Comprehensive and Evidence-based Treatment Program

1. Comprehensive and Evidence-based Treatment Program

2. Structuring Treatment Sessions • Client-centered vs. clinician-directed • Client-centered • Loose structure • Clinician follows the client’s lead • For young or cognitively impaired clients • Clinician-directed • Highly structured • Clinician leads the session • For older or less severe clients

3. Techniques • Clinician-directed • Drill • Drill-play • Structured play • Client-centered • Play

4. Drill and drill-play • Yield lots of responses from the client • Best in the initial stages of treatment • Establishes sound or pattern • Does not promote generalization

5. Structured play and play • Does not yield many target responses • Best after a sound or pattern is established • Promotes generalization • Videotape “Articulation and Phonological Disorders”

6. Administering trials • Present stimuli • Provide cues/prompts • Consequate response • Response record • Pause, and repeat

7. Example Activities(can be used at any response level) • Buried treasure: production practice cards are “buried” in sand or styrofoam pellets • Tic-tac-toe: for every correct production, a mark is made in grid • Road. Child lines cards up to make a road and drives a truck over the cards saying each word as he drives over it. • Bean Bag. Place cards on the floor; child throws bean bag on cards and names the card he hit. He can also tell you which card he will try to hit before throwing the beanbag. • Feed Clown. Child says words to clown (large cardboard clown face with large hole for mouth) and then puts the cards in the clown’s mouth. May be adapted to feeding cookies (cards) to Cookie Monster puppet. • Store. Child buys the cards from the store clerk (you). Child tells you what he wants to buy. • Hide n’ Seek. Hide the cards in obvious places around the room. Child says words as he hides them.

8. Promote generalization from day one • Choose an activity that will naturally elicit the target phoneme or pattern • “Go Fish” if working on /f/ or the elimination of stopping process • “Feed the Animal” if working on weak syllable deletion

9. Probing for Generalized Responses • Generalization to untrained stimulus items • Generalization across word positions • Generalization across response topographies (levels of response) • Generalization within sound classes • Generalization across sound classes • Generalization across situations

10. Promoting generalization and maintenance through stimuli • Select stimuli from natural environment • Use common verbal antecedents • Vary the audience • Vary the physical setting

11. Promoting generalization and maintenance through responses • Choose functional objectives • Teach multiple exemplars • Use complex response topographies • Move from continuous to intermittent schedule of reinforcement • Use naturally occurring reinforcers • Delay reinforcement • Train others to reinforce • Reinforce generalized responses • Teach self-monitoring • Involve family and others in treatment program

12. Phonological Awareness • The knowledge of sounds, and how those sounds blend together to form words • Correlation between severe phonological disorders and poor phonological awareness • Poor phonological awareness has been linked to poor reading http://www.doe.virginia.gov/VDOE/Instruction/Reading/findings.pdf

13. Role of the Speech-Language Pathologist • Assess and train foundation skills necessary to literacy development • Rhyming • Alliteration • Phoneme isolation • Sound blending • Syllable identification • Sound segmentation