Approach to Treatment of Phonological Disorders

1. Approach to Treatment of Phonological Disorders Distinctive Features Phonological Processes Oral Motor Therapy

2. Distinctive Feature Approach • McReynolds, et.al. (1975) • Two phases of treatment • Nonsense syllables – initial position • Nonsense syllables – final position • Authors report that this approach yields generalization of a feature to untrained sounds

3. Phase 1: Nonsense Syllables (I) • Step 1: • Child is instructed to produce a consonant in which the feature is lacking • For example, if the feature that the child is lacking is +voice, then the child is told to produce a consonant that is –voice (pie). • Step 2: • Child is instructed to produce a minimal pair (pie-bye)

4. Phase 2: Nonsense Syllables (F) • Step 1: Child is instructed to produce a consonant in which the feature is lacking (for example, ape, if the feature is +voice) • Step 2: Child is instructed to produce minimal pair containing both +/- feature (ape-Abe)

5. Phonological Process Approach • Cycles Approach • Author is Hodson and Paden, (1983/1991) • Textbook is Targeting Intelligible Speech: A Phonological Approach • Designed to be used with preschool children who are highly unintelligible and exhibit numerous phonological process errors

6. Cycles Approach • Program is planned around cycles • Cycle is a period of time in which all of the process errors are facilitated • A cycle of treatment can last from 5 weeks up to 16 weeks

7. Targeted Patterns • Early developing phonological patterns • ICD, FCD, WSD • Posterior/anterior contrasts • t/k, d/g • /s/ clusters • liquids

8. Structure of the Cycle • Each phoneme within a pattern should be trained for 60 minutes per cycle, before shifting to the next phoneme in that pattern • Each pattern should be worked on at least 2 hours each cycle • Only one pattern should be worked on during any single session • 3-6 cycles are necessary for a child to become intelligible

9. Sequence in a Session • Review of previous session’s words • Auditory bombardment • Target word cards made • Production practice • Different play activity every 5-7 minutes • Stimulability probing • Auditory bombardment • Home program (auditory bombardment daily; naming picture cards daily)

10. Phonological Contrast Approaches • Minimal pair contrast therapy • Perceptual training (optional) • Production training • Present minimal pair, model, imitation • Multiple productions – operant conditioning • Spontaneous productions

11. Phonological Contrast Approaches (continued) • Maximal pair contrast therapy • Procedures are similar to minimal pairs, but the error feature is not used, a phoneme that is maximally different (numerous features differ) from the target is used

12. Multiple Opposition Method • Useful for children who substitute a specific sound for multiple sounds • t/s; t/k; t/sh; t/th • In a single therapy session, all substitutions are treated simultaneously, using minimal pairs • bat-bass • bat-back • bat-bash • bat-bath

13. Oral-Motor Therapy • Controversy over its effectiveness and the underlying principle that oral motor exercises do not involve speech production, and the time spent on oral motor exercises may be better spent on teaching articulation directly

14. Oral Motor Exercises • Oral awareness • Brushing exercises • Strengthening • Tongue elevation • Tongue protrusion against resistance • ROM • Touch tip of tongue to nose, then chin

15. Review of the Literature • No credible studies that indicate that oral motor exercises are of benefit to speech production • Lots of studies that indicate articulation and phonology treatments discusses previously are of benefit to speech production