Artic & motor speech intervent lecture

Speaker: Kate Margetson
Context: Week 3 of Pediatric Speech Intervention for SPH 530
Guest Lecturer: Professor Sharon MacLeod
Focus Topic: Articulation and motor speech intervention
Cultural Acknowledgment: Respect paid to traditional custodians of the land, specifically on Wiradjuri country, and acknowledgment of indigenous people present.
Main Reading Material: Chapter 14 of MacLeod and Baker's (2017) textbook titled "Articulatory and Motor Speech Intervention Approaches."
Optional Reading Material: Chapters from the "Interventions for Speech Sound Disorders" textbook, including videos of interventions linked to the book's website.

Focus: Interventions for phonological impairments and inconsistent speech disorders.
Transition: This week introduces motor speech interventions targeting articulation impairment, childhood apraxia of speech (CAS), and childhood dysarthria.

Clear articulation of the objectives tied to the content delivered by Professor Sharon MacLeod.

Historical Background: Speech therapy's origins connected to helping children and adults articulate sounds, dating back to Greek and Roman times.
Early Techniques: Historical techniques include diversely ineffective methods such as placing marbles in the mouth while speaking.

The lecture divided into three main parts:
1. Intervention for Articulation Impairment
2. Intervention for Childhood Apraxia of Speech (CAS)
3. Intervention for Childhood Dysarthria

Historical Figure: Charles Van Riper, recognized as the father of speech therapy.
- Principles Established: His principles still relevant today, beginning with ear training.
- Ear Training Importance: Helps children recognize differences in sounds (e.g., TH vs. B sounds).

Resource References: Involves referencing the textbook and Dr. Caroline Bowen's website.
- **Stages of Intervention:
1. Sound Isolation:** Focus on producing the sound independently (Example: "ssss" for 'S').
2. Nonsense Syllables: Practice sounds in nonsense syllables, emphasizing facilitating contexts.
  - Evolution of sound practice, e.g., contrasting 'ka' (back vowel) with 'ki' (front vowel).
3. Real Words: Introduce sounds in different positions relative to words (initial, medial, final).
  - Technique variations for practicing sounds described, including games and playful interaction during practice.
4. Carryover: Application in naturalistic settings, promoting spontaneous speech using practiced sounds.

Practice Necessity: Children require extensive practice akin to learning musical instruments or sports to develop motor plans for speech.
Intervention Techniques: Engaging games used to encourage naturalistic practice, increasing exposure and frequency of target sounds.
Games for Engagement: Examples include going fishing with items that start with target sounds.

Articulation Approach Efficacy: Evidence suggests that addressing one sound at a time can be slow; focusing on a chronology of sound patterns may yield faster results.
Diverse Resources: Encourages utilization of multiple resources for intervention, including materials from various sources and acknowledgment of differences in American vs. Australian English pronunciation.
- Commercial Resource Caution: Most resources are American-made and may not suit Australian vocabulary or pronunciation styles.
- New Resources: Informing about a new program, "Save Bananas," aimed at offering practice in a gamified format, developed in collaboration with colleagues.

Instrumental Techniques: Instruments used include ultrasound, electropalatography (EPG), and spectrography to assess and enhance speech production.
Clinical Applications: Description of clinical tools such as EPG to visually track tongue placement against the palate during speech production.
Electropalatography Technique: Requires custom-made palates to visualize tongue contact areas for sounds.
Ultrasound Use: Tracking the tongue shape and movement during speech to aid children who struggle with specific sounds.

Intervention Case Study: A child with difficulties in the production of sounds necessitated specific tongue placements visualized by EPG.

Resource Availability: Promotion of resources from "Apraxia Kids".
Motor Learning Principles: Focused application of motor learning principles adjusts according to child age, symptoms, and family preferences.
Dynamic Treatment Model (DTTC): Recent approaches including DTTC allow for motivational feedback mechanisms during practice.
- Example of Feedback Mechanism: Positive reinforcement for attempts to print sound rather than perfection.

Collaborative Speech Productions: Focus on simultaneous production of words as a cueing strategy.
Motor Learning Principles Reinforcement: Usage of gestural and Coarticulation cues while gradually increasing speech rate.

Intervention Strategy Development: Notable inclusion of the Nuffield Dyspraxia Programme in children with CAS and comparison with other intervention trials demonstrating efficacy.

REST (Rapid Syllable Transition Treatment): Designed for children with lexical stress difficulties using practice of pseudo-words.
The Prompt Approach: Certification program focusing on tactile prompts to guide articulators for speech accuracy.

Developed by: Gail Gillen, emphasizing literacy connections in speech development.

Framework for Addressing Dysarthria: Utilizes a systems approach focusing on respiration, phonation, resonance, and articulation aiming to improve overall intelligibility.
AAC (Augmentative and Alternative Communication): Considered as a supportive tool for children with severe speech difficulties.

Final Note on Communication Acquisition: Emphasizes the importance of various strategies for supporting children with speech-related challenges, including interventions targeted to individual needs.