clinicians employ 'stepping up' to increase task difficulty or 'stepping down' to simplify tasks when a child struggles. This concept relates clearly to Vygotsky's Zone of Proximal Development and scaffolding strategies, with the Dynamic Temporal and Tactile Cueing (DTTC) method highlighting this adaptive approach.

Stimuli, Resources, Materials, and Activities

Intervention involves stimuli, which are the sounds or syllables practiced, and resources like objects or images used for elicitation. Activities engage children through different management modes, including drill, which features high-frequency practice with minimal play, and drill play, which incorporates high frequency within a structured game. Structured play offers a moderate practice rate, while unstructured play is child-directed with minimal directives.

Application of Techniques and Conclusion

In practice, techniques are tailored to specific needs, such as improving a child's production of multisyllabic words like 'dinosaur' by using simultaneous imitation or visual aids like blocks to represent stress. Integrating auditory and production cues is vital for effective speech sound learning. By adjusting strategies according to performance, clinicians can provide the necessary support to enhance the adaptive learning and progress of children with SSD.