last part of McLeod & Baker ch 13 reading

Stimulability Intervention Overview

  • Purpose: Enhance successful communication through stimulability intervention.

Key Concepts

  • Stimulability Intervention: A therapeutic approach targeting speech sound production through various modalities.

  • Multimodal Cues: Incorporation of various stimuli to aid learning and retention, including:

    • Alliterative Names: Each consonant corresponds with a character, e.g.,

      • Munchie Mouse

      • Zippy Zebra

    • Visual Aids: Pictures associated with each character.

    • Gestures: Specific hand or body movements linked to the character (e.g., zipping a jacket for Zippy Zebra).

Procedure

  • Targeted Consonants: 21 English consonants are targeted, with exceptions for three consonants: GL and the OR sound. Each consonant is assessed in:

    • Isolation for fricatives, affricates, and nasals (e.g., “zoo”).

    • Consonant-Vowel (CV) contexts for plosives and glides with 'h' classified as a glide.

Session Structure

  1. Elicit Stimulability Probe (5 minutes):

    • Examines child’s ability to produce 24 English consonants.

    • Contexts: one of three vowel contexts (a, u), depending on sound position.

    • Example: “za” assessed in syllable initial position only.

    • Sequential administration of the probe:

      • Session 1: Target consonants with vowel “a” (e.g., “za”).

      • Session 2: Target consonants with vowel “a” (e.g., “za, zo, ozo, d z”).

      • Session 3: Target consonants with vowel “u” (e.g., “za, zoo, uzu, us”).

  2. Review of Alliterative Characters (5 minutes):

    • Focuses on verbal articulation and joint attention towards character names, pictures, and corresponding gestures.

    • Children encouraged to articulate sounds but are not pressured to do so.

  3. Play-Based Stimulability Activities (30 minutes):

    • Dominant aspect of a session.

    • Activities include turn-taking games (e.g., Go Fish, Lotto) using picture cards of the alliterative characters.

      • SLP Role: Produces character name, speech sound, and gesture.

      • Child Role: Attempts to name the character and imitate gesture, focusing on target speech sounds.

    • Imitation: While not required, phonetic cues and shaping are encouraged if child is receptive.

  4. Palindrome Generalization Probe (5-8 minutes):

    • A task administering palindromes (e.g., “pop”, “bub”, “dad”, “nan”) to monitor generalization to simple Consonant-Vowel-Consonant (CVC) words.

Duration and Sessions

  • Typical Length: Approximately 12 sessions over 6 weeks, with 45-minute sessions scheduled twice a week.

  • Possible Extension: Intervention duration can extend to 12 weeks.

  • Precursor Approach: Can serve as a precursor to more advanced contrastive approaches.

Suitable Candidates

  • Target Population: Children aged 2 to 4 years old.

  • Criteria: Children exhibiting small phonetic inventories who are not stimulable for absent phones.

Evidence Base

  • Research Support: Limited to peer-reviewed case study reports and descriptions from book chapters.

  • Outcomes: Generally positive; children show increased stimulability for a range of speech sounds.

  • Misconceptions: The approach is not aimed to enhance overall speech intelligibility but to increase speech sound stimulability.

  • Recommendation: The approach is best as a preliminary step before utilizing contrastive phonological interventions:

    • Minimal pairs

    • Maximal oppositions

    • Treatment of the empty set

    • Multiple oppositions

    • Non-contrastive intervention

Resources Needed for Implementation

  • Materials Required:

    • Pictures of alliterative characters.

    • Corresponding gestures linked to the characters.

    • Laminated multiple copies of picture cards for activity use.

  • Additional Equipment Examples:

    • Magnetic fishing rods with paper clips for interactive games.

    • Lotto boards featuring alliterative characters.

    • Envelopes for pretend mailbox activities involving character cards.