Early Intervention and Assessment

Bagless Therapy vs. Bringing Materials

• Split between bagless therapy proponents and those who bring materials.
• Fear: Parents feel they need specific toys, missing the point that the strategy is the intervention.
• There is no such thing as an "evidence-based toy"; toys are not interventions.
• The strategy used with the toy is the intervention.
• Example: Best session with an early intervention kid involved using a fork in the backyard, promoting generalization using household items.

Wrapping up Therapy

• Don't just cut off services; provide education to the family.
• Give a list of activities for home practice.
• Provide upcoming milestones and red flags to watch for.
• Reassure them they can reach out if development changes.

Safety in Early Intervention

• Early intervention (home visits) is powerful but safety is paramount.
• Providers give up control in home environments.
• Ask potential employers: "What do I do if I'm unsafe at a client's home?"
• Company should have a solid safety protocol.
• Distinguish between genuine safety concerns and generalizations about zip codes.
• Some companies require therapy in a room with an external-facing door.
• Regardless of the setting (home, hospital, school), you have the right to feel safe.

Siblings Joining Sessions

• Sometimes siblings can be helpful communication partners, sometimes they're a distraction.
• Suggestions for managing siblings in sessions:
  • Have alternative activities for the sibling.
  • Clearly state the session is focused on the identified child.
  • Offer sibling referral information if needed.
• Use "I wonder" statements to address distractions non-confrontationally.
  • Example: "I wonder how Witten would do if we moved him to a different room."
• "I wonder" strategies can also model techniques like wait time.

Personal Safety Acknowledgment

• Acknowledge the importance of ensuring one's safety before entering an environment.

Arizona Articulation Proficiency Scale

• One confusing worksheet: stimulability/imitation tasks.
  • Used to check stimulability in different contexts (e.g., sha, asha, ash).
  • Helps determine where to start therapy.
• Ear training can be challenging; subjectivity in articulation assessment.
• Raw scores may be off; check weighted values for sounds.
• Use the feedback button to check answers during test administration.
• Scoring can be off on the simucase part. Slow down and focus when scoring.

Scoring and Phonology Coding

• Phonology coding: Only evaluate the sound being assessed in that section.
  • Note other errors, but they don't impact the score if not part of the evaluated sound.
  • Example: In "horse" said as "hoses", only the initial /h/ is scored in that section.
• For "mouth" said as "mouths" (th → fs), it's an error but not one of the listed phonological processes.
  • Could be noted as "other" if needed.
• Not every error is a phonological process.
• Test has narrow descriptions for each phonological process.
• Example: Deaffrication according to this test is when a CH or a J is replaced with the fricative. So SHH or ZH.

Word Articulation Subtotals

• Add scores on page one (initial: 4, 7, 2) and page two (7.5, 3, 5.5, 11.5, 10, 7.5).
• The sum of page 1 and 2 should be 29.
• Subtract the sum from 100 (100 - 29 = 71).
• Use the resulting value (71) to find the standard score.

Definitions on the Back

• Prevocalic voicing: The kid takes an unvoiced sound and changes it to a voiced sound. Example: "thumb" to "dump".
• Stopping is going from that th continuant sound to that d which is a stopped sound.
• One Error can be representative of two phonological processes.
• Postvocalic devoicing: Voiced final consonant replaced by a devoiced consonant.
  • Example: If "bathtub" was said as "bathtub", that would have been pre postphocalic devoicing because she changed the b, which is a voiced consonant, to the p, which is the unvoiced consonant. It's those cognates, those ones that are in the same box on the IPA chart.

Key Differences

• The weighting of the sound scores is different. Some sounds worth more than others.
• Developmental, has to do with what Jess said.
• Word Intelligibility: Listener to understand when "Kate," I actually meant "cake" because of the possibilities of the other phonemes filling in and actually making words.
• Sound rating depends on frequency of sound
• Arizona favored over Goldman Fristoe because can see some inconsistencies with the patients a little bit easier.
• Apraxia: Expect where we expect to see those inconsistencies Consonants or vowels? Vowels.
• Goldman Fristo doesn't formally assess vowels, Arizona does.
• Can the Goldman Fristo be used to diagnose Apraxia?
• In Arizona only look at initial and final position of words.
• Assessments through an appropriate lens.
• Arizona + Con Lewis= Goldman Fristoe

Cameron's Case

• Reduced intelligibility impacting their lives on a daily basis? She took him out of school, which is a big thing, I feel like.
• How else does his speech kind of impact your family dynamic? They talked about how he gets frustrated when he can't be understood, and so there's just a lot of communication breakdowns.
• Speech Production is the main thing that's going on.
• In order to do a feeding evaluation, we have to have different code, from the physician and then a speech and language evaluation.
• If they aren't speaking, when at that point, were even further behind than we would have been had we started when they were 18 old.
• Have the hearing been tested?
• Kids speak the way that they hear, so if there's an underlying hearing loss, we are fighting an uphill battle by doing articulation therapy for a kid who can't hear us.
• Tubes are amazing. They impact on their speech production.
• How do we navigate treatment for kids and their sensory needs.
• If he can't be or if he can't sit still, kinda just somehow utilize that in therapy.
• Obstacle course, Get moving. Nothing says we have to sit at a table to do therapy.

Speech Intelligibility

• What do we measure?
• Nature of the Goldman Fristo and it's not how we talk. Connect the sample.
• Do the children have speech connectedness. Not something you should be testing in the Goldman Fristo.

Understanding Coarticulation

• The student's are asked why Cameron's expressions are neutral. The student's were surprised by that. Is it because the student's can't talk? Did the student's have consistent final consonant deletion because consistent deletion, expressive?
• Cameron's Treatment : Questions about treatment. Navigate the data collection. Conect data. If the child is always using the wrong word, find out why the word choice is wrong, so that you're guiding the patient to use the correct process during your session.

Data Collection Method

• Wyatt : P is unvoiced and B is voiced.. Hand on boys box will show and feel the differences.

Next Week's Assignments

• Hadley Assessment and you will Qualify Her. Do Hadley then, Luisa case.
• Hadley and Accident Cases are very differnt.
• You are approching them differently
• Discuss Ethical guidelines. Have students explain ethical guidelines they need to be aware's of during treatment. Ethical Guidelines. If you have a patient you work with for a logn time and their speech improves, how many sessions do you need to have them, before you recommend something like Accented Mod?
• When parents aren't hearing results, make sure you have a doctor that isn't overlooking your concerns and referring you to a Specialist so that you can begin those steps right away.
• Student shared Calypso hours and had help figuring out the system!