Study Guide Exam 2 - SLP 641 - Summer 2026

Principles of Naturalistic Recast and Indirect Imitation

• Naturalistic Recast Implementation: This technique involves the clinician modeling the correct production of a sound immediately following a child's error.
  • The clinician does not ask the child to repeat the utterance.
  • It serves as a natural model rather than a direct correction.
• Indirect Imitation: This approach means the clinician does not explicitly ask the child to repeat a sound or word directly. Instead, questions or prompts are used to elicit the word naturally (e.g., "What's this?").
• Cross-Linguistic Vowel Distinctions:
  • Ukrainian Phonology: The Ukrainian language possesses only six vowels.
  • Educational Contrast: Ukrainian-influenced speech may not distinguish between the English vowel sounds $/ʊ/$ (as in "pull") and $/u/$ (as in "pool").
  • Internal Perception: A speaker's ears and speech system naturally perceive these sounds as very similar due to the absence of the distinction in their native phonology.
  • Clinical Remediation: Practitioners can improve the hearing and production of this difference through listening activities and visual feedback tools, specifically naming Praat.

Therapy Demonstrations: Case Examples and Protocols

• 1. Recast for Velar Fronting:
  • Client (Lisa): "I dot a tey tard!" (while holding a picture of a key).
  • Clinician Response: "Oh! You got a key card! Yes, you got a key card!"
• 2. Direct Imitation Protocol (for $/tʃ/$ Stimulability):
  • Activity: Use the "Cheeky Chick" card.
  • Instruction: Clinician says, "Say cheeky chick."
  • Outcome Assessment: Lisa attempts "cheeky chick." She is then recorded as either "stimulable for $/tʃ/$ on this trial" or "not stimulable for $/tʃ/$ on this trial."
• 3. Indirect Imitation Protocol (for $/r/$ Stimulability):
  • Activity: Use the "Rowdy Rooster" card.
  • Instruction: Clinician asks, "What's this?" or "Who is riding the motorcycle?"
  • Outcome Assessment: Lisa says, "Rowdy rooster." The clinician notes if Lisa was stimulable or not for $/r/$ based on this naturalistic elicitaiton.
• 4. Explaining Vowel Contrasts: Relates to the $/ʊ/$ vs. $/u/$ distinction mentioned in the cross-linguistic section.
• 5. Strategic Use of Prolonged Voiced Interdental Fricatives /̠:/:
  • Rationale: The clinician helps the child (Tommy) produce an approximation of a later-developing sound.
  • Technique: Have the child hold the voiced "th" (/̠/) and then stop the movement.
  • Shaping: This movement is subsequently shaped into another target sound. This builds upon sounds the child can already produce to make difficult sounds easier to acquire.
• 6. Eliciting the Alveolar Fricative $/s/$ (Shaping Technique):
  • Step 1: Clinician says, "Say $t...t...t...t$."
  • Step 2: Clinician instructs, "Now make the air keep going…"
  • Client (Lisa): "ssss"
  • Step 3: Clinician instructs, "Now turn your voice on."
  • Client (Lisa): "zzzz"
  • Documentation: Clinician states, "Lisa was successful with this cue."
• 7. Minimal Pair Activity Implementation:
  • Example Pairs:
    • tea $→$ sea
    • pie $→$ sigh
    • toe $→$ sew
  • Clinical Explanation: The clinician uses pictures of the two words and asks the child (Sam) which picture he wants.
  • Communication Breakdown: If the child says "tea" when intending "sea," the clinician points out the wrong picture was chosen because changing one sound changes the meaning.
  • Home Program Component: Parents should practice these picture pairs for $5$ to $10$ minutes daily by encouraging the child to choose or request the correct picture.
• 8. Eliciting the Rhotacized Mid-Central Vowel $/ə/$:
  • Cue: Clinician says, "Say 'duhhhh'… now pull your tongue back and make it strong… drrrrrr."
  • Outcome: The clinician documents success or failure based on the achievement of the approximation.
• 9. Bilingual Therapy and Shared Sounds:
  • Clinical Scenario: A child (Ollie) speaks both Spanish and English.
  • Target $/k/$: The clinician selects $/k/$ because it exists in both languages.
  • Rationale: Because $/k/$ is a shared sound, learning it can improve speech in both languages simultaneously, making therapy more efficient.
• 10. Differential Specific Immediate Feedback:
  • Correct Production: "Excellent! That was a great strong $/r/$. Your tongue stayed back."
  • Incorrect Production:
    • Client (Lisa): "/wu/"
    • Clinician: "Nice try. I heard a $/w/$. Let's pull your tongue back and try another strong $/r/$."

Articulation vs. Phonological Disorders

• Articulation Disorder:
  • Classification: Motor (motoric) disorder.
  • Nature: Difficulty physically producing speech sounds.
  • Level: Errors involve the phonetic level (how sounds are physically made).
  • Scope: Usually affects one or a subset of sounds.
  • Example: $/r/ → [w]$.
• Phonological Disorder:
  • Classification: Linguistic disorder.
  • Nature: Difficulty organizing and using sounds correctly within the language system.
  • Level: Errors occur at the phonemic level (sound system).
  • Scope: Usually affects many sounds and follows predictable patterns.
  • Example: Velar fronting where $/k/ → [t]$.

The "Late Eight" Sounds

• The Sounds:
  1. $/ʃ/$ ("sh")
  2. $/ʒ/$ ("measure")
  3. /̸/ ("think")
  4. /̠/ ("this")
  5. $/s/$
  6. $/z/$
  7. $/l/$
  8. $/r/$
• Rationale for Late Emergence (Bleile, 2017): These sounds require:
  • Precise tongue placement.
  • Fine motor control.
  • Accurate airflow.
  • Greater linguistic complexity.
• Arguments for Early Treatment: Persistent errors in these sounds may:
  • Reduce overall intelligibility.
  • Negatively affect literacy.
  • Impact spelling and reading skills.
  • Lower the child's confidence.
  • Continue into adulthood if left untreated.

Cross-Linguistic Phonology: Spanish and English

• Shared Sounds: Clinicians should know at least seven shared sounds. These include:
  • $/m/$
  • $/n/$
  • $/p/$
  • $/b/$
  • $/f/$
  • $/t/$
  • $/d/$
  • $/k/$
  • $/g/$
  • $/l/$
  • $/w/$
• Clinical Importance: These are easier therapy targets because the child already utilizes them in both linguistic systems.

Coarticulatory Advantage and Facilitating Contexts

• Facilitating Clusters for $/r/$:
  • $/tr/$ and $/kr/$: These provide a facilitating context. The tongue is already moving toward the correct $/r/$ position following the production of $/t/$ or $/k/$.
• Difficult Clusters for $/r/$:
  • $/pr/$ and $/br/$: These are more difficult because the lips are closed for $/p/$ and $/b/$. The tongue must travel a significantly farther distance to reach the $/r/$ position, increasing the difficulty of production.
• Facilitating Vowels for Alveolar/Interdental Sounds (/s, z, ̸, ̠/):
  • Best paired with high front vowels.
  • Examples: $/i/$ and $/ɡ/$ (as in "see" or "seat").
• Facilitating Vowels for Palatal Sounds ($/ʃ, ʒ, tʃ, dʒ/$):
  • Best paired with back or rounded vowels.
  • Examples: $/u/$ and $/o/$ (as in "shoes" or "judge").

Sound Elicitation Methods

• Phonetic Placement: Teaching the exact placement of the tongue and lips.
• Sound Modification: Shaping one sound into another (e.g., transitioning from $/t/ → /s/$).
• Facilitating Contexts: Leveraging specific vowels or consonants that naturally assist in reaching the target position.
• Nonsense Syllables: Practice through combinations like "sa, si, su."
• Metaphors: Conceptual labels for sounds, such as:
  • "Snake sound" for $/s/$
  • "Motorcycle sound" for $/r/$
  • "Wind sound"

Treatment Hierarchy and Generalization

• The Hierarchy of Production:
  • Isolation
  • CV (Consonant-Vowel)
  • VC (Vowel-Consonant)
  • Words
  • Phrases
  • Sentences
  • Conversation
• Home Program Essentials:
  • Identification of target sounds.
  • Specific practice schedule.
  • Clinician modeling.
  • Positive feedback mechanisms.
  • Short daily blocks ($5$ to $10$ minutes).
  • Simple activities and parent demonstrations.
• Generalization (Carryover):
  • Definition: The transfer of correct speech from clinical settings to new words, new people, new settings, and spontaneous conversation.
  • Strategies for Improvement:
    • Consistent home and classroom practice.
    • Developing self-monitoring skills.
    • Engaging with different communication partners.
    • Randomized practice schedules.
    • Functional daily activities.

Specialized Treatment Approaches

• PROMPT:
  • Acronym: Prompts for Restructuring Oral Muscular Phonetic Targets.
  • Nature: Tactile, kinesthetic, and motor-based.
  • Primary Application: Used mostly with Childhood Apraxia of Speech (CAS).
• DTTC (Dynamic Temporal and Tactile Cueing): Primarily indicated for severe CAS.
• Cycles Approach: Designed for the highly unintelligible child.
• Core Vocabulary: Used for inconsistent speech disorder.
• Minimal Pairs and Multiple Oppositions:
  • Minimal Pairs: Utilizes one sound contrast to help the child recognize that changing a sound changes the meaning.
  • Multiple Oppositions: Used in cases of phoneme collapse.
• Psycholinguistic Approach (Minimal Pairs Purpose):
  • Scenario: Child says "tea" instead of "key."
  • Clinician Response: "I heard tea, but I think you wanted a key."
  • Visual Strategy: Show both pictures and ask, "Which one do you want?" to trigger the child's awareness of the communication breakdown.
• Complexity Approach: Focuses on teaching the difficult sounds first (e.g., late-developing or non-stimulable sounds) to trigger faster change across the sound system.

Sensory-Perceptual Training (Ear Training)

• Progression Order:
  1. Stimulation
  2. Perception (Ear training)
  3. Identification
  4. Sound isolated from words
  5. Discrimination
• Key Requirement: During this phase, no speech production is required from the child.

Case Analysis and Sound Identification

• Sound Identification Cue:
  • Sides of tongue touching molars.
  • Tongue forms a "U" shape.
  • Tongue is pulled back.
  • Jaw is squared.
  • Answer: $/r/$
• Case Diagnosis Indicators:
  • CAS (Childhood Apraxia of Speech): Indicated by a child exhibiting multiple vowel shifts and being not stimulable for vowels. Best treatments: PROMPT or DTTC.
  • Minimal Pair Target: Indicated when a child uses "stop/top" or "star/tar."
  • Extensive Error Patterns: If a child has more than 6 sounds in error, the clinician should prioritize noticing communication breakdowns through visual contrast (e.g., "Which one do you want?").

High-Yield Summary Facts

• Articulation: Focuses on motor + phonetic aspects.
• Phonology: Focuses on linguistic + phonemic aspects.
• Late Eight: /r, l, s, z, ʃ, ʒ, ̸, ̠/.
• Shared sounds: These represent easier targets for bilingual therapy.